State Panel Takes On Medicaid Task Force Reforming Program To Prepare For Federal Changes

Any government program that pays out $2.26 million a month in one North Idaho county alone is bound to have some red tape.

Diana Blackwood can accept that.

But the mother of a 9-year-old boy with learning disabilities said Medicaid sometimes seems to offer little else.

“If you have a child with cognitive disabilities, it takes an act of God to get service from Medicaid,” the Silverton woman said.

Six years ago, after her son fell down a stairwell and suffered brain injuries, Blackwood struggled before finally getting coverage for “neuro-psychological evaluations.”

Then, when services were only available in Montana or Spokane, she had trouble getting Medicaid to pay the bills.

“They wouldn’t even send notices refusing to pay so I could appeal them,” she said.

Blackwood’s problems are typical of the kind a governor’s panel seeks to review over the next four months.

The panel of legislators and health care workers is charged with reforming the health care program that costs the state about $100 million a year and prompts headaches for both Medicaid recipients and providers. The federal government pays another $229 million for Idaho’s program.

The project comes as Congress considers politically charged changes that could lead to caps in federal funding for states. Such efforts languished after first being proposed last winter, but House Republicans unveiled newer reform proposals last month.

Idaho Gov. Phil Batt’s panel wants to prepare the state for changes to come. The panel stopped in Coeur d’Alene last Wednesday to listen to health care providers and Medicaid recipients like Blackwood explain the ills and graces of the program.

While still essentially on a fact-finding mission, officials expect concerned citizens to come out in droves in coming weeks to identify problems. More than 100 showed up at the Coeur d’Alene meeting.

“Providers, like private care facilities, worry about rising costs and receivers worry about losing services,” said Dick Compton, a Kootenai County commissioner appointed to the panel. “Like everything else, we’re seeing increasing demand with limited budgets.”

Medicaid, sometimes confused with Medicare, is a federal and state funded, state-administered health care program for poor, elderly and disabled people. Medicare, meanwhile, is not covered or managed by states and is designed as a health care entitlement program for all senior citizens.

About 6,000 Kootenai County residents split some $2.26 million in Medicaid payments each month. Only Ada, Canyon and Bonneville counties have more recipients.

Enrollment and costs of Medicaid have skyrocketed in recent years, some months doubling from five years ago. Now, including administration costs, Medicaid accounts for about 14 percent of the state budget.

The state is limited in its ability to control some costs and services. Since the federal government currently covers about 70 percent of all costs, any changes proposed by the panel would only affect the remaining 30 percent - unless Congress follows through.

But, as with welfare reform, that’s no guarantee.

Batt used a similar approach with welfare, creating a citizen’s advisory committee which recommended 44 reform proposals. The Idaho Legislature only acted on eight and all but 12 require federal action.

On May 22, Batt mailed President Clinton a letter, urging him to waive some federal rules so Idaho’s reforms could be enacted. It’s not clear how Clinton will respond.

“Idaho’s 30 percent is not the biggest chunk of Medicaid,” said Bill Walker, spokesman for the state Health and Welfare Department. “But there are still things we can do.”

The panel hopes to develop proposals by September, hold hearings, then make recommendations to Batt by December.

, DataTimes