As the COVID-19 pandemic continues to take its toll, Medicaid, the federal-state health program that serves those with limited income, will be called upon to save lives.
We must ensure that this national treasure—a proven lifeline for 1 in 5 Americans—has the capacity to do so.
Medicaid enrollees already face significant roadblocks to care, and COVID-19 is just the latest barrier. As reports of people forgoing medical attention during the pandemic increase due to social distancing guidelines and restrictions on nonemergency visits, we must ensure that the healthcare needs of the most vulnerable Americans are being met.
To accomplish this, states should ensure broad access to telehealth services for Medicaid enrollees during this national emergency. While historically there was limited Medicaid coverage of telehealth, the Centers for Medicare & Medicaid Services are outlining policy considerations for states to expand this benefit.
The guidance is useful, but states need the funding to cover telehealth so it can be implemented universally during the pandemic.
One bipartisan proposal, the Modernized Medicine Act (H.R. 6538) introduced by representatives Fred Upton, R-Michigan, Joseph P. Kennedy III, D-Massachusetts, and Lisa Blunt Rochester, D-Delaware, would increase the federal Medicaid reimbursement to states (FMAP) by 1% during the national emergency for states that expand telehealth. In an announcement, Upton noted that the “legislation is simply common sense and urges states to expand telehealth services, helping to keep both patients and our health care workers safe.”
Giving states the resources they need to expand telehealth during the COVID-19 pandemic will ensure continuity of care for millions of Americans. People living with mental health issues or substance abuse disorders, for instance, who rely on Medicaid may not seek the treatment they need.
Virtual therapy will keep them cared for. Adding to the complexity of this crisis is the need to protect our front-line healthcare workers. Telehealth options reduce the frequency of face-to-face contact and the risk of exposure to COVID-19.
But there is much more at stake here: the viability of the Medicaid program itself and its ability to care for those most in need. States’ economies have been decimated during the COVID-19 lockdowns. Non-essential businesses are closed and not contributing payroll or sales tax to state coffers. Employees of those businesses are not generating any income, translating to huge sums of foregone income tax.
And the shutdowns may stretch two full months, followed by only staggered re-openings. To balance their budgets, states will have to dial back discretionary spending. This could include cuts to Medicaid eligibility and reimbursement to providers and services, which will be harmful to those who can afford them least.
The CARES Act—the federal stimulus response to the pandemic—temporarily increased the FMAP by 6.2%. While a good start, it won’t be enough to protect Medicaid if states put it on the chopping block.
The National Association of State Budget Officers has called on the president and Congress (PDF) to further increase the FMAP by 5.8% (12% total), which matches the increase included in the American Recovery and Reinvestment Act of 2009.
This will stabilize Medicaid, shielding it from steep cuts that would harm the poor, while simultaneously helping Medicaid providers recover from the loss of patient volume during the pandemic.
This 12% increase in FMAP need not be permanent. Rather, it is a bridge for states to ensure that low-income people don’t experience further setbacks due to something out of their control.
Medicaid, unlike Medicare, was designed as a federal-state program so that states could create approaches for the needs of their own citizens backed by the resources of the federal government. Those resources are needed during this generation-defining crisis, now more than ever.
Gerard Vitti is the founder and CEO of Healthcare Financial Inc., a Boston-area company that assists individuals in obtaining healthcare benefits. He is a member of FierceHealthcare's Editorial Advisory Council.