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Medicaid Overhaul Needed

Location: Washington, DC

Wilson: Medicaid Overhaul Needed

Task Force Chair Places Focus on Improving Health; Urges National Strategy on Longterm Care

Washington, DC - Congresswoman Heather Wilson, who chairs the Energy and Commerce Committee Medicaid Task Force, today said that she expects an open discussion in the 109th Congress about challenges facing the Medicaid program, options for reform and possible legislation to make the program better.

"It's time to take a long look at making the Medicaid program work better for the people it serves," Wilson said, speaking to 200 state Medicaid officials at the National Health Care Leadership Conference. "Medicaid is set up to process claims, not to improve the health of people."

In recent weeks, Wilson has been conferring with governors around the country about Medicaid reform and needs in their states. "Medicaid has surpassed Medicare and is now the largest public health insurance program in the United States with 48 million beneficiaries and expenditures of $280 billion," Wilson said, addressing conference attendees in New Orleans by telephone.

"While we have spent several years improving the Medicare program, Medicaid improvement is only now beginning to emerge as the next major health care challenge."

"Before we move ahead with solutions, we must understand what the problems are," Wilson said. "We know that Medicaid does a poor job of managing chronic diseases like diabetes, asthma and heart disease. As one doctor said to me, 'The system only gets paid if people are sick. It's not set up to improve the health of poor people.' States need a waiver from the federal program to prevent disease or reduce risk factors."

"Medicaid is a one-size-fits-all program in a society that demands choices. We should empower people to take ownership of their health care." "In many ways, the financing of long-term care is our greatest challenge, and it is in this area that we may see the greatest changes," Wilson said.

Medicaid is the single largest payer of long-term care costs, accounting for 43% of spending. "We need a national strategy on long-term care in this country to address the tremendous costs associated with the doubling of our senior population in the next 20 years."

"We also know that, under the pressure of expanding enrollment and increased costs, states have developed questionable financial schemes to maximize federal dollars," she added. "State agencies focus on the money stream, rather than focusing on what's best for patients."

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