[NYAPRS Enews] Senate Health Bill Would Change State's Medicaid Reimbursement

[Harvey Rosenthal]

Senate Health Bill Would Change State's Medicaid Reimbursement

Brian Tumulty Washington Bureau  Gannett News Service  September 20,
2009

 

New York and other states would help pay for expanding the number of
people eligible for Medicaid, under the health care reform proposal
drafted by Senate Finance Committee Chairman Max Baucus.

 

The 10-year cost of the Senate bill is estimated at $856 billion - much
less than the cost of House health care legislation, in part because it
would do less to compensate states for expanding Medicaid eligibility to
single adults and families earning up to 133 percent of the federal
poverty level.

 

On average, states would face a 0.98 percent increase in their Medicaid
costs, according to Baucus, D-Mont., who unveiled his bill Wednesday.
Medicaid is the federal-state health insurance program for the poor.

 

Costs would not be evenly spread under the Baucus plan, and New York
would get a less generous federal subsidy than most other states because
it already is closer to the proposed Medicaid expansion.

 

For example, most states provide Medicaid coverage to single adults only
if they are disabled. New York allows coverage for all single adults
with incomes up to the federal poverty threshold of $10,830 for singles.

 

The threshold is higher for larger households -- $14,750 for a family of
two and $18,310 for a family of three.

 

New York also covers childless couples up to the poverty threshold;
parents up to 150 percent of the poverty level; and pregnant women
earning twice the poverty threshold.

 

Children also have generous coverage in New York, and if they aren't
eligible for Medicaid, the State Children's Health Insurance Program
(SCHIP) will cover them if their family has an income up to four times
the poverty threshold. New York's SCHIP coverage is the most generous in
the nation.

 

The Senate plan also would provide subsidies to families and individuals
earning between the poverty threshold and 133 percent of poverty to help
them purchase insurance through a new exchange program.

 

Baucus said he told some governors in a conference call the day before
the bill was unveiled that drug rebates would at least partially pay for
those subsidies. The prescription drug rebate, created in 1990, requires
drug manufacturers to enter into an agreement with federal health
officials to offer the rebate to Medicaid state programs.

 

What matters most to New York and other states already close to the
proposed new Medicaid eligibility standard is that they would qualify
for an increase of only 27.3 percentage points in their federal Medicaid
aid in 2014. States with more restrictive rules would get an increase of
37.7 percentage points.

 

Moreover, the federal Medicaid formula aid for New York already is one
of the lowest in the nation, with the federal government reimbursing the
state for 50 percent of its costs. Other states get more than a 70
percent.

 

In New York, county governments share the cost, paying a quarter out of
every dollar spent on Medicaid. The impact on county governments would
be capped because the state does not allow their share of the costs to
grow more than 3 percent a year, according to a state health official.

 

http://www.lohud.com/article/20090920/NEWS05/909200333/1026/NEWS10/Senat
e-health-bill-would-change-state-s-Medicaid-reimbursement 

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