Restrictions on Medicaid; "This policy demonstrates the president’s compassion."

[dajoki]

U.S. Curtailing Bids to Expand Medicaid Rolls
By ROBERT PEAR
Published: January 4, 2008
http://www.nytimes.com/2008/01/04/washington/04health.html?_r=1&ref=us&oref=slogin

WASHINGTON — The Bush administration is imposing restrictions on the ability of states to expand eligibility for Medicaid, in an effort to prevent them from offering coverage to families of modest incomes who, the administration argues, may have access to private health insurance.

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Until now, states had generally been free to set their own Medicaid eligibility criteria, and the Bush administration had not openly declared that it would apply the August directive to Medicaid. State officials in Louisiana, Ohio and Oklahoma said they had discovered the administration’s intent in negotiations with the federal government over the last few weeks.

The federal government has leverage over states, because it pays a large share of the costs for Medicaid and the State Children’s Health Insurance Program, and states have to comply with federal standards to get federal money. The insurance program was created for children whose families have too much income to qualify for Medicaid but not enough to buy private insurance.

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“We want states to focus on enrolling their neediest population before they consider expanding Medicaid and CHIP to middle-income families,” Mr. Fratto said. “This policy demonstrates the president’s compassion. He wants to direct scarce tax dollars to those with the greatest needs.”

Administration officials say government health programs start to “crowd out” private insurance when they cover families with incomes from 250 percent to 300 percent of the poverty level — about $51,600 to $62,000 for a family of four.