Cuomo's Medicaid Medicine Going Down Pretty Well

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Welcome to Politics Bites, where every afternoon at It's A Free Country, we bring you the unmissable quotes from the morning's political conversations on WNYC. Today on the Brian Lehrer Show, Jim Tallon, president of the United Hospital Fund, talked about the new budget agreement and its effect on New York's healthcare.

A spoon full of sugar helps the medicine go down, right?

Cuomo's axe to the New York Medicaid budget of almost three billion dollars raised few cries of pain among the state's health care industry--but where was the sugar? 

James Tallon says it wasn't about a tradeoff this year, it was simply a medicinal dose of reality.

Folks in healthcare in New York recognized also that outside of New York there is also a conservative extreme in American politics that really wants to dismantle our governmental programs, so candidly, while there were big cuts in New York, if you look at the glass half full, this was Democrats, Republicans, Governor and legislature coming together essentially to affirm a modified, a reduced but nonetheless a very comprehensive fifty billion dollar Medicaid program in New York.

Tallon said Republicans in the House of Representatives and in over 20 states want to simply get people off the Medicaid rolls to save costs. Their plan is to reduce eligibility for the program or get rid of it altogether, which Cuomo did not do. In that sense, Tallon said the Governor's approach affirmed his commitment to the program, even as he pushed people in the industry to make it more efficient--which they are willing to do.

Consensus that something had to change in the health care system

People in health care know that there's room for better management of care, in fact that is the fundamental underlying theme of the federal Affordable Care Act, the health care reform bill passed in Washington.

The difficult part is that costs are concentrated in persons who have complex health care needs and the current health care system doesn't make it easy to treat complicated cases comprehensively. 75 percent of New York Medicaid funding--or 31 billion dollars--is spent on just 20 percent of patients.

These are patients with multiple chronic illness, sometimes there is mental illness, behavioral health problems associated with physical concerns, some people are in the long term care system, they're eligible for the Medicaid and Medicare system, that's an added complication.

Tough medicine, but necessary

Cuomo made it clear there wasn't going to be an influx of any additional money to the system, so there was consensus something had to give. Tallon said the fact that Cuomo brought Medical and health care industry professionals into the discussion of how to improve the system (the Medicaid redesign team) was helpful.

Everyone in health care said look, there's room to better manage this, not that it will be easy. The tough and challenging fact is that we don't have a lot of experience, the commercial insurance industry largely doesn't deal with folks who have these more complicated problems.

Will the Medicaid cuts actually make New York State healthier? Hard to know, but it's a new regimen.