Medicaid Reform Tops Governors’ Meeting Agenda

WASHINGTON–Medicaid reform stood center stage at the four-day
National Governor’s Association Winter Meeting, which ended March
1.

At the meeting, the NGA released its Medicaid in 2005:
Principles and Proposals for Reform, a report giving various
recommendations to modernize the failing health care program for
the poor, funded jointly by the federal government and the states.
“Today Medicaid is largely what it was in 1965,” the report stated.
“Unlike other programs, it has not been modernized. It still has
many of the original eligibility and benefit mandates, discourages
personal responsibility, limits cost sharing, emphasizes treatment
rather than prevention, and does not reflect the changing
demographics of Medicaid beneficiaries.”

The report recommends, among other things, basing Medicaid
eligibility on income only, and simplifying the process for
obtaining Medicaid waivers, including those for family planning and
home- and community-based health.

During talks with governors at the meeting, HHS Secretary
Michael Leavitt said he saw agreement on several issues, including
the fact that Medicaid should recognize home- and community-based
care as a “preferred alternative” to nursing homes, the New York
Times reported.

And although partisan politics seemed alive and well, governors
on both sides of the aisle expressed admiration for the new HHS
secretary. “We like Mike Leavitt. We trust Mike Leavitt,” Michigan
Gov. Jennifer Granholm told reporters last week.

A former governor himself, Leavitt oversaw changes within Utah’s
Medicaid program, which has recently gained favor as a model for
lawmakers nationwide seeking to save their own state programs.
Utah’s Primary Care Network provides coverage of more low-income
people but offers fewer benefits. Among other things, inpatient
hospitalization, specialty pharmacy services and most catastrophic
costs aren’t covered.

While state governors struggle to provide options for the
over-burdened program’s future, the Bush administration has
proposed cutting $60 billion from projected federal Medicaid
spending over the next decade.