Gov. Robert Bentley and Medicaid chief of the state painted a grim picture on the day of Wednesday of what will happen to the state’s 1 million Medicaid recipients due to a lean general fund budget passed by the Legislature.
The governor vetoed the $700 million budget he claimed was $85 million short of money required to maintain services and reimbursement amounts in the state’s Medicaid program and sustain a transition policy to managed care later this year. On the day of Tuesday, although, the House voted 71-24 and the Senate voted 22-10 to override Bentley’s veto of the general fund budget.
The governor has hinted he may call lawmakers back into particular session over Medicaid funding.
Bentley and Alabama Medicaid Commissioner and General Counsel Stephanie Azar arranged a press conference in Montgomery on the day of Wednesday to outline what programs could be cut due to the budget shortfall. The governor, who has been embroiled in a scandal relating to his previous top aide, made it obvious to the media he would merely discuss Medicaid and the Prison Transformation Initiative Act. The Senate on the day of Tuesday voted 23-11 to pass an $800 million prison construction bill.
“Do not inquire me anything other than those 2 things,” Bentley claimed. “This proposed state has actual issues. We are here in an attempt to resolute those issues. We have been appointed by the people to try to solve those issues because we have persons who are hurting and our job is to try to assist the people of this state.”
Azar asserted the additional / extra $85M missing from the general fund budget would have helped the state in developing Regional Care Organizations. The RCOs would have transformed the Medicaid network from a fee-for-service model to one that offers managed care. In the month of February, the state got federal approval of the Section 1115 Demonstration Waiver and the promise of $328 million in federal funding over the next 3 years to execute the RCO policy.
She claimed the following programs could be cut, with the permission from the CMS (Centers for Medicare and Medicaid Services):
Azar claimed her agency is also looking at decreasing administrative costs, which could save $3.5 million. Eradicating drug coverage for adults could save another $50 million to $60 million. She claimed the state could change its adult drug coverage, but could not legally make changes to drug coverage for kids.
She stated the cuts could also be made in the reimbursement amounts to ambulatory surgical centers and physicians as well as programs that cover optometry, dental care, transportation and ones that gives advantages to expectant mothers. Azar further added Bentley has little flexibility in deciding which of those programs would be decreased back at a savings of upto $50M.
She claimed that she had negotiations with CMS over the budget of state case and further added there is no timeline on when these proposed cuts could take effect.
“None of us needs to be standing here discussing over any of these,” Azar claimed. “It is the governor’s and Medicaid’s objective to sustain the RCO program. The (1115) waiver was a huge milestone and we should be proud of that.”
Rather his Medicaid defeat, Bentley on the day of Wednesday thanked members of the Senate who passed the prison bond measure. A huge initiative of Bentley’s, the $800 million bond issue would fund 4 major new prisons. As of the end of the year 2015, the state’s prisons were crammed to about 180% capacity.
Bentley visited Limestone Correctional Facility in Harvest on the day of Monday as part of a statewide tour to encourage the initiative.
The bond issue would consolidate most of the state’s existing services into 3 men’s prisons and 1 women’s facility to replace the Tutwiler Prison for Women, which has been a subject of a federal abuse investigation. The latest prisons are projected to be at 125% capacity when they open.
Authorities with the Alabama Department of Corrections have not officially claimed what prisons would close as part of the consolidation.
Prison Commissioner Jeff Dunn said in the month of March that as long as services are modernized, the state should not require hiring more corrections officers.
Opponents of the bill claim new construction does not do enough to deal the systemic problems leading to overcrowding.
Senate President Pro Tem Del Marsh said he considers the state will transition away from simply “warehousing” persons with a renewed concentration on vocational training and rehabilitation.
Sen. Quinton Ross, D-Montgomery, said on the day of Tuesday that his co-workers should “slow down” to consider the bill.
“Here we are sitting on the verge of a general fund budget where we cannot find money to keep our Medicaid system afloat, but we are ready to float bonds to the tune of $800M to fund the prisons,” Ross stated. “There is something wrong with the scenario.”
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