November 2, 2005
News from the States
To follow up on any of the items featured in this publication, please contact Steven Buck, director of state policy at email@example.com
Fallout from Katrina Continues for Louisiana
Facing a $1.5 billion deficit in the state’s general fund, Louisiana lawmakers are contemplating devastating cuts to the state’s Medicaid program. Early estimates suggest that a $300 million cut is in order for the program (the cut would be nearly $1 billion when federal matching funds are considered). The cuts would leave an estimated 108,000 low-income children and 2,500 low-income pregnant women without coverage. The state is also considering the termination of pharmacy benefits for more than 100,000 beneficiaries. (The Chicago Tribune, October 21, 2005)
Three-Tiered Benefits Design Proposed for Idaho
Citing “out-of-control” Medicaid expenses, Idaho Governor Dirk Kempthorne has proposed a Medicaid reform plan based upon the establishment of a three-tiered benefit structure. Kempthorne’s proposal would create a benefit plan for healthy children and adults; a plan for people with disabilities, mental health problems and other chronic needs; and a plan for the elderly (regardless of health status). The governor hopes that the proposal will be accepted by the Centers for Medicaid & Medicare Services (CMS) and be implemented by July 1. Early reviews of the plan suggest important considerations and protections for persons living with mental illness. (The Idaho Statesman, October 22, 2005)
New York County Establishes Medicaid "Czar"
Monroe County (NY) has created a new county executive position to coordinate the county’s Medicaid programs. The first appointee, Bill Carpenter -- introduced as the Medicaid "Czar" -- plans to pursue four initiatives to address cost pressures. The four-pronged approach includes increased uses of technology, requirements that able-bodied beneficiaries look for employment, provisions to require care managers for those recipients not in managed care, and the introduction of pharmacy rules that mirror the procedures followed by other state-funded pharmacy programs. (Democrat and Chronicle, October 22, 2005)
Medicaid Managed Care to Pay for Illinois' “All Kids”?
Illinois Governor Rod Blagojevich has floated a proposal to transfer 1.7 million state Medicaid recipients to a primary care management model. Blagojevich predicts the change will save $57 million in the first year of the program. The savings would be used to fund the governor’s “All Kids” program, a new proposal to offer health insurance to the more than 250,000 children of Illinois whose parents can’t afford employee-sponsored health plans or otherwise make too much money to qualify for Medicaid. (Rockford Register Star, October 24, 2005)
Blue Cross Says No to Florida’s Privatized Medicaid Program
Florida’s largest health insurance carrier, Blue Cross Blue Shield of Florida, has declined to participate in the state’s new Medicaid service delivery model, citing that the company was “not prepared to devote the kind of resources needed to succeed.” The decision represents a significant speed-bump in the implementation of the state’s newly approved Medicaid waiver. The new benefits model is expected to debut in Broward and Duval Counties by July 1. (The Business Journal of Jacksonville, October 23, 2005)
Maine Legislative Committee Studying Medicaid Growth
A special legislative committee has begun to develop revisions to Maine’s Medicaid program. At its initial meeting, the committee agreed that the program’s current rate of growth is unsustainable. (The program has grown by $260 million annually for the last three years.) As part of their work, committee members will review mandated populations and benefits as well as the optional populations and benefits that the state has elected to cover in years past. According to research, Maine is on par with 22 other states in the benefits it offers children and surpasses the national average for benefits offered for adults. (Lincoln County News, October 25, 2005)
Los Angeles Embarks on Housing Initiative
City officials in Los Angeles have announced an initiative to develop service-enriched housing to address the city’s estimated 35,000 residents who are considered chronically homeless. The initial investment of $50 million is expected to increase to a total investment of $250 million through state and federal matching funds. In launching the plan, city officials cited research from the University of Pennsylvania that followed 4,679 homeless people living with mental illness in New York City. After the city implemented a service-enriched housing model, 95% of the costs incurred were offset by a decline in the use of other city services. (Los Angeles Times, October 26, 2005)
NAMI Advocacy Tools & Resources
NAMI South Carolina has recently launched a series of issue updates for its members and constituents. Within the last few months, the organization has released a briefing on the CATIE study and efforts in Crisis Intervention Teams (CIT). To review the briefing paper, click here for information on CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness) and click here for the CIT brief.
Additionally, NAMI South Carolina, in partnership with the South Carolina Psychiatric Association, has initiated an effort to activate constituent involvement in response to anticipated threats to medication access. A copy of a constituent activation postcard is available by clicking here .
Washington Quick Glance
House and Senate Set to Consider Legislation Reforming and Cutting Medicaid; Proposals to Curb Targeted Case Management Rejected
This week and next, both the House and Senate will be taking up legislation to reform the Medicaid program and achieve a net $10 billion in savings over the next 5 years. Congressional leaders and the Bush Administration hope to reach agreement on the legislation – known as budget "reconciliation" – by Thanksgiving. The reconciliation package touches not only Medicaid, but also a broad range of domestic programs including farm subsidies, student loans, food stamps, and child support enforcement to achieve an overall savings target approaching $50 billion.
The separate bills reported by the House Energy & Commerce and Senate Finance Committees this past week differ substantially. The House bill closely follows recommendations put forward by the National Governors Association (NGA) granting states unprecedented flexibility to impose higher cost sharing and premiums on beneficiaries and design benefit packages below current Medicaid standards. By contrast, the Senate bill achieves most of its savings through cuts in payments to Medicare managed care plans and higher rebates paid to states by generic and brand name drug makers.
NAMI leaders can learn more about the reconciliation process and requested action by clicking here.
NAMI Statehouse Spotlight is an electronic newsletter provided free of charge as a public service. With more than 1,100 state and local affiliates, NAMI is the nation's largest grassroots organization dedicated to improving the lives of people with severe mental illnesses. Contributions to support our work can be made online at www.nami.org/donate.
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