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Medicaid News
Governors Want $40 Billion for State Medicaid
Programs, Obama Promises Help
CMS Also Issues Final Medicaid Rule to Gives States
More Flexibility in Benefit Offerings
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Daily Reports
KaiserNetwork.org |
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See news release
from CMS on Medicaid changes, below this news story. |
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Dec. 3, 2008 - President-elect Barack Obama and
Vice President-elect Joe Biden on Tuesday met with 49 governors and
governors-elect during a meeting of the
National Governors Association in Philadelphia to discuss an
economic stimulus package that could include additional federal Medicaid
funds for states, the
North Jersey Herald News reports (Jackson/Reitmeyer, North Jersey
Herald News, 12/3).
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States Ask Feds for Health Care Help with Medicaid
and SCHIP
This report by Statline.org, published November 26,
explains the health care crisis faced by many states as more of the
burden for Medicaid, SCHIP move to them
By Pauline Vu, Stateline.org Staff Writer
Dec. 3, 2008
Medicaid Patients Get More Authority to Direct
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 Medicaid rule will even allow hiring family members
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Sept. 29, 2008
AARP Study Finds Older Americans Not Getting
Medicaid LTC at Home Where They Want It
Only four states spending more than 50% of Medicaid
dollars on seniors for home, community services
July 14, 2008
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the Need for Emergency Room Services
Local and rural initiatives will provide alternative
health care settings for non-emergent needs
April 21, 2008
Governors Oppose New Medicaid Regulations that
Reduce Federal Funding
California officials estimate they could lose $12
billion over 5 years
Feb. 25, 2008
Medicaid in Crisis as Bush Administration Tries to
Shift Billions in Cost to States
Strained state budgets and economic downturn force program cuts
Feb. 21, 2008
Read more
Medicaid News |
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As a result of the current economic recession, many
states face large budget deficits and increased costs because of
declines in revenue and increased enrollment in state programs (Smitherman/Dresser,
Baltimore Sun, 12/3). Twenty states have reduced their fiscal year
2009 budgets by a combined $7.6 billion, and 30 expect additional
deficits of more than $30 billion, according to NGA (Parsons, "The
Swamp," Chicago Tribune, 12/2).
During the two-hour meeting, the governors
requested a total of $176 billion (Diaz,
Minneapolis Star Tribune, 12/2). The request included $40 billion
for Medicaid over two years through an increase in the Federal Medical
Assistance Percentage (Riskind,
Columbus Dispatch, 12/3).
Tennessee Gov. Phil Bredesen (D) said that Obama
also discussed a proposal under which the federal government would cover
the total cost of new Medicaid beneficiaries who enroll in the program
because they lost their jobs and health insurance as a result of the
recession.
According to
USA Today, Obama during the meeting "reassured" the governors that
he would include financial assistance for states in a stimulus package
(Hall/Wolf, USA Today, 12/3). Congressional leaders have said that they
plan to prepare a stimulus package that Obama could sign when he takes
office on Jan. 20, 2009, and the governors "pledged to build support for
the plan," the Baltimore Sun reports (Baltimore Sun, 12/3).
The stimulus package might include as much $500
billion in funds (USA Today, 12/3). Senior Democratic aides maintain
that leaders will make "key decisions" about the stimulus package by the
end of the week, according to the
Wall Street Journal (Weisman, Wall Street Journal, 12/3).
Democratic Plans
Democratic congressional leaders plan to approve several bills early
in the 111th Congress that received "considerable bipartisan support"
this year but were blocked by Republican lawmakers or the Bush
administration, the
Wall Street Journal reports. Although an economic stimulus bill --
potentially including additional funding for state Medicaid programs --
is the highest priority, Democrats also will aim for "low-hanging
fruit," such as an expansion of SCHIP and a repeal of President Bush's
ban on embryonic stem cell research, according to the Journal.
While these smaller measures could be inserted into
other bills likely to be proposed, such as a comprehensive health care
plan, "passing them as stand-alone measures could earn bigger headlines
and political benefits," the Journal reports (Bendavid, Wall Street
Journal, 12/3).
Broadcast Coverage
● CNN's "The Situation Room" on Tuesday reported
on the meeting between Obama, Biden and the governors (Malveaux, "The
Situation Room," CNN, 12/2). A transcript of the program is available
online.
● Fox News' "Special
Report With Brit Hume" on Tuesday reported on the meeting (Hume,
"Special Report With Brit Hume," Fox News, 12/2).
● NPR's "Morning
Edition" on Wednesday reported on the meeting (Liasson, "Morning
Edition," NPR, 12/3).
● PBS' "NewsHour
with Jim Lehrer" on Tuesday reported on the budget deficits faced by
many states. The segment includes comments from Colorado Gov. Bill
Ritter (D), Michigan Gov. Jennifer Granholm (D) and South Carolina Gov.
Mark Sanford (R) (Woodruff, "NewsHour with Jim Lehrer," PBS, 12/2).
● WBUR's "Here
and Now" on Tuesday reported on the meeting. The segment includes
comments from NGA Vice Chair and Vermont Gov. Jim Douglas (R) ("Here and
Now," WBUR, 12/2).
CMS Issues Final Medicaid Rule to Gives States More
Flexibility in Benefit Offerings
News Release, Dec. 3, 2008 - A final regulation
giving states unprecedented flexibility in designing their own Medicaid
programs, including adjusting their benefit package to more closely
align with beneficiary needs was announced today by the Centers for
Medicare & Medicaid Services (CMS).
The rule implements provisions of the Deficit
Reduction Act of 2005 (DRA). The rule is the latest in a series of
regulations to implement the administration’s goals of aligning Medicaid
more closely with private market insurance and giving states more
control over their Medicaid benefits packages. Many of those
regulations, however, are the subject of a congressional moratorium.
“This new rule recognizes that states are in the
best position to design plans that provide Medicaid beneficiaries better
health care for the same or even lower cost,” CMS Acting Administrator
Kerry Weems said. “With this flexibility, beneficiaries will have more
choices and greater control over their health care decisions.”
Under the regulation, states can now offer their
beneficiaries health care that has the same value as plans that are
being offered to other populations in the state, through alternative
benefit packages called “benchmark plans.”
Benchmark plans are models states can use in
designing new programs. These benchmark plans are similar to the
flexibility provided to states under the State Children’s Health
Insurance Program (SCHIP). Benchmark coverage includes:
● The standard Blue Cross/Blue Shield
preferred provider option service benefit plan under the Federal
Employees Health Benefit Plan;
● State employee coverage;
● Coverage that is offered by the largest
commercial health maintenance organization in the state; or
● Coverage that the Secretary of Health and
Human Services approves.
These benchmark options provide states with the
opportunity to target benefits to meet the specific needs of
individuals. In some cases, state employee benchmark coverage may be
more generous than the state Medicaid plan. Approved coverage may offer
the opportunity for disabled individuals to obtain integrated coverage
for acute care and community-based long term care.
For individuals who cannot afford the premiums
associated with health insurance offered through their employer, states
have the option of paying part of the employee premium to make it more
affordable, so the employee can maintain private coverage. These
proposed rules also give states the flexibility to provide wrap-around
and additional benefits, such as dental coverage.
“Until passage of the Deficit Reduction Act of
2005, states had few options, other than through waivers, to update the
health benefit packages offered through their Medicaid programs to meet
the needs of the people they serve,” Weems said. “These changes allow
states to use modern methods of providing health insurance coverage and
encourage families to participate in their own health care decisions.”
CMS also published a final rule that gives states
the flexibility to change current premiums and cost sharing
requirements. The rule implements Sections 6041, 6042, and 6043 of
the DRA, and closely follows what is allowed under SCHIP. Individuals
with family income below 100 percent of the federal poverty level (FPL)
can be charged only “nominal” cost sharing and premiums. Higher
out-of-pocket charges can be charged to individuals with incomes above
150 percent of the FPL. As in SCHIP, all cost sharing must be limited
to no more than 5 percent of the family’s income. The 2008 FPL for a
family of four is $21,200.
Both final rules are available on the Federal
Register Web site at:
http://www.archives.gov/federal-register/.
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