More questions on the Medicaid waiver

Pat is wondering whether a directive by White House chief of staff Rahm Emanuel will stop Governor Caricier's global Medicaid waiver.

Meanwhile, the NYT -- which has a front-pager today looking at growing Medicaid costs in a number of states, has a sidebar on how Rhode Island is pursuing a different approach.

The agreement calls for Rhode Island to limit Medicaid spending to $12 billion over the next five years, a move critics call foolish in light of the worsening economy. The state had an unemployment rate of 9.3 percent in November, one of the nation’s highest, and some fear that the $12 billion amount will not begin to suffice if more people qualify for Medicaid.

But Gary D. Alexander, director of the state’s Department of Human Services, said Rhode Island’s Medicaid rolls had bucked the national trend by decreasing over the last year, a phenomenon he could not explain.

The continued march of unanswered questions about Carcieri's plan, the lack of resistance by the General Assembly, and the Congressional delegation not publicly objecting until the eighth hour, remain rather striking.

Even with the savings in the current budget having been marked down significantly, the absence of stronger opposition may mostly reflect a reluctance to make up costs in other ways.

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