Lawmakers discuss rising Medicaid costs

With just one meeting left, the Legislature's Medicaid Interim Committee is running out of time to make policy recommendations for the massive $1.6 billion program.

Just as they have been at four earlier meetings, legislators on Friday were flooded with data and material on the rapidly rising costs of the state's Medicaid program and discussions of the dire consequences of failing to rein in spending.

"We can hide our heads now and pass it on to the future generation ... or we can try to address it now," said Sen. Allen Christensen, R-North Ogden. "It's a case of now or later."

The state's general fund is growing at a rate of 5.5 percent a year, while Medicaid spending has increased at 11 percent annually, said Mark Andrews, policy analyst from the Office of Legislative Research and General Counsel. At that rate, by the year 2022, Medicaid would take up some 31 percent of the general fund.

Currently, the program, which provides health coverage for nearly 300,000 seniors, disabled and low-income Utahns, represents one-fifth of the state's total $8.9 billion state budget.

"We can either let Medicaid continue exactly on the course that it's on and, as a result of that, we'll have an option of either raising taxes or cutting other programs that are funded by general tax dollars," said committee co-chairwoman Merlynn Newbold, R-South Jordan.

During Friday's three-hour meeting, the 12-member body discussed five areas for possible cost containment, including one proposal long advocated by the director of the Utah Department of Health but which has been repeatedly shot down by lawmakers — a preferred drug list for Medicaid patients.

"We remain of the opinion that this is a tried-and-true mechanism. It's used by most states in their Medicaid programs and in private practice," said Dr. David Sundwall, who estimated that a drug list for just two categories of pharmaceuticals would save an estimated $1.7 million a year.

Other areas singled out for savings include consolidating services to determine Medicaid eligibility for Utahns, expanding in-home and community-based care for Medicaid patients over use of nursing facilities and possible changes to the delivery of mental-health care. Another idea that received very little discussion Friday was decreasing the Medicaid reimbursement for hospital outpatient services.

Utah already ranks near the bottom in the nation in how much it reimburses medical providers who treat Medicaid patients, a statistic that prompted a failed measure in the 2006 legislative session to increase reimbursement rates for doctors and dentists.