State makes changes to Medicaid proposal

Associated Press,

COLUMBIA -- State officials said they revised a part of the proposed major changes in Medicaid to make sure children will continue to receive the same services if a new state-federal health insurance program is approved.

The revisions follow criticism from legislators and advocates for the poor, who worried children would have services cut under the new proposal, which creates personal health accounts for Medicaid recipients.

The account would be used to purchase private health insurance or pay for care directly. And the amount of money for each account would depend on the person's age, sex and physical condition.

State Health and Human Services director Robert Kerr said the state can't withdraw the proposal, which could affect about 850,000 people in South Carolina, but it will continue to make changes as warranted. The proposal has been criticized, but Kerr said it is early in the process and he is open to suggestions. He said he hopes the federal government approves the proposal by the end of the year.

Kerr told legislators Wednesday that the agency will submit a revised proposal. "I won't cut children's benefits," Kerr said.

According to part of a revised proposal posted on the agency's Web site:

"The children's benefit package, at current eligibility levels, for all plans must include all mandatory and optional services including Early and Periodic Screening, Diagnostic and Treatment Services," a program advocates say is critical for healthy development. Those 18 and younger make up more than half of Medicaid recipients in South Carolina.

The revision also said plans will be held "to the same amount, duration and scope rules for these services as the agency is today."

"That's good to hear," said Sue Berkowitz, director of the South Carolina Appleseed Legal Justice Center, an advocate for low-income communities. "I think that they are obviously back tracking on a lot of issues, now that the public is responding."

Legislators and the public packed a conference room at the Statehouse on Wednesday to hear about the new proposal. Many House Democrats have opposed the changes.

"I left the meeting feeling somewhat better than I did going in because they understand now their waiver has to be adjusted," said House Minority Leader Harry Ott, D-St. Matthews. "The public knows what they're trying to do, and they, as well as members of the Legislature, intend to make sure the poor children in South Carolina don't suffer."

Berkowitz said she still is concerned about 19-and 20-year-olds who could lose some services under the new proposal.

South Carolina is seeking at least 30 changes to Medicaid. The agency hopes the changes will hold growth in the $4.8 billion annual program to about 6 percent a year over a five-year period. Last year, South Carolina's Medicaid program grew by 5.8 percent, one of the lowest growth rates in the nation.

Kerr also said his agency is reconsidering whether to require higher co-payments for medical services from Medicaid recipients.

"Two dollars isn't much money to me, but it's a lot to someone on Medicaid," Kerr said, noting that a family of three must make less than $15,000 a year to quality for the program.

A 10-member committee also has been appointed to help the agency with aspects of the proposal, which Kerr said is needed to curb spending and growth in the program that cares for the state's neediest residents. The committee includes doctors, health care officials and advocates.