Medicaid recipients will pay more for their healthcare if Governor Gina Raimondo’s budget proposal passes because it would add a co-pay to certain services, administration officials told reporters earlier today.
The governor’s proposed budget seeks to raise $3.2 million through the new co-pays which, by middle class standards, appear small. Inpatient hospital visits would have a $3.00 copay, non-emergency visits to the emergency room an $8.00 co-pay, non-preventative physician visits would have a $3.00 co-pay, and prescription drugs would carry a $2.50 co-pay for generics and $4.00 for brand names.
But even these nominal amounts can have an outsized effect on poor and destitute people.
“It does have an impact on consumer behavior,” said Eric Beane, the secretary of the Health and Human Services department.
There are about 300,000 Rhode Islanders in the Medicaid program, a joint state/federal program that provides health care to low income and/or disabled adults and children and the elderly. Children and people with disabilities will not be charged the co-pay, Beane said.
24 other states, including Massachusetts, currently impose co-pays on Medicaid services, Beane said.
The Medicaid co-pays are part of Raimondo’s effort to balance the state budget without significantly raising broad-based taxes or cutting social services.
“She pushed us very hard to control costs,” said Director of Administration Michael D’Biase. He said Raimondo gave his office two basic ground rules for putting together a budget. “One was to control Rhode Island’s competitiveness,” he said. And the other was “to protect the services of the Rhode Islanders most in need.”
A broad-based tax increase was not considered, according to two administration officials who didn’t want to be identified by name. Taxes would increase on tobacco products, software, and security services.
Instead of increasing taxes, Raimondo’s budget hopes to raise new revenue by legalizing sports gambling and increasing the number of medical cannabis compassion centers.
Sports gambling would only become legal in Rhode Island, pending a case currently before the US Supreme Court. It would only be legal at Twin River casinos in Lincoln and, soon, Tiverton, but an online component is possible. As it does on table games, the state would get approximately 60 percent of Twin River’s take on a sports book. The Raimondo Administration says this would mean about $23 million in new revenue for Rhode Island.
Raimondo also proposed allowing for 12 new medical cannabis compassion centers. Currently there are three – in Providence, Warwick, and Portsmouth. This could raise another $5.1 million, administration officials said. Unlike the three existing compassion centers, new compassion centers would not be able to grow their own product (an earlier version of this post incorrectly indicated otherwise) – unless the applicant already has a cultivator license . Norman Birenbaum, who runs Rhode Island’s medical cannabis program, said this is an effort to prevent the monopolistic forces in the medical marijuana market and help maintain a diversity of strains.
The $250 million for school construction would be put to voters on the November ballot.
Interestingly, the proposed budget assumes Congress will agree to fund the CHIP, or the Children’s Health Insurance Program. Republicans are currently threatening to cut funding for the program.