Transcript Slide 1

Disability Policy Seminar
February 15, 2011

Challenges
◦ State budget deficits
◦ Push for flexibility
◦ Potential for major structural changes as part of
deficit reduction
◦ Getting implementation done right

Opportunities
◦ Expansion of coverage
◦ New options for home- and community-based
services

Cuts inevitable but some deeper than needed:
◦ Rainy day funds still available in some states
◦ Lack of a balanced approach

Pressure to repeal maintenance-of-effort
provision
◦ AZ waiver request
◦ Repeal would have significant impact on people
with disabilities

New Medicaid waiver requests could include:
◦ Block grant waivers would cap state and/or federal
spending on the program
◦ Requests to increase cost-sharing and premiums
above Medicaid limits
◦ Requests to limit benefits for certain groups




Senate bipartisan negotiations
Leading proposals would cap federal
spending as share of GDP
“Look Ma, No Hands” Approach
Connecting the dots leads to Medicaid Block
Grant



Biggest challenge is playing defense and
offense at the same time
Need for strong messages on value of
Medicaid
Maintain focus on implementation
◦ Benefit packages for Medicaid
◦ Eligibility determination process
◦ Consumer support and education