Medicaid, Passport provide early debate fodder for '11 governor's race

11/17/2010 07:16 PM

If this week has been any indication, the one of the first big policy battles of next year’s governors race will be what to do with the biggest budget busting program the state oversees: Medicaid.

The Wednesday, Nov. 17 edition of Pure Politics focused on the challenges posed by the federal-state Medicaid program — the $6 billion program that covers health costs for more than 800,000 poor and disabled Kentuckians.

It’s been eating up bigger parts of the state budget each year. And most recently, the Passport Health Plan that administers Medicaid to people in Jefferson County and its 15 surrounding counties has come under the harsh spotlight of public scrutiny.

All this has put Gov. Steve Beshear’s administration somewhat on the defensive. The legislature tasked the administration with finding ways to streamline the Medicaid program. And now officials are calling for increased oversight of the Passport plan’s finances as a result of state Auditor Crit Luallen’s review of the program that found inefficient spending and other record-keeping issues. .

All this has opened the door to criticism from Beshear’s potential Republican rivals in next year’s governor’s race. Phil Moffett, a Louisville businessman, and Senate President David Williams have both made public statements criticizing the administration over Medicaid policy and oversight.

Williams, this week, shared his philosophy about what needs to happen with Medicaid at a hearing:

Williams also engaged in a cross-examination-like back-and-forth with Beshear’s Health and Family Services Cabinet Secretary Janie Miller over Passport.

One of the key issues is whether Passport, as a managed care provider, saves the state more money than if the state just directly reimbursing doctors and hospitals for care for the poor and disabled who are covered by Medicaid.

The state audit report said no review had been conducted, and Williams pressed Miller about why the cabinet wouldn’t conduct that analysis before renewing Passport’s $793 million annual contract.

The Courier-Journal’s Tom Loftus wrote about the internal review Miller referenced. Here’s what his Feb. 18 article said about then-Medicaid Commissioner Elizabeth Johnson’s report:

Passport Health Plan, often praised for its efficiency as Kentucky’s only Medicaid managed care venture, costs the state far more per person than the state’s regular Medicaid program, a key state official contends.

The assertion was made in a five−page letter sent Tuesday by state Medicaid Commissioner Elizabeth Johnson ? and strongly disputed by Passport officials ? to the staff of the House budget committee.

Passport has generally been credited with achieving big savings. House Speaker Greg Stumbo, D−Prestonsburg, said Friday that the House was looking at expanding “some of the programs that we know work like the Passport program.”

But Johnson said in her letter that in fiscal 2009 the state spent $388.89 per member per month for coverage provided by Passport ? 21 percent more than the $321.59 it spent to insure those in the regular Medicaid program.

Beshear proposed this week expanding managed care operations as well as a cost-savings measure.

Williams said that should have been looked at earlier but also questioned why the cabinet hasn’t extensively studied whether it saves as much money as advertised.

- Ryan Alessi


Subscribe to email updates.

Subscribe and get the latest political intelligence delivered to your inbox.