Medicaid Program

Contrary to Robert Erlandson's letter ( "Van Hollen shows why it will be so hard to reduce the deficit," July 26), Rep. Chris Van Hollen's op-ed ("Medicaid cuts would hurt us all," July 25) correctly pointed out the consequences of cutting Medicaid. As Rep. Van Hollen wrote, whenever uninsured people go to the hospital and get care they cannot afford, we all pay for that with increase premiums that are used to cover uncompensated hospital costs. According to Families USA, about $1,000 of each of our health insurance premiums go every year to cover the health care costs of the uninsured.

While Rep. Chris Van Hollen may wish that a deal to fix the federal government's fiscal problems could leave Medicaid untouched, the reality is that if the federal deficit is to be addressed, entitlement programs like Medicaid must be fundamentally reformed ("Debt crisis could hurt Maryland," July 17). Under the current Medicaid system, in which the federal government gives Maryland a dollar-for-dollar match for every Medicaid dollar the state spends, there is little incentive to control costs.

Congress is engaged in an ongoing debate on proposals to reduce the deficit. There is no question we need get our fiscal house in order and put our nation on the path to long-term fiscal stability - the question is how. First, we must ensure that we do no harm to our still fragile economy - anything that would put American jobs at risk is unacceptable. Second, we must find a balanced approach that does not put undue burdens on our seniors and most vulnerable or slash critical investments in education, infrastructure and innovation.

Reader Suzanne R. Schlattman ("Ryan budget would hurt Maryland," May 9) writes, "we here in Maryland … know far better" how to run the state's Medicaid program. I couldn't agree more. So why does she oppose the reforms that passed the U.S. House, which would give Maryland officials unprecedented flexibility to run their program? Could it be because those reforms would also require Marylanders to pay for more of their own bright ideas? Michael F. Cannon, Washington The writer is director of health policy studies for the Cato Institute.

In the December 16 article "O'Malley provides grim preview of budget," I was surprised to read this: "While the governor has been tight-lipped about potential areas for cuts, he said Wednesday that he might look at programs that had been spared in previous budgets. Those could include education and health care. " Health care spared? No. In fact, health care in Maryland has been cut drastically. The state has funded the rapid expansion of its Medicaid program almost totally on the backs of providers, including hospitals.

As discouraging as government finances — both in Annapolis and Washington — have been of late, there is some good news on the horizon. Estimates released last week by the Maryland Department of Health and Mental Hygiene suggest the state will collect about $20 million more from scofflaws attempting to defraud the Medicaid program. That may not solve the state's projected $1 billion-plus projected budget deficit in fiscal 2012, but it certainly doesn't hurt. In the fiscal year that ended June 30, the health department recovered about $26.5 million as a result of Medicaid fraud, waste and abuse investigations, which was also higher than in previous years.

Tucked into the newly enacted federal health care legislation is a mandate that states expand Medicaid, which will cost Maryland hundreds of millions of dollars. But Gov. Martin O'Malley declared in a recent speech that this bill will actually save the state money. Considering that in the same speech, he also bragged about the state's health care programs — without noting their significant problems — perhaps his judgment isn't all that reliable. Just as the state's 2008 Medicaid expansion (championed by Mr. O'Malley)

WASHINGTON - -With Senate Democrats poised to pass a sweeping overhaul of the nation's health care system, Republicans sought Wednesday to frame the bill as a tarnished product of backroom deals and political maneuvering, with some going so far as to declare it illegal. Much of the day had the feel of the final minutes of a football game in which the outcome already had been decided. As Republican senators raised new criticisms of the measure, Democrats were celebrating on the sidelines as though the final vote had been taken.

Health care advocates implored Gov. Martin O'Malley yesterday to continue a planned expansion of the Medicaid program even as he is expected to severely cut the state's budget to fill a huge budget shortfall. O'Malley, a Democrat, indicated he may not be able to fully fund the health care expansion in the budget he submits to the General Assembly next week, though he noted that a federal stimulus package in the coming weeks could change his plans. Congress is working on a package that includes additional Medicaid dollars for states.

When Ida Brown was diagnosed with Alzheimer's disease three years ago, her daughter sought assistance from a state program to help elderly people of limited means receive care in their homes or communities. But even though Brown, now 85, was too sick to live on her own - she couldn't dress or feed herself, and she wandered off at night - she was too well to get help from the state. Her daughter, Diane Byus, sued the state, and with the help of the Maryland Legal Aid Bureau and AARP, she won. The Maryland Court of Special Appeals ruled last month that the Department of Health and Mental Hygiene's standards for that portion of the Medicaid program were stricter than is allowed under federal law, and now the department has been ordered to re-evaluate Brown.