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"Howard Dean delivered health care for nearly every child in Vermont and a real prescription drug benefit for seniors who need help."

Medicaid cuts will affect thousands of Vermonters
January 23, 2002

By DAVID MACE

Vermont Press Bureau

MONTPELIER — Tens of thousands of Vermonters would see their state health care benefits rolled back or cut off completely under Gov. Howard Dean’s proposed budget, which seeks to wring $16.5 million in savings from Medicaid.

In an effort to curb costs in a rapidly expanding part of the social services budget, Dean is proposing to require many people who got coverage under his expansions of Medicaid programs to pay for a greater share of their health care.

Medicaid is the state-run program that uses both state and federal money to provide benefits to the poor and disabled. Over the past several years Dean has expanded the programs by allowing participation by Vermonters with incomes higher than the federal guidelines.

Under the proposed budget, about 3,200 elderly or disabled Vermonters who get half the cost of long-term drugs paid for under a program called VScript Expanded would see their benefits disappear. This would save the state nearly $2.5 million. A single Vermonter with an annual income up to $19,332 is currently eligible.

And even those making less who are covered under the state’s standard VScript program will see their costs rise.

Currently, a single person with an income as high as $15,036 is eligible to have all their long-term drugs covered for only a $1 or $2 co-payment.

Under Dean’s proposal, those people — about 3,200 are currently enrolled — would be required to pay half the costs of their drugs, though they would not have to pay more than $750 out of pocket in a year. This would save the state an estimated $800,000.

And Vermonters who get help paying for drugs under the Vermont Health Access Plan, or VHAP Pharmacy, which covers all drugs and requires only a $1 or $2 co-payment, would also have to pay half the cost with a $750 limit.

Currently, about 10,300 people get such assistance, which is available to people with incomes up to $12,888 for a single person. The savings from making them pay half is estimated at nearly $2.7 million.

Finally, some 21,000 residents who get help paying for other medical care under VHAP’s programs would see the services they get reduced and co-payments increased, such as a $250 co-payment for hospital treatment.

All Medicaid patients would see some benefits curtailed because the state would no longer pay for dentures, chiropractic, or podiatry services, and would limit prescription drug choices more severely.

Dean’s plan would also lower the amount the state pays to hospitals for treating Medicaid patients, rolling back an effort by the Legislature last year to beef up the reimbursement level and reduce “cost-shifting.”

That’s what occurs when the state and federal government don’t pay enough to hospitals and doctors to cover the cost of treating patients on Medicaid and Medicare, the health care program for the elderly. Doctors and hospitals must then charge more to patients with insurance coverage, driving up insurance costs.

http://timesargus.nybor.com/Legislature/Story/41169.html