Vilsack: Medicaid policy would cost Iowa
By Ed Tibbetts, Lee News Bureau | Posted: Saturday, October 09, 2004
On the eve of President Bush's visit to Waterloo today, Iowa Gov. Tom Vilsack complained that the Bush administration is pushing a policy that would cost the state more than $200 million in Medicaid funding over the next four years.
The governor told an Iowa Nurses Association breakfast in Davenport that losing the money would result in drastic cuts in services. "It would be devastating," he said.
In a letter sent to the president Friday, Vilsack wrote that 144,000 Iowans could see reduced prescription drug coverage, 17,000 could lose home and community-based care and hospice services could be cut for nearly 2,000 Iowans.
The governor said he and Republicans have tried to negotiate with the Center for Medicare and Medicaid Services, or CMS, which oversees Medicaid. But in the letter sent Friday, he wrote that the administration has instead "seen fit to play by its own new unwritten rules -- while ignoring the devastating effects this would have on access to health care in Iowa."
The dispute centers on the administration's intent to reform an aspect of the financing system for Medicaid, the federal-state health insurance program for the poor. For years, states have used contributions from local governments and other health-care providers to help pay for their share of the Medicaid program. The contributions are called intergovernmental transfers and they leverage additional federal Medicaid dollars.
Critics of the administration say it is trying to solve federal budget problems by cutting off money to states and is doing so under the radar with inadequate public comment or discussion.
Federal officials and auditors, though, have complained that the transfers often are done illegally and that federal costs are being driven up as a result. That "has the effect of shifting the cost of the program from state/local governments to the federal government," wrote Mark McClellan, the administrator for CMS, in an April letter to U.S. Sen. Chuck Grassley, R-Iowa.
Bill Pierce, a spokesman for the federal Department of Health and Human Services, called the governor's letter inaccurate Friday and said the agency is still in negotiations with Iowa. All the administration wants to do, he said, is ensure that no illegal or improper intergovernmental transfers are approved. "If the governor is sincere, we'll be able to work it out," he said.
The dispute over such transfers has high stakes for both federal and state governments. Medicaid is a fast-growing part of government spending. In Iowa, for example, about $2 billion is spent annually on Medicaid services. Vilsack's letter said the cost to Iowa if transfers are lost could exceed $500 million over four years.
"This was fully approved by CMS in past years," said Roger Munns, a spokesman for the Iowa Department of Human Services. "They're the ones that are changing the rules. Dare I say a 'flip-flop.' "
Statehouse Republicans called Vilsack's letter a political ploy. Senate President Jeff Lamberti, R-Ankeny, said the federal government has not even had time yet to act on a state proposal sent in September. "The governor has thrown bipartisan cooperation under the bus in favor of furthering his own political career," he added.
Vilsack has become a regular surrogate for Democratic presidential nominee U.S. Sen. John Kerry, D-Mass., and the governor once was considered a possible running mate. Vilsack said President Bush's frequent campaign trips to Iowa prompted the letter, but the governor said he is merely using today's visit as an opportunity to draw attention to a problem that has grave consequences for the state's poor.
"I wouldn't be doing my job if I didn't," he added.
Ed Tibbetts can be contacted at (563) 383-2327 or etibbetts@qctimes.com.
-----Original Message-----
From: Todd Dorman
Sent: Friday, October 08, 2004 4:03 PM
To: Todd Dorman; 'mgilles@wcinet.com''; 'editor@iafalls.com'; 'mcpress@osage.net''; 'mike krapfl'; 'K Brown'; 'dave kraemer'; 'Charlotte Eby'; 'Ann Gilligan'; Dave Yoder; Karen Luken; SCJ Front Door; Jim Jenkins; John Quinlan; Glenn Olson; 'Mike Williams'; 'Ames Tribune'; Nancy Newhoff; Saul Shapiro; Webb Cole; Tom Thoma; Mark Ridolfi; Linda Watson; Jane Reynolds; Jan Horgen; Frank Myers; Doug Schorpp; Craig Brown; Bob Steenson; 'mcpress@osage.net''; Gary Metro; 'mgilles@wcinet.com''; Jeff Tecklenburg; Britt Editor; 'editor@iafalls.com'; Rusty Schrader; Ann Phillips; Jan Touney; Janet Hill; 'tcc@iafalls.com'
Subject: DM Bureau Advisory ADD
VILSACK MEDICAID n Iowa governor assails Bush administration for what he says are moves to cut Medicaid funding for Iowa. By Ed Tibbetts of the QC Times. Upcoming.
The governor told an Iowa Nurses Association breakfast in Davenport that losing the money would result in drastic cuts in services. "It would be devastating," he said.
In a letter sent to the president Friday, Vilsack wrote that 144,000 Iowans could see reduced prescription drug coverage, 17,000 could lose home and community-based care and hospice services could be cut for nearly 2,000 Iowans.
The governor said he and Republicans have tried to negotiate with the Center for Medicare and Medicaid Services, or CMS, which oversees Medicaid. But in the letter sent Friday, he wrote that the administration has instead "seen fit to play by its own new unwritten rules -- while ignoring the devastating effects this would have on access to health care in Iowa."
The dispute centers on the administration's intent to reform an aspect of the financing system for Medicaid, the federal-state health insurance program for the poor. For years, states have used contributions from local governments and other health-care providers to help pay for their share of the Medicaid program. The contributions are called intergovernmental transfers and they leverage additional federal Medicaid dollars.
Critics of the administration say it is trying to solve federal budget problems by cutting off money to states and is doing so under the radar with inadequate public comment or discussion.
Federal officials and auditors, though, have complained that the transfers often are done illegally and that federal costs are being driven up as a result. That "has the effect of shifting the cost of the program from state/local governments to the federal government," wrote Mark McClellan, the administrator for CMS, in an April letter to U.S. Sen. Chuck Grassley, R-Iowa.
Bill Pierce, a spokesman for the federal Department of Health and Human Services, called the governor's letter inaccurate Friday and said the agency is still in negotiations with Iowa. All the administration wants to do, he said, is ensure that no illegal or improper intergovernmental transfers are approved. "If the governor is sincere, we'll be able to work it out," he said.
The dispute over such transfers has high stakes for both federal and state governments. Medicaid is a fast-growing part of government spending. In Iowa, for example, about $2 billion is spent annually on Medicaid services. Vilsack's letter said the cost to Iowa if transfers are lost could exceed $500 million over four years.
"This was fully approved by CMS in past years," said Roger Munns, a spokesman for the Iowa Department of Human Services. "They're the ones that are changing the rules. Dare I say a 'flip-flop.' "
Statehouse Republicans called Vilsack's letter a political ploy. Senate President Jeff Lamberti, R-Ankeny, said the federal government has not even had time yet to act on a state proposal sent in September. "The governor has thrown bipartisan cooperation under the bus in favor of furthering his own political career," he added.
Vilsack has become a regular surrogate for Democratic presidential nominee U.S. Sen. John Kerry, D-Mass., and the governor once was considered a possible running mate. Vilsack said President Bush's frequent campaign trips to Iowa prompted the letter, but the governor said he is merely using today's visit as an opportunity to draw attention to a problem that has grave consequences for the state's poor.
"I wouldn't be doing my job if I didn't," he added.
Ed Tibbetts can be contacted at (563) 383-2327 or etibbetts@qctimes.com.
-----Original Message-----
From: Todd Dorman
Sent: Friday, October 08, 2004 4:03 PM
To: Todd Dorman; 'mgilles@wcinet.com''; 'editor@iafalls.com'; 'mcpress@osage.net''; 'mike krapfl'; 'K Brown'; 'dave kraemer'; 'Charlotte Eby'; 'Ann Gilligan'; Dave Yoder; Karen Luken; SCJ Front Door; Jim Jenkins; John Quinlan; Glenn Olson; 'Mike Williams'; 'Ames Tribune'; Nancy Newhoff; Saul Shapiro; Webb Cole; Tom Thoma; Mark Ridolfi; Linda Watson; Jane Reynolds; Jan Horgen; Frank Myers; Doug Schorpp; Craig Brown; Bob Steenson; 'mcpress@osage.net''; Gary Metro; 'mgilles@wcinet.com''; Jeff Tecklenburg; Britt Editor; 'editor@iafalls.com'; Rusty Schrader; Ann Phillips; Jan Touney; Janet Hill; 'tcc@iafalls.com'
Subject: DM Bureau Advisory ADD
VILSACK MEDICAID n Iowa governor assails Bush administration for what he says are moves to cut Medicaid funding for Iowa. By Ed Tibbetts of the QC Times. Upcoming.
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