Medicaid Reform Proposal Causes Confusion

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(Host) There’s growing confusion at the Statehouse over the future of a Medicaid reform proposal. Senate Democrat leaders want to consider delaying full debate on the issue until the federal government has issued a final ruling on the state’s new Medicaid waiver. The Douglas administration opposes this approach.

VPR’s Bob Kinzel reports

(Kinzel) As the Senate Appropriations Committee works to draft a budget for next year, the chair of the panel, Susan Bartlett is finding it more and more difficult to reach final decisions about funding for the state’s Medicaid program. Bartlett says this is happening because of the enormous uncertainty surrounding the Douglas administration’s plan to implement significant reforms of the program.

The administration needs permission from the federal government to put many of these changes in place. This week it made key revisions to its plan after federal officials said that part of the state’s approach would not be approved. Bartlett says it makes no sense to closely examine the Administration’s new plan because it’s likely that it will also be subject to important changes during the federal review process.

(Bartlett) “How do we know that the fifteenth of June there isn’t going to be ” Oh, here’s another curve ball and it doesn’t work.” So the ability to have much faith in the process, or the information that we have and that is going to remain constant, is just very very difficult.”

(Kinzel) Bartlett says the best approach to take may be to wait until the Administration has gotten final approval from the federal government for its waiver – then Bartlett says there can an intelligent debate over the merits of the plan:

(Bartlet) “And as time goes by, we don’t want to waste our time or taxpayers’ dollars running in circles. And so we’re trying to get information and then to reach a decision that is good for the state of Vermont, and do it in a manner that’s timely and respectful of all those different issues. I guess it’s probably not hard to tell that I’m very frustrated right now.”

(Kinzel) Administration Secretary Charles Smith doesn’t want the Legislature to delay its consideration of Medicaid reform. Smith says the state faces a projected eighty-million dollar Medicaid deficit next year and he says that the problem, left unchecked, will grow a lot bigger in the coming years.

(Smith ) “I don’t think we can duck the hard issues for fiscal year ’06. The fact is, we do have an eighty-million dollar deficit in the Health Access Trust Fund for fiscal year ’06. And I think before we abandon ship – I think we have to look at the measures we do have at hand to bring discipline to Medicaid in this next fiscal year.”

(Kinzel) Smith says the state will formally submit its new waiver application next week. There’s no telling when federal officials will issue a decision on the plan. The state submitted a waiver dealing with at home care for the elderly last year and it’s still waiting for a decision in that case.

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

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