>
>Dear Colleague,
>
>
>On March 20th, the National Governors' Association ( http://www.nga.org/ )
>announced the much-awaited creation of its Medicaid Reform Task Force.
>The task force will have a definitive say in any plan approved by Congress
>to restructure Medicaid. Its formation comes at a time when most States
>are making deep cuts in their Medicaid programs and the Bush Administration
>is proposing that it be turned into a block grant and that strict limits be
>placed on all future spending.
>
>
>The NGA has not taken a position on the Administration's proposal. It is
>instead expected call for "reforms" that will provide more federal aid to
>States while giving each even more control than now over how it designs and
>administers its Medicaid program. The principles the new task force will
>use to develop its recommendations are listed at the end of this alert.
>The task force has 10 members and is co-chaired by Kentucky Governor Paul
>Patton (D), NGA's chairman, and Idaho Governor Dirk Kempthorne (R), NGA's
>vice-chairman. Others members include: Connecticut Governor John Rowland
>(R); Florida Governor Jeb Bush (R); Iowa Governor Tom Vilsack (D); Indiana
>Governor Frank O'Bannon (D); Maryland Governor Robert Ehrlich (R); Missouri
>Governor Bob Holden (D); North Dakota Governor John Hoeven (R); and, New
>Mexico Governor Bill Richardson (D)
>
>
>In announcing the task force's creation Governor Patton said that
>"Medicaid's 47 million enrollees include over 23 million children, 5
>million seniors and 8 million adults with disabilities---these are the
>people we need to remember as we embark upon this process". Now we must
>make sure that the nation's Governors do just this by keeping the rights
>and needs of people with disabilities of all ages in the forefront as the
>NGA, the Administration and Congress debate and decide the future of
>Medicaid.
>
>Governors ? especially those on the task force ? must hear from people with
>disabilities, our families and allies on: 1. Why Medicaid matters to
>children, adults and seniors with disabilities; 2. How Medicaid cuts in
>your State are harming people with disabilities; and, 3. How Medicaid
>must be strengthened and improved to enhance the health, independence and
>productivity of people with disabilities throughout the nation. When you
>to call, write and/or set up a meeting with your Governor, please make the
>following types of points:
>
>Why Medicaid matters: Tell your Governor how your State's Medicaid program
>is enabling you and/or others you know to live healthier, more independent
>and productive lives in the community. Be sure to cite personal examples of
>how Medicaid makes a critical difference in the everyday lives of people
>with disabilities and their families.
>
>How cuts are harmful: Tell your Governor how Medicaid funding cuts for
>community living services, prescription drugs, durable medical equipment
>and other vital services are directly affecting you, your family and other
>children, adults and seniors with disabilities. Talk about the real harm
>(e.g., loss of independence, unnecessary institutionalization, injury or
>death) that these and other planned or proposed cuts will produce.
>
>What improvements must be made: Tell your Governor that to be responsive
>to the needs, interests and civil rights of children, adults and older
>Americans with disabilities any Medicaid reform proposal put forward by the
>Nation's Governors must:
>
> Guarantee that all Americans with disabilities who want to live in
> their community with affordable supports can do so regardless of
> their age, disability, where they live, employment status or the form
> of assistance require.
> Create a greater federal role in the equitable financing of and
> enhancing the quality and appropriateness of all long-term services.
> Eliminate the institutional bias in Medicaid and Medicare that robs
> millions of Americans of their most basic freedoms, dignity and
> independence daily.
>
>
>Urge your Governor to state publicly that these 3 principles must serve as
>part of the basis of any Medicaid reform plan advanced by the National
>Governors' Association and/or approved by Congress. Please act today
>because the NGA task force is expected to put forward its recommendations
>to the Administration and Congress by the end of May.
>
>We would also appreciate being notified of the results of any discussions
>or correspondence that the disability community has with your Governors
>regarding this issue. You can do so by e mailing us at
>[log in to unmask]
>
>People with disabilities and Medicaid: These are some facts to keep in
>mind as you correspond and/or meet with your Governor in the next few
>weeks:
>
> Medicaid is the only program in the nation that pays for the complete
> range of services that are essential to enabling many persons with
> disabilities to live in their own homes and communities.
> Throughout the 1990's increasing numbers of Americans received the
> supports they required to live in their own homes and communities
> through Medicaid.
> Yet, despite the fact that most children, adults and senior with long
> term services needs live in the community, most states still spend 70
> percent or more of their Medicaid funding on nursing homes and other
> institutions.
> Hugh inequalities exist across and even within States as to what
> people with different disabilities but a common need for community
> living services receive.
> The federal government and States share a responsibility under the
> ADA and Section 5O4 to make certain that Medicaid and other public
> funds are used in ways that support people with disabilities to live
> in the community rather than in nursing homes or other institutions.
>
>To be genuine, Medicaid reform proposals adopted by the NGA and Congress
>must address rather than ignore these critical facts.
>
>
>Thanks.
>
>
>Bob Williams and Henry Claypool, Co Directors
>
>
>Advancing Independence: Modernizing Medicare and Medicaid (
>http://www.aimmm.org )
>
>NGA Medicaid Reform Principles: The task force will develop recommendations
>based on NGA's Medicaid reform principles, adopted last month at its Winter
>Meeting. They include:
>
> The Medicare and Medicaid programs are interrelated and any change
> made to Medicare, whether to strengthen its solvency, address its
> financing, or for other purposes, should be considered in conjunction
> with reforms to Medicaid.
> The federal government should assume full responsibility for the
> acute, primary, long-term, and pharmaceutical care of the dual
> eligibles, individuals who are enrolled in the Medicare program, but
> because of their low-income, are also eligible for the Medicaid
> program.
> It is also unacceptable for Medicaid to be the only long-term care
> program in this country. Other sources of coverage, whether federal,
> employer-based, personal, familial, or community-based, must be
> developed.
> States must have greater ability to manage the Medicaid program with
> respect to eligibility, benefits, cost-sharing, and coordination with
> private sector insurance.
> Medicaid reform proposals that provide states broader Medicaid
> program authority should weigh fiscal and health policy implications
> of the current financing structure, or an alternative approach.
> Efforts to reduce fraud and abuse by Medicaid beneficiaries and
> providers are essential to safeguarding limited health care
> resources, but any effort to develop error rates to measure state
> performance should be strongly opposed.
> To the extent possible, all current waivers should be replaced with
> clear statutory authority.
> The federal government should pay 100 percent of the cost of any new
> Medicaid mandates imposed under an act of Congress, federal
> regulation, or court decision based on federal laws and regulations.
> The federal cap on the commonwealths and territories should be
> removed and a federal contribution for commonwealths and territories
> should be implemented that is comparable to that of the states.
>
>
>
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