Kaiser Daily Health Policy Report Highlights News Coverage of State Medicaid Developments

• Georgia: A new state rule that includes promissory notes in Medicaid income eligibility calculations went into effect this month, the Atlanta Journal-Constitution reports. A promissory note is a written agreement to pay a certain amount of money at a specified time to another individual. Promissory notes are popular among the elderly because they are an easy and legal way to protect savings or leave an inheritance while ensuring Medicaid eligibility. Under the new standards, promissory notes now will be required to be actual loans, bear interest and be paid back in equal monthly payments in order to be valid. If the state considers the note valid, it most likely will be counted in an individual's assets and could make the holder ineligible for Medicaid. Becky Kurtz, Georgia's ombudsman for long-term care facilities, said the new rule will affect about 500 families. It is expected save Georgia $1.6 million (Jacobs, Atlanta Journal-Constitution, 5/9).
  
  
• Iowa: The state House Appropriations Committee on Monday approved a measure that would allocate $70 million to fund the Iowa Medicaid program through the end of the fiscal year, the AP/Omaha World-Herald reports. Full House approval was expected soon afterward. According to the AP/World-Herald, state lawmakers are working to resolve a $25 million gap between the House and Senate budget proposals. Committee Chair Bill Dix (R) said, "[W]e don't want Medicaid funding to fall victim" during negotiations if the House rejects the Senate's larger budget proposal. Meanwhile, the House already has approved a Senate plan for a pilot program that would extend a limited form of Medicaid to as many as 30,000 patients now receiving charity care at two state hospitals (AP/Omaha World-Herald, 5/10).
  
  
• Missouri: Plans to eliminate coverage for more than 90,000 Medicaid beneficiaries have "sparked a fierce debate over the morality of the cuts" in the state, NPR's "Morning Edition" reports. According to NPR, Gov. Matt Blunt (R) "hasn't wavered" in his position that failing to reduce spending on Medicaid -- enrollment in which has more than doubled in the past 10 years to cover almost one in five citizens -- would "poison" the state economy and the proposed cuts could motivate residents to seek jobs offering health coverage. A commission will soon be formed "with a mandate to dismantle" the state's Medicaid program by June 30, 2008, NPR reports. The segment includes comments from Amy Blouin, executive director of the Missouri Budget Project; Blunt; Sam Man, a preacher in Kansas City who spoke at a recent vigil against the Medicaid cuts; Jessica Robinson, press secretary for Blunt; and former and current Medicaid beneficiaries (Morris, "Morning Edition," NPR, 5/11).
  
  The complete segment is available online in RealPlayer. Expanded NPR coverage is available online.



• New Hampshire: Families with no annual income would have to pay a $10 monthly premium per child, up to a maximum of $30, for Medicaid coverage under a proposal currently under consideration in the state Senate, the AP/Arkansas Democrat-Gazette reports. Families with some income who are in the lowest income category would pay as much as $20 per child each month, up to a maximum of $60. Federal law requires states to provide Medicaid benefits at no cost to residents with the lowest incomes, so the proposal would need federal approval to become law. The addition of the premiums would save the state about $12 million over the next two years. State Medicaid Director Steve Norton said the state likely would see a 5% drop in Medicaid enrollment, or about 3,000 children, as a result of the change. Advocates for state Medicaid beneficiaries have said the proposal would force poor families to rely on emergency departments for medical care. According to the AP/Democrat-Gazette, the state House at first "embraced" the idea but has "backed off" recently, while the proposal "is still alive" in the state Senate (Love, AP/Arkansas Democrat-Gazette, 5/9).