by Benjamin Domenech on April 23, 2012
Here’s a worthwhile primer on Texas’s Medicaid enrollment growth and the increasing percentage it makes up of Texas’ budget.
Due to federal health care reform, in 2014 all states will be required to provide Medicaid services for all citizens at or below 133 percent of FPL with Medicaid services. At present, Texas Medicaid does not cover childless adults, and has stiffer income requirements than 133 percent of FPL for some services. Exhibit 4 show current Medicaid eligibility categories as well as required changes for 2014.
Medicaid in Texas is on track to increase from 14% of the budget in 2001 to 37% in 2023. A graph is available here.
by Benjamin Domenech on March 30, 2012
While the disagreement over the Medicaid mandate to the states was not the largest issue discussed at the Supreme Court this week, one moment during debate deserves attention – the contention by Justice Breyer that the federal government would be “unreasonable” to withdraw the entirety of Medicaid funding to a state over their unwillingness to accept the additional expansion under President Obama’s law. Attorney Paul Clement responded:
MR. CLEMENT: And if I could just add one thing just to the discussion is the point that, you know, this is not all hypothetical. I mean, in — there was a record in the district court, and there is an Exhibit 33 to our motion to summary judgment. It is not in the joint appendix. We can lodge it with the Court if you’d like.
But it’s a letter in the record in this litigation, and it’s a letter from the secretary to Arizona, when Arizona floated the idea that it would like to withdraw from the CHIP program, which is a relatively small part of the whole program.
And what Arizona was told by the secretary is that if you withdraw from the CHIP program, you risk losing $7.8 billion, the entirety of your Medicaid participation.
The letter Clement cites is Exhibit 33 here.
by Benjamin Domenech on March 9, 2012
A group of House Republican members including Reps. Rokita, Huelskamp, Broun, and Ohio’s Jim Jordan, head of the Republican Study Committee, introduced a comprehensive Medicaid reform measure this week. An excerpt from their press statement on the bill, titled the State Health Flexibility Act:
“The status quo in Medicaid is unfair to the poor and to our children. Waste and fraud run rampant. The poor are promised care but often struggle to find a doctor. And our children will be taxed to pay off the debt incurred for programs that do not work like they should. ObamaCare makes all of these problems even worse. The State Health Flexibility Act frees the states from Washington’s one-size-fits-all dictates so they can design programs around the needs of their own citizens, yet it does not cut a single penny from current funding. We must take this opportunity to make Medicaid more affordable, more accountable, and provide better care to the people who need it most.”
The members maintain that under the State Health Flexibility Act, each state will have a far greater opportunity for innovation and experimentation under an overall cap on funding:
- Federal funding for Medicaid and CHIP will be combined into a single block grant. States may spend their own funds at whatever level they choose.
- The states will have sole authority to determine eligibility, benefits, provider reimbursement rates, and to improve the quality of care and access to vital services.
- States may use up to 30% of their federal funding to support other welfare programs, including Temporary Assistance for Needy Families (TANF), Supplemental Security Income (SSI), and Food Stamps if the need is greater in those areas.
- Each state may use a portion of its block grant to establish a Rainy Day Fund to prepare for potential spikes in program enrollment that might arise from periods of high unemployment or other unforeseen circumstances.
- States will no longer be forced to wait months and sometimes years negotiating waiver-requests from HHS in order to implement their own reform ideas.
Read more details at the RSC’s site.
by Benjamin Domenech on February 28, 2012
There’s a podcast interview here with Beverly Gossage concerning Kansas Gov. Sam Brownback’s new Medicaid plan.
Kenneth Artz reports on the plan here:
Over the past ten years, Kansas’ Medicaid budget has grown about 7.5 percent year—a rate consistent with the growth in other states, but one that lawmakers say cannot be sustained. To improve outcomes and reduce costs, Gov. Sam Brownback, a Republican, has proposed a method of privatizing the system, which serves about 350,000 Kansans.
Brownback’s administration promises the plan, named “KanCare,” will achieve the savings without reducing coverage for the disabled, the elderly, or poor families, and without cutting payments to doctors, hospitals, clinics, and nursing homes.
Read the rest at The Heartlander.
