Federal Perspective Changes in Medicaid Alice Burton Director

Federal Perspective Changes in Medicaid Alice Burton, Director Academy. Health June 2, 2005

Medicaid & SCHIP – Federal Changes § Budget resolution calls for $10 billion in Medicaid reductions over 5 years – Budget Resolution is broad budget framework – Final Medicaid reductions might be more or less than $10 billion § Medicaid Commission created § SCHIP Reauthorization due by 2008, maybe sooner

Medicaid Commission § “To advise Secretary on ways to modernize Medicaid the Medicaid program so it can provide high quality health care to its beneficiaries in a financially sustainable way” (CMS Charter, 5/19/05) – By Sept 1 2005 – recommendations on $10 billion in savings over 5 years – By Dec. 31 2006 – Longer-term recommendations that ensure sustainability

Potential Sources of Medicaid Savings § President’s budget savings proposals totaled $13. 9 billion over 5 years (CBO scoring) – Provider taxes $5. 7 billion – Rx pricing $5. 2 billion (some Govs support) – Asset transfer $1. 4 billion (some Govs support) – Targeted case management $1. 5 billion § Gov Warner letter with suggested savings: Rx pricing, asset transfer and $2 billion by allowing states to charge higher co-pays

Next Steps in Federal Budget Process § Commission report – September 1, 2005 § House and Senate Committee action – Response to reconciliation instructions expected by September 15, 2005 § Appropriations bills separate § FY 2006 starts October 1 st

States Propose Changes to Medicaid § Reductions in Eligibility: – Tennessee & Missouri § Concept papers or waivers to “redesign” including individual accounts – Florida, Georgia, Vermont, West Virginia, New Hampshire § Changes to Disproportionate Share Funding and other financing issues