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Governors to Lobby for Medicaid Reforms
Task Force releases
summary for 50 governors to review
By
Kathleen Hunter, Stateline.org
Staff Writer
 June
3, 2005 - The nation’s governors are seeking consensus on a new
blueprint to fundamentally restructure Medicaid, the government’s
largest health care program, that seeks to stem its exploding costs
without cutting off medical care for more Americans.
A task force of 11 governors released
a four-page summary on June 1 of proposals that now will go before
all 50 governors at the
National Governors Association’s annual meeting in July. More
details are expected to emerge June 15 when NGA Chairman
Gov. Mark Warner (D) of Virginia and Vice Chairman
Gov. Mike Huckabee (R) of Arkansas testify before the
U.S. Senate’s Finance Committee.
The NGA plan, many elements of which previously
have been reported, focuses on granting states more flexibility to try
innovations in managing their Medicaid programs, on making it easier for
low-income and disabled people to secure private health insurance, and
on reducing Medicaid's role in funding nursing home and long-term care.
Skyrocketing costs and swelling membership rolls
have in recent months propelled Medicaid, the 40-year-old federal-state
program that serves 53 million low-income and disabled Americans, to the
forefront of the nation's domestic policy agenda.
Medicaid has eclipsed K-12 education as the single
largest portion of states' budgets, making it a top concern for
governors. But the program, which pays for nearly half of all long-term
care and covers almost two-thirds of nursing home residents, also has
captured the attention of budget cutters in the White House and
Congress.
The governors’ proposal, which they hope will help
sway Congress’ efforts to reform Medicaid, calls on the federal
government to:
> Allow states to adopt tiered, enforceable
co-payments for prescription drugs that Medicaid covers.
> Give states more freedom to innovate by
cutting the federal red tape and long waits for states seeking
exemptions to Medicaid rules.
> Remove legal barriers to states managing
optional Medicaid benefits, in an effort to keep states from landing in
court when they try innovative Medicaid strategies.
> Establish a National Health Care Innovations
Program that would support 10-15 state-level health care reform
initiatives.
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Governors adamantly oppose a congressional proposal
to cut $10 billion from the $330 billion Medicaid program over five
years and argue that federal and state officials should focus on
achieving long-term reforms to pare Medicaid costs instead of
letting budget cutbacks drive the debate.
A bipartisan group of 11 governors, consulting with
Medicaid officials from at least 30 states, has been holding
teleconferences since early this year to draw up a counter-proposal to
Congress' budget plan to chop the program.
Governors also announced June 1 that they would not
join in a commission headed by U.S. Health and Human Services Secretary
Michael Leavitt that has until Sept. 1 to devise a strategy to achieve
the $10 billion in cuts. Congressional Democrats also oppose the cuts
and are boycotting the Leavitt panel, which still is being formed.
Nominations to the panel are due June 3.
Governors plan to move forward with their own
recommendations independently and present final versions to Congress as
well as to the commission. NGA officials say the final proposal will
build on elements of the interim policy.
One controversial area that many governors are
reluctant to touch is the accounting loopholes that some states now use
to qualify for additional federal money, known as intergovernmental
transfers.
The Bush administration, which has proposed
eliminating the transfers, identified 15 states as using the techniques
to get millions of extra federal dollars.
The
Center on Budget and Policy Priorities, a Washington think tank that
focuses on policies affecting the poor, released a
study May 31 on the effects of making Medicaid beneficiaries
responsible for more costs associated with their health care.
Send your comments on this story to
letters@stateline.org. Selected reader feedback will be posted in
the Letters to the editor section.
Contact Kathleen Hunter at
khunter@stateline.org.
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