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Medicaid Likely Target for Savings Far into the Future, Panel Says

By Rebecca Adams, CQ HealthBeat Associate Editor

November 10, 2011 -- Health policy experts recently warned that deficit reduction efforts affecting Medicaid are only just beginning.

"Think of it as the first play of the Super Bowl," said Tony McCann, a Georgetown University professor who used to run the Maryland Medicaid program. "This is the first step in a very long process."

McCann spoke on a panel at a briefing by the Alliance for Health Reform.

Another panelist, former federal Medicaid director and House Democratic aide Tim Westmoreland, said that now would be a terrible time to cut Medicaid.

"Any cuts today will be tomorrow's workability problems," he said. Cuts would be counterproductive, Westmoreland said, not only because Medicaid creates jobs, but also because if growth reductions are too low, then the program will not be able to function. For instance, many Medicaid patients have a difficult time finding a doctor who will accept Medicaid. That problem would only grow worse if provider payments were cut, he said.

At the end of the briefing, an aide to Republican Sen. Charles E. Grassley of Iowa asked the panel whether it would make more sense to restructure the program.

The aide, Rodney Whitlock, said that a major problem for Medicaid is not that program officials spend too much, although he said he believes the program does spend "a lot." Rather, Whitlock said, the issue is that the program tries to do too much by serving a disparate range of people, including children, people with disabilities and nursing home patients.

"Medicaid is the only program in America that puts all of those people under one program," he said. "Medicaid would be better served if we broke it into its constituent populations."

Westmoreland, after engaging in a brief debate with Whitlock about whether that would produce any savings, finally said: "You might be right."

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