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The Connecticut Experience-Medicaid

The Connecticut Experience-Medicaid. Patricia Baker Connecticut Health Foundation May 13, 2004. Preservation of Medicaid as we know it. Medicaid in the form of a block grant supported by Bush Administration hopes to control costs and undermine entitlements

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The Connecticut Experience-Medicaid

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  1. The Connecticut Experience-Medicaid Patricia Baker Connecticut Health Foundation May 13, 2004

  2. Preservation of Medicaid as we know it • Medicaid in the form of a block grant supported by Bush Administration hopes to control costs and undermine entitlements • Bush block grant proposal strongly and visibly supported by our Governor • CT Health Foundation and Anthem Foundation Commissioned report by the Health Policy Institute of Georgetown and Child Health Council now CT Voices for Children to examine impact of changes on CT • Providers and others were in state of denial- Report presented in June 2003

  3. Preservation of Medicaid • Block grant comes to CT • Late night negotiations on budget implementer bill yields agreement by a select few in leadership to pursue waiver that includes premiums on Medicaid children,parents, elderly and medially needy at the 50% poverty rate and above, co pays, and the elimination of EPSDT- August 30, 2003

  4. Preservation of Medicaid • CT Health Foundation convened original work group to determine what the foundation and original policy experts should do in light of passage of budget implementer. • Legislative monitor explaining we must act to inform policymakers regarding impact in a user friendly way • Board memos updating them of actions and why it is important to act

  5. Preservation of Medicaid • Goal: Waiver provisions would be repealed • Our role: • Analyze the impact of proposed changes producing hard numbers • Consider target audience regarding format and distribution of public information if we are to be effective • Dissemination is equally important to content in order to accomplish goal • Activist role in connecting dots

  6. Preservation of Medicaid • Format-Policy Briefs • 5 Briefs –breaking down each issue including economic impact of changes on the whole state- 5th added when pursuit of a global cap came to light. All are posted on websites • Timing of release scheduled to build momentum going into the session and throughout the session

  7. Preservation of Medicaid • Making the dots connect: • Medicaid defense coalition • Ct Academy of Pediatrics • Outreach to unlikely suspects • Media • Educate both sides of the aisle

  8. Preservation of Medicaid • We Won!!! • Going into the session, there were enough cosponsors on the repeal bill to pass the legislation, but mostly one party support. • Education of legislators both policy implications and context of real people’s lives is necessary-some legislators saw us at the line if not over so there is risk with activist role • 2005budget sees allocation to reverse cuts • Budget Implementer has specific language against the pursuit of a global cap

  9. Lessons Learned/Issues to Consider • GIH policy calls help-I was inspired by our first call when MA spoke of their experience defending the Medicaid budget • Financing drives program priorities, but there is not an automatic connection for all board and staff • To be successful think of it in terms of an initiative fight with concrete outcomes so strategy and tactics follow vs. shed some light onto the problem

  10. Lessons Learned/Issues to be Considered • Imperative to connect the dots from research and analysis to convening, to legislative monitoring, to media to public education to advocacy- Work group spoke every 2-3 weeks from September to May. • Must marry thoroughness and impeccable data with quick turnaround and nimbleness- One more “Woe is me” story will not carry the day • Waiver process is a very secretive - executive branch to executive branch discussion, need to monitor and bring out into light of day

  11. Lessons Learned/Issues to be Considered • Leadership is key, need legislative champions including unlikely suspects • Timing, dissemination, and promotion are key to success • Use every strategy available to the foundation, research, publications, communication, grantmaking, convening, etc.

  12. Lessons Learned/Issues to be considered • Grassroots are essential and weak, need to think long-term about what we can do. People want top down strategy to take care of the basics. • Medicaid is very complicated and make no assumptions that folks understand it including the committees of cognizance • Medicaid does need reform, and we must ask ourselves what can we do to promote a positive reform in our state.

  13. Lessons Learned/Issues to be considered • Must pay attention to the internal side of the shop as well as external • Is the Board behind the campaign; do they understand the implications • Effort very time intensive, what capacity do you have internally, what do you have externally, can you act quickly, must make it a top priority to win • Are people prepared to see foundation in the center of controversy • Name will be in papers, must ensure credibility by having the best analysis possible

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