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Medicaid head upgrades agency's financial outlook

By Desiree Hunter
Associated Press Writer

MONTGOMERY — Poor and disabled Alabamians who rely on Medicaid for health care will have to wait a little longer to find out if any services will be cut, but the financial outlook may not be as dire as it was this summer, the agency's head said Wednesday.

Commissioner Carol Steckel told a legislative committee that Medicaid's budget won't be completed by the Thursday deadline, when it was to be submitted to the governor, and her earlier estimate of a $600 million deficit in federal and state funds was premature.

She also didn't have details about negotiations with the Centers for Medicaid Services over federal funds and if the agency would need at least the same amount of funding it asked for last year.

That frustrated committee members who attended the hearing hoping to learn the agency's financial needs for fiscal year 2009, which begins Oct. 1, 2008. But Steckel said there was no need for alarm.

"This was a budget dialogue for 2009. It is now October 2007. This is something we go through every year with Medicaid," she said after the sometimes tense hearing. "We'll work through these issues, but to have a very public debate that scares people, I think is inappropriate. It's always darkest before the dawn."

Members of the joint committee said they wanted to become more hands-on in the process and asked to take part in the CMS negotiations, which Steckel said have been going on for two years.

Steckel said she welcomed their participation and was already considering some of the members' suggestion to look into reducing the amount of money spent on nursing homes and exploring other options.

Rep. John Knight, D-Montgomery, chairman of the House Government Appropriations Committee, said he called Wednesday's hearing because he was worried that time was running out before the Legislature reconvenes in February.

Medicaid provided medical services to more than 777,374 poor and disabled Alabamians in the 2006 fiscal year and the legislators said they have
already started hearing from constituents who are worried about having their services cut back.

"I want to know what does it take to provide at least what we are providing at the present time and some assurance that we're not going to be taking anybody off the Medicaid program," Knight said.

Steckel said in August that the agency would need about $200 million more in state funds — which would be matched by nearly $400 million in federal money — to continue current operation levels. Medicaid is receiving about $470 million in state funds in the 2008 fiscal year that began Oct. 1.

Some of the numbers she used to calculate those estimates have since changed, she said, and there's chance the shortfall could be smaller than originally thought.

"Some of the trends seen going one way are now going a different way. Some of the projections are not coming in," she said. "Those were preliminary at that point in time."

Kimble Forrister, executive director of Alabama Arise, said concerns like the ones raised Wednesday have unfortunately become expected.

"For the last 15 years there's always been Medicaid funding shortfalls and I think it's built into our system. We don't provide the level of funding that other states do and that's what's going on," he said. "Some day we're going to have to face up to the need for more funding for Medicaid. Whether this year is it, I don't know."

Copyright 2005 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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