CMS Announces Medicaid Plans for Hurricane Katrina Evacuees
CMS Administrator Mark McClellan on Friday announced plans to make it easier for Hurricane Katrina evacuees to enroll in state Medicaid programs, CongressDaily reports. CongressDaily reports that many evacuees across the country face "the difficult task of finding health care." Medicaid eligibility rules differ from state to state, and many evacuees have no documentation to prove their residency or economic status. McClellan is sending states a template that evacuees can use to apply for emergency Medicaid waivers, retroactive to one week before the hurricane. Evacuees with or without documentation will be able to use the template. States will have flexibility to lower copayments and beneficiary contributions (Werber Serafini, CongressDaily, 9/9).
McClellan said CMS officials are working with states to provide a new category of Medicaid and SCHIP eligibility for evacuees who cannot prove either current eligibility or their eligibility in their home state (CQ HealthBeat, 9/9). There are no clear estimates of how many evacuees will seek Medicaid in their new host states, but Ruth Kennedy, deputy director of Louisiana's Medicaid program, said that before the hurricane, Louisiana had slightly less than one million Medicaid beneficiaries, two-thirds of whom lived in areas affected by the hurricane (CongressDaily, 9/9).
McClellan said that legislation will be needed to determine who will pay for the care of emergency beneficiaries, CongressDaily reports. "We're asking states to report in their full costs," including administrative costs, McClellan said. He added that the federal government could match state expenditures at no more than the "current match rate until the administration and Congress decide" how to proceed financially. "We need legislative authority to make that happen," he said (CongressDaily, 9/9).
President Bush on Thursday said states will be reimbursed for "showing compassion," including reimbursements for Medicaid services. Democrats in the House and Senate have offered legislation that would provide full federal funding (CQ HealthBeat, 9/9).
Ohio Medicaid Director Barbara Edwards, speaking during a phone news briefing on Friday sponsored by the Kaiser Commission on Medicaid and the Uninsured, said state Medicaid officials throughout the country want "simple and straightforward" answers from the federal government about reimbursement for providing health care to evacuees. Edwards said that states have questions about how Medicaid eligibility should be determined for people whose medical status cannot be immediately determined, as well as for individuals who now qualify for the program because of losses suffered during the hurricane.
Kennedy said demand for Medicaid is likely to increase, for example among elderly people who had previously been cared for by family members who would now require nursing home care. "Time is of the essence," Kennedy said, adding that it will become more difficult for states to provide needed health services if the federal government does not provide clarification soon (CQ HealthBeat, 9/9).
Republican congressional aides on Friday said party leaders have decided to postpone budget deadlines for entitlement savings until after the Columbus Day recess (Cohn/Mitchell, CongressDaily, 9/9). As part of the process, the Senate Finance Committee has been charged with finding $10 billion in Medicaid spending reductions over five years (California Healthline, 9/8).
According to CongressDaily, many Senate and House members advocated putting off indefinitely "consideration of the filibuster-proof budget reconciliation bills because of the need to respond to Hurricane Katrina and the uncertainty of GOP support for trimming entitlements" (Cohn/Mitchell, CongressDaily, 9/9).
The Washington Post reports that the hurricane has given the Bush administration and lawmakers from both political parties opportunities "to incorporate long-held -- and normally polarizing -- policy goals into the huge federal aid racing to the Gulf Coast." For example, Democrats in both chambers have introduced legislation that would expand Medicaid temporarily for all Hurricane Katrina survivors, regardless of income. Single men and couples without children, groups who typically are not eligible for Medicaid, would be allowed to receive the emergency benefits, which would be funded entirely by the federal government. The Senate version would last six months and would cost between $6 billion and $8 billion.
Rep John Dingell (D-Mich.) said the scale of the disaster warranted the changes and added that the legislation is not being used as a chance to permanently expand Medicaid (Weisman/Goldstein, Washington Post, 9/10). In another sign of the shift, Bush, "who has been particularly pointed in his criticism of New Deal and Great Society programs, such as welfare and Medicaid," has agreed to open Medicaid to millions of people affected by the hurricane (Gosselin/Hook, Los Angeles Times, 9/10).