As I was having a “chat” with my husband earlier this
week about who was supposed to have come up with a dinner plan, I started
thinking about the similarities between married life and health care reform
implementation. (Well, to be honest, this wasn’t my very first thought when I
came home to find a dark kitchen, cold oven and three hungry kids). Weddings are an inspirational beginning
to a life together, but the true test of a marriage or committed partnership
often is how you handle the details of daily life. Similarly, the signing of
the Affordable Care Act gave us an inspirational vision of how health reform
might work, but it is nitty-gritty action like CMS’s recently proposed rule to
provide states with a 90 percent matching rate for their Medicaid eligibility
systems through 2016 that may be more important in the end.
The proposed rule is not fun or easy to make your
way through (for a cheat sheet, see Tricia Brooks’ blog on the topic, but it goes straight to the heart of the infrastructure we need for health
reform to work for low-income people. Even if the Affordable Care Act had not
passed, states would have needed to modernize their decades-old Medicaid
eligibility systems. In many
states, these systems already are straining to keep pace with the families
losing jobs in the current economic downturn and often function only if
caseworkers manually use “workarounds” to overcome computer-coding problems.
Now, with millions more people expected to apply for Medicaid, it is more
important than ever to develop state-of-the-art, beneficiary-friendly Medicaid
enrollment systems.
To help ensure that the proposed rule becomes final and
is strengthened in targeted ways, we are working with several other national
organizations to encourage state and national partners, beneficiary advocates,
provider organizations and others to prepare and submit detailed comments on
the proposed rule. I strongly
encourage you to take a look at the comments available at this link and to sign on by January 5, 2011 or to submit your own
comments. The comments are aimed at:
* Encouraging CMS to consider making the enhanced federal
funding available past 2016;
* Promoting the opportunity for beneficiaries and
advocates to provide input into how eligibility systems should work;
* Accompanying the new eligibility systems with more
streamlined, beneficiary-friendly application and renewal procedures;
* Ensuring eligibility systems comply with all civil
rights laws and are designed to work for beneficiaries in a culturally and
linguistically appropriate manner;
* Ensuring eligibility systems are effective at
communicating with beneficiaries, such as by producing materials at an
appropriate literacy level and supporting the role of community-based
organizations in helping families enroll in coverage;
* Clarifying the availability of enhanced federal support
for upgrading all aspects of a state’s Medicaid eligibility system, including
its role in evaluating eligibility for seniors and people with disabilities.
As for the short-term challenge in my home life earlier
this week, we went with the tried and true “workaround” – ordering pizza. But, in the New Year, I think we’ll be
adopting some new and streamlined procedures for the dinner hour.