Colorado Medicaid reform: federal matching funds promote waste

The Colorado legislature should cut wasteful spending by Medicaid and the Child Health Plan Plus. When these programs spend a dollar from a Colorado taxpayer, the federal government gives them a dollar taken from a taxpayer in another state.  Hence, Medicaid and the Child’s Health Plan program administrators are rewarded for spending more and punished for spending less.

These programs devour about ten percent of the state budget. Hence it’s no surprise that “Colorado faces a budget deficit of between $50 million and $257 million for the rest of this fiscal year,” reports the Denver Business Journal. Balancing next year’s budget could require $1.1 billion in cuts — about 5% of the budget.

Federal matching funds rewards extravagant spending. Administrators can expand their budgets, staff, and salaries. Programs stray from serving the truly needy, as the Independence Institute’s Citizens Budget documents. So lax was the recent Child Health Plan Plus expansion that about six of every ten new enrollees had private insurance.

Low enrollment fees and copayments also encourage imprudent spending. For example, it’s just $2 for a podiatrist visit.

A penny squandered is a penny “earned.” Colorado Medicaid made errors processing claims more often than private insurance, which cost taxpayers thousands of dollars. But the feds reward them for this, too.

Instead of federal matching funds for Medicaid, Colorado should request a lump-sum block grant. This would reduce perverse incentives.

A version of this article was printed in the Boulder Daily Camera on January 15, 2011.

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