Thursday, September 1, 2011

GOP Governors Renew Push for More Authority to Restrict Medicaid

The Republican Governors Association (RGA) released a report Tuesday (Aug. 30) detailing 31 recommendations for loosening federal Medicaid standards, in order to give states far more autonomy in determining who is eligible and what they are eligible for. The report, titled A New Medicaid: A Flexible, Innovative and Accountable Future, has been endorsed by 30 GOP governors and territorial leaders, including Governor Walker.

As an Associated Press/ Washington Post article reported Wednesday, the RGA report says that “Medicaid should be custom-designed by each state to best provide care to children, the poor and disabled without federal rules and the waivers required to get around them.” The recommendations include longtime GOP priorities such as repealing the health care reform law's “maintenance of effort” requirement that places restrictions on the ability of states to cut their Medicaid rolls.

Advocates are concerned that giving states broad authority to change Medicaid will be very detrimental for the low-income families, seniors and people with disabilities that the program serves. The Georgetown Center for Children and Families (CCF) released a brief earlier this year detailing what’s at stake for children and families if stability provisions such as the “maintenance of effort” requirement were repealed. They found that more than a third of Medicaid and CHIP beneficiaries would be at risk and more may face red-tape barriers to coverage.

The RGA report was submitted to Congress just as GOP appointees to the new “super committee” were getting together to discuss their priorities for achieving the goal of cutting $1.2 trillion from the federal deficit. Mississippi Governor Haley Barbour said the report should be "helpful" for the super committee, since giving states broader options for cutting Medicaid spending will also reduce the federal matching dollars for that spending. Previous GOP efforts this year to give states broad power to rewrite their Medicaid programs have been blocked by the Senate, so the best chance to enact such recommendations is to get them included in whatever deficit reduction package is developed.

As Georgetown CCF discussed, broad authority to change Medicaid could quickly unravel the nation’s progress in covering children and families. In addition, advocates argue that such changes will significantly increase the number of people who are uninsured and underinsured, which will have the effect of increasing uncompensated care and shifting additional cots onto the insured.

Jon Peacock and Sara Eskrich

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