Columnist Dan Fagan's Oct. 1 column on the Louisiana Department of Health's management of the Medicaid program ignores a set of complex facts about the department’s eligibility program in order to launch an attack against Medicaid.
While it’s true that the department is pursuing ways to ensure Medicaid dollars are well spent, no one has argued that the program isn’t doing what it’s designed to do. The program is helping residents get healthier, visit emergency rooms less often and prevent chronic conditions, all of which has saved the state $282 million.
Fagan relies on several sweeping claims that deliberately ignore the complexity of a program as large as Medicaid. For example, he attacks Medicaid recipients as “government dependents,” while leaving out the fact that there are nearly 30,600 nursing home residents in the state that use Medicaid for long-term care.
Nursing home residents are a small percentage of Medicaid recipients compared to the hundreds of thousands of working poor who receive coverage, but they are an important population to discuss. That’s because Fagan wants readers to believe the department is determined to keep “ineligible” people in Medicaid, no matter the costs.
The reality is, a computer system we implemented to make Medicaid more efficient was automatically removing otherwise qualified people — including nursing home residents — from Medicaid. We found this was often for a technical reason, not because a nursing home resident suddenly found a new source of income.
We temporarily stopped using a feature in which a computer automatically ends a person’s eligibility until an eligibility expert reviews that case. Our intent was to make sure that someone who is eligible did not lose their coverage and are kicked out of their home. For efficiency reasons, we expect to return to this automated feature eventually, but for now we allow analysts to make the determination first. This ensures people have time to get their paperwork in order.
The same goes for other Medicaid recipients who weren’t returning their renewal packets. Rather than end their coverage automatically, we wanted to make sure residents have the time to provide the necessary financial information.
Medicaid is administered using a complex system that we continue to monitor closely. I am confident this system will save the state money and manpower in the years to come. We are committed to running an efficient program that is fair to everyone, the taxpayers and those who are most vulnerable.
Rebekah Gee, MD
secretary, Louisiana Department of Health