Georgia still looking to Reshape Medicaid supports

Over a year ago, a proposal from the Governor's office to reform our Medicaid system was circulated. Following the release of this paper, there were a number of meetings attempting to build consensus to redesign Medicaid services in Georgia that eventually stalled with no real progress. It seems this effort has resurfaced in an invitation for an event to be held on June 30th that was forwarded by Mark Johnson entitled "A Call to Action: Redesigning Medicaid Long-Term Care (LTC)." Speakers for this workshop include:

Dr. Rhonda Medows, Commissioner for DCH, Renard Murray, Associate Regional, Administrator CMS, Region IV, Joy Cameron - NGA Center for Best Practices, Donna Deleno Neuworth and Van Thomas, AARP Policy Institute, Patrick Flood – Commissioner, Vermont Department of Aging and Disabilities, and Governor Sonny Perdue

During the day, work groups will be exploring ideas such as Helping Individuals with Disabilities Return to the Workplace, Developing a State Long-Term Care Partnership Program, Developing Self-Directed Personal Care Services without a Waiver, Expanding Insurance Coverage for Persons with Disabilities, Offering HCBS Without Waivers, and Offering HCBS Alternatives to Children in Psychiatric Residential.

Four days after I recieved this email, I stumbled on an article in the Washington Post entitled States' Changes Reshape Medicaid.

After winning greater freedom from federal Medicaid rules, states are moving aggressively to transform the nation's largest public health insurance program, adding fees, restricting benefits and creating incentives for patients to take responsibility for their health. The changes are just beginning in several states that are being watched closely by governors nationwide. Those changes are reshaping Medicaid, which covers 55 million poor and disabled Americans, so that the program more closely resembles private insurance, rather than a social welfare system run with a strong, central government hand. Since its creation in the 1960s, Medicaid has been a shared responsibility of the federal government and the states. States shoulder more than 40 percent of the cost, which totals $338 billion this year, and have always had certain freedom to decide how many benefits to cover. But the federal government has determined many of the program's basic contours.

Last December, Congress granted states broad flexibility to alter benefits, charge patients more and expand the role of private insurers as part of a law that will cut federal Medicaid spending by $43 billion in the next decade. Even before the law, the Bush administration was sympathetic to states that wanted greater say over how their programs are designed. The law, called the Deficit Reduction Act, and the administration's policies have eliminated a hallmark of the program: Until now, every Medicaid patient within a state has qualified for the same benefits.

Medicaid's new direction borrows ideas from the overhaul of the welfare system a decade ago. That transformation also decentralized a major piece of the social safety net, limited government assistance, expanded the private sector's role and tried to instill self-reliance in low-income people who had depended on government help. Alan Levine, secretary of Florida's Agency for Health Care Administration, said the revised Medicaid will give patients more "emotional buy-in" by increasing their choices and incentive to take care of themselves, while eventually saving the state money. "We are doing it for the right reasons."

The article finished with a quote from Alan Levine, "I just hope it works." A lot of people's who depend on this saftey net share his hope.