Sounds like there may be changes for Medicaid recipients with getting ready
for the baby boom, so Medicaid does not become bankrupt.
Dana
--- Begin Message ---
----- Original Message -----
From: joe harcz
PANEL CALLS FOR BIG CHANGES IN MEDICAID
http://www.amhersttimes.com/index.php?option=com_content&task=view&id=3430&Itemid=27
Amherst Times - PANEL CALLS FOR BIG CHANGES IN MEDICAID
Written by ROBERT PEAR
Thursday, 23 November 2006
A federal advisory panel says that long-term care for aging baby boomers
threatens to bankrupt Medicaid, and it recommends sweeping changes to rein
in costs,
including greater use of managed care for the sickest Medicaid recipients.
The proposals set up a likely clash between the new Democratic Congress and
the Bush administration, which has sent strong signals that it will seek big
savings in Medicaid next year.
Panel members adopted the recommendations last week, by a vote of 11 to 1,
and are drafting a report to be submitted next month to
Michael O. Leavitt,
the secretary of health and human services. Mr. Leavitt created the panel in
May 2005 and is receptive to many of its proposals.
The panel, known as the Medicaid Commission, said states should have more
freedom to alter benefits and eligibility for the program, which serves more
than
50 million low-income people.
Moreover, it said states should be allowed to enroll some of the sickest
Medicaid recipients, including nursing home residents and people with
disabilities,
in managed care plans.
The panel said such plans "would provide a medical home and better
coordinated care" for people entitled to both Medicaid and Medicare. Care is
often fragmented
now because Medicaid pays nursing homes while Medicare is the primary payer
for doctors and hospitals, and in many cases "clinical data is not shared,"
the panel said.
People enrolled simultaneously in the two programs account for 13 percent of
Medicaid recipients, but more than 40 percent of Medicaid costs. Medicaid,
which is financed jointly by the federal government and the states, covers
two-thirds of the nation's 1.6 million nursing home residents.
"The anticipated costs for long-term care services in this country threaten
the future sustainability of the Medicaid program," the panel warned. It
recommended
that the federal government and the states provide new tax incentives for
people to buy private insurance covering the costs of long-term care, so
they
would not rely so much on Medicaid.
"Public policy should promote individual responsibility and planning for
long-term care needs," said the panel, led by former Gov. Don Sundquist of
Tennessee,
a Republican.
More generally, the panel said states should be free "to consolidate or
redefine eligibility categories" and should be given "greater flexibility to
design
Medicaid benefit packages."
The proposals drew a swift negative response from
Democrats
who will be responsible for Medicaid in the new Congress. Representative
John D. Dingell
of Michigan, who is in line to become chairman of the Energy and Commerce
Committee, dismissed the panel as "a hand-picked commission stacked against
working
families."
Senator
Max Baucus
of Montana, the Democrat in line to lead the Finance Committee, said many of
the proposals would make it more difficult for "the most vulnerable
Americans"
to get comprehensive care.
John C. Rother, policy director of
AARP,
the lobby for older Americans, said, "In some states, flexibility means
cutting benefits."
But Christina Pearson, a spokeswoman for Secretary Leavitt, said, "He
definitely supports more flexibility for states to meet the needs of
different population
groups."
Grace-Marie Turner, a commission member, said, "People who rely on both
Medicaid and Medicare are the most vulnerable beneficiaries, but in most
cases,
nobody is coordinating their care." Even if a state wants to place them in
managed care, it may take months or years to get federal approval, said Mrs.
Turner, who is president of the Galen Institute, a research center focusing
on health policy.
The commission said states should be able to place all types of Medicaid
recipients in managed care without getting "a waiver or any other form of
federal
approval." But, it said, individuals should be able to "opt out" of managed
care.
Gwendolyn G. Gillenwater, a commission member who is policy director of the
American Association of People With Disabilities, an advocacy group, voted
against
the report.
"People with disabilities have not had good experience with managed care,"
Ms. Gillenwater said. "We need federal protections and safeguards. People
with
disabilities should at least have a choice of two managed care plans. And
what are your choices if you opt out of managed care? The alternatives are
getting
more and more limited."
The panel said Congress should rewrite the Medicaid law to encourage the use
of home care and community services, instead of nursing homes and other
institutions.
In an interview, Angus King, the former Maine governor who is the panel's
vice chairman, said: "We need to reverse Medicaid's institutional bias.
Community
care - that's what people want. It's better for beneficiaries. And it's less
expensive."
The panel urged the Bush administration to study a novel idea: increasing
federal subsidies for low-income groups added to the Medicaid rolls, while
scaling
back subsidies for higher-income people added to the program. The panel said
this would help achieve "Medicaid's core purpose," serving low-income
people.
NATIONAL ADAPT MAILING LIST - Adapt MiCASA List http://www.adapt.org
--- End Message ---
