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