AMA delegates condemn proposed Medicaid cuts

Doctors particularly oppose a proposal to raise premiums and co-pays for very poor children.

By David Glendinning, AMNews staff. Nov. 28, 2005.

Dallas -- To some physicians, the fight Congress is waging over the Medicaid program presents the ideal chance for doctors to demonstrate that they are truly interested in protecting their patients, not their pocketbooks.

The American Medical Association House of Delegates approved a resolution at the Interim Meeting earlier this month condemning provisions in a U.S. House budget reconciliation bill that would raise cost sharing on most Medicaid beneficiaries. The legislation, which at press time House leadership was still attempting to pass, would cut nearly $12 billion from the program over five years in part by increasing out-of-pocket costs for low-income and disabled beneficiaries.

Of particular offense to physicians are provisions that would raise premiums and co-payments on extremely poor children who are at or below the federal poverty level. The American Academy of Pediatrics introduced the resolution, which was adopted by delegates without one voice of dissent.

"We believe these proposed cuts in the U.S. House are unconscionable," said Ron Levine, MD, former North Carolina state health director. "Anyone who believes that they will save money not looking after poor children is very, very mistaken."

But while no disagreement on this issue surfaced among the delegates, the directive to take action was accompanied by written and voiced concerns that the AMA has not assigned a high enough legislative priority to opposing the Medicaid reductions. The absence of a 2006 Medicare physician payment increase in the House budget bill -- as well as a proposed 1% raise coupled with a Medicare pay-for-performance provision in the Senate-passed version -- prompted a public response from the Association that did not extend to the Medicaid issue, the pediatrics academy said.