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DHW director uncertain of Medicaid savings

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Richard Armstrong, the director of the Idaho Department of Health and Welfare (DHW), said he’s not certain that he can come up with the $42 million in savings to Medicaid that lawmakers are asking him to find.

“I am being pushed absolutely to the edge of a very, very serious cliff,” Armstrong said. Lawmakers on the Joint Finance-Appropriations Committee (JFAC) gave DHW and the governor the authority to find savings in Medicaid costs by reducing health care prices and benefits. “The notion that we can solve these problems, I think, is not real. There are so many barriers in front of us to be able to get this kind of a reduction that it is a daunting task.” Medicaid provides health care for low-income children and adults as well as people with disabilities and other special health needs. DHW estimates more than 150,000 Idahoans will be on Medicaid during the next fiscal year, which begins in July.

Armstrong said he will do his best to find savings, but his hands are somewhat tied. “We will pursue all of these issues, absolutely. However, what you have to understand (is that) we have to have permission on everything from the federal government.” The federal government pays 79 percent of Medicaid costs. That money for health services comes with regulations and oversight. Armstrong said the last time DHW asked for federal approval for state Medicaid reductions, it took nine months to get a response. “If we turned in the request today, the ability to see significant changes in 2011 is dim,” Armstrong said. The 79 percent federal reimbursement rate will go down. Currently, it’s set to expire at the end of December, but Congress could push that deadline back to June 2011. “The biggest problem that we as a society face in Idaho is the fact that the federal matching rate is to go back,” Armstrong said. “That would be $140 million in general funds that would be required to maintain the Medicaid program.”

Armstrong added that current federal rules prevent some service reductions, which could limit his search for savings. One issue proposed by lawmakers would be to institute waiting lists for non-essential health services. “We cannot put people into waitlists because that is in effect a de facto change in their eligibility,” Armstrong said. He also said it may not be doable to change Medicaid’s prescription drug program, which was suggested by Rep. Fred Wood, R-Burley. Armstrong said he received the list of recommended savings and reductions from lawmakers Thursday, and will need a few days for his staff to come up with a path forward. “I think there’s a host of issues that we need to spend some time on,” he said.

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  3. Ronald Blong

    I’m 64 with allot of Disabilities and take several Medications that i cant do without and could not pay for out of my Total Social Security income. Added up I only get a total of $727 a month and without a roomate i wouldent be able to have a place to live. I been on the Section 8 Housing list since Oct. 2007. they gave out Voulchers this year from about April oe 2007 and stoped ween they were on Aug. 2007, only a few months. and dont think they will get any fundung for i dont know how long. It was years before they started up again last. On Medicaid Perscriptions, I thinh there could be some savings if we paid $1-2 on each as a co-pay.In my situation i would rather do that than lose my medications. I know Medicaid dont pay full price on Perscription cost as my Doctors told me this, they pay a little over the Pharmacy’s wholsale cost. With out our meds. most of us could not survive, or lead as close to tolarable life at all. In my case and most others the Medications keep us from having to have Very expensive Surjurys, Hospital Cost etc. because we can manage our medical Disabilities the best we can and avoid the altertinive procedures and Doctor, Hospital care. I think cuting or taking away our medications would a VERY BAD DECICION . A VERY SMALL CO-PAY WE COULD LIVE WITH.That would work out. Wallmart and others offer only a few meds that cost $ 4. They are making a Profit in doing it. The MARK UP ON MEDICATIONS IN AMERICIA IS OUT OF CONTROL AND THE GOVERMENT SHOULD PUT A STOP TO IT. If you can buy the same Brand Exact Meds. from Canada, Mexico and in Europe, who also have way cheaper Generics. you can see the prices are out of control.Also we cant get medicaid meds from other Countrys. But i thing Americia has safer controls. and since they have a deal with Pharmacys here for a bit over there cost it would make sence that a Small Co- Pay for medicaid Rx. would cut cost so we dont lose our medication.