Medicaid Reimbursements Is Insufficient

Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent residents, including low-income adults, their children, and people with certain disabilities. Poverty alone does not necessarily qualify someone for Medicaid. Medicaid is the largest source of funding for medical and health-related services for people with limited income in the United States.
 
Medicare is a social insurance program funded entirely at the federal level and focuses primarily on the older population. As stated in the CMS website, Medicare is a health insurance program for people age 65 or older, people under age 65 with certain disabilities, and people of all ages with end stage renal disease. The Medicare Program provides a Medicare part A which covers hospital bills, Medicare Part B which covers medical insurance coverage, and Medicare Part D which covers prescription drugs.
 
Medicaid is a program that is not solely funded at the federal level. States provide up to half of the funding for the Medicaid program. In some states, counties also contribute funds. Unlike the Medicare entitlement program, Medicaid is a means-tested, needs-based social welfare or social protection program rather than a social insurance program. Eligibility is determined largely by income. The main criterion for Medicaid eligibility is limited income and financial resources, a criterion which plays no role in determining Medicare coverage. Medicaid covers a wider range of health care services than Medicare. Some people are eligible for both Medicaid and Medicare and are known as Medicare dual eligibles. In 2001, about 6.5 million Americans were enrolled in both Medicare and Medicaid.
 
Witnesses testifying before the House Energy and Commerce Health Subcommittee on Tuesday said that insufficient Medicaid reimbursements and onerous paperwork for dental care have led many dentists to decline to treat beneficiaries, CQ HealthBeat reports. According to witnesses, these inefficiencies are putting children in the program at risk of not receiving preventive dental care that could stave off more serious medical problems. American Dental Association President Kathleen Roth said that in Wisconsin, where she practices, the "reimbursement schedule is so meager that, in most cases, it doesn't cover dentists' overhead." She added, "The whole process is so frustrating that it discourages dentists from participating in the program at all." Subcommittee Chair Rep. Frank Pallone (D-N.J.) said, "Millions of families who obtain their health insurance from their employers do not have policies that cover dental care, leaving them with few places to seek care." Witness Nicholas Mosca, dental director for the state of Mississippi, said that Congress should expand dental care coverage within SCHIP when the program is reauthorized later this year. However, Raymond Scheppach, executive director of the National Governors Association, said, "Benefit mandates, or any other attempt to make SCHIP more like Medicaid, will only serve to thwart this progress and could ultimately erode the improvements made so far." Subcommittee ranking member Nathan Deal (R-Ga.) said that rather than implementing mandates, Congress should consider providing liability waivers or a tax deduction to dentists who provide care at no cost to the poor. He added, "At some point, people must take personal responsibility for their oral health". 
 
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