Opinion : Letter to the Editor: Retroactive Medicaid Enrollment

To the Editor, Iowa's Medicaid program has contained a clause allowing people to enroll in Medicaid 90 days after they've used the services of a hospital or healthcare provider. Dawn Pettingill is chair of a committee that is changing the rules. Here are some implications of Dawn's request to disallow retroactive payments. One member of an elderly couple falls, and long-term care is required. Today, that person could be accepted immediately by a nursing home and, the nursing home receives reimbursement for the cost of the patient's care for the time between moving to the home and being accepted into the Medicaid program. Without your active involvement, Dawn's committee will adopt the administrative rules eliminating retroactive enrollment on November 14th and that the person may not be able to enter the home until being accepted into Medicaid, a process that can take several months. The nursing home would lose $10,000 to $20,000 for the care they provided, or the patient wouldn't receive care until they were enrolled. Instead of receiving professional care 24 hours a day, the patient would have to rely on friends, their spouse, or children. The result could be a severe burden on the family, and potentially dangerous both for the patient and their spouse. Let's imagine another scenario. An uninsured person injured in an auto accident is permanently disabled and qualifies for care under Medicaid. Before the rule requested by Dawn's committee, the hospital received reimbursement for the cost of the emergency care and hospitalization as long as Medicaid accepted the patient within 90 days. Under the new rules, the hospital is required to provide care but would have no way to collect payment. About 60% of Iowa's long-term care residents receive care because they qualify for Medicaid after exhausting their assets. The request to eliminate retroactive coverage and the upcoming administrative rule from Dawn's committee shifts the burden of care onto families and the cost onto hospitals and nursing homes. Poor decisionmaking by former Governor Branstad created this economic crisis within the state's Medicaid program. Legislators making an even poorer one now won't improve the situation. Please contact your legislators. Tell them Iowa doesn't need to be the first state in the U.S. to eliminate retroactive enrollment. Call them because you care for our seniors, those who are injured, and those without means to pay. Call for your friends, your loved ones and for the hospitals and nursing homes we rely on as part of a civilized society. The members of the Administrative Rules Review Committee are as follows. Clicking on the link will provide their phone numbers. House Members

• Dawn E. Pettengill (R, District 75), Chair 515-281-3221
• Megan Jones (R, District 2)
• Amy Nielsen (D, District 77)
• Rick Olson (D, District 31)
• Guy Vander Linden (R, District 79)

Senate Members

• Mark Chelgren (R, District 41), Vice Chair 641-777-7047
• Mark Costello (R, District 12)
• Wally E. Horn (D, District 35)
• Pam Jochum (D, District 50)
• Jack Whitver (R, District 19)

To send an email through the Iowa Hospital Association's Action Center click here. -Kurt Karr