State lawmakers push for Medicaid control

CURT WOODWARD

Associated Press


SEATTLE - Lawmakers from across the nation are pushing for more freedom in running the massive Medicaid health care program, saying the current setup is unwieldy and destined to collapse if costs aren't controlled.

"Everybody believes that the program can't sustain itself over time," said Joy Johnson Wilson, health policy director for the National Conference of State Legislatures. "We can either come up with a plan or we can wait for crash and burn."

The conference's Medicaid proposal, due for a final vote Friday at the group's annual convention, calls on Congress to give states more control over several areas, including eligibility, benefits and prescription drugs.

Such changes should allow states to find cost-cutting avenues without revoking coverage from the needy, said Wyoming Republican state Sen. Charlie Scott, a member of the group's health committee.

"States are the laboratories. Let us experiment," Scott said Thursday.

States and the federal government expect to spend about $329 billion this year on Medicaid, the joint health care program for the poor and disabled that serves about 53 million people. Scott said his home state, like many others, has seen the cost of Medicaid grow by 8 percent to 10 percent a year.

"Basically, any program that goes up with that kind of growth is going to be trouble," he said.

Federal lawmakers are trying to reduce Medicaid spending by $10 billion over the next five years, and the legislatures' conference is trying to influence that decision.

One notable plank of the proposal would allow states to alter the eligibility tests for Medicaid.

Under the current system, administrators spend too much time trying to determine which category a Medicaid applicant fits into, Wilson said. Allowing states to switch to a more straightforward means test would ease that problem, she said.

The conference's proposal also asks for the freedom to charge some Medicaid patients higher co-payments and other fees.

That measure is intended to make the program act more like private coverage for patients with higher incomes, who sometimes opt for the government health plan even if they are eligible for insurance through an employer.

The nation's governors also have called for the ability to charge co-pays, but that approach has been criticized by watchdogs who say more fees could drive the poor away.

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National Conference of State Legislatures: http://www.ncsl.org