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You know those Old Westerns where the
hero rides in at that last minute to save the day. That's what last week's
"clawback" reduction announcement must have felt like to many states trying to
maintain their Medicaid programs in the wake of increased need and reduced
revenues caused by the recession.
The trailer would go something like this:
The trailer would go something like this: "State coffers were running dry while residents were
struggling to get by. Just when things were looking really grim, Secretary Sebelius and her Medicaid Director Cindy Mann ride into town to save the day."
While the "clawback" sounds like a character from a horror movie rather than the Western motif I'm trying to
conjure up, it's really not all that scary. "Clawback" is just the stage name for the monthly payments states send
to the federal government to pay a portion of the Medicare Part D prescription
drug costs for "dual eligibles" or those people who are eligible for both
Medicare and Medicaid. It comes into play in this scenario because HHS decided
that the temporary increased federal match rate included in the American
Recovery and Reinvestment Act (ARRA) should be applied to clawback
payments. Now, states will receive
about $4.3 billion in financial relief through a temporary reduction in their payments. This is welcome news to
Medicaid Directors, state leaders, health care advocates and all the children,
families and individuals who are relying on them for help to get through these
tough times.
Meanwhile, back at the corral, HHS
Secretary Sebelius encouraged states to use the savings to "continue to provide
critical health care services to the nearly 60 million beneficiaries who depend
upon it". Some states appear to be heading in
that direction already. In Tennessee, which will save about $120 million, the
TennCare director said he hopes to use the temporary savings to "mitigate
or postpone" recently recommended caps limiting services to adult,
nonpregnant enrollees on TennCare, the state's Medicaid program.
This temporary boost should help more
states better cope with escalating health care costs, increasing numbers of
uninsured residents and declining revenues. It's a brief respite of welcome news but there is certain to
be more trouble around the bend if Congress fails to extend the ARRA fiscal
relief provisions. Better keep those horses saddled up.
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