Last updated: Dec. 23, 2003

STATE SENATE MEDICAID REFORM TASK FORCE RECOMMENDS SOME REAL REFORMS AND SOME BRUTAL CUTS – A MIXED BAG FOR OVER 3,000,000 NEW YORKERS WHO RELY ON
MEDICAID

News Analysis by Michael Kink


A State Senate Task Force issued recommendations for reform of New York’s
$42 billion Medicaid program Monday in Albany. The report included many
positive recommendations, including reforms that would decrease reliance on
high-cost nursing homes and increase access to consumer-directed and
community-based care for people with serious disabilities, including
HIV/AIDS; a Preferred Drug List that could cut the cost of drugs by billions
without hurting individual health (if it’s done right); and increased
emphasis on disease management, care coordination and preventive care.

But we’re concerned about exactly how the Senate reformers propose to cut
$2.5 billion from Medicaid (their stated goal) without hurting
beneficiaries. We know the state can save money by reducing the cost of
drugs, and we’re optimistic that the Senate Republican leadership has gotten
behind independent living principles that people with disabilities have
fought for for 30 years.

But other aspects of the proposal are just plain scary. Senate reformers
want to move low-income kids off Medicaid and onto Child Health Plus, which
could lead to the loss of important lifesaving services for children with
serious disabilities and health problems. They want to cut benefits and
increase "cost-sharing" in the Family Health Plus program, which provides
health coverage to nearly 800,000 lower-income working New Yorkers. They
propose new restrictions on the spouses of disabled elderly beneficiaries
who need to go into nursing homes. And they have proposed an intensive
utilization review program, which could be a good thing if it’s used to
improve access to needed care, but which also could be a blunt instrument to
ration care for the needy if placed in the wrong hands.

The best thing about yesterday’s Task Force report was the tone and tenor of
the presentation. Senate Majority Leader Joseph Bruno said clearly and
unequivocally that "it is the responsibility of a civilized society to
provide health care for those who are in need." Task Force co-chairs
Raymond Meier and Kemp Hannon said their aim was to maintain, improve and
increase care for those most in need, while establishing a strong and smart
policy for the Medicaid health care infrastructure going forward. Those are
goals we can support.

We were also happy that Bruno and the other Senators refrained from hostile
or demonizing rhetoric when talking about Medicaid and Medicaid
beneficiaries. Compared to the aggressive attacks on the poor we saw in
1995 and 1996, yesterday’s press conference was a significant and
substantive improvement.