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Inside Deficit Reduction: What it Means for Medicaid

Thursday, November 10, 2011

Medicaid currently provides health and long-term care to 68 million Americans, and the Patient Protection and Affordable Care Act would significantly expand Medicaid beginning in 2014. As a countercyclical program, Medicaid typically faces increased enrollment at the same time that states are looking to cut their budgets. Although the Budget Control Act of 2011 exempts safety-net programs like Medicaid from across-the-board cuts, Medicaid has remained a keenly debated topic in discussions of how to reduce the deficit.

Which proposals affecting Medicaid might receive serious consideration by the “super committee” in its quest to find $1.2 trillion or more in savings by its November 23 deadline? What impact would these changes have on the populations served by this program, providers, and states? Will suggested reforms “bend the cost curve” or simply shift costs among states, the federal government, and beneficiaries? How do states’ current efforts to reduce their Medicaid budgets fit in? When major changes have been made to Medicaid in the past, how have beneficiaries and stakeholders been affected?

To address these questions and more, the Alliance for Health Reform and four cosponsors presented a November 10 briefing. Panelists were: Tim Westmoreland of Georgetown University, former director of the Medicaid program at HCFA (now CMS); Tony McCann of Georgetown University and the University of Maryland, formerly of HRSA; Andrew Allison, executive director of the Kansas Health Policy Authority and founding president of the National Association of Medicaid Directors; and DeAnn Friedholm, director of the health care reform team at Consumer’s Union. Ed Howard of the Alliance, Diane Rowland of Kaiser and Bruce Chernof of The SCAN Foundation co-moderated. Along with the Alliance, cosponsoring the event were The Commonwealth Fund, the Kaiser Family Foundation, the Robert Wood Johnson Foundation and The SCAN Foundation. This briefing was the third in a four-briefing series on the mechanics, dynamics and politics of deficit reduction. The last briefing in the series will take place in December.


Diane Rowland, Kaiser Family Foundation, Moderator
Bruce Chernof, The SCAN Foundation, Moderator
 Tim Westmoreland, Georgetown University, Speaker
 Tony McCann, Georgetown University and the University of Maryland, Speaker
 Andrew Allison, Kansas Health Policy Authority, Speaker
 DeAnn Friedholm, Consumers Union, Speaker
(Click on the camera icon to see a video of the speaker's presentation.)

Transcript, Event Summary and/or Webcast and Podcast

Transcript: Transcript (Word Document), 11/10/2011
Event Summary: Event Summary (Adobe Acrobat PDF), 11/18/2011

The full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.

Speaker Presentations

Allison Presentation (Adobe Acrobat PDF), 11/10/2011
Chernof Presentation (PowerPoint), 11/10/2011
McCann Presentation (PowerPoint), 11/10/2011
Rowland Presentation (PowerPoint), 11/10/2011

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Source List (Adobe Acrobat PDF), Alliance for Health Reform, 11/10/2011
Materials List (Adobe Acrobat PDF), Alliance for Health Reform, 11/10/2011
Speaker Bios (Adobe Acrobat PDF), Alliance for Health Reform, 11/10/2011
Agenda (Adobe Acrobat PDF), Alliance for Health Reform, 11/10/2011
Event Summary (Adobe Acrobat PDF), , 11/18/2011

Offsite Materials (briefing documents saved on other websites)

A New Medicaid: A Flexible, Innovative and Accountable Future, Republican Governors Public Policy Committee, 8/30/2011
Solving the National Medicaid Crisis, The Heritage Foundation, 5/6/2011
- Blase, Brian
DataBrief: Dual Eligibles Across the States (Adobe Acrobat PDF),The SCAN Foundation, 10/31/2011
DataBrief: Dual Eligibles, Chronic Conditions, and Functional Impairment (Adobe Acrobat PDF),The SCAN Foundation, 10/31/2011
Medicaid: A Lifeline for Blacks and Latinos with Serious Health Care Needs, Families USA, 10/1/2011
DataBrief: Dual Eligibles – Health Services Utilization (Adobe Acrobat PDF),The SCAN Foundation, 2/28/2011
DataBrief: Eligibility Pathways for Dual Eligibles (Adobe Acrobat PDF),The SCAN Foundation, 2/28/2011
Updates on State Budgets in Recession and Recovery, Kaiser Family Foundation, 11/1/2011
- Gordon, Tracy
The High Cost of Capping Federal Medicaid Funding (Adobe Acrobat PDF),AARP Public Policy Institute, 4/30/2011
A Profile of Medicaid Managed Care Programs in 2010: Findings from a 50-State Survey (Adobe Acrobat PDF),Kaiser Commission on Medicaid and the Uninsured, 9/1/2011
- Gifford, Kathleen, Vernon K.Smith, Dyke Snipes, and Julia Paradise
House Republican Budget Plan: State-by-State Impact of Changes in Medicaid Financing, Kaiser Family Foundation, 5/31/2011
Implications of a Federal Block Grant for Medicaid, Kaiser Family Foundation, 4/30/2011
Republican Consensus Recommendations to The Joint Select Committee on Deficit Reduction, US Senate Committee on Finance, 10/1/2011
Letter to The Joint Select Committee on Deficit Reduction (Adobe Acrobat PDF),America's Hospitals and Health Systems, 10/12/2011
Recommendations to The Joint Select Committee on Deficit Reduction, US House of Representatives Committee on Energy and Commerce, 10/13/2011
Medicaid and the Budget Control Act: What Options Will Be Considered? (Adobe Acrobat PDF),Kaiser Family Foundation, 10/31/2011
Medicaid Financing Issues: Provider Taxes (Adobe Acrobat PDF),Kaiser Family Foundation, 5/31/2011
Proposal to Establish Federal Medicaid Blended Rate‟ Would Shift Significant Costs to States, Center on Budget and Policy Priorities, 6/24/2011
- Park, Edwin and Judith Solomon
Untangling Medicaid Myths, The Boston Globe, 11/7/2011
- Nordahl, Kate and Sarah Iselin
Medicaid Matters…in Super Committee Deficit Reduction Deliberations (Adobe Acrobat PDF),Paraprofessional Health Institute, 9/30/2011
Moving Ahead Amidst Fiscal Challenges: A Look at Medicaid Spending, Coverage and Policy Trends, Results from a 50 State Medicaid Budget Survey for State Fiscal Years 2011 and 2012 (Adobe Acrobat PDF),Kaiser Family Foundation, 10/31/2011
Governors Scramble to Rein in Medicaid, The Wall Street Journal, 2/28/2011
- Murray, Sara, Janet Adamy and Neil King JR.


Tony McCann, recently retired as chief financial officer at the Health Resources and Services Administration, noted that Medicaid is really four distinct programs,  at the Nov. 10 briefing cosponsored by the Alliance, The Commonwealth Fund, the Kaiser Family Foundation, the Robert Wood Johnson Foundation and The SCAN Foundation. (18 min.)

Tim Westmoreland of Georgetown University's Law Center outlines why he thinks cutting Medicaid funding during a recession is a very bad idea. From the Nov. 10 briefing on deficit reduction cosponsored by the Alliance, The Commonwealth Fund, the Kaiser Family Foundation, the Robert Wood Johnson Foundation and The SCAN Foundation. (11 min)

Andrew Allison, director of the Kansas Div. of Health Care Finance, notes that care for the elderly and disabled is a major cost driver for Medicaid in his state, not enrollment increases. From the Nov. 10 briefing on deficit reduction sponsored by the Alliance, The Commonwealth Fund, the Kaiser Family Foundation, the Robert Wood Johnson Foundation and The SCAN Foundation. (13 min.)

DeAnn Friedholm of Consumers Union urged that Medicaid budget cutters keep in mind the people affected by the cuts, at the Nov. 10 briefing on deficit reduction. Cosponsors were The Commonwealth Fund, the Kaiser Family Foundation, the Robert Wood Johnson Foundation and The SCAN Foundation. (11 min.)


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