Projo Politics Blog

By Katherine Gregg
Journal State House Bureau

PROVIDENCE, R.I. - All four members of the state's Congressional delegation sent Governor Carcieri a letter Tuesday, warning that the proposed Medicaid overhaul that he is promoting "could pose serious risks to the Medicaid program, leading to unprecedented cuts'' to both patients and providers.

In their letter, U.S. Sens. Jack Reed and Sheldon Whitehouse and U.S. Reps. James Langevin and Patrick Kennedy reiterated many of the concerns that have been voiced during three days of State House hearings, namely: that the administration has not yet spelled out what it is going to do to the government-paid medical insurance program that covers 180,00-plus Rhode Islanders.

"Despite numerous public briefings ... a detailed plan and justification are still not public and accessible. Collectively and individually, we have made repeated requests for specific information, but we are still awaiting key details,'' they wrote.

"For example, the state has not provided data on the impact on beneficiaries, nor has it provided projections of state spending, savings, or the assumptions and methodologies on which such projections are based.''

But "from the information we have, one aspects of the waiver seems quite clear. The aggregate cap on spending could leave the state up to $842 million short of its projected obligations over five years. This is because the cap is based on national projections in the president's budget and does not factor in Rhode Island's specific circumstances - including a significant aging population and skyrocketing unemployment.''

They questioned whether the state has the capacity - and "administrative preparation and capability'' - to save money by limiting nursing home placements to those with the "highest need.''

Aside from this broad concern, they raised concerned about an "unprecedented approval process'' proposed for eligibility, benefits and cost-sharing, saying: "there are no protections to ensure that essential benefits are available to those for whom they are medically necessary, and the specific changes that the state will seek remain unknown.''
"In closing, they wrote, "the waiver raises more questions than it answers,'' they said.

State lawmakers are under a self-imposed deadline to decide by this weekend - and logistically, before their work week ends on Thursday - whether to reject, amend or allow the waiver to take effect without their action.

All four members of congress from Rhode Island are Democrats. The governor is a Republican.

 Tags  global waiver Governor Carcieri House of Representatives Jack Reed Jim Langevin Medicaid Patrick Kennedy Senate Sheldon Whitehouse

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