We never have any trouble building aircraft carriers that the navy doesn't 
want. We have tons of money for foreign aid. Congress has never not voted 
itself a pay raise. We are involved in military actions that are best described 
as questionable and extremely expensive. We waste money building bridges to 
islands that have a population of less than 50 people. If 10% of the senseless, 
useless pork was eliminated from the budget, we wouldn't have a problem paying 
medicaid or medicare. Why does Washington always believe that the poor and 
handicapped are the problem. They spend nothing on preventative medicine and 
then don't understand why so many people are in Emergency Rooms for healthcare.
I don't know what the answer is, but I know the people we keep sending to 
Washington DC don't have a clue as to what to do. 

john



In a message dated 11/29/06 03:09:15 Eastern Standard Time, DAANOO writes:
Sounds like there may be changes for Medicaid recipients with getting ready for 
the baby boom, so Medicaid does not become bankrupt.
Dana




Subj:Fw: panel calls for big changes in medicaid
Date:11/28/2006 12:31:48 PM Eastern Standard Time
From:ADAPT [EMAIL PROTECTED]
To:micassa list [EMAIL PROTECTED]

----- Original Message ----- 
From: joe harcz 

PANEL CALLS FOR BIG CHANGES IN MEDICAID 

http://www.amhersttimes.com/index.php?option=com_content&task=view&id=3430&Itemid=27
 

Amherst Times - PANEL CALLS FOR BIG CHANGES IN MEDICAID 



Written by ROBERT PEAR 



Thursday, 23 November 2006 



A federal advisory panel says that long-term care for aging baby boomers 
threatens to bankrupt Medicaid, and it recommends sweeping changes to rein 
in costs, 

including greater use of managed care for the sickest Medicaid recipients. 



The proposals set up a likely clash between the new Democratic Congress and 
the Bush administration, which has sent strong signals that it will seek big 

savings in Medicaid next year. 



Panel members adopted the recommendations last week, by a vote of 11 to 1, 
and are drafting a report to be submitted next month to 

Michael O. Leavitt, 

the secretary of health and human services. Mr. Leavitt created the panel in 
May 2005 and is receptive to many of its proposals. 



The panel, known as the Medicaid Commission, said states should have more 
freedom to alter benefits and eligibility for the program, which serves more 
than 

50 million low-income people. 



Moreover, it said states should be allowed to enroll some of the sickest 
Medicaid recipients, including nursing home residents and people with 
disabilities, 

in managed care plans. 



The panel said such plans "would provide a medical home and better 
coordinated care" for people entitled to both Medicaid and Medicare. Care is 
often fragmented 

now because Medicaid pays nursing homes while Medicare is the primary payer 
for doctors and hospitals, and in many cases "clinical data is not shared," 

the panel said. 



People enrolled simultaneously in the two programs account for 13 percent of 
Medicaid recipients, but more than 40 percent of Medicaid costs. Medicaid, 

which is financed jointly by the federal government and the states, covers 
two-thirds of the nation's 1.6 million nursing home residents. 



"The anticipated costs for long-term care services in this country threaten 
the future sustainability of the Medicaid program," the panel warned. It 
recommended 

that the federal government and the states provide new tax incentives for 
people to buy private insurance covering the costs of long-term care, so 
they 

would not rely so much on Medicaid. 



"Public policy should promote individual responsibility and planning for 
long-term care needs," said the panel, led by former Gov. Don Sundquist of 
Tennessee, 

a Republican. 



More generally, the panel said states should be free "to consolidate or 
redefine eligibility categories" and should be given "greater flexibility to 
design 

Medicaid benefit packages." 



The proposals drew a swift negative response from 

Democrats 

who will be responsible for Medicaid in the new Congress. Representative 

John D. Dingell 

of Michigan, who is in line to become chairman of the Energy and Commerce 
Committee, dismissed the panel as "a hand-picked commission stacked against 
working 

families." 



Senator 

Max Baucus 

of Montana, the Democrat in line to lead the Finance Committee, said many of 
the proposals would make it more difficult for "the most vulnerable 
Americans" 

to get comprehensive care. 



John C. Rother, policy director of 

AARP, 

the lobby for older Americans, said, "In some states, flexibility means 
cutting benefits." 



But Christina Pearson, a spokeswoman for Secretary Leavitt, said, "He 
definitely supports more flexibility for states to meet the needs of 
different population 

groups." 



Grace-Marie Turner, a commission member, said, "People who rely on both 
Medicaid and Medicare are the most vulnerable beneficiaries, but in most 
cases, 

nobody is coordinating their care." Even if a state wants to place them in 
managed care, it may take months or years to get federal approval, said Mrs. 

Turner, who is president of the Galen Institute, a research center focusing 
on health policy. 



The commission said states should be able to place all types of Medicaid 
recipients in managed care without getting "a waiver or any other form of 
federal 

approval." But, it said, individuals should be able to "opt out" of managed 
care. 



Gwendolyn G. Gillenwater, a commission member who is policy director of the 
American Association of People With Disabilities, an advocacy group, voted 
against 

the report. 



"People with disabilities have not had good experience with managed care," 
Ms. Gillenwater said. "We need federal protections and safeguards. People 
with 

disabilities should at least have a choice of two managed care plans. And 
what are your choices if you opt out of managed care? The alternatives are 
getting 

more and more limited." 



The panel said Congress should rewrite the Medicaid law to encourage the use 
of home care and community services, instead of nursing homes and other 
institutions. 



In an interview, Angus King, the former Maine governor who is the panel's 
vice chairman, said: "We need to reverse Medicaid's institutional bias. 
Community 

care - that's what people want. It's better for beneficiaries. And it's less 
expensive." 



The panel urged the Bush administration to study a novel idea: increasing 
federal subsidies for low-income groups added to the Medicaid rolls, while 
scaling 

back subsidies for higher-income people added to the program. The panel said 
this would help achieve "Medicaid's core purpose," serving low-income 
people. 

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