Volume 11 Number 223
Monday, November 20, 2006
ISSN 1091-4021

The Medicaid Commission Nov. 17 adopted a set of long-term recommendations designed to improve the future stability and financial sustainability of the Medicaid program.

The recommendations adopted largely reflect the proposals set forth in the commission chairman's mark, which were discussed during an open session with public testimony Nov. 16 (No. 222 HCDR 11/17/06). But the commission also adopted several amendments during the Nov. 17 voting session.

The recommendations contained in the chairman's initial mark are designed to:

• promote greater personal responsibility in planning for long-term health care needs;
• increase flexibility for states to design their Medicaid benefit and simplify eligibility categories
• continue support for the use and adoption of health information technology, pay for performance, and price transparency; and
• expand coordinated care of beneficiaries, including a managed care program for dual eligibles.

Adopted Amendments

The additional recommendations adopted by the commission include proposals to study alternative insurance models for long-term care and examine "scaled match" federal funding for states that add lower-income populations to their Medicaid programs.

Other amendments included proposals to encourage states and the federal government to share in any savings achieved through "innovative case management" strategies for dual eligibles, and encourage the federal government to provide new options for uninsured individuals to obtain private health insurance through refundable tax credits or other subsidies to keep them from "defaulting" into Medicaid. The commission also adopted a proposal to encourage federal and state agencies to ensure that new or upgraded HIT systems meet certain accessibility requirements.

Department of Health and Human Services Secretary Michael O. Leavitt established the Medicaid Commission in May 2005. The first commission report was issued September 2005 and made recommendations on how to reduce Medicaid spending by $11 billion over a five-year period (No. 170 HCDR 9/2/05).

The commission's report on long-term reforms is due Dec. 31.

Dingell Downplays Significance

Rep. John Dingell (D-Mich.), who is expected to become chairman of the House Energy and Commerce Committee when Democrats take over the House in January, downplayed the significance of the commission report.

"While some in Congress thought this effort would bear fruit, I see no proof of that in this report," Dingell said in Nov. 17 statement. "It is the job of the Congress to review the Medicaid program and legislate necessary changes, not a hand-picked Commission stacked against working families."

More information on the Commission.