State to consider rationing Medicaid health care, doctor association proposes

Wisconsin State Journal
January 9, 2011

As the state prepares to plug a $1.2 billion Medicaid hole, it looks beyond cutting enrollment, payments and entire benefit programs to another option: rationing Medicaid care, as Oregon does.

That’s what the Wisconsin Medical Society, the state’s doctor association, is proposing to do. Oregon ranks Medicaid services and refuses to cover a fourth of them because of budget constraints.

In Oregon, Medicaid covers ear tube surgery for chronic ear infections, for example, but not medications for pink eye.

Treatments for vaginal cysts barely made the cut this year, while drugs for a skin rash fell just below that.

The goal is saving money without removing people from Medicaid, the state-federal health plan for the poor.

Wisconsin’s $6 billion Medicaid program, which expanded significantly under Democratic Gov. Jim Doyle, now covers 1.2 million people, or one in five residents.

The Medicaid budget gap for 2011-2013 is estimated to be $1.2 billion, said Seth Boffeli, spokesman for the Wisconsin Department of Health Services.

It’s inevitable the state will have to make drastic cuts, said Dr. Tim Bartholow, a senior vice president of the medical society.

“We want as many people as possible to have access to some Medicaid care, rather than let some have terrific Medicaid access and other people have none,â€