Setting the Record Straight: Maryland's Medicaid Program is not Spiraling out of Control

There are many misconceptions floating about in cyberspace about Maryland’s Medicaid program. The worst one is that spending for this program is spiraling out of control. Projections released last month by the Center for Medicare and Medicaid Services (CMS), the federal Medicaid agency, recently announced that Medicaid cost projections have decreased below last year's projections. Maryland is one of the states highlighted that is expected to have lower Medicaid expenditures for fiscal year 2006 than in its previous fiscal year. These declines can be attributed to states (Maryland included) and the federal government taking aggressive measures to control spending. In Maryland, these measures include limiting hospital stays, decreasing provider payments, and limiting health care access for legal immigrants.

Another misconception about Maryland’s Medicaid program is that it is generous in its eligibility criteria. At 39% of the federal poverty limit (FPL), Maryland’s eligibility for working parents is among the lowest in the country, ranking 40th in the nation when compared to other states. Barring disability, single adults without dependent children do not even qualify for Medicaid.

Of all Medicaid enrollees, 60% of those receiving assistance are children of low-income families; yet, data from the Maryland Health Care Commission indicate that approximately 90,000 Medicaid-eligible children remain uninsured. One can surmise from these data that there is still a persistent need among low-income families for health insurance coverage. It is a fact that Maryland’s Children’s Health Program (MCHP) is among the most generous in the country. It covers children with family incomes of $2,766 – $4,150 per month. However, these families do pay monthly premiums to participate in that program.

In sum, Maryland and the rest of the nation have a health care crisis, not a Medicaid crisis. Health care costs are escalating for all of us. Governments (both state and federal) should be doing more, not less, to ensure health care coverage for people who cannot afford it. Medicaid must continue to cover life-saving services for people with serious health needs, like children with chronic diseases and seniors who need critical care. This country must address the rising costs of health care; however, the solution cannot include further cuts to Medicaid.

Joanna Shoffner