Opinion: Calif. Medicaid Case Key to Reform Law Goals
A case before the Supreme Court to determine whether health care providers and Medicaid beneficiaries can sue states over reimbursement rates could have a significant effect on whether the health reform law "can meet the goal of expanding health care access by broadening eligibility for Medicaid," former CMS Administrator Bruce Vladeck and American University law professor Stephen Vladeck write in a New York Times opinion piece. The case stems from Medi-Cal -- California's Medicaid program -- reimbursement rate cuts that the California Legislature approved in 2008 to help address the state budget shortfall. The authors ask, "if beneficiaries or providers can't enforce the equal access provision, who will?" California officials and the Obama administration argue that HHS will enforce the equal access mandate, they note. However, "the department utterly lacks the financial, legal, logistical and political wherewithal to enforce the provision," they write. They conclude that "the Obama administration may be complicit in eviscerating Medicaid -- and setting back the broader goal for ensuring that all Americans have access to quality health care."
- "Killing Medicaid the California Way" (Vladeck/Vladeck, New York Times, 10/13).