In the meantime, the new Governor of New Hampshire is backing off the plans that were being developed during the prior administration. Part of that plan is to focus on community based services in lieu of nursing home care. Another part was reported to be something along the lines of health savings accounts (HSA).
While New Hampshire is holding off, the word is the Jeb Bush, in Florida, facing Medicaid costs himself, is going to push some form of health savings account as well.
I don't know the details of either HSA proposal, but it'll be worth
looking into. I'm skeptical upfront though. Afterall, by Medicaid
definition, we're talking about a poor population. So the ability to
effectuate the "savings" in Health "Savings" Account should be
challenging. Less well known, but perhaps even more important is that
most people are on Medicaid for short spells. In New York, the average
length of time on Medicaid is a bit over nine months. While the bulk of
spending is made on behalf of those enrolled for longer periods, it
will still be interesting to see how poor people are supposed to "Save"
for significant care or coverage in a short period.
And in Tennessee, their innovative TennCare program is caught in a brutal fight, with the Governor proposing substantial cutbacks.