Rhode Island, White House Close To Deal On Global Medicaid Waiver
Rhode Island Gov. Don Carcieri (R) and acting CMS Administrator Kerry Weems on Monday announced that they are close to a deal on a "global Medicaid waiver," which would provide all of the state's federal dollars for its Medicaid program in one lump sum, the Providence Journal reports (Peoples, Providence Journal, 12/9).
In adopting a global waiver, the governor would agree to limit Medicaid spending to $12.4 billion through 2013. In exchange for capping spending, the state would receive broad authority to change services, such as nursing home care, subsidized transportation for the elderly and beneficiaries with disabilities, health insurance for low-income children and parents, and prescription drug coverage for seniors. State Department of Human Services Associate Director Murray Blitzer said that if the state runs out of its allotted funds before the five-year mark, it will lose matching federal funds, which would force the state to pay the program's full cost or cut services (Kaiser Daily Health Policy Report, 7/31).
The two parties have agreed to cap the amount the state receives for five years, but other provisions must be worked out. Carcieri said negotiators are categorizing potential Medicaid changes into three categories: those that could be adopted without federal oversight, those that would require expedited federal approval and "dramatic kinds of changes" that would require further discussion with CMS. He said, "It's the details of what are in each of those categories that we're really trying to work our way through." He added, "I am very hopeful that we'll have this thing resolved in the next week" (Providence Journal, 12/9).
Weems said, "Medicaid is eating into state budgets at a very, very rapid rate," adding, "We're going to run the experiment. The states are the great laboratories of democracy." According to the AP/Boston Herald, it "remains unclear" whether the incoming Obama administration could overturn such Medicaid agreements struck by states with the Bush administration (AP/Boston Herald, 12/8).
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