Medicaid changes could hit the poor

Are we so screwed up that we can't take care of the poor, sick and elderly? We all pay a huge amount of taxes, including hidden taxes and yet the states and government are always crying poor mouth and blaming the poor. Where is all that money going? ........bd

Medicaid changes could hit the poor

Mon Dec 19, 2:48 PM ET

WASHINGTON (Reuters) - The spending bill approved by the House early on Monday and awaiting a Senate vote could increase the out-of-pocket costs of many of the poor people who rely on the joint federal-state program for their health care.

The legislation also tightens eligibility rules for long-term care. Medicaid pays for roughly half of nursing home bills.

The mostly Republican backers of the bill say the changes are necessary to preserve a financially beleaguered social program that has not been updated to keep up with the changes in U.S. health care.

Mostly Democratic critics say it shreds the health safety net for the most vulnerable Americans. The AARP is among the interest groups opposed to the health care legislation.

The net savings are $4.7 billion over five years, but run to around $23 billion over 10 years. The bill:

- Gives states more flexibility in deciding what health benefits to give to those on Medicaid although basic services will be required for children, pregnant women and senior citizens.

- Allows states to require poor people to pay more out of pocket for their care by increasing co-payments or premiums. Advocacy groups say this could cost $10 billion over a decade.

- Increases from three to five years the "look-back" period to see whether middle or upper income seniors had transferred or hidden assets to qualify for Medicaid coverage of nursing homes. It also disqualifies anyone with more than $750,000 in home equity from Medicaid eligibility.

- Changes the way Medicaid pays for medications, particularly generic drugs. Instead of using a formula known as "average wholesale price," which critics in both parties say bears little relationship to actual prices, the payments would be based on "average manufacturer's price" which would be publicly available. Starting in 2007, the federal government will not pay more than 250 percent of the AMP of the lowest-cost version of a generic drug.

- Requires states to use basic identification documents, like drivers licenses or passports, to better enforce current law and prevent illegal aliens from getting Medicaid coverage.

- Includes $2.14 billion to help Medicaid costs in states affected by Hurricane Katrina.

- Includes the Family Opportunity Act, which makes it easier for families to get health care for disabled or special needs children without being forced to remain in poverty or institutionalize their children.


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