RCPA - Rehabilitation and Community Providers Association


Governor Bush to Testify on Medicaid Reform
January 31, 2003

The National Council for Community Behavioral Healthcare (NCCBH) has noted that Governor Jeb Bush (R-FL) is slated to testify before Congress on Tuesday, February 4 regarding proposed Medicaid reform. Given that Governor Bush is President George W. Bush's brother, as well as the fact that President Bush specifically referenced potential proposals to alter financing and funding streams for behavioral health care services, NCCBH is concerned that Governor Bush's recommendations will be given preference.

Governor Bush, as well as Governors Bill Owens (R-CO) and John G. Rowland (R-CT), released a letter yesterday addressed to President Bush and Secretary of Health and Human Services Tommy Thompson, which includes some of the following points:

  • Reference to states facing financial and fiscal crises: "...rather than seek one-time federal assistance through Federal Medical Assistance Percentage (FMAP), [feds] should look at rewriting the Medicaid law."
  • "...[must] reassess its [Medicaid] purpose, re-establish a set of principles for providing coverage for lower income Americans, and test new models that lead to a sustainable and affordable program [for the future]."
  • "States need additional flexibility and opportunities for innovation..."
  • "...[Medicaid] continues to limit cost sharing and does not reflect the changing demographic characteristics of its beneficiaries..."

The Governors' letter also referenced specific recommendations, including recognizing state and federal funding limits and moving away from entitlement without responsibility and integrating mental health reform as an important component of any Medicaid restructuring.

NCCBH offered the following:

"The National Council is very concerned about how one would 'move away from entitlement without responsibility,' imposing increased cost sharing and cost saving responsibilities to consumers, and allowing private plan options. While mental health is mentioned as a component of any restructured Medicaid program, there are no specifics. We are concerned that 'integrating mental health reform' does not mean incorporating recommendations from the Mental Health Commission, but could suggest a standard reimbursable benefit."

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