Rhode Island Medicaid Recipients Brace for Program Cuts

Published June 1, 2009

As a result of an agreement with the federal Centers for Medicare and Medicaid Services, Rhode Island must cut Medicaid spending to $12.3 billion annually through 2013. In return, the state will get more authority to decide which services to offer, under the agreement made by Gov. Don Carcieri (R).

Some advocacy groups say the agreement could lead to a slippery slope of cuts that would leave low-income residents with little or no health coverage. Up to 31,000 low-income Rhode Island residents will lose taxpayer-funded dental coverage this summer.

‘Cuts Need to Be Made’

Paul Gessing, president of the Rio Grande Foundation, says the poor economy and unsustainable Medicaid spending make the cuts necessary.

“These are tough budgetary times, and cuts need to be made,” Gessing said. “It’s certainly worth cutting Medicaid wherever possible. If dental is where state leaders can best find cuts, I would encourage other states to take steps like this.”

Paul Guppy, vice president of research for the Washington Policy Center, says sudden loss of coverage is an example of the inevitable risk when government becomes involved in health care.

“The governor’s decision to eliminate dental coverage dramatically illustrates the fatal weakness of letting the government control your health care in the first place,” said Guppy. “Politicians can always change the deal, usually making it worse, and there is little individual citizens can do about it. For example, Congress arbitrarily cut Social Security benefits for everyone born after 1960 by extending the retirement age to 67.

“A smarter approach would be for Rhode Island to provide its low-income residents with personal, Medicaid-funded Health Savings Accounts and let the recipients decide what to do with their benefits, using them for dental care or any other health services they happen to need,” Guppy said.

Benefits Abused

Opponents of the cuts say changing the rules could adversely affect the taxpayer-funded health centers that treat low-income patients. Because most private providers refuse to take Medicaid, the centers, which are Medicaid patients’ primary sources of treatment, may be forced to close if fewer people are able to retain coverage.

Gessing says dental coverage is a luxury that is being abused by providers who perform unnecessary procedures and inflate costs.

“Medicaid is susceptible to abuse, so it’s good to see that at least one state is not blindly pouring money into it anymore,” Gessing said. “Dental coverage is a pretty rare treat when you talk about your average employer-provided health care coverage.”

Aricka Flowers ([email protected]) writes from Chicago.