MEDICAID: States Initiate Image Makeover
Today's Wall Street Journal queries, "Can Medicaid be made warm and fuzzy?" Several states have introduced cuddly mascots and image makeovers to rehabilitate the beleaguered image of Medicaid and attract more of the estimated 40% of uninsured children who are eligible for, but not yet enrolled in, the new federal Children's Health Insurance Program. The Journal notes that since Medicaid's inception in the 1960s, "[l]ower income Americans came to hate its grueling and humiliating application process, doctors complained about low reimbursement levels and states focused considerable energy on ferreting out 'cheats'" -- all of which gave the program a less-than-positive image. Jim Verdier of Mathematica Policy Research Inc. said, "There are an awful lot of people eligible for Medicaid who simply don't enroll. To some extent it is a matter of perception, and if you can fix that, why not?"
Dr. Dynasaur Is In
Vermont pioneered efforts "to make Medicaid more user friendly" nearly ten years ago with the smiling "Dr. Dynasaur," complete with white coat and stethoscope. Following that lead, Connecticut introduced a program called Husky -- short for Healthcare for UninSured Kids and Youth -- named after the state's icon, and reduced its application from 19 pages to four. Michael Starkowski, deputy commissioner for the state's Department of Social Services, said, "We think the name is having a profound impact," in part because a "record" 3,300 uninsured children have enrolled since the program debuted in June. In a similar vein, Wisconsin adopted the name BadgerCare, which originates from the University of Wisconsin-Madison's popular Bucky Badger mascot. Although many of the states' outreach programs appear to be working, critics charge that "the makeovers are too superficial." Ann Kohler, director of New York's Medicaid program, argues that "changing the name doesn't really do the trick," and that "[w]hat you want to do is de-stigmatize the program." To that end, New York moved its program "from its welfare agency to its health department," is "revamp[ing] the application process," in addition to deploying Medicaid workers to communities to enroll children. Arkansas' Medicaid director Ray Hanley called the name changes "kind of pathetic" and detailed the state's efforts at more substantive reform, including "eliminating what he calls the 'hassle factor,'" and reimbursing health providers more rapidly via an electronic system (Lagnado, Wall Street Journal, 9/24).