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Medicaid

Medicaid Q&A

By wire services
Published January 12, 2005


What does the governor want to do?

Convert the federal-state Medicaid program to something more like government-funded health insurance.

Why?

The state's share of funding Medicaid has doubled in the past six years and is expected to reach $17-billion in state and federal money next year. It already takes up a fourth of the state budget. Gov. Jeb Bush believes his plan will rein in those costs.

What is Medicaid?

It was created by Congress in 1965 as the health care program for the nation's poor and disabled. In Florida, 2.3-million people qualify for Medicaid. Many of those are nursing home patients.

Is Medicaid another word for Medicare?

No, Medicare is for people 65 and over. Medicaid is open to anyone who meets the income guidelines, though some people over 65 qualify for both.

How poor do you have to be to qualify?

Different Medicaid programs have different limits. Generally, Medicaid serves pregnant women, children and the disabled who have incomes less than 150 percent of the federal poverty level, or $18,850 for a family of four. Nursing home residents with higher incomes also often qualify because of the steep costs.

How will the governor's proposal save money?

Rather than paying doctors and hospitals directly for services, Bush wants to pay insurance companies to cover the costs just as they do for private clients. He says that would give the state more certainty over annual costs and shift some of the risk to private insurance companies.

Are insurance companies willing to do that?

That's unclear. It won't work without them, so Bush proposes capping benefits, and the financial risk for insurance companies, at a certain level. Patients requiring more care would be covered by a catastrophic fund financed through a percentage of the Medicaid premiums.

What stands in Bush's way?

The federal government and the state Legislature must both agree to make the changes.

When would the change happen?

If Bush has his way, by the end of this year.

[Last modified January 12, 2005, 06:00:09]


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