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New Models for Medicaid

Atlanta Journal Constitution

Faced with skyrocketing Medicaid costs, Gov. Sonny Perdue and two other Republican governors in the Deep South are leading the charge to restructure the program and create models for reform efforts nationwide. 

For more than a year, Perdue, Gov. Jeb Bush of Florida, Gov. Mark Sanford of South Carolina and their staffs have been working to craft new ways to administer Medicaid, the publicly funded health insurance plan for the poor, elderly and disabled. 

Taking cues from the Bush administration and prominent conservative thinkers, such as former House Speaker Newt Gingrich, they are working on proposals --- called waivers --- that aim to curb Medicaid's rising costs. 

The proposals are all framed around similar themes. They advocate a more market-oriented approach, encourage patients to take more responsibility for their health, and require them to pay part of the cost of care. Several other states are looking at substantial changes to their Medicaid programs. 

The three Southern governors want greater flexibility from the federal government to curb costs in their states. But some consumer advocates worry that less stringent federal control may lead states to cut benefits that are now mandatory. 

They also argue that increases in co-payments, premiums and deductibles may make it impossible for Medicaid's low-income users to afford critical health care. 

"I think this could be a really dangerous trend that could undermine the whole purpose of the Medicaid program, which is to ensure that vulnerable people who have no other access to health care have a real safety net," said Rachel Klein, deputy director of health policy for Families USA, a health care advocacy group. 

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