Nebraska Medicare Medicaid Gift Drawing Fire

I’m glad that someone is taking a look at the provision in the recently passes Senate health care reform bill that has Nebraska’s medicare Medicaid reimbursement at a full 100%. The Courant’s Christopher Keating reports:

In a move being made by other states, Republican Gov. M. Jodi Rell called for legal action Wednesday if Nebraska receives more Medicaid money than the other 49 states as part of the national health care bill.

Rell wrote a letter to Connecticut Attorney General Richard Blumenthal regarding a provision inserted into the massive federal legislation that would fully fund Medicaid for the home state of Senator Ben Nelson, a Nebraska Democrat. The provision has been widely reported as part of the many deals struck to reach a compromise on health care.

Across the country, attorneys general in at least seven states are voicing similar concerns about the Nebraska compromise and questioning its legality.

The Senate vote on the bill is scheduled at 8 a.m. Thursday. The Christmas Eve vote is highly unusual as the Senate has not been in session on that day in the past 46 years.

Unlike Connecticut, Nebraska would be able to receive 100 percent reimbursement of its Medicaid costs if the provision is enacted and signed into law by President Barack Obama. Currently, Connecticut receives 50 percent of the cost for Medicaid, which is a federal-state program that provides health care for the poor.

“The inequity of this provision is astonishing,” Rell wrote Wednesday in her letter to Blumenthal. “The doling out of favors for senators is appalling. The cost of this federal health care bill is beyond comprehension because of all the special provisions included to garner the 60 votes for passage.”

“By the time Washington finishes with this proposal and drops it at the taxpayers’ doorsteps, it will be monstrous,” Rell said. “The Senate may get their votes, but the American taxpayer will get the bill. The best Christmas gift Congress could deliver to the American people would be to strip out every special consideration, every gift, every piece of pork and concentrate on the heart of the matter – real and affordable reform.”

Right on. Strip them out, but then wouldn’t that derail Chris Dodd’s attempt at erasing his very negative polling numbers in Connecticut? From another story, this time from Politico’s John Bresnahan:

Sen. Chris Dodd (D-Conn.) is using every last bit of clout he has accumulated during three decades in the Senate, calling in favors, winning sweetheart deals and steering hundreds of millions of dollars to his home state.

He’s one of the most politically vulnerable Democratic senators, and he’s not being shy about using his influence to insert into 2010 spending bills dozens of earmarks for senior citizen centers, low-income heating assistance, education programs, new buses and highway funds in Connecticut.

Dodd is pushing the Pentagon to buy more Connecticut-built aircraft engines, and he’s pressing for more federal dollars for high-speed rail in the Nutmeg State.

And his earmark largesse doesn’t include a $100 million provision he anonymously stuck into the Senate Democratic health care package, money that Dodd wants to go to the University of Connecticut’s medical center.

At first, Dodd didn’t want to claim credit for that one, but he ’fessed up when asked by The Associated Press.

“With a tough reelection battle next year, Sen. Dodd is trying to move anything in Washington that isn’t nailed down up to Connecticut,” said Steve Ellis, vice president of Taxpayers for Common Sense, a spending watchdog group.

Ellis’s group estimates that Dodd — either by himself or with other lawmakers — has secured 92 earmarks worth at least $121 million for Connecticut.

I think Rell is thinking along those lines too, not to say the Nebraskan Medicare Medicaidlargess is particularly bad for Connecticut when you consider that the medicare tab for the state is about 20% of the budget, or 3,724 million. About half of that is covered by the feds, so that leaves 1.8 billion on the hook for Connecticut Taxpayers.

  • Correction Request and a Couple of Comments

    Please note, for what it is worth:

    1. Medicare is funded 100% by the federal government. The states have no role in funding Medicare.

    2. The program in question in your post is Medicaid, a federal-state program in which the federal government and state governments share the cost of medical assistance.

    3. The federal share of the Medicaid partnership varies from state to state. Connecticut’s federal/state sharing formula is 50/50. A full list of the sharing percentages state-by-state can be found at: http://aspe.hhs.gov/health/fmap10.htm. At present, the highest federal share seems to be Mississippi, where the federal government pays a bit over 75% of Medicaid payments.

    4. If Ben Nelson has succeeded in getting Nebraska’s Medicaid program funded at 100% by the federal government (I haven’t read the bill, so I can’t verify that this is in fact the case, but I will take your word for it), then it will of course be the highest (possible) federal share for a state Medicaid program. But it is important to note that there are _already_ (for a variety reasons, no doubt) significant differences state by state in federal/state cost divisions.

    5. My guess is that, if Nebraska gets 100% federal funding for Medicaid, other states will work like crazy to get the same deal. Gov. Rell’s comments may be an opening shot in that effort. Interestingly enough, a complete federal takeover of Medicaid financing would probably be the most significant and efficient form of financial assistance that the federal government could give to the states. As noted in the post, even at a 50/50 rate, this would be a significant benefit to the State of Connecticut, by eliminating one of the largest line items in the state budget.

    /wonkery

    • turfgrrl

      Correction Request and a Couple of Comments: Mea culpa. In my haste I mis-identified the largess. yes it is Medicad.

  • BLARNEY

    Ain’t it wonderful how they bribe each other WITH OUR MONEY.