Did Governor Doug Burgum ask his Director of Medicaid Services what her thoughts were on proposed Medicaid changes under the Graham-Cassidy bill? Did he walk down the hall, knock on Maggie Anderson’s door, and ask if there were any concerns about the long-term implications this bill would have on state administration of Medicaid Services? How involved are our in-state administrators in this process?
One day after Doug Burgum signed a letter drafted by Republican Governors signaling their support of Graham-Cassidy, Medicaid directors issued, “a warning on new Obamacare repeal bill.” In their warning to Republican Senators, Medicaid Directors from all 50 states said:
Taken together, the per-capita caps and the envisioned block grant would constitute the largest intergovernmental transfer of financial risk from the federal government to the states in our country’s history
Flexibility is desired but does no good without the resources necessary to create, implement, and sustain the new program. With a federal funding block grant under Graham-Cassidy, is Doug Burgum, Al Carlson, and Rich Wardner going to appropriate the state dollars necessary to ensure services are upheld? Will they promise to fund Medicaid at a level necessary to keep rural hospitals out of the red? Will nursing homes be able to hire enough staff to maintain quality of care, or will they close up if they solely rely on North Dakota funding? Do you trust your state government to do what is necessary for the most vulnerable North Dakotans? I’ve been in that Legislature as a member and I’m not optimistic.
If North Dakota’s Director of Medicaid Services was involved from the beginning, I’m curious what she told the Governor? Did Maggie Anderson share concerns with Burgum or his staff that block grants would be a disaster for Medicaid in North Dakota? Or because of the politically charged atmosphere in Bismarck, did Anderson stay silent about concerns only to see them revealed in a letter from the National Association of Medicaid Directors?
Seems like a lot of questions with few answers doesn’t it? I think they’re legitimate and we deserve answers. This uncertainty is what happens when legislation that impacts one-sixth of the economy is kept secret and rushed almost entirely for partisan reasons. The Medicaid Directors agree in their letter:
With only a few legislative days left for the entire process to conclude, there clearly is not sufficient time for policymakers, Governors, Medicaid Directors, or other critical stakeholders to engage in the thoughtful deliberation necessary to ensure successful long-term reforms
If Burgum did have the conversation with our Medicaid experts and they did raise concerns, my last question to the Governor is; why didn’t you listen?