Carcieri's big Medicaid gamble

Governor Carcieri touts a federal Medicaid waiver as a ticket to savings in the Rhode Island budget, but it seems as if an awful lot of questions about how this will work remain unanswered. Given how the Ocean State has a very high percentage of elderly residents, this plan comes with considerable risk.

From the ProJo:

And last week’s federal approval is just one step in a process that the governor now says could take several years to fully implement and probably won’t achieve the initially projected $67 million in savings for the budget year that ends June 30.

The administration is still months away from rolling out some of the proposal’s more dramatic details, including new eligibility criteria for admission to nursing homes. In the near future, only those considered to have the “highest need” will be guaranteed Medicaid-subsidized admission.

“I just got off the phone with [U.S. Secretary of Health and Human Services Michael] Leavitt,” Carcieri said yesterday. “… He reiterated again the importance of this as a demonstration to the nation of what can be done with the management of Medicaid funding and Medicaid programs.”

While the governor cites flexibility, critics fear the plan would force hundreds of elderly people out of nursing homes and reduce medical services for the poor. For example, going forward, Medicaid recipients would be placed into three categories, with nursing home placement guaranteed only to those with the highest level of medical need.

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