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Medicaid co-pays to more than double for substance abuse and mental health services next year

Last modified: 12/28/2015 2:05:02 PM
People who make more than $11,700 and are insured under the state’s Medicaid expansion program will pay higher co-payments starting in 2016.

The Joint Legislative Fiscal Committee on Friday signed off on the increase, which is required for the health care program to move forward next year. The changes are based on an actuarial calculation.

Most co-payments will remain less than $10. But the co-pays for mental health and substance abuse inpatient services are set to increase from $50 to $125.

Only a portion of the Medicaid population – adults who make more than 100 percent of the federal poverty limit, roughly $12,000 – pay co-payments, which are capped at a quarterly limit of $147.

The changes approved Friday will affect roughly a third of the 44,000 people enrolled in the Medicaid expansion program and 5,500 of the 140,000 people on Medicaid, which covers pregnant women, low-income children and people with disabilities.

Rep. Mary Jane Wallner, a Concord Democrat, questioned whether the increased costs for substance abuse inpatient services could detour people from getting needed help.

Jeff Meyers, with the Department of Health and Human Services, said it’s valid question.

“I think it’s something we’re going to have to work on,” he said.


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