Planned Medicaid Cuts Hit Dental, Home Care
Governor Patrick must trim $117m; higher copays expected
More than a million low-income Massachusetts residents covered by Medicaid would be required to pay more for visits to certain doctors and receive prior approval for some expensive psychiatric medications under a plan announced yesterday by the Patrick administration to narrow a $307 million shortfall in the state’s MassHealth program.
Some of the biggest changes are in dental care for adults, who would no longer receive dentures or other oral care except for cleanings, X-rays, and emergency services.
Under the proposals, the state will also stop paying for personal care attendants for patients requiring the in-home aides less than 15 hours a week.
Medicaid is jointly financed by the state and federal governments: For every 38 cents the state spends on MassHealth, Washington chips in 62 cents, so Massachusetts has to come up with savings of about $117 million.
The recession and widespread job losses have swelled the number of residents seeking assistance through the Medicaid program by more than the Patrick administration anticipated when it put together this year’s budget proposal a year ago.
Today, more than 1.2 million residents are receiving Medicaid assistance, up 115,000 from a year ago.
Copayments for office visits to specialists would double, to $6. Most patients would pay about $1 more for generic medications, and copayments for brand name drugs would jump from $3 to $5 for people who make more than about $15,000 a year.
The state also wants mental health patients to get prior approval from MassHealth before they can fill prescriptions for certain brand name antidepressants and other psychiatric medications if comparable generic drugs are available.
Advocates for the poor, disabled, and elderly criticized the proposals, saying the administration was attempting to balance the budget on the backs of the state’s most vulnerable citizens. The cuts to dental care and in-home health services, they said, would be especially painful.
“Dentures aren’t a luxury,’’ said AARP Massachusetts state director Deborah Banda. “And if you are someone who relies on a personal care attendant to help you get out of bed or to the bathroom, that’s not a luxury either.
Also drawing stinging reaction was the administration’s proposal to eliminate all of the funding for nursing home pre-screening, a $2.5 million cut that advocates said could force many more seniors into nursing homes. The counseling explores other options that can help people stay at home longer, such as personal care services.
“This program is a money saver, because it diverts people from nursing homes,’’ said Al Norman, executive director of Mass Home Care.
The cuts identified so far, which also include some reduced payments to hospitals for patients who stay beyond 20 days, add up to about a third of the savings needed.
Dougherty said the proposed increases in patient copayments, cuts in dental services, and the elimination of the nursing home prescreening probably will not go into effect until April because state lawmakers must first approve the measures and then hold public hearings. He said he expects legislators to vote next week.
