Letting Medicaid be Medicaid

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If a disability insurance plan offered by Sen. Edward Kennedy (D-MA) passes, it would change the profile of Medicaid, Larry Minnix, president and CEO of the American Association of Homes and Services for the Aging, said this week.

“Our program will allow Medicaid to be Medicaid again, to cover the basic needs of poor people, many of whom have complex problems,” explained Minnix, whose organization helped craft the disability plan, which is outlined in the new Affordable Health Choices Act.

The idea sounds almost too good to be true. Medicaid, a state-federal program, has become so massive and unwieldy, it’s hard to think of it as anything but, well, a drain on state and other government budgets.

But the idea of a disability insurance program is encouraging. If people buy into such a program, they would receive cash that they would be rightfully entitled to in the event they needed it. (For more on the proposal, click here.)

Of course, the projected $50 a day would not cover all expenses. But it would help with some caregiving or other basic needs.

And Medicaid, while it would still be necessary, would not have as much heavy lifting to do.

That sounds like relief to me.

How fast is too fast for healthcare reform?

The pace of healthcare reform is moving so rapidly, it begs the question: Is it going too fast?

President Obama wants a bill on his desk by August. It seems that he is willing to bend on the details, but he wants something concrete.

Meanwhile, there are a few itty-bitty (I’m being facetious) details to work out, such as, well, the question of how to pay for the plan, which is expected to exceed $1 trillion, and how much the government would be involved in the new system.

Long-term care, as mentioned, is on board with at least part of Kennedy’s plan—the disability insurance part of it.

But not everyone, even some Democrats, is buying into healthcare reform. The projected cost and the potential of government interference in healthcare appear to be the biggest sticking points.

But in what seems to be classic fashion, Obama is sticking to the schedule. Today, he took his case to Wisconsin, reiterating the importance of healthcare reform now. Momentum, in fact, may be just what Obama is after. Since he took office, things have happened at such a speedy clip almost anything seems possible. Stimulus package? Check. Bank bailout? Check. Taking over what was the largest automotive company in the world? Check. Hey, why not an overhaul of the healthcare system? It’s all in a day’s work.

And even though it has eluded Congress before, healthcare reform seems to be different this time around. Bruce Yarwood, president and CEO of the American Health Care Association, made this point at his group’s Congressional Briefing last week.

Unlike 1994, the administration isn’t acting alone on reform. Instead, it has laid out principles and instructed Congress to make it happen. Political heavyweights Sen. Max Baucus (D-MA), chair of the Senate Finance Committee, and Kennedy, chair of the Senate Committee on Health, Education, Labor and Pensions (HELP), are conferring. Meanwhile, over in the House, powerful Rep. Henry Waxman (D-CA), chair of the Energy & Commerce Committee, is working out a plan with Education and Labor Committee Chairman George Miller (D-CA). So Congress and the president are paddling upstream together.

Not since the New Deal has there been so much government activity.

Healthcare reform is “moving,” Yarwood told his members. “You have an administration that is prepared to bring about the change,” he noted.

According to Minnix: “We are optimistic about healthcare reform because the leaders know it has to be done.”

Like so many developments that have occurred over the last year, events have unfolded and played out in an almost surreal fashion.

There has been a lot of history-making this year. I have a hunch we should be prepared for more.
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McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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