LTC Bullet: Rhode Island Ready

Monday, July 6, 2009

Philadelphia, PA--

LTC Comment: Our Rhode Island project spurs a White House press room Q&A and a national magazine article. Details, text and video, after the ***news.***

State X Project Donors: The following individuals and/or their companies contributed financially to support Phase 1 of our work in Rhode Island. All will be recognized in our report: Keystone ($5,000): Thomas Campbell Jackson; Foundation ($1,000 to $500): Rick Leonard; Sue Howarth; Phil Sullivan; Steve Forman; Building ($250 to $50): Claude Thau; B.J. Randolph; Teresa Eagan; Sally Leimbach; Honey Leveen; Bill Dorfii; Alan Jonas; Kyle Hitt; Annemiek Storm; Heady Nezhadpour. As our project is ongoing, additional support is needed and welcome.

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LTC BULLET: RHODE ISLAND READY

LTC Comment: As this LTC Bullet sends, I'm en route to Providence, RI. Tomorrow we begin four days of intensive briefings and interviews. The Ocean State Policy Research Institute (OSPRI) president and I are on a mission to (Phase 1) understand and (Phase 2) fix long-term care financing in Rhode Island.

Later this week, I'll send Center members "embed" reports from the LTC policy front in the Ocean State. As always, our LTC Embed reports provide members nearly real-time information about our field research and advocacy. You'll know who we meet with, anything important they tell us on the record, and what we think it means.

For now, here's some exciting news that shows we're really onto something in Rhode Island. The issues we're working on with the Ocean State Policy Research Institute (because of generous contributions from special "State X Project" donors) are getting national media attention!

A member of the White House press corps interviewed OSPRI president Bill Felkner and Center President Steve Moses, who is also an "OSPRI Health Reform Fellow," last Tuesday about Medicaid, long-term care financing and the Rhode Island Global Medicaid Waiver.

The next day, reporter John Gizzi asked White House press secretary Robert Gibbs about the potential use of similar waivers in other states. To see the exchange between Mr. Gizzi and Mr. Gibbs, click here, then go to the very last question in the July 1 press conference at about 42 minutes, 20 seconds in.

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Here's the transcript:

MR. GIBBS: Yes.

Q Thank you, Robert. Medicaid is a big part of the health care problem, and I think it's costing $300 billion a year, and that's a big reason the states need help. Last year the state of Rhode Island became the first and so far only state to get a waiver on Medicare. And of course --

MR. GIBBS: Medicaid?

Q Medicaid, sorry, on Medicaid. As it is, they'll allow Washington to put a cap on Medicaid funding and, in turn, if they can determine eligibility, put limits down and reform the system. Allowing states to have waivers on Medicaid, is that something that's on the table with the President now?

MR. GIBBS: Let me talk to the health team. I don't know the degree to which that's something that -- how much they've gotten involved in that. Obviously, I think you mentioned Medicaid represents a growing fiscal component for states, especially in harder economic times, and that obviously is something that has to be looked at and addressed in anything that's comprehensive.

But again, I think that also strengthens the argument for changing the way health care is done and ensuring that it's done in a way that's affordable, again, not just for families and small businesses but for state governments, as well.

Thanks, guys.

[Press conference ends]

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Reporter John Gizzi followed up with this story, also available online here.

White House Won't Rule Out Waivers to States on Medicaid

by John Gizzi

07/02/2009

As the cost of Medicaid soars and continues to be a major cause of financial turmoil for the states, the Administration won't rule out letting individual states get waivers from the 44-year-old program that was originally designed for lower-income patients and welfare recipients.

With so many people neither in lower-income brackets or on welfare on the Medicaid rolls, the price-tag on the program is nearly $300 billion a year. Last year, the state of Rhode Island sought a waiver from the federal Medicaid system, which was approved on January 16 of this year and signed by Kerry Weems, acting Administrator of the Center for Medicare and Medicaid Systems (CMS).

Much like the waivers in the 1990's that gave states a free hand to deal with ballooning welfare rolls (and were the genesis of the "tough love" welfare plan signed into law by President Clinton in 1996), the waiver on Medicaid permits Gov. Donald Carcieri and his health care team to determine eligibility requirements, toughen limits, and reform the system in Rhode Island.

Citing the example of Rhode Island at the White House briefing yesterday (July 1st), I asked whether allowing more states to have waivers is something that is on the table with President Obama as he grapples at a time when so many states are in the red because of Medicaid costs.

"Let me talk to the health team," Press Secretary Robert Gibbs told me, "I don't know the degree to which that's something that -- how much they've gotten involved in that. Obviously, I think you mentioned Medicaid represents a growing fiscal component for states, especially in harder economic times, and that obviously is something that has to be looked at and addressed in anything that's comprehensive.

"But again, I think that also strengthens the argument for changing the way health care is done and ensuring that it's done in a way that's affordable, again, not just for families and small businesses but for state governments, as well."

Whatever the Administration does, it is quite likely that, as Medicaid costs go up, the national press and other states will keep an eye on Rhode Island. There, Bill Felkner and the Ocean State Policy Research Institute (OSPRI) have been the driving force behind the waiver and are in the process of laying out specific proposals to cut costs of Medicaid. [The preceding sentence refers to our work with OSPRI in RI.] It also seems a good bet that Gov. Carcieri will have a lot to say about this during the upcoming National Governors Association (NGA) meeting in Mississippi on the weekend of July 25th.

John Gizzi is Political Editor of HUMAN EVENTS.

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Reporter Gizzi says this story will also be in the print edition of Human Events this week. Human Events is a conservative magazine. But whether you personally lean right or left politically, national coverage of our issue in any venue is terrific.

That's because our issue plays right or left equally well. For conservatives, it's fiscal responsibility. For liberals, it's a fairness issue. Why use scarce welfare resources to indemnify prosperous heirs of affluent seniors against Long Term Care costs when they're probably mostly Republicans anyhow? (Smile)

When the debate boils down to facts and logic, we win. That's why national media attention on our issue is so very important.