Rhode Island Plan To Revise Medicaid Program Risky
Rhode Island Gov. Donald Carcieri (R) last month asked CMS to approve a waiver that would allow the state "to change much of its Medicaid program from an open-ended entitlement with no limit on spending to a capped budget with fixed expenditure limits" as part of a plan to address "looming budget deficits and curb rising Medicaid costs, two problems that are bedeviling many states," a New York Times editorial states.
Rhode Island officials hope "to make up the difference, without harming patients, by providing health care more cheaply" and seek to require "most long-term care patients to get treatment at home or from community-based services rather than in expensive nursing homes," the editorial states. "If that isn't enough, it wants flexibility to charge higher copayments, put people on waiting lists for treatment, and limit the duration and scope of services," according to the editorial.
States "already have great leeway when it comes to Medicaid, so it may be reasonable to give Rhode Island the flexibility to try something new," but the plan "is still a risky path," according to the editorial. In the event that costs "escalate more rapidly than expected and savings don't materialize, the state might feel obliged to cut Medicaid spending even more drastically," and "Rhode Island's most vulnerable citizens would pay the price," the editorial states. The editorial adds that "prudent leaders would be wise to watch what happens -- and especially what happens to Rhode Island's poorest residents -- before following this path" (New York Times, 9/15).
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