The departing administration of Gov. John N. Dalton today proposed a package of "cost containment recommendations" that would bar about 50,000 disadvantaged patients from the state's Medicaid rolls and slash medical benefits for 250,000 more.
Human Resources Secretary Jean Harris, presenting the plan to the House Appropriations Committee, said it would keep the governor's budget in line by saving the state an estimated $140 million over the next two years.
The bulk of that amount, Harris said, would come from reducing benefits to patients and sharply curtailing Medicaid payments to hospitals and nursing homes.
The proposals, a distillation of an earlier fund-cutting package that had received the approval of state health officials, have drawn loud outcries from advocacy groups speaking for handicapped and disadvantaged citizens, as well as for nursing homes.
Harris insisted, however, that the cuts were needed to slow a program growth rate of more than 12 percent a year.
"There can be no doubt that measures must be taken to bring the program under control," she said.
Members of the committee took no action on the package yesterday, but seemed to agree that they needed to hold down Medicaid costs and close an expected $122 million gap between Medicaid costs and planned expenditures over the next two years.
"I get frantic when I think of the growth we've seen in the past ten years," said committee chairman Richard M. Bagley (D-Hampton).
Still, the committee appeared divided on many of the plan's specifics, including one that would require the indigent parents of premature babies to pay the cost of any hospital care beyond the first 12 days.
"This is a terrible thing," said Del. Dorothy S. McDiarmid (D-Fairfax) of the package. "Everybody's going to be between stones and hard places."
Under some of the new proposals, the state would:
Remove from the Medicaid rolls 24,500 aged, blind and disabled Medicaid patients who do not live in nursing homes, for a savings of $23.37 million annually.
Decline to pay Medicaid bills for 270 nursing home patients whose incomes are higher than $875 per month, for a savings of $400,000 annually. An earlier plan had called for an eligibility cap of $500 per month, forcing 800 elderly and bedridden patients to leave their nursing homes, but Harris said that public protest had caused a softening of the administration's proposal.
Discontinue Medicaid coverage for 4,200 low-income youths aged 18 to 21 and sharply limit medical treatment available to another 12,000 children and 8,000 adults, for a savings of $10.4 million a year.
Eliminate coverage of optical and podiatry services for the state's 250,000 Medicaid patients. Maximum savings would be $3.2 million annually.
Decline to pay for Medicaid patients who stay in the hospital more than 12 days at a time, compared to the current limit of 21 days, for a savings of $9.4 million a year.
Base payments to hospitals and nursing homes on an annual inflation rate of 9 percent, as opposed to the current 12 percent inflation rate, saving $4.6 million a year.
Sharply limit reimbursement to pharmacists for drugs used by Medicaid patients, at a savings of $3 million a year.