Governors Circulate Draft Statement on Possible Medicaid Reforms
Governors seeking to create a "united position" on Medicaid have been circulating a 12-page working draft statement of possible changes, including increasing deductibles and making asset transfers more difficult, the AP/Long Island Newsday reports. According to aides, the draft statement, which could be taken to Congress and the Bush administration, includes a proposal that would make it more difficult for seniors to transfer their assets to family members or others to qualify for nursing home care under Medicaid.
Another proposal would allow the state to investigate more thoroughly a beneficiary's finances and seek repayment for government-provided care. In addition, the draft includes a proposal to establish or increase deductibles and copayments for beneficiaries. Governors hope such a proposal would force beneficiaries to contribute to the cost of the program and discourage abuse. The proposals also would try to discourage businesses from eliminating retiree health benefits or otherwise shifting employees to Medicaid, by establishing incentives such as tax credits (Tanner, AP/Long Island Newsday, 4/25).
Governors also said they would like to create costs savings by making the program more efficient through electronic medical records and state purchasing pools (AP/Kansas City Star, 4/25).
Virginia Gov. Mark Warner (D), chair of the National Governors Association, and several other governors declined to give further details on the draft statement. However, Warner said that the proposed changes would be balanced with other policies that would make paying for long-term care more affordable, such as giving beneficiaries tax credits for long-term care insurance.
Arkansas Gov. Mike Huckabee (R) said the difficulty with Medicaid reform is that changes would affect each state differently (AP/Long Island Newsday, 4/25). Governors said they have reached no agreements on draft statement proposals, and "it's unclear whether a majority" will be able to reach a consensus, according to those familiar with the draft statement, the AP/Kansas City Star reports (AP/Kansas City Star, 4/25).
In related news, it "appears" that Sen. Gordon Smith (R-Ore.) has reached an agreement with the Bush administration to create a commission that would study Medicaid reform in exchange for making some program spending reductions, CQ HealthBeat reports. A GOP source said Medicaid spending reduction likely will be less than the $12 billion proposed by Sen. Judd Gregg (R-N.H.).
While "budget writers hope that a Medicaid deal will catalyze an overall [budget] agreement ... it remains unclear" whether lawmakers will be able to find $40 billion to $45 billion in savings in other programs, CQ HealthBeat reports (CQ HealthBeat, 4/22).
The Los Angeles Times on Sunday examined the different proposals states are considering to control spending on Medicaid, which is "often a state's single biggest budget item." According to the Times, "Every state has frozen or is trying to cut" Medicaid payments to physicians. In addition, more than one dozen states are looking to reduce the number of beneficiaries or reduce benefits.
A proposal by Tennessee Gov. Phil Bredesen (D) would eliminate 320,000 adults from the state's Medicaid managed care program. Several states are also considering more sweeping reforms, such as a proposal by Missouri Gov. Matt Blunt (R) that would eliminate the Medicaid program within three years (Simon, Los Angeles Times, 4/24).
C-SPAN's "Washington Journal" on Monday included interviews with Rebecca Adams, a Congressional Quarterly reporter; Matt Salo, director of health legislation for the National Governors Association; and CMS Administrator Mark McClellan, about Medicaid ("Washington Journal," C-SPAN, 4/25). The complete program will be available online in RealPlayer and Windows Media after the broadcast.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.