There is a proposal on the agenda from the Bush administration, which would provide states with more flexibility to make Medicaid coverage decisions. Short term, the proposal would offer extra cash to states that chose the more flexible plan but would cap federal outlays after seven years. While Governors Bush and Rowland generally supported the administration's proposal, Bush expressed concerns about whether the proposal would recognize population growth. By contrast, Governor Richardson said the administration's plan shirks federal responsibility.
The Bush Medicare plan could narrow HME playing field. In a March 3 report, The White House explained its plan for Medicare reform. The plan would offer three coverage options to beneficiaries: the traditional fee-for service plan, with a drug card estimated to achieve savings of 10 to 25 percent; a preferred-provider-type plan that would include prescription drug benefits, preventive benefits and protection against high out-of-pocket drug costs; and a managed-care plan that would add a prescription drug benefit and look somewhat like the Medicare plus Choice plans currently available. If the prescription drug benefit succeeded in luring a large percentage of beneficiaries away from fee-for-service, the shift could narrow the playing field for home medical equipment providers.
The Senate committee has endorsed letting AHCA proceed with a program called "Senior Health Choices," which would move elderly Medicaid clients into managed-care systems in several pilot projects around the state. All Medicaid services for seniors -- nursing homes, adult day care, and home-delivered meals -- would be provided by a managed-care organization. However, the services could be provided by a variety of health groups and would not be confined just to HMOs. Medicaid reform, limits on legal settlements paid by businesses, elimination of a tax break for wealthy investors and rules to control growth in Florida are four of Bush's major agenda items.........
