Maintaining retrospective Medicaid eligibility is the ethical, humane approach

As a practicing oncologist in a state with 40% of its residents on Medicaid and as president of the American Medical Association, I was distressed to read that the CMS is encouraging states to apply for waivers to eliminate the 90-day retroactive Medicaid eligibility period (“New Medicaid barrier: Waivers ending retrospective eligibility shift cost to providers, patients,” Feb. 11, p. 24).

The CMS contends that this policy shift will encourage patients to enroll in Medicaid earlier, but that has never been shown to happen. Instead, patients who are eligible but not enrolled in Medicaid at the time of a serious illness, will simply forgo care while their Medicaid application is pending or face insurmountable medical debt. Many states allow retroactive eligibility as part of an effort to mitigate the effects of churning in and out of Medicaid as incomes fluctuate.

As an oncologist, I can go ahead and start treatments on a patient with a new cancer knowing that Medicaid coverage will kick in. I hate to think that patients won’t seek treatment because of medical bills piling up, even though Medicaid would otherwise pay them. A delay in cancer care can mean the difference between life and death.

AMA policy calls for the presumptive assessment of eligibility and retroactive coverage to the time at which an eligible person seeks medical care. That is the ethical and humane approach, and the federal government should not be allowing states to sidestep their moral obligation.

Dr. Barbara McAneny

President American Medical Association

CEO New Mexico Oncology Hematology Consultants

Albuquerque