Latest News

Studies: Medicaid vital to kids, seniors

More than a half-million Floridians rely on Medicaid to pay for cancer, diabetes, heart disease and other illnesses, and that federal safety net may be crucial as private health insurance costs rise far faster than wages.

That picture comes from a pair of separate studies released Tuesday. Families USA examined Medicaid usage in major states, and found that in Florida, seniors and children are among its biggest recipients.

The Kaiser Family Foundation surveyed employers and found that annual premiums for their family health plans increased 9 percent from the prior year, to about $15,073, greatly outpacing the 2.1 percent rise in workers’ pay.

Dr. Dwight Fitch, a Bradenton radiation oncologist, said he is seeing more patients turn to Medicaid as they lose their jobs or insurance in the struggling economy.

“A lot of times, people have the wrong perception of the Medicaid recipient,” he said. “They think if you’re on Medicaid, you’re poor because you’re not trying. That’s really not the case.”

The program is vital, he said, because without insurance, patients often postpone care they need.

“It’s very difficult to have preventive care, and then you show up at the doctor’s door with a bad case of diabetes,” he said.

“If you had better insurance you would have been checked out sooner. And something that could have been curable ends up not curable.”

Diabetes, lung disease and heart failure are among the illnesses affecting hundreds of thousands of Florida Medicaid recipients, according to Families USA, a Washington, D.C.-based advocate for consumers and healthcare reform.

Ron Pollack, its executive director, said the program also covers services not covered in the report but vital to Florida’s seniors. “Medicaid is the biggest payor of nursing homes and long-term care,” he said. “There are so many people that depend on Medicaid as their lifeline.”

The group’s findings illustrate how many Floridians rely on the program for chronic illness.

More than 541,000 use the program to pay for heart disease or stroke care, the group found, about half of them are over age 65. Normally, they would be covered by Medicare, but those with very low incomes also are eligible for Medicaid.

Other seniors may be in Medicaid because high-cost illnesses, like heart attacks, may use up their savings. Charges for the average hospital stay in Florida for a heart attack is more than $78,000, the group found.

Medicaid covered lung disease treatments for about 333,000 state residents -- about half of them children. The diseases include long-term, sometimes lifelong conditions like asthma and chronic obstructive pulmonary disease.

Other major categories included about 208,000 diabetes patients and 52,000 cancer patients, the study found.

While Medicare may cover most of seniors’ expenses, Medicaid helps those with serious health conditions cover co-payments and deductibles, Pollack said.

The group released the study as a Congressional super-committee is looking for places to trim the federal budget.

“We wanted people to know there’s a lot of people who depend on Medicaid,” he said.

The study notes efforts nationwide to cut Medicaid, usually a major portion of state budgets. Florida is testing a pilot managed-care Medicaid program in five Central Florida counties. The state spent about $20 billion on Medicaid last year, with about 55 percent of the money coming from the federal government.

About 3 million Floridians are eligible for the program, which now primarily covers children and pregnant women. In 2014, the Affordable Care Act, the Obama administration’s health care reform plan, would expand Medicaid to all people earning up to 133 percent of the federal poverty level -- about $25,000 for a family of three.

Davis Gulliver, Herald staff writer, can be reached at 745-7080, ext. 2630.