By Harvey Brody
The abundance of misinformation about the Affordable Care Act and Medicaid is bordering on the ridiculous. A factual understanding of New York and Medicaid is important. In 1966 New York joined the national Medicaid program. Preceding Medicaid was Medicare. Medicare was enacted to assist folks on Social Security with support for health care costs.
Medicaid’s purpose was to provide indigent health care. New York actually submitted an application to join the Medicaid program that said the costs will be paid 25 percent by each county, 25 percent by the state and the rest by the federal government.
The question to Gov. Andrew M. Cuomo is exactly how much public money goes for the actual payment of medical costs for indigent people, and how much for the payment of medical costs for children whose parents can’t afford their health care? Our state comptroller’s frequent audits of the Medicaid/Child Health Plus health care programs offer different answers.
New York engages in the “waiver game.” It claims a bogus error rate and places Medicaid applicants into managed care. Simply finger imaging all Medicaid applicants would eliminate 20 percent of the enrollees. We actually do that for all public benefit applicants except for Medicaid. The reason is that the more New York Medicaid recipients, whether phantoms or not, the more people are needed to “administer” the program.
Taxpayers should know exactly the costs of administering the Medicaid program that are often paid for by the federal government. This data should specifically identify the number of individuals employed in the Medicaid program. After 31 years as a state Medicaid investigator, I retired in disgust at the failure of the state to attempt fiscal controls of wrongful spending of public money.
There are actually simple solutions to increase the use of Medicaid and now Child Health Plus to afford indigent individuals health care. First we must accept that health care is a human right not a privilege. Then ensure that only the most qualified individuals engage in the Medicaid program either in administration or enrollment as recipients. State government must not inhibit county governments from engaging in Medicaid program integrity.
Medicaid is part of the essential public benefit safety net and should not be isolated from the other public benefit programs administered by the counties and state. Finger imaging of all applicants for Medicaid should start.
Consistent Medicaid policy must begin. It is necessary that the counties and New York City actually collaborate with the state Medicaid program in administration and integrity with Medicaid providers, applicants and recipients.
Our governor cannot misspeak about the matter of county funding of Medicaid. He can simply look at the state’s 1966 application for enrollment into the national Medicaid program and resubmit the application changing the funding scheme.
Harvey Brody, who lives in Amherst, served as a Medicaid fraud investigator for 15 years with the state Office of the Medicaid Inspector General.