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Home Front Economy
Medicaid law trade-off
2007-02-12
New federal rules requiring proof of U.S. citizenship for Medicaid coverage will save Colorado $300,000, but cost $2.9 million to implement, according to state estimates.
Sounds like cooked figures. If they'd said it would save Colorado 2.7m and cost 2.9 to implement it'd have been much more believable.
The state Department of Health Care Policy and Financing, which administers Medicaid, has asked for an additional $2.8 million in the coming year to help counties cover most of the additional cost. The state estimates that the new rules will result in 200 people losing Medicaid coverage in 2007 - and about 170 of them would be children.
So, really, you shouldn't change the way things are. They're only children, y'know...
The state's figure is based on U.S. census data and a report by the nonprofit Kaiser Family Foundation, a health care think tank. More than 400,000 Coloradans are enrolled in Medicaid, at a cost to the state and federal governments of about $2.3 billion in the last fiscal year. The average cost of Medicaid care for a child is about $1,500 a year, according to state data. "How does it make sense to spend millions of dollars to keep an estimated 200 people, most of them children, off of Medicaid?" said Elisabeth Arenales, an attorney with the Colorado Center on Law and Policy - a nonprofit advocacy group.
"Elisabeth! I think the books need more garlic!"
Lisa Esgar, of the state Health Care Policy and Financing Department, said Colorado has no choice but to do what the federal government requires. The department's estimate of the cost to do that is based on an average of five additional minutes for a county employee to process Medicaid applications.
"We're outta garlic. Here, see if this basil helps!"
"We really didn't know what to base an estimate on, but the federal government has done some research," Esgar said. The $2.9 million includes $67,000 of the estimated $170,000 cost of updating the computer system that processes applications for Medicaid and other benefits for the indigent, disabled and elderly. The remaining $103,000 for the computer system has been requested by the state human services department.

Congress' Deficit Reduction Act of 2005 made numerous changes to Medicaid, including requiring that anyone applying for coverage provide proof of citizenship. Medicaid is a joint federal and state program to provide health coverage for the disabled, elderly and very poor. In 2006, the Congressional Budget Office estimated that the new rules would slice 35,000 people from Medicaid roles nationwide, and save taxpayers $220 million over five years.

Estimates of how many undocumented residents are receiving Medicaid have been hard to come by, said Donna Cohen Ross of the nonprofit Center for Budget and Policy Priorities.
"Nope. Nope. Just can't find 'em. Might as well give up."
The Washington-based group last week released a report on how states are complying with the new rules. Esgar said the state has no estimate of how many people have been purged from Medicaid in Colorado since the rules took effect July 1. A state law passed last year requires Colorado residents to show proof of citizenship when applying for a variety of benefits in addition to Medicaid. Nichole Paramelly, spokeswoman for Arapahoe County, said she had no estimate of how many people had been denied Medicaid or other benefits because of the new rules.
"We keep totals from year to year, but we'd have to spend an extra twenty or thirty minutes comparing, so it wouldn't be cost effective."
"Try adding more onion!"

"Illegal immigrants weren't eligible for any of these services before, so we're not really turning away any new people," Paramelly said.

Arenales said the greater concern is people - such as the homeless - who are eligible for Medicaid but cannot get the documents to prove it. Esgar said county officials worry about that too.
"I'm worried, Bob!"
"Definitely, people are concerned that the barriers are preventing some people who would otherwise be eligible from getting benefits," Esgar said.
"Me, too, Herb!"
Cohen Ross said it is difficult to guess how many fall into that category. "Those people still exist, those people still get sick, and they still seek care," she said. Medicaid may not pay for that care, but someone will have to, she said.
Posted by:Anonymoose

#7  Denver is a "sanctuary city", and local law makes it illegal to ask immigration status. Illegals receive benefits rather easily, while a young single mother making the new increased minimum wage earns too much to qualify for Head Start! I'm strongly leaning toward a national ID card.
Posted by: Danielle   2007-02-12 12:23  

#6  --35,000 people from Medicaid roles nationwide,---

Yet Evita wants to cover 9 million children, and the estimate is 3 million of them are illegals.

Go figure.
Posted by: anonymous2u   2007-02-12 11:47  

#5  Let's see here 200 - 170 = 30/2 = 15

So you're telling me that 15 couples have 170 kids? Peeeewww, I'm in Mass and it stinks all the way over here.
Posted by: AlanC   2007-02-12 09:50  

#4  mmm! The costs are one time and the savings ongoing. This is Kyoto/Lancet/Insertwhatever arithmetic.
Posted by: phil_b   2007-02-12 07:25  

#3  Now combine this with shipping those who can't provide proof of US citizenship back to Mexico their country of origin then we'll have something!
Posted by: gorb   2007-02-12 06:24  

#2  The description of the implementation cost makes sense to me: upgrading computers and programming, a few extra minutes per applicant to key in the extra data costing a bit in overtime, unmentioned but hopefully also calculated the cost of running data through police and FBI computers. The savings number is a propaganda ploy, I suspect. Unless Colorado already knows precisely which of the recipients are either legal aliens or illegal alien recipients with false papers -- in which case why have those people been receiving coverage until now?
Posted by: trailing wife   2007-02-12 06:11  

#1  ..I call BS. Explain to me how adding a box to a form or having a bureaucrat ask a question will cost $2.9 million.
And only 200 people, 170 of them children? That's some left winger's wet dream, not a genuine statistic.

Mike
Posted by: Mike Kozlowski   2007-02-12 04:55  

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