Friday, March 28, 2008

Looking Out of a Hole

In Mississippi, people on Medicaid have to apply and then renew each year to stay on the program. That is actually what everyone in every state does. If that were the end of the story, my job would be done.

In Mississippi we also make you do each of these renewals in face to face meetings. They are called interviews. That is exactly what they are not.

The state pre-sets the time when you meet. Hope you can make it. When you are on Medicaid because you're 80 and cannot fend for yourself, well....I sure hope someone can give you a ride. Gotta work? No car? No problem! We just kick you right off. As you may know, Medicaid is for 3 groups of people: the elderly, poor children (not their parents), and the blind/disabled. Basically, these are the Mississippians least able to fend for themselves. They now have to go to these meetings to stay on the program. This would be fine if there was a true value to the policy. The time isn't used to vet the applicants. It is not used to root out fraud. It is not time to access and aid in the healthcare of the enrollee. This is what Gov. Haley Barbour says it is for. That's a lie. It isn't. I spent a year travelling to every office in every county in the state. I interviewed workers and managers in every office. No one was doing the things listed above. No one was under the illusion that they were supposed to do these things. Several openly laughed at the notion that it was their instructed job.

The twist is this. The face to face meetings are simply a requirement of over 600,000 citizens to hand deliver their paperwork. It is a policy designed to fail. The program requires 2300 face to face meetings a day to stay at its current size. St the same time they started to close down the very Medicaid offices that operate the system. County after county across the star have no Medicaid office at all. The counties that have offices often are open 4 or 7 hours a month. The offices don't even have signs to tell you that you're in the right place when you walk in the door. We are making our citizens meet people that don't show up for work, then when it doesn't work out, we blame the sick. Wonderful. Our infant mortality rate has skyrocketed. We actually now pay more to serve FEWER people on Medicaid. We have kicked off nearly 80,000 people so far. By far, most are kicked off because they have no office they can actually visit. Oh yeah...and we are breaking the law to boot.

I'm at the capitol. And its my job to make all this stop.


brd said...

Keep working on these things. I get discouraged at these ridiculous things here in my state too. We need smart ombudsmen like you to help make a difference. It does seem, at times, like the objective is to see how many people can be eliminated from rather than served by the system.

Karen said...

Low income families with dependents are also eligible, so adults that are not blind nor disabled can also qualify for Medicaid, IF their income is low enough. Expecting all of these people to come to meetings is rediculous. So now many of the services we provide at UMC that used to get some payment from Medicaid get no payment at all because the patient lost their Medicaid benefits. So now *we* are suffering along with the patients... Thanks, Haley.

Polly said...

well, sorta. the income requirements for an adult to be on the system are so low, you'd pretty much have to make around $40 a week.