Reaction to Bush Administration’s Medicaid Proposal ‘Noncommittal to Hostile’
The Medicaid reform proposal announced last week by the Bush administration has received "noncommittal to hostile" reaction, the Hartford Courant reports (MacDonald, Hartford Courant, 2/4). Under the proposal, announced by HHS Secretary Tommy Thompson on Friday, states would no longer have to apply for federal waivers to deviate from federal standards for Medicaid eligibility and benefits. States would be required to maintain comprehensive Medicaid coverage for the roughly two-thirds of beneficiaries whose income levels are low enough that the federal government mandates that they be covered, but for beneficiaries covered at the states' discretion, states would be permitted to change Medicaid rules and regulations, simplify and alter eligibility requirements and tailor or cut benefits. The proposal would give states a fixed amount of money, rather than matching funds, for the beneficiaries that they choose to cover. States that decide to join the new optional Medicaid program would receive a total of $3.25 billion in additional federal subsidies in 2004 to fund new programs and $12.7 billion over seven years, but federal funding would decrease for the three years after that, resulting in a net of no cost to the federal government (California Healthline, 2/3). Administration officials said that the proposal, which requires congressional approval, would "give states greater flexibility to target scarce dollars at poor people who need health care the most," the Courant reports.
The House Energy and Commerce Committee plans to hold a hearing on the Medicaid reform proposal on Thursday (Hartford Courant, 2/4). Committee Chair Billy Tauzin (R-La.) is "generally supportive" of the proposal, the Wall Street Journal reports. However, Sen. Charles Grassley (R-Iowa), chair of the Senate Finance Committee, which has jurisdiction over Medicaid, said that he is "reserving judgment" until he has studied the proposal (Lueck, Wall Street Journal, 2/3). Sen. Max Baucus (D-Mont.), the ranking Democrat on the committee, said, "I am particularly concerned about the impact [the proposal] may have on millions of vulnerable Americans who rely on [Medicaid] for their insurance."
The National Governors Association has not taken a position on the Medicaid reform proposal (Hartford Courant, 2/4). The NGA said in a short statement, "We look forward to reviewing the details of the proposal and working with [Thompson] and Congress to reform this critical federal-state partnership program" (NGA release, 1/31). Florida Gov. Jeb Bush (R), who favors the proposal, and New Mexico Gov. Bill Richardson (D), who has not taken a position on the proposal, will testify at the House Energy and Commerce Committee hearing. Connecticut Gov. John Rowland (R) endorsed the proposal, saying, "These reforms will give states flexibility to create innovative health care programs" (Hartford Courant, 2/4). The Memphis Commercial Appeal reports that the proposal would provide TennCare, Tennessee's Medicaid managed care program, with more opportunity to charge copayments and premiums, revise benefit plans and make other reforms. However, opponents said that the proposal would leave Tennessee responsible for cost overruns (Brosnan, Memphis Commercial Appeal, 2/1).
Advocates for Medicaid beneficiaries also raised concerns about the reform proposal. "It's dangerous," according to Sheldon Toubman, a staff attorney for the New Haven Legal Assistance Association in Connecticut. He added, "It would signal the end of Medicaid as an entitlement." Ron Pollack, executive director of Families USA, said, "This is a deal for short-sighted politicians," adding, "The longer-range problems are going to be someone else's" (Wall Street Journal, 2/3).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.