Washington, D.C., August 30, 2005 -
Guaranteeing treatment for children with conditions detected during screenings and ensuring access to preventive services are among four priorities policy-makers should protect when considering Medicaid reform, according to a white paper released today by the American Public Health Association (APHA). The paper says protecting the public's health, not achieving artificial, short-term financial savings, should drive Medicaid reform efforts, particularly as proposed cuts would disproportionately affect minority and rural beneficiaries and exacerbate health disparities.
"Investing in the public's health today will ultimately save in national health expenditures tomorrow," says Georges C. Benjamin, MD, FACP, the paper's co-editor and APHA's executive director. "Public health services, in most cases, have proven to be cost-effective in the long run, most notably for services like immunizations and pre- and post-natal care."
Dr. Benjamin says the goal of reform should be to limit the increase of uninsured and underinsured people while maintaining Medicaid's role in narrowing the nation's health disparity gap.
The paper urges federal and state policy-makers to give priority to the following four areas:
- Ensuring Access to Preventive Services. Medicaid provides coverage to proven preventive and screening services, giving beneficiaries incentives to use these cost-saving and cost-effective services. Without coverage for immunizations and screenings for sexually transmitted infections, beneficiaries not only place their lives at risk, but jeopardize the health of the population at large.
- Guaranteeing treatment for children with conditions and illnesses detected during screenings. Under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program, states are required to treat children for mental health disorders, vision and hearing loss, and other conditions detected during screenings. By eliminating the guarantee of treatment from the program, these children from low-income households and without wrap-around insurance coverage will likely go untreated. Forgoing treatment puts their educational attainment, emotional and cognitive development and lives at risk.
- Prohibiting Cost Sharing for Receipt of Covered Services. Instituting or increasing co-payments or premiums is likely to cause beneficiaries to go without needed care, causing them to further overload emergency health services and become uninsured. On this point, APHA disagrees with the Medicaid Commission and the National Governors Association (NGA), which have proposed instituting or increasing co-payments.
- Assuring Access to Affordable Prescription Drugs. With prescription drug costs increasing rapidly under Medicaid and economy-wide, cost-saving measures that do not jeopardize beneficiaries' access to cost-effective treatment should be considered. These measures include reconsidering the use of the Average Wholesale Price (AWP) to determine prices of prescription drugs under Medicaid, exploring the expansion of state purchasing pools to garner larger pharmaceutical drug rebates, and requiring larger pharmaceutical industry drug rebates to states across-the-board. APHA agrees with the Medicaid Commission and the NGA that the AWP is inflated and its use should be reconsidered.
The paper is being sent to members of Congress and other health organizations who share APHA's recommendation that coverage of current beneficiaries and services be maintained or strengthened to protect the public's health. "We want Congress to see that this program is vital not only to Medicaid's 50 million beneficiaries, but to the overall health of our nation," says Courtney Perlino, MPP, the paper's author and health policy analyst for APHA. The full text of the white paper is available here. The executive summary can be found here.