Over five years, the Congressional Budget resolution requires $10 billion in Medicaid cuts. And the National Governor's Association and the National Conference of State Legislators are working away developing proposals to meet the $10 billion goal without taking it out of the hides of the states.
Newsday thinks New York should be one of the states that cuts Medicaid costs. They got most of it right, especially the emphasis on institutional focus of policy and care in New York. There were a couple of exceptions:
- Most everybody these days is blaming middle and upper class folks who dump their assets or put them in trust in order to become eligible for Medicaid financed nursing home care. Yet, I can't recall a single article or paper that presents any data on the scope of this problem. They also call for incentives for private long term care insurance. Hey, I thought we'd already done it, but this is a notion that I've always thought was low leverage. So I'm not surprised that whatever incentives we have tried haven't made much of a dent. This coverage is too expensive. Don't ever expect it to make much difference. More importantly, for all the rhetoric, the centerpiece of New York's long-term care policy is nursing homes. Keep people out and even if they require assistance, they will burn up their assets at a much slower pace and Medicaid's cost will be lower.
- Local share. Newsday notes that "it's good that the state is finally planning to cap the local share, but it must do so in a way that doesn't penalize poorer counties." Nice sentiment, but isn't this a done deal? Seems to me that there would be some real risk for localities if the new cap were re-opened. They might wind up with less than they already got.
Well, we'll see what all those folks have to offer. Whatever it is, it's not likely to be pleasant. That's especially so in New York because of the new cap on on the local share of Medicaid costs. We'll cover that extensively later in the week.