Perspective               

Medicaid Overhaul Imperils Coverage for Low-Income Older and Disabled Americans

Department of Health and Human Services Secretary Tommy Thompson outlined the Bush Administration's plans to redesign Medicaid last month, offering states more "flexibility" in exchange for capped federal funding. Under this plan, "dual-eligibles," the low-income people with Medicare also enrolled in Medicaid, could lose critical prescription drug and long term care benefits not covered under Medicare.

The plan gives states the choice of continuing their Medicaid programs as is or receiving capped allotments for Medicaid that could potentially give states additional funds amounting to hundreds of millions of dollars over the next seven years. Health care advocates warn that the funding cap would force states to spend less on each enrollee as the Medicaid rolls swell with the aging of the baby boomer population, effectively ending Medicaid as an entitlement program.

According to the Kaiser Family Foundation, serious budget shortfalls have already driven 49 states to consider or enact Medicaid eligibility restrictions or reductions in optional but critical benefits, such as prescription drug coverage, hospice care, and dental and vision services.

_________________________________