States consider options for funding Medicaid

The Billings Gazette: Montana lawmakers questioned the state's top health official "about plans to hire a private company to manage part of Medicaid, asking why the administration hasn't had a more public discussion on the proposal." The Legislative Finance Committee also listened to "health care providers and former officials who experienced the state's 1995 foray into private management of Medicaid for the mentally ill — and how it became a disaster for its low-income patients and their providers." Gov. Brian Schweitzer has proposed a "demonstration project" in five counties that would contract with a private firm to manage care for Medicaid patients. State health care providers said they had not been informed of the plan (Dennison, 11/16).

The Associated Press: Schweitzer also "asked Tuesday for federal permission to sell cheaper prescription drugs in his state through the federal Medicaid program, a proposal he expects will catch the eye of other cash-strapped states." Schweitzer expects the waiver "would allow Montana residents to get the drugs at about half the retail price," since the "federal government can get cheap drug prices for Medicaid…because of Congress' negotiations with special interest groups." Schweitzer said his plan would "cost the government nothing -- and could even save it money because it would open up the doors for government-subsidized Medicare patients to buy-in at the cheaper Medicaid rate." The waiver, which would come from the Centers for Medicare & Medicaid Services, comes with a lengthy application process that could delay an answer for several months (Gouras, 11/16).

The (Springfield, Ill.) State Journal-Register: Illinois Gov. Pat Quinn is touting federal health-care reform as an "opportunity to transform Medicaid into a program that saves money, keeps patients healthier and attracts more doctors." In 2014, the federal law will expand Medicaid "to anyone with a household income below 133 percent of the federal poverty level," including "large numbers of low-income adults without children." The expansion could add 700,000 to 800,000 people to Illinois' Medicaid program. "By law, all of the costs associated with a Medicaid expansion will be picked up by the federal government until 2019. … After that, the feds will cover 90 percent of the expansion cost, leaving the state with about $200 million in expansion-related expenses each year." Quinn's administration believes the state could keep patients healthier and avoid "costly and wasteful care" through "an expansion of managed-care and better-coordinated care" (Olsen, 11/16).

NPR: "In Arizona, 98 low-income patients approved for organ transplants have been told they are no longer getting them because of state budget cuts" to the Arizona Health Care Cost Containment System, the state's version of Medicaid. "Facing a $1.5 billion budget deficit, Arizona has cut out all state-funded lung transplants, some bone-marrow transplants and some heart transplants." Arizona says the cuts will save $4.5 million this year, and "data also show the procedures have poor outcomes and that most patients die after the transplants" (Robbins, 11/17).

The (Baton Rouge, La.) Advocate: "Health insurance companies are stepping up their campaign to take over part of Louisiana government's health insurance program for the poor," while "Louisiana's pediatricians joined a coalition of health-care groups working on an alternative provider-directed, patient-centered plan similar to one in North Carolina that has no insurance company involvement." The Jindal administration scheduled a public forum on Wednesday "to discuss the restructuring of Louisiana's health-care delivery system for the poor," after it received heavy criticism of its proposed "insurance-based 'coordinated care networks'" and decided to halt their implementation (Shuler, 11/16).

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This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.