Projo 7 to 7 News Blog

The Carcieri administration will ask the federal government to cap spending on Rhode Island's health programs for the low-income, elderly and disabled at $12.4 billion over the next five years, in accordance with a "global Medicaid waiver" proposal given to the General Assembly today.

The governor said he needs the waiver to control mounting Medicaid-related costs. In exchange for agreeing to limit Medicaid spending through 2013, the federal government would grant the Carcieri administration broad authority to change the programs without federal oversight.

Changes, for example, would affect seniors' ability to access nursing homes, community-based services, group homes for the disabled, and health insurance programs for the low-income. But the waiver released today doesn't include many specifics. See the 168-page proposal here.

The Carcieri administration acknowledges that the waiver concept, which has never been done before in any state, carries an inherent risk.

Critics fear the state could run out of its Medicaid allotment before five years is up, forcing the state to slash Medicaid programs or to bear the full costs on its own. Last year, the state spent roughly $1.8 billion -- more than one quarter of the total state budget -- on Medicaid programs, primarily on long-term care for the elderly and disabled.

While the administration today said it hopes to secure $12.4 billion over five years, that is merely the starting point for negotations. Other key questions are subject to negotiations, including "escape clauses" that would allow the state to walk away from the spending cap.

Carcieri officials could not outline a specific timeline for how long negotiations may take. But the $67 million in savings outlined in the state budget require an Oct. 1 implementation date for dozens of waiver-related changes.

Administration officials acknowledged earlier today that the Oct. 1 deadline may not be met. But the administration is "on the hook" to save $67 million and would do so regardless, according to the Adelita Orefice, the deputy secretary of health and human services.

-- Steve Peoples, Journal State House Bureau

 Tags  Carcieri global Medicaid waiver Medicaid

Comments

Dan said:

Wasn't the plan was supposed to be ready to go by now? Now he is applying for a blank check from the FEDS with no specifics? Why are we paying him and all his cronies to design plans that don't work or even exist? Where is his great plan for dealing with Council 94? We know "Governor Cancer" is a lame duck, but come on...... Somebody working for him must know something... Oops, I forgot, anyone with any knowledge gets fired like Bob Warren.

Link | July 29, 2008 2:18 PM
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info said:

Although the plan is a bit different from RI's, technically "the waiver concept,which has never been done before in any state", has been done in Vermont. They adopted a Global Commitment Waiver in the fall of 2005. Here is a link:
http://www.ncsl.org/programs/health/shn/2008/sn517a.htm

Link | July 30, 2008 12:50 AM
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EDWARD WALKER said:

This sounds like a very, very risky proposal and I question why this have never been considered by any other state.
I believe, in these tough financial times that we are now confronting, it is about time that we stop considering ourselves as independents and look at those proposals that other states have implemented to reduce costs that works.
Why try to re-invent the wheel here in Rhode Island all the time.
Perhaps just thinking how we can reduce costs by consolidating programs both on the state and municipal level would go a long way in helping things out financially.

Link | July 30, 2008 9:30 AM
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Barbara said:

Here we go again not only hurting the people who have the least and suffer the most, we are also making sure that those whose medicaid benefits are cut or limited will have to seek out the most expensive care available (e.g., hospital emergency rooms, inpatient treatment)that no one will be paying for. As usual, we continue to hurt the most vulnerable people, take the most from the people who can least afford it, and shoot ourselves in the foot by being so short-sighted! Maybe some more hopitials and nursing homes can go into bankruptcy or close so that no one can get care. Maybe we should put more people who work in public social services out of work - again the people who make the least and do the most! While we are at it - can't we give the rich some more tax cuts!!! As usual, (republican)government at its finest!

Link | July 30, 2008 10:46 AM
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