A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

National Medicaid Commission Update

National Medicaid Commission Update

September 5, 2005

Earlier this summer, the Bush Administration appointed a commission to develop recommendations to curtail the growth in Medicaid spending. Below is an update on the Commission from the National Health Law Project:

"On August 18th, the Bush Administration's Medicaid Commission made its recommendations to cut $10 billion over five years from Medicaid. The commissioners will send their recommendations to Congress and to the HHS Secretary by September 1. After September 1, 2005 and before December 31, 2006, the commission will hold meetings to consider long-term changes in Medicaid. Dates and places for these meetings have not been set. For information on the commission, visit http://www.cms.hhs.gov/faca/mc/default.asp.

"The commission voted to recommend several short-term options, including implementing tiered copayments for prescription drugs, changing the drug rebate formula, extending the Medicaid drug rebate program to Medicaid managed care, increasing the current "look-back" period for Medicaid eligibility from three years to five, and changing the penalty period start date for individuals transferring assets for Medicaid eligibility purposes.

"In addition, the National Governors Association and National Conference of State Legislatures recently provided short-term recommendations to Congress to cut Medicaid spending. Among its recommendations, the NGA supports increasing cost-sharing for people with incomes over 100 percent of the federal poverty level, and requiring the Department of Health and Human Services to support the states when waivers are legally challenged. For further information, see http://www.nga.org/files/pdf/0508medicaidreform.pdf."

From our perspective, the proposed changes on co-payments will be the most damaging. The eligibility changes mostly affect elderly looking for Medicaid support for their nursing home bills. Affluent families do estate planning that escapes all of these rules changes -- it's the uninformed, less affluent with smaller estates who get caught in these rules.