Rowland and eight other governors on the task force met behind closed doors Thursday to discuss their emerging plan to revitalize the states’ ailing Medicaid programs in the face of falling state revenues, spiraling health care costs and growing numbers of seniors who are eligible for some form of state assistance.

Among other ideas, the governors discussed ways to deal with recipients who are eligible for both Medicare and Medicaid, new plans for prescription drug benefits and long-term care options and ideas for partnerships with private health-care providers..

The task force is working on a tightly held Medicaid reform proposal, which they hope to unveil by mid-May. The governors have said very little publicly about their plan but Rowland, who has been outspoken on the Medicaid crisis, said flexibility is the essence of the proposal.

Rowland said he wants to make a wide range of services available through Medicaid, so that eligible individuals can choose the least costly kind of care that meets their needs. For example, he said, Medicaid should pay for alternatives to expensive nursing home stays -- such as in-home care.
While Rowland said most benefits for qualified Medicaid recipients “would be maintained” under the governors’ proposal, he acknowledged the task force is considering changes to eligibility or adding co-payment requirements to some services. Critics have charged this could result in needy people losing coverage.

Connecticut is one of many states that has applied for a waiver from the U.S. Department of Health and Human Services to allow the state to reduce payments to seniors receiving aid who have given away substantial sums of money over the past 5 years. Currently, states review only the past three years to determine eligibility. Rowland said Thursday he is confident the federal government will grant the waiver.
A key focus of the task force, and one that is subject to much debate, is deciding how exactly their Medicaid proposal will be financed.

The federal government has offered states $12.7 billion worth of incentives to re-evaluate their Medicaid programs over the next seven years. Funds would be cut back in the following three years, so that the total federal spending would remain unchanged over a 10-year period.

Rowland hopes the temporary injection of cash isn’t simply postponing the Medicaid crisis until 2010.

Rowland said perhaps it seems like a “leap of faith,” but he believes that having the extra money now will allow states to create new and more efficient programs that will save money in the long run. He compares the work the NGA is doing to the welfare reform process of 1996, which he said reduced costs in the long run by making funds available in the short term to help people find work and transition off welfare.