If a deal to reduce theĀ deficit results in lower federal payments to states for Medicaid and the Childrenās Health Insurance Program, then the National Governors Association will say no thanks.
As part of the ongoing negotiations between the White House and Capitol Hill, one proposalĀ wouldĀ combine the federal governmentās Medicaid and CHIP payments into a singleĀ blended rate for each state. A analysisĀ says that change would mean less federal funding for already cash-strapped states, likely forcingĀ state governments to reduce services and cut payments to health care providers.
āIf the blended rate ā¦ is intended to do some good things for the states for us to administer at the ground level, weād like to have that conversation,āĀ Ā Gregoire, a Democrat, said. āIf on the other hand itās code for dramatic cuts, thatās a different subject. And, unfortunately, thatās what most of the governors believe that it is. ā¦ If blended rates is code for cutting benefits and cutting people, that is going to be a huge problem to the states, where weāre already struggling because of the recession with increased case loads.ā
Department of Health and Human Services Secretary Kathleen Sebelius counters that āthe blended rateĀ in and of itself doesnāt necessarily lower contributions to states. It really depends on what the underlying premise is.ā
āIs it easier for states to have one rate and know what their match is? Probably. Is that something that then is going to be accompanied with a decrease in funding? Thatās the point at which I think a lot of states are nervous,ā said Sebelius, herself a former governor. āItās really what happens with the underlying assumptions of what the federal contribution is.ā
A blended Medicaid-CHIP rateĀ could also provide some administrative simplification to states, Sebelius noted.Ā The CBPP analysis foundĀ that any administrative savings would be āslight.ā
Sebelius and Gregoire addressed the Medicaid blended rate issue during an HHS call with reporters Ā announcing the agencyĀ said would help states reduce the cost of care for 9 million Americans who are eligible for both Medicare and Medicaid, known as ādual eligibles.ā Ā The proposal includesĀ demonstration programsĀ to test models to help states share the savings from coordinating care for duals andĀ to help states improve the quality of care for people in nursing homes. HHS also announced a ātechnical resource centerā to help states improve care for dual eligibles.