Connecticut Official Doesn’t Want Medicaid Cuts
MEDICAID
The Norwalk Hour
Kelly Carroll
Boston University Washington News Service
11/1/2007
WASHINGTON – A Connecticut state official has asked the U. S. Department of Health and Human Services to refrain from making cuts to long-running state Medicaid programs.
David Parrella, director of Medical Care Administration for the state Department of Social Services, testified in Congress Thursday that proposed cutbacks in programs and funds would do more harm than good.
“Despite the occasional messiness that ensues in a program of this size, we are not a runaway train on spending,” he said at a hearing of the House Oversight and Government Reform Committee. “To restrict the state option to use Medicaid to fund any of these activities will only make life harder for the millions of poor Americans who look to you for answers on health care.”
The Centers for Medicare and Medicaid Services has recently proposed several restrictions to Medicaid state programs to correct what the Government Accountability Office called “inappropriate financing arrangements.” According to Marjorie Kanof, representing the agency, these arrangements, particularly a state’s ability to shift fiscal responsibility for Medicaid services to the federal government instead of its own, have had “significant fiscal implications for the federal government and states.” She also noted that although the exact amount is not known, “additional federal funds generated through these arrangements…was in the billions of dollars.”
Kanof, who is the managing director of health care for the agency, added: “States’ use of these creative financing mechanisms undermined the federal-state Medicaid partnership as well as the program’s fiscal integrity. States must share in Medicaid costs in proportions established according to a statutory formula.”
Rep. Chris Shays (R-4th), a member of the committee, agreed that states should pay their proper share of Medicaid costs.
“If I was governor, I would say to my staff, ‘I want you to get as much money out of the federal government as you can get,’” he said in an interview. “The problem is, that’s not being true to the program. It’s finding loopholes and taking advantage of them. I’m not a state legislator. I’m a member of Congress, and I have an obligation to make sure our federal dollars are spent honestly.”
In his testimony, Parrella said that, with these restrictions, the Centers for Medicare and Medicaid Services is trying to put new limits on how a state can raise its share of Medicaid funding, as well as trying to redefine what services are coverable. According to Parrella, who has experience working in the Medicaid field, Washington has good reason to worry about the integrity of its program, but in some areas, Washington is incorrect.
“They maintain that the elimination of $20 billion in federal Medicaid funding for Medicaid administrative activities…is appropriate because these activities were never intended to be part of Medicaid, despite decades of approved state plan amendments across the nation,” he said in his testimony. “It is surprising that this philosophy should come at a time when most experts in the field would say that the nation’s health care system is in a state of crisis.”
Shays, on the other hand, said that none of the planned changes would kill any program within Medicaid. Instead, they would slow the increase in spending by only eight-tenths of a percent.
“There’s no cuts here, this is slowing increase,” he said. “There’s more money being spent. We are spending tens of billions more dollars every year. It’s just an issue of who has to make up” the extra spending
Connecticut, through Medicaid, its HUSKY A program for uninsured children, and state-administered general assistance, is able to provide health care for low-income people. According to Parrella, Connecticut has not had a problem with inappropriate financing of programs or with shifting costs from the state government to Washington.
“Where money wasn’t being spent on the health care providers…that’s what they are really trying to clamp down on. But we don’t have any history of that,” he said.
If there is a problem in other states, he said, “then they should issue regulations about that. Very simply, if you’re going to spend Medicaid money, the money should go to Medicaid providers and pay for Medicaid services. Period. End of story.”
###
