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Report: Medicaid Funding Schemes Hurt Seniors, People With Disabilities; Threaten State Budget

April 19, 2017

AUGUSTA – A new analysis of data concerning Maine’s Medicaid program shows that seniors and people with disabilities could be significantly harmed by changes in the way the program is funded.

According to “Medicaid Capped Funding: Findings and Implications for Maine,” a study from the State Health Reform Assistance Network, the vast majority of Maine’s Medicaid spending was for elderly and disabled enrollees, even though they accounted for just 38 percent of total enrollment.

“With over three quarters of Maine’s Medicaid spending being used to provide health care to older adults and people with disabilities, policymakers at both the state and federal level should be concerned about any proposal that would limit those funds, shift costs to the state and jeopardize its ability to respond to the health care needs of these vulnerable populations,” said Robyn Merrill, executive director of Maine Equal Justice Partners.

While the American Health Care Act failed to move through Congress, ideas in the proposal to change the way Medicaid, called MaineCare here, are funded continue to be discussed.

Funding schemes, such as per capita caps and block grants, would put health care coverage in Maine at risk and shift significant costs from the federal government to the state.

“Maine’s state budget relies heavily on federal Medicaid funding. Medicaid represents the single largest source of federal funding for the state, the vast majority of which is for seniors and people with disabilities,” the study found.

Shifting those costs to the state could jeopardize funding for other priorities, including education.

The findings of the white paper were presented today by Patricia Boozang, a nationally recognized expert on health care policy, will present the findings of a new white paper that explores the impact on Maine of proposed changes to Medicaid.

“Medicaid Capped Funding: Findings and Implications for Maine,” shows the significant damage the state would suffer if schemes such as block grants or per capita caps were put in place for Medicaid funding.

Patricia Boozang, who presented the findings on Wednesday, is the senior managing director for Manatt Health, where she advises clients on the implementation of coverage, delivery systems and payment reforms across government and private health insurance programs.

Boozang advises states on Medicaid expansion design, implementation and sustainability, and has particular expertise in alternative expansion models through 1115 waivers. For Arkansas, she helped develop and implement the state’s groundbreaking Private Option initiative, and its successor program, Arkansas Works.

As a technical assistance expert in the Robert Wood Johnson Foundation’s State Health Reform Assistance Network, Boozang counsels states on the Affordable Care Act, most recently leading the foundation’s State Network 1332 Waivers Affinity Group.

Drawing on her wealth of experience in Medicaid managed care and other delivery system reforms, Boozang regularly advises health systems on Medicaid ACO development and other delivery system transformations. She advises the Coalition of New York State Public Health Plans, an association of eight managed care plans that serves more than 2 million beneficiaries of that state’s public health insurance programs.

The Together for Medicaid is a collaborative effort by organizations from across the state that have joined together in opposition to significant changes to Medicaid’s financing structure that would undermine the program. The TFM leadership team includes Maine Equal Justice Partners, Consumers for Affordable Health Care, Maine People’s Resource Center, the Maine Council on Aging, Maine Children’s Alliance, New Mainer’s Public Health Initiative and the Consumer Council System of Maine.