How will Medicaid restructuring affect medical care in Kentucky? 

 

It is as yet unknown how the restructuring of Medicaid will affect medical care in Kentucky.  Medicaid is a social insurance of last resort originally designed for women and children to assure their safety and health if they had no other insurance.   Over the years the program has been gradually broadened to meet the needs of many special interest groups.  Invariably each of these interest groups have presented strong arguments for inclusion of their particular group.  For instance, the state now pays for nursing home care for indigent older people and provides specialized evaluation and treatment for children with problems such as autism.  These and a host of other programs have great merit but with the current budget shortfall each individual area will undoubtedly be looked at carefully to see if it can be fully supported or supported at all until the state budget offers a surplus.  It is harder for physicians to prescribe newer and more effective medicines at times and more frustrating both for the patient and the physician.  Unfortunately there is only so much money in the Medicaid program and most physicians feel at this time that we must concentrate this resource in the most vulnerable areas until times are better.  The question which will be widely debated over the coming months is “What are the most vulnerable areas?”.