A group of Minnesota health plans and hospitals has unveiled a proposal to trim Medicaid costs through service cuts and tax hikes. They recommend scaling back certain optional services that Minnesota currently offers under its Medicaid program, such as dental care. Waivered services for the elderly and people with disabilities would also be reduced (waivers pay for things like home modifications and attendant care). The proposal suggests that people with disabilities should be moved into managed care as a further cost-saving measure. “Sin taxes” on alcohol and tobacco would generate additional revenue.
The health plans already serve tens of thousands of Medicaid enrollees, so their ideas will carry substantial weight at the Legislature. But there are a lot of bitter pills in this proposal. Republicans are bound to reject anything resembling a tax increase and disability advocates will vehemently oppose any effort to move people with disabilities into managed care. Already, health plans are being accused of plotting ways to add more publicly funded customers to their rolls. I don’t like most of the ideas contained in the proposal, but the document does serve an important function. It articulates the severity of the cuts that will be necessary to reduce health care spending, even with some additional revenue tools. Perhaps it will prompt our elected leaders to start a frank and specific debate on our health care priorities.
