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Many people in Kansas City rely on Medicaid to afford their health care costs. However, some view the Medicaid program as troubled.

Two Republican congressmen are proposing that Congress consider cutting optional Medicaid eligibility and benefit categories. This proposal would provide a means of reducing spending on Medicaid. Senator Orrin Hatch and Assemblyman Greg Walden sent a letter to the Medicaid, CHIP Payment and Access Commission (MACPAC) requesting that the commission develop a detailed report. The congressmen have asked that MACPAC provide an outline of the report by January 25. MACPAC has agreed to do so.

Currently, the Medicaid program must cover certain mandatory benefits, such as doctor appointments and inpatient services. Recipients of Medicaid may also receive federal “optional benefits,” such as child psychiatric services, hospice stays and prescription drug benefits. Moreover, states have the option of providing Medicaid to optional eligibility groups.

According to some, this letter shows that Congress recognizes there may be other ways to control Medicaid spending without resorting to capped payments. Critics of capped payments believe that they would make it so that states would have to cut benefits to recipients and narrow eligibility requirements, meaning some people who need benefits would not receive them.

The congressmen claim that by paying for optional benefits, those who may be more in need of benefits, such as those with disabilities, have to wait longer to obtain the care they need. However, proponents of the current Medicaid program state that this argument is not accurate as those on such waiting lists are in need of services that are already optional under Medicaid.

In addition, proponents of Medicaid also claim that some benefits that are currently optional, such as prescription drugs, should actually be mandatory. For example, some say that reducing the costs of prescription drugs would be a better way to lower the amount of spending on Medicaid.

While some may believe there needs to be a reduction in Medicaid spending, in fact, Medicaid provides many essential services to those who may otherwise be unable to afford them. Medicaid planning is an important part of elder care for many U.S. citizens, meaning that any Congressional action regarding the program deserves careful review.

Source: Modern Healthcare, “GOP lawmakers eye cuts in ‘optional’ Medicaid benefits,” Virgil Dickson, Jan. 13, 2017