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Medicaid directors warn against “transfer of risk, responsibility, and cost to the states of historic proportions”

Monday, Jun 26, 2017 - Posted by Rich Miller

* From a “consensus statement” from the National Association of Medicaid Directors (NAMD) Board of Directors on the Republican US Senate healthcare plan

The Senate bill does formalize several critical administrative and regulatory improvements, such as giving Medicaid Directors a seat at the table in the development of regulations that impact how the program is run, and the pathway to permanency for certain waiver programs.

However, no amount of administrative or regulatory flexibility can compensate for the federal spending reductions that would occur as a result of this bill.

Changes in the federal responsibility for financing the program must be accompanied by clearly articulated statutory changes to Medicaid to enable states to operate effectively under a cap. The Senate bill does not accomplish that. It would be a transfer of risk, responsibility, and cost to the states of historic proportions.

While NAMD does not have consensus on the mandatory conversion of Medicaid financing to a per capita cap or block grant, the per capita cap growth rates for Medicaid in the Senate bill are insufficient and unworkable.

Medicaid - or other forms of comprehensive, accessible and affordable health coverage - in coordination with public health and law enforcement entities, is the most comprehensive and effective way address the opioid epidemic in this country. Earmarking funding for grants for the exclusive purpose of treating addiction, in the absence of preventative medical and behavioral health coverage, is likely to be ineffective in solving the problem and would divert critical resources away from what we know is working today.

Medicaid Directors recommend prioritizing the stabilization of marketplace coverage. Medicaid reform should be undertaken when it can be accomplished thoughtfully and deliberately.

The NAMD is a “professional organization representing leaders of state Medicaid agencies.”

       

10 Comments
  1. - Amalia - Monday, Jun 26, 17 @ 12:54 pm:

    Anyone with a serious health issue, or, if you think about it…anyone as things are diagnosed all the time….must be up in arms about this healthcare bill. It has several terrible aspects. All I can say is contact your friends in other states like Maine, WVA, Alaska and pray to find Republican Senators who get that the bill as it stands is bad for the health of Americans.


  2. - Joe Bidenopolous - Monday, Jun 26, 17 @ 12:56 pm:

    It’s be nice if Governor Gaslight expressed an opinion on the bill and it’s potentially harmful impact to the Illinois Medicaid program and Illinoisans in general.

    Then again, state services are being slashed all over the place, social service providers are going out of business or starkly reducing services, anti-violence programs have been allowed to whither and die, real people out on the streets are getting hurt, and Governor Gaslight has never been happier. So I guess it shouldn’t be a surprise - his silence obviously means he supports it. Until he says otherwise, that’s what I’m going to believe.


  3. - Perrid - Monday, Jun 26, 17 @ 1:04 pm:

    Cutting funding first and saying that it will lead to more efficiency and thus no loss of services, without actually defining what those changes are, is like jumping out of a plane without a parachute and saying you are sure you can find one before you hit the ground. Talk about putting the cart before the horse…


  4. - Precinct Captain - Monday, Jun 26, 17 @ 1:14 pm:

    The more you learn about the Republican healthcare plan, the worse it gets. And the more craven Bruce Rauner’s silence becomes.


  5. - Rich Miller - Monday, Jun 26, 17 @ 1:15 pm:

    “Cutting funding first and saying that it will lead to more efficiency and thus no loss of services, without actually defining what those changes are, is just like what we’ve seen the past two years in Illinois.”

    Fixed it for you.


  6. - Mokenavince - Monday, Jun 26, 17 @ 1:18 pm:

    The Senate version if the health care bill is a train wreck.Just a huge tax cut.The Trump voters are going to get slammed.It just keeps getting worse. This should be a bi-partisan bill, and they should quit grandstanding.


  7. - Mama - Monday, Jun 26, 17 @ 1:34 pm:

    “Cutting funding first and saying that it will lead to more efficiency and thus no loss of services, without actually defining what those changes are, is just like what we’ve seen the past two years in Illinois.”

    This will destroy healthcare in Springfield.


  8. - wordslinger - Monday, Jun 26, 17 @ 2:08 pm:

    Calling a tax cut for the 1% funded by kicking millions off insurance coverage a “health care bill” is just a perversion of the language.


  9. - Last Bull Moose - Monday, Jun 26, 17 @ 2:50 pm:

    Transferring risk, responsibility, and cost to the States is standard conservative practice. The liberal converse is to use unfunded mandates and matching funds to transfer effective control to the Federal government.

    In theory the States could fund the desired level of healthcare. In practice they won’t, partly because they cannot print money and run continuing deficits and partly because other uses for funds will seem more important.

    Obamacare was funded in part by requiring the young and healthy to overpay for mandatory insurance. This would never have passed as a tax, so it was disguised as premiums.

    As a nation, we want better healthcare but don’t want to pay for it. Seems to be a habit.


  10. - cdog - Monday, Jun 26, 17 @ 6:03 pm:

    Maybe it will someday occur to people that turning a $2.00 bottle of aspirin in to a $3000 (200x$15) profit center and charging taxpayers, employers, and self-employed the $3000, isn’t such a smart way to run a country.


Sorry, comments for this post are now closed.


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