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What's in a Draft? Plenty When It Comes to Governors and Medicaid

MAY 6, 2005 -- Making it tougher for individuals to transfer their assets in order to qualify for Medicaid coverage, increasing the use of "reverse mortgages" to fund long-term care, and raising co-payments for medical services are all elements of a National Governor's Association (NGA) draft proposal to overhaul the Medicaid program.

The 12-page document also includes a variety of ideas to help increase health care coverage for both current Medicaid beneficiaries and those that may become eligible for the program and to address factors that increase health care costs. They include providing both incentives and penalties to make individuals more responsible for their own health care, creating state purchasing pools to help small businesses buy health care coverage for workers, and moving to a package of benefits that resembles the State Children's Health Insurance Program (SCHIP) to help non-elderly, non-disabled Medicaid individuals have health care coverage.

As lawmakers worked to complete a fiscal 2006 budget resolution, ideas from the governors' draft proposal began to circulate through the media and congressional offices and even were quoted on the floor of the House, the NGA said in an April 28 statement.

NGA officials also stated the draft represents "a set of concepts" discussed by the association's 11-governor working group and the document "does not in any way represent current NGA policy" which requires a supermajority vote of the executive committee or all governors.

The group still maintains, however, that "Medicaid reform must be driven by good policy and not the federal budget process," the NGA stated.

Other ideas raised in the memo include:

  • Streamline the federal Medicaid waiver process "or even change the federal statute to eliminate the need for waivers altogether."
  • Create "a new national dialogue" on how to deal with the issues of aging population, including "potential sources of funding for end-of-life care."
  • Using health care tax credits for individuals and employers as well as state purchasing pools to help slow the growth of low-income individuals becoming eligible for Medicaid.

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