Free or low-cost transport to medical appointments for those who need it has been a mandatory Medicaid benefit since the program’s inception in 1966. It’s specified in federal regulation. Scattered cases of fraud have marred the administration of Medicaid transportation and the desire to rein in Medicaid spending has led some policy-makers to consider ways to limit this benefit, formally called non-emergency medical transportation (NEMT).
Our new research examines the value of non-emergency medical transportation for people with three relatively common and expensive diseases. We demonstrate that such transportation provides a healthy return on investment (ROI) for two of the three conditions. Trimming non-emergency medical transportation in Medicaid runs contrary to trends in other health insurance markets and is likely penny-wise and pound-foolish for Medicaid’s coffers.
To date, a few states have limited transportation through federal waivers. Iowa and Indiana generally don’t generally offer it to their Medicaid expansion populations. Kentucky and Massachusetts are seeking to follow. In its budget proposal for 2019, the Trump Administration wants to let states limit the transportation benefit without seeking a waiver, a move that could increase the number of states that curtail non-emergency medical transportation.