Lawmakers Raise Concern About Rhode Island Global Waiver

Main Category: Medicare / Medicaid / SCHIP
Article Date: 18 Sep 2008 - 10:00 PDT

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Several lawmakers have raised concern with the "closed-door negotiations" being conducted between Rhode Island Gov. Donald Carcieri's (R) administration and CMS officials about the state's request for "global Medicaid waiver," which would allow Rhode Island to make broad changes to its Medicaid program, the Providence Journal reports (Peoples, Providence Journal, 9/16).

In adopting a global waiver, the governor would agree to limit Medicaid spending to $12.4 billion through 2013. State Department of Human Services Associate Director Murray Blitzer said that if the state runs out of its allotted funds before the five-year mark it will lose matching federal funds, which would force the state to pay the program's full cost or cut services. In exchange for capping spending, the state would receive broad authority to change services, such as nursing home care, subsidized transportation for the elderly and beneficiaries with disabilities, health insurance for low-income children and parents, and prescription drug coverage for seniors. If approved, the waiver is expected to save the state an estimated $67 million this year (Kaiser Daily Health Policy Report, 9/16).

"The plan has far-reaching implications" that would affect the state's180,000 Medicaid beneficiaries, but "if approved, it would also pave a new road for other states eager to limit the cost of expensive and sometimes controversial 'entitlement' programs," the Journal reports.

Letters, Concern
At least eight congressional leaders, including the entire Rhode Island delegation, have written letters to officials urging more disclosure and transparency of the negations.

In a letter sent in late August to HHS Secretary Mike Leavitt, Senate Finance Committee Chair Max Baucus (D-Mont.) and Sen. Jay Rockefeller (D-W.Va.) wrote, "Medicaid provides a federal guarantee of health benefits for those in need. And that guarantee cannot be negotiated away through secret pacts between the Bush administration and governors seeking to cut Medicaid." They added that the waiver "could hurt" many people. State House Finance Committee Chair Steven Costantino (D) recently wrote a letter to the Carcieri administration requesting a "Plan B" proposal to balance the state budget, the Journal reports.

Rhode Island Department of Human Services Director Gary Alexander said state officials will meet with CMS officials in the next few weeks to formally begin negotiations for the proposal. A spokesperson for Rockefeller on Monday confirmed that Bush administration officials will hold a private briefing for congressional leaders later this week to discuss the proposal (Providence Journal, 9/16).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

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