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Petitioning Representative Diana DeGette and 4 others

Eliminate Managed Care Medicaid in Colorado

Denver Health Medicaid is a "managed care" system, which means patients in it can only go to Denver Health facilities for all their medical needs. This is a problem because the current waiting list for a Denver Health primary care doctor has 7,000 people on it. This means almost a quarter of the 30,000 new Medicaid patients in Denver have health insurance that they can not use.  These same people could get health care tomorrow if they were not forced to see only Denver Health providers. 

As a doctor who sees mostly Medicaid clients, I have witnessed hundreds of cases of disease progressing because clients could not get into Denver Health appointments, and my office is not even in Denver. Since they can't get care at Denver Health, they go to other area clinics and emergency rooms, which then shoulder the cost for the care care that Denver Health is getting paid to provide. 

Amazingly, patients are "passively enrolled" into the Denver Health Medicaid system without being asked. This happens every time they get Medicaid (including every time they lose and regain it), and every time they move to Denver county (including when they are born in Denver). It happens a few months after getting Medicaid, by which time they have already found a non-Denver Health provider, and then that relationship is broken in a bait and switch move. They are mailed a letter saying they can call to change back to Regular Medicaid, but most patients never actually get the letter, don't understand it, or can't call to change for many reasons (including long hold times). 

The outdated Managed Care Medicaid concept has failed to save money. Ending it now allows us to find more providers to see Medicaid patients, to focus on new Medicaid initiatives such as the Accountable Care Collaborative, and to free tens of thousands of Coloradoans to get the care promised to them by the Affordable Care Act.

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