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 Article of Interest - Medicaid

Medicaid '900-Lb Gorilla' State Must Wrestle With, Panel Told

from Gongwer News Service, February 12, 2003
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Michigan's Medicaid program is the "900-pound gorilla" that the state has to wrestle with as it searches out ways to solve its budget problems, Community Health Director Janet Olszewski told the Senate Government Operations Committee on Wednesday.

Ms. Olszewski and other officials are digesting all the ideas generated so far by Governor Jennifer Granholm's Medicaid summit to determine what might best control costs without drastically affecting services, she told the panel at her confirmation hearing.

Ms. Olszewski was confirmed unanimously by the committee, as have all members of Ms. Granholm's Cabinet, and now will go before the entire Senate for a confirmation vote.

The hearing came on the same day that the Saginaw-based Center for Civil Justice filed a federal lawsuit against the state for cuts in Medicaid ordered in December by former Governor John Engler. That cut eliminates Medicaid eligibility for low-income parents and grandparents caring for a child that receives income.

Besides trying to handle the Department of Community Health's share of the budget problems, Ms. Olszewski said her goals are to foster innovation to help the state attack and reduce some of its major health problems including obesity and lead poisoning of children.

The appointment of Michigan's first surgeon general will be important to promoting healthy lifestyles and reducing health threats, she said. The surgeon general, Kimberlydawn Wisdom will also be chiefly responsible for the public health side of the department.

Many of the questions aimed at Ms. Olszewski also dealt with mental health and among those, she said the state should aim at some form of parity with health insurance coverage also covering mental treatments. Whatever the state devises, she said, "we should craft a Michigan solution."

She also said the state is working together with local mental health officials in Wayne County to craft treatment plans for the 220 patients still in the Northville Hospital, which the state is preparing to close.

Sen. Shirley Johnson (R-Royal Oak), who sat in on the hearing, said mental health services in the state had suffered over the previous decade and if at all possible "I don't want to see them touched" in the budget Ms. Granholm will release on March 6.

But the biggest issue facing the department is finding a way of controlling costs of the Medicaid program. In finding those solutions, the state has to remember that people will always seek medical care when needed, even if they are not enrolled in Medicaid or if physicians won't treat Medicaid patients, she said.

The basic options in controlling Medicaid costs are limited to enrollment of recipients, the types of services offered and the fees paid health care providers, she said. While the state considers options it also has to factor in changes planned in the program at the federal level, she said.

One area the state will have to look at is recovery of assets from individuals placed in nursing homes on Medicaid. The federal government requires recovery in cases where a patient has unspent assets, and Michigan is one of only two or three states not following the requirement. Eventually, Ms. Olszewski said, the state could face financial sanctions if it does not enact recovery programs.

However, when it enacts a recovery program the state would likely only recover between $1 million to $2 million.

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