As Congress Expands Medicaid/SCHIP, Expect Everyone Else’s Costs to Rise

Medicaid and SCHIP effectively get discounts by paying providers below-market rates. But as more people enroll in these plans providers will need to shift more costs to commercial payers. That’s the conclusion of a report released by the Colorado Department of Regulatory Agencies.

The report compares the health insurance markets in Denver and Weld County (which includes Greeley and rapidly developing communities north of Denver), with the market in Pueblo, Colorado, which has high Medicaid and SCHIP populations and which receives more than one-third of the 2006 disproportionate share payments allocated to Colorado’s eligible privately owned hospitals. Those payments are designed to reimburse hospitals for taking care of Medicaid patients. Overall, people in Pueblo use more medical care; and, despite ample government funding, private health insurance cost more.

Pueblo has 491 staffed hospital beds per 10,000 population, compared to 322 in the Greeley area. Pueblo has 3.2 annual physician office visits per capita compared to 2.7 in Weld and 2.8 in Denver. Pueblo has 1.6 emergency department visits for every 10 people, compared to 0.7 and 1 in Weld and Denver, respectively.

Further, people in Pueblo appear to be at least as healthy as people in the other two areas. Denver has a smaller fraction of obese people, and fewer diabetics, and fewer poor people than Pueblo. Yet there are no apparent differences between Pueblo and Weld County, and all three groups appeared to have similar proportions of smokers, the overweight, and people with asthma, high cholesterol, and high blood pressure.

Comments (6)

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  1. Bruce says:

    I agree with the conclusion, even without the data.

  2. Larry C. says:

    This is consistent with the AHIP study you reported on. Obama’s expansion of these programs is going to make insurance more expensive for all the rest of us.

  3. Linda Gorman says:

    Making it more expensive may be fine with certain segments of the health policy world. As Massachusetts has shown, if you put enough burdens on the private market it eventually goes away. Government ends up running the show and you get government controlled health care without bothering to debate it.

  4. Joe S. says:

    I think Linda is right. I see a death spiral in the making. The more people who enroll in government programs, the more expensive private insurance becomes. And the more expensive private insurance becomes, the more people who will drop out and enroll in a government program.

  5. Zafar says:

    No, medicaid is not tirreble treatment, but she may be waiting a couple of hours for her appts if she’s forced to go to a gov’t medical facility instead of her normal doctor. i had medicaid when i was pregnant and after delivery. I was able to continue going to my regular doctor and a good pedi because they accepted the medicaid.Ask her doctors office if they take it medical assistance. And ask your current pedi ask them if they take medical assistance. These days most doctors do, especially ob’s and pedi’s

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