Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, October 5, 1995 TAG: 9510050070
SECTION: VIRGINIA PAGE: A-1 EDITION: METRO
SOURCE: SANDRA BROWN KELLY STAFF WRITER
DATELINE: LENGTH: Medium
The latest block grant distribution proposal uses formulas that would give Virginia $2,621 per person in poverty by 2002. By comparison, New Hampshire would get $6,564.
House and Senate plans both favor states with high-cost Medicaid programs and penalize those that have the most prudent plans and thereby have "sinned" the least, said Laurens Sartoris, VHA president.
Medicaid, which dates from the 1960s, is regulated by the federal government, and money is passed out almost as needed.
But under the block grant proposals, each state would be given a yearly grant with a built-in rate of growth and would control their own Medicaid programs.
The VHA doesn't quarrel with the intent of Congress, only with its method, Sartoris said. That's the message he and Tom Robertson carried to Washington on a recent visit with legislators.
Robertson, president of Carilion Health System Inc. in Roanoke, represents the VHA on the American Hospital Association.
Under the Medicaid proposal approved last week by the House Commerce Committee, Virginia could lose an estimated $3.3 billion in anticipated Medicaid payments over seven years, according to a study by The Urban Institute.
The Washington think tank, which conducted research for The Kaiser Commission on the future of Medicaid, also projected that the number of Medicaid recipients will grow more than 25 percent between now and 2002 and put pressure on states trying to live within fixed Medicaid budgets.
States should be treated equally in the distribution of federal Medicaid money, and their growth patterns should be considered, Sartoris said.
Reimbursement from Medicare, the federal health care program for the elderly, already is more level, he said. For example, the Medicare payment for an appendectomy is the same no matter which state the operation is done in, except that there are adjustments for labor costs.
Under currently proposed formulas, Virginia would maintain its rank of 45th for federal funding per Medicaid beneficiary.
However, Virginia is a high-growth state, Sartoris said. And the average age of the growth group is older than in other states, which will put pressure on Medicaid resources.
The state spends 70 percent of its Medicaid funding on people who are blind, aged and disabled. It pays for a majority of the patients who live in nursing homes, he said.
"These people weren't poor all their lives, but are Virginians who spent down their assets," Sartoris said.
State officials have indicated they are comfortable with the Medicaid formulas. The Washington Post pointed out last week that Gov. George Allen was one of the Republican governors who had advised Congress on how to divide the money.
"With the relief from the mandates and with the formula, I am confident that we will have the resources to run an efficient, effective program in the commonwealth," Kay Coles James, Virginia's secretary of health and human resources, told the Post.
Sartoris said the VHA isn't disagreeing with state officials.
"But Virginians should not have to support expensive Medicaid programs in other states when the need here cannot help but grow," he said.
by CNB