Medicaid fare-ness.(unpaid Medicaid transportation vouchers)(No Sacred Cows)

James MaCauley keeps $1,200 worth of Medicaid vouchers in a briefcase in the trunk of his taxicab. He's been waiting since November for the District of Columbia to pay him for the vouchers. The stack represents the hundreds of times MaCauley has taken a Medicaid patient to the hospital and has been handed a $5 voucher instead of cash.

But last August the District government ran out of funds to pay cab drivers for transporting Medicaid patients.

"It's like we are funding the system," MaCauley says of the city's cabbies.

In the sometimes circuitous world of government services, taxi drivers in the nation's capital are being stiffed by the city's Medicaid program. What do cabbies have to do with the health program for the poor and disabled? In D.C. and some states, Medicaid patients receive vouchers for transportation to their medical appointments.

But the District's cash shortage has left cab drivers and the city's largest fleets holding the bag. Drivers for just one company, Capital Cabs, are sitting on more than $100,000 in unpaid Medicaid vouchers.

"We can't underwrite the government," says Isaiah Anderson, secretary-treasurer of Capital Cabs, which has 500 taxis on the city's streets. With no assurance that the District will reimburse the company for transporting Medicaid patients, Capital stopped paying its drivers for their vouchers. And with Medicaid funding in the District on the chopping block, vouchers are likely to become a footnote in Medicaid history.

One of every four D.C. residents qualifies for Medicaid, one of the highest rates in the country, and Mayor Marion Barry has pledged to cut $100 million out of the District's $928 million Medicaid budget next year. Some $17 million in ...