Medicaid Reform: Fuhgeddaboutit

posted by Alan Greenblatt

Tommy Thompson, the former governor of Wisconsin and secretary of Health and Human Services during President Bush's first term, has been peddling lots of ideas about Medicaid lately. One of them is for the program to be split in two.

The federal government would take responsibility for long-term care, while states would pay for acute care. Thompson says only the feds can afford to tackle the long-term dilemma, while states, under this scenario, would compete to come up with great ideas for general health care.

"States should have the responsibility and encouragement to change Medicaid," Thompson told a session of the National Governors Association meeting on Saturday. "The opportunity to change health care is in this room, it's with you."

I asked Thompson afterwards how his idea had been received so far. "It's early to say, but I've been receiving a lot of positive response, which makes me feel good."

Well, good for him. But is this a live idea?

We talked about how it might indeed sound good to states. Long-term care is the real budget-buster in Medicaid. Such a state-federal split should sound good to states still kicking themselves for passing on the Reagan-era proposal that they pay for welfare, while Washington would take over Medicaid. And it's not so different from ideas that former Oregon Senator Bob Packwood used to float as chairman of the Senate Finance Committee.

Still, the governors I talked to about it didn't seem to think it was at all likely. "It means the federal government would have to take the risk, because that's the growing part of the budget," said Mississippi's Haley Barbour.

Comments

[Ken Krimer]

The federal govt will continue to pass to the people and states the burden of long-term care. As a society we choose independence rather than being taxed and getting state medical services (like Denmark). But either way we're gonna pay, out-of-pocket or long-term care insurance. (guidetolongtermcare.com)