Legislature seeks role in approval of Medicaid waiver

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(Host) The Legislature is expected to pass a bill this week that requires the Douglas administration to get specific legislative approval for a proposed federal Medicaid waiver. It could be several months before the details of the waiver are finally negotiated and the delay could affect how lawmakers review the plan.

VPR’s Bob Kinzel reports.

(Kinzel) Tucked away in this year’s budget adjustment bill is a provision that makes it very clear that lawmakers want to be equal partners with the governor’s office concerning the possible approval of a new federal Medicaid waiver. Under the proposed waiver, the state would have greater flexibility in using federal funds but it would have to agree to a five-year spending plan that would provide a set amount money to run the various Medicaid programs. The state would not receive additional funds if enrollment goes up.

The Douglas administration says the waiver is a key part of its overall Medicaid reform plan. Without the waiver, the administration says the program will experience an $80 million deficit in the next fiscal year. The administration says action is needed this year because the projected deficits could grow by several hundred million dollars in the coming years.

Senate Appropriations Chairwoman Susan Bartlett says it’s critical for the Legislature to review the specific details about the final agreement because the waiver could have a significant impact on the delivery of services:

(Bartlett) “Because it may make a lot of sense but it could also be a catastrophic deal. And if it isn’t good long-term for the state then we might as well not mess around with it. We’ll figure out how to deal with our problems on our own.”

(Kinzel) Timing is a key factor in this debate. The Douglas administration is hoping to win approval for the waiver by the end of the month. But Administration Secretary Charles Smith says that approval might not include the specific details of the financial agreement – details that are very important to Senator Bartlett:

(Smith) “Whether we’re going to have all the answers that everybody wants when they want them? No. But we’re all in the same boat here and we all have to work towards getting to the far shore on a very difficult issue.”

(Kinzel) Because it’s uncertain when the Bush administration will make a final decision about the waiver, the House Appropriations Committee has decided to bring its spending plan for next year to the House floor in about two weeks without the Medicaid component. They plan to debate the Medicaid changes once the details of the federal decision are fully known.

For Vermont Public Radio, I’m Bob Kinzel in Montpelier.

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