LTC Bullet: Open Letter to Governors on Medicaid and LTC

Thursday, May 15, 2003

Santa Fe, NM--

LTC Comment: The states' fiscal crisis does not have to ruin Medicaid if Governors act quickly to target and improve LTC eligibility. The Center for Long-Term Care Financing can help. More after the ***news.***

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*** Here's an example of why state Medicaid programs need help: "Gerald E. Hunter. California is About to Pull the Plug on Nursing Homes with Budget Cuts. Morgan Hill Times (CA), May 6, 2003. Section: Editorial. Gerald Hunter, executive director of the Gilroy Healthcare and Rehab Center asks readers to take notice of California's burgeoning nursing home crisis. Victims of chronic under-funding, lack of long-term state planning, over-regulation, increasing costs and now the prospect of additional funding cuts of from 15-22 percent, nursing homes in the state are teetering on the brink of disaster. With 11 percent of the state's homes already in bankruptcy, and many more planning to close if further budget cuts are implemented, the elderly and frail are facing the often-deadly trauma of having to move. Hunter asks, 'Who will provide the care? Think about it.' " Source: AHCA/NCAL Gazette, May 7, 2003. ***

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LTC Comment: State budgets are hurting. Medicaid, America's LTC safety net, is suffering. Huge cuts in eligibility and services already underway or under consideration will hurt the poor first and most, but formerly prosperous recipients who qualified through Medicaid planning will feel the pain too. We think there is a better way. Instead of taking a meat-axe to their home and community based waivers and other Medicaid LTC services, states can target Medicaid more effectively to the genuinely needy, encourage reliance on private financing sources such as home equity conversion, and use part of the savings to encourage the purchase of private LTC insurance with state tax credits and deductions. We estimate states can save at least five percent of their Medicaid nursing home budgets in the short run and twenty percent or more over time by implementing thoughtful reforms. The Center for Long-Term Care Financing recently sent the following letter to all State Governors (and Lt. Governors, Medicaid directors, and AHCA, AAHSA, and ALFA State affiliates) offering to help assess the problem and propose solutions. LTC Bullets readers who would like to see our LTC Choice or Magic Bullet recommendations implemented are encouraged to forward this issue of LTC Bullets to your Governors, state legislators, Medicaid administrators, and local media. Invite them to check out the Center for Long-Term Care Financing at and to contact Executive Director Amy McDougall (425-377-9500 or to set up a meeting or conference call.

May 2, 2003

Dear Governor,

With most states facing their worst budget crises since WWII, Governors have to think outside the box more than ever. Burgeoning Medicaid long-term care costs have caused some state executives to consider draconian cuts in Medicaid services, eligibility, and provider reimbursements. How can you minimize such reductions or avoid them altogether, while still controlling Medicaid LTC expenditures?

The Center for Long-Term Care Financing is a 501(c)(3) charitable, nonprofit, nonpartisan think tank and public policy organization. Our mission is to "ensure quality long-term care for all Americans." We believe our analysis, experience, and creativity can help state governments reduce Medicaid dependency and increase private financing of long-term care. Our goal is to save states 20 percent or more of their nursing home budgets while empowering Medicaid to provide a wider spectrum of higher quality long-term care.

If you and your advisers are not completely confident about the answers to the following questions, I urge you to contact the Center's Executive Director Amy McDougall at 425-377-9500 to set up a meeting or conference call.

If these questions raise the slightest concern in your mind, rest assured the Center for Long-Term Care Financing can assess your Medicaid program and make money-saving, politically sensitive recommendations that will improve long-term care for all your constituents: rich, poor, and in between.

Thank you for your time and consideration. Please check out our work products and bona fides at My direct dial line is 206-283-7036 or email,


Stephen A. Moses
President, Center for Long-Term Care Financing