July 02--MONTGOMERY -- There is another health-care discussion happening here this week.
Separate from the U.S. Supreme Court upholding the Affordable Health Care Act, Alabama health officials are considering switching the state's ALL Kids insurance program from the Blue Cross Blue Shield Network to the state's Medicaid network.
The reason, said Dr. Don Williamson, the state's public health officer who temporarily oversaw Medicaid earlier this year, is economics: Medicaid reimburses doctors at a lower rate than Blue Cross does and will save the state money.
"Using the Medicaid network, we are able to serve the same number of patients for less money," Williamson said.
It would cost the state $50 million to run ALL Kids through Blue Cross next year, Williamson said. "Unfortunately, we only have $37 million for 2013," he added.
ALL Kids serves about 87,000 children of low-income and under-insured families.
Parents pay on a sliding scale for premiums and co-pays. Benefits include regular check-ups and immunizations, doctor visits when ill, prescriptions, vision and dental care, hospitalization and mental health care.
Williamson said no children would be cut from ALL Kids benefits under the proposed change, but switching them to Medicaid could limit their access to care because physicians can refuse to accept the less profitable Medicaid.
"Because of the reimbursement rate, it will make it harder for children to be seen," Williamson said.
Dr. Grant Allen, a Florence doctor and president of the Alabama chapter of the American Academy of Pediatrics, said he already has seen six pediatricians leave the state this year because of cuts to Medicaid and its reimbursements.
"That means decreased access to care," he said.
Medicaid reimbursement rates are about one-third less than Blue Cross' are, he said.
"You can only do so much of the right thing before you can't pay the light bill," he said.
Parent's premiums and co-pays would not change, Allen said.
And given the state government's economic situation, the American Academy of Pediatrics supports the move from Blue Cross to Medicaid, he said.
"Really, there is no other option," Allen said.
For its part, Blue Cross said it tries to help ALL Kids stretch its limited dollars.
"We are in regular contact with the ALL Kids staff to ensure that we are operating efficiently and effectively so that the 85,000 children covered can receive the best medical care possible," Koko Mackin, a spokesperson for Blue Cross Blue Shield of Alabama, said in an email.
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