Idaho Examiner -
Idaho Rep. Tom Loertscher

Tuesday, October 25, 2005

House Highlights - Interim Report – October 2005

By Tom Loertscher

As the time for the next session of the Legislature approaches, the interim schedule picks up. All types of organizations invite legislators to visit with them and in addition to those meetings some things come from the House. This past week included a two day joint meeting of the House and Senate Health and Welfare Committees in the capitol city. There have been a number of developments during the summer that deserve some attention prior to convening in January.

The top attention getter of the meeting was the new Medicare part D prescription drug benefit that is scheduled to begin January 1, 2006. It is part of what is termed the Medicare Modernization Act (MMA), and the interest of the committees has come about because of the role that the State has in its implementation. Because every current Medicare participant is eligible for the benefit, the Social Security Administration has mailed an inch thick publication in an effort to explain the application process and the benefit options available. Reportedly, many of those who have attempted to read the manual have found it to be confusing, leaving more questions than answers. It is suggested that if you need help with the application process that you contact the Idaho Department of Heath and Welfare, Idaho Commission on Aging, Idaho Department of Commerce and Labor, District Health Department, Idaho Legal Aid or the Social Security Administration for assistance. To add to the confusion of this brand new program there are between forty and fifty different options for seniors to choose from, that involve deductibles, co-pays, and premium levels. Penalties will be assessed each month if the May 15, 2006 deadline is missed.

If you are confused by the above description, you are not alone and of course there are too many details to discuss here. The comments from the members of the committees were noteworthy. Those comments ran the gambit, “Who in their right mind would have thought this up?” to “This is a nightmare.” The other part of MMA that is significant is that Idaho and every other state will have to write a monthly check to the Feds for what is termed our dual eligible population, those who are on Medicare that are also eligible for Medicaid. Those checks will total in the millions of dollars and according to what was suggested at our meetings, it would be a growing figure as that group of recipients grows. Those check amounts will not be coming from existing budget savings that may or may not materialize, but will come in the form of a supplemental appropriation to the Department of Health and Welfare. Whether or not you agree with this new prescription drug benefit, it is coming at warp speed. From my perspective, it seems that the implementation of this new “entitlement” is being done before the program design is complete, as evidenced by the federal people who still don’t have answers to unique questions of policy as they affect individuals. As with anything this big there are bound to be problems, big problems.

Also on the agenda for the two day meeting were presentations on Avian Flu, Medicaid reform, Mental Health, automation needs (computers and programming) and employee compensation (also known as raises). All of these items represent the need for more money. It was made clear that these items just represent the request that has gone to the Governor’s office and do not contain any of his thinking on these matters. Overall these requests represent an increase over last year’s budget in excess of twenty percent. Medicaid is continuing its upward spiral and in the words of the Department our present course is “not sustainable.” I agree, and have been saying so for some time. Several of our people including the Governor met in Washington D.C. with Secretary Leavitt about new waivers seeking new flexibility in our Medicaid design. We were not given much detail of the request and at this stage it is not possible to know if the flexibility the Department desires is helpful or not. The devil is always in the details and past experience leads me to believe that flexibility could lead to the use of those famous words we all know and love, “More money.” If it is of any comfort, the two committees are at least forewarned of what is coming in January. Tevia in “Fidler On The Roof” said something like this, “Good news is slow coming and bad news refuses to leave.” Are you getting that feeling?