State officials, physicians, patient advocates and Medicaid recipients attended a public forum earlier today about big changes to one of the state's largest entitlement programs. In June, lawmakers at the General Assembly directed state health officials to cut more than 350 million dollars from Medicaid spending. Jessica Jones reports officials hope forums like this will help them decide where to cut costs.
John Carson and his 31-year-old daughter Emily Carson attended today's hearing to find out what changes might be in store for them personally. John was seated in the front row of the audience in a metal folding chair. Emily, who has spastic quadriplegic cerebral palsy, watched the event from her enormous black wheelchair parked near her dad.
John and Emily Carson: "Emily, they were talking about Medicaid today, which is where you get your money? So is that why you came today? Yes. Did you enjoy your time today? Yes. "
Emily Carson is hearing impaired and moderately mentally retarded. Thanks to Medicaid, she receives ten hours of personal care every week that includes bathing, meal preparation and getting to the bathroom. Funds also help pay for her transportation to volunteer jobs that get her out of the house and keep her motivated. But John Carson is doubtful there'll be funding for that this year.
John Carson: "Obviously that'd be the first thing to go, she'd end up being isolated, she'd end up requiring a lot more care."
Carson says he knows the state's budget is tight- and that state health officials have tough tasks ahead.
Carson: "I hope that the people making the cuts can be sympathetic to the end recipient of the service. Looking at the committee, I judge that they have that ability. Their hands are in a difficult position, you know. "
Today's forum was held by a state-appointed Medicare Advisory Committee that will help the Department of Health and Human Services decide what to cut. The Secretary of DHHS, Lanier Cansler, says lawmakers didn't list specific dollar amounts when they cut 350 million dollars from the program in June.
Lanier Cansler: "They listed the various things that they wanted us to do, such as cut provider rates, eliminate inflation factor from any cost-based reimbursement, modify some services, increase generic utilization, and alist of other things. So we are working all of those things. "
Cansler says the reduction is one of the largest cuts to Medicaid in the state's history. The total impact comes to about a billion dollars because state spending on Medicaid is matched by the federal government. Suggested cuts include everything from eliminating optical services and supplies for low-income patients to a 2 percent rate reduction for health care providers. That means providers would shoulder more of the cost to treat patients. Doctor Karen Smith heads the state's Medicaid Advisory Committee.
Karen Smith: "I really think the key thing that I would ask each person to do, whether you are a provider of service, or a recipient of service, is recognizing that we must all come together in our communication, and we really must communicate. "
State officials presented two power point presentations today that outlined possible cuts. Raleigh pediatrician Dr. Peter Morris said they were sobering. He's the board chair of Action for Children, a non-profit child advocacy organization. He's worried that the proposed rate reduction for health providers will discourage doctors from treating low-income North Carolinians.
Peter Morris: "How many physicians across the state might withdraw from the Medicaid program, how much less access to care might there be, how much more use of emergency rooms might there be, and a backfire. You could have saved money from changing the outpatient rate, but you'll spend more money by using the emergency room. "
In the end county governments must often pick up the cost of emergency room visits patients can't afford to pay for. State officials will hold two more forums to get public input on the proposed Medicaid cuts- the next is scheduled for September and the last public session will take place in October.