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Governors Propose Unacceptable Glorified Medicaid Block Grant

February 6, 1996

Today, a bipartisan group of the nation's governors presented their Medicaid reform plan to the full membership of the National Association of Governors. The proposal was received with overwhelming support by 48 of the 50 governors in attendance. In a press conference today, President Clinton acknowledged he has some further questions about the proposal, but noted that it appeared the proposal would meet his bottom line on Medicaid -- keeping the guarantee of the program for women, children, disabled and the elderly.

Although AIDS Action has only seen a brief six page summary of the plan, on its face it is completely unacceptable to the AIDS community. It will not meet the health care needs of people with HIV/AIDS under the Medicaid program and could exclude people with HIV/AIDS from eligibility from the program.

What is the Governors' Proposal Really?

On the surface it looks like a good faith attempt to assist in the resolution of the federal budget stalemate. What the nation's governors are proposing, however, is a block grant quite similar to the Republican "Medigrant" proposal which the President vetoed late last year. This is a glorified block grant with some modest federal requirements. This plan would give states complete control over what kind of services are available, who receives those services, and who provides the service. Each state would receive one lump sum payment to provide services to all beneficiaries for the entire year. Only if states exhaust the base payment and also meet other emergency criteria will they be eligible for additional federal funds. This proposal would create incentives for states to limit eligibility and benefits.

The Governors' Plan:

  • Eligibility: The states are granted complete authority to define disability. Many people with HIV/AIDS could be denied eligibility for coverage simply because they do not meet the state's definition of disability.
  • Benefits: Under the governors' proposal, mandatory benefits are guaranteed only for a narrowly defined guaranteed population. Many people with HIV and AIDS currently receiving benefits under medically needy provisions, could be denied not only access to optional services but to mandatory benefits as well. States would determine what benefits are available and which groups of Medicaid beneficiaries might have access to specific services. States would have the option of restricting the amount of patient physician visits to one a month, for example, or providing certain benefits like prescription drugs only to specific populations, like children.
  • Affordability: States would be free to require copayments from Medicaid beneficiaries for services. People with HIV and AIDS could be forced to choose between physician visits and prescription drugs at great cost to their overall health.

AIDS Action:

Call the Senate Switchboard at 202-224-3121 and tell your senators to oppose the governors proposal to reform Medicaid. Call President Clinton at 202-456-1414 and tell him to reject the governors' proposal. Remind the President that he promised to maintain the entitlement status of Medicaid and you expect him to keep his word. The Governors' proposal does not protect the entitlement and jeopardizes the health care of people living with HIV and AIDS.

E-mail addresses for your Senators can be found posted in HandsNet at Resources/Congressional Contacts. You can reach the White House by e-mail at

For more information, contact
AIDS Action Council
1875 Connecticut Avenue NW #700
Washington DC 20009
202-986-1345 (fax)
202-332-9614 (tty)

This article was provided by AIDS Action Council.
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