The Medicaid mess

September 12, 1991

As expected, the federal government has issued regulations eliminating federal reimbursements for a creative financing scheme that state officials have been relying on to help pay Maryland's soaring Medicaid costs. As a result, the state's budget deficit will grow beyond the $300 million already predicted. Moreover, $13 million the state expected for last fiscal year has been disallowed by the feds, which further exacerbates the deficit.

Federal officials maintain that states' efforts to increase their reimbursements would cost the federal government $3 to $5 billion a year, and they simply don't want their expenses to rise that much. But in defense of these "fool the feds" efforts, Congress has required states to expand their Medicaid services, but has refused to give them any more money to pay for these mandates. Meanwhile, the recession has added thousands of new people to Medicaid rolls. States simply can't keep up with the costs. What are they supposed to do?

From the White House, all we hear on domestic issues is "no new taxes." What, if anything, President Bush thinks can be done to create a sensible health care system for this country remains a mystery. So it's no wonder that the best hope for solving the health care crisis probably lies in state initiatives like the one presently being fashioned by state Sen. Paula Hollinger. Hollinger's plan would create a system of universal health insurance for Maryland, called by its acronym, UHIM. The plan would give all Marylanders access to a reasonably priced, no-frills basic health care plan. In most every other country, such access would be taken for granted.

Here, however, the system of relying on private employers to insure working Americans and on the government to cover the elderly and the poor has broken down, at a severe cost to millions of people. So far, nobody in the White House seems to have noticed -- or to care.

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