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Join the Medicaid Debate, Challenge Governors
January, 2005

Bob Kafka of ADAPT, writes:

Dear Supporters:

If Not Now! When? Medicaid Reform in the 109th Congress!!!!!!

The Community First Resolution the Governors will be considering at the National Governors Assn (NGA) Winter Conference (attached) in DC February 2005 will have major implications for the future of Medicaid in our country. What the NGA supports/opposes will influence Congress and the Bush Administration.

Governor Rendell of Pennsylvania has introduced the resolution that has the support of ADAPT and other national advocacy groups in the country. ADAPT asks for all national organizations to support the Community First Resolution.

It is important that all the Governors support the Community First! Resolution and the principle of the ADA's "most integrated setting."

Please contact or have your members contact their Governor's office and ask for their support of the Community First! Resolution.

Summary of the Community First Resolution

  1. Support for Federal legislation to end the institutional bias in the long term care system;

  2. Implementation of the Olmstead decision so no individual is forced to live in a nursing home or other institution because of the lack of home and community services;

  3. Medicaid reform should not result in block granting or losing any of the current Medicaid protections

Happy New Year
For an Institution Free America,
The ADAPT Community

ADAPT National Action February 26th-March 2nd Washington, DC
FOR INFO: 512/442-0252 or 303/733-9324

Steve Gold, writes:

PWD, YOUR GOVERNOR AND "REFORMING" MEDICAID - THE BATTLE CONTINUES - Information Bulletin #75 12/04

The NYTimes front page story on 12/26/04 was entitled "Governors Unite In Medicaid Fight." In all likelihood, this will be the disability fight for 2005! While the Administration keeps hinting about "block grants" and super waivers, the Governors are singing a very different tune. They are telling the federal administration that "reform should not be part of a federal budget reduction process, especially if it does nothing more than shift additional costs to states." While we could agree with that, there's more.

The Governor of your State is an important player, and therefore your disability community MUST know the facts and be ready to hold your Governor accountable.

Here are the Governors' arguments:

  1. During the past four years, Medicaid's increases are due to increases in the number of eligible persons.

  2. Medicaid pays for 70 % of all persons in nursing homes.

  3. Persons who receive Medicare AND Medicaid, known as the "dual eligibles," account for 42% of all Medicaid's expenditures.

These three issues DIRECTLY impact on persons with disabilities. Our responses?

  1. I do not know if the number of persons with disabilities has increased that much over the past four years. Given the SSI numbers, I do not see it. Also, since the economy has gone down and as businesses continue to cut off health benefits for their workers and retirees, those probably are the reasons for the increased number of eligibles.

  2. You can sure tell your Governor how to save substantial Medicaid money that they are paying to nursing homes. Let the consumer decide whether they want Medicaid to pay LESS and receive the same services in the community or pay MORE in the nursing homes. Your Governors know this, but the nursing home lobby has historically been big financial contributors to the election campaigns! If your Governor truly wanted to save substantial Medicaid funds, move the money from the nursing homes to the community.

    FACT: In FY 2003, nationally Medicaid spent nearly $ 45 billion on nursing home care versus $ 4 billion on home and community based waivers for both the elderly and persons with disabilities (this excludes the MR population who normally are not NH eligible.) [If you want this data for YOUR state, email Steve Gold and tell me your state.]

  3. Because Medicare is 100% federally funded, and Medicaid is paid by both the federal and state governments, it's obvious why the Governors want the benefits for dual eligibles to be completely funded by only the federal government.

However, the real dual eligible issue is that they cost the States because Medicare does not pay for long-term care! The disability community must be careful that we do NOT want the only change to be WHO pays for nursing homes. We want persons to live in their own homes and communities and receive whatever they need there - whether payment is 100% federal or shared federal and state.

What Advocates Should Do:

  1. Join ADAPT in Washington, DC. 2/25 -3/1 when the National Governors' Association will meet to discuss your future! Medicaid reform is their number one issue.

  2. Get to your Governor NOW. Demand a meeting directly with the Governor - not bureaucratic intermediaries. Tell your Governor about specific folks who want to live in their community and tell your Governor to stop wasting Medicaid funds on expensive and unwanted nursing homes. Tell them to start a Money Follow the Person initiative, to develop true community based services, and to contract with Independent Living Centers to go into each nursing home and offer persons a real community program.

  3. Know the facts about your State and its Medicaid funding. Don't let your Governor' office talk around you. We have the facts on our side!!

Steve Gold,
The Disability Odyssey continues

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