Medicaid directors seek flexibility from supercommittee

State Medicaid directors say the supercommittee could cut federal spending by giving them more flexibility over their programs.

The National Association of Medicaid Directors (NAMD) urged the supercommittee on Thursday to relax the rules that govern how states make changes to their Medicaid programs. NAMD said the relaxed standards would produce savings for both states and the federal government, but its recommendations don't include any estimates of those savings.

The organization said states shouldn't need waivers to move Medicaid patients into managed care. States are increasingly turning to managed care as they try to trim their budgets, but they have to shift patients into the programs in small groups and obtain multiple waivers from the federal Medicaid agency to do so.

"Managed care has become a dominant delivery system model in our nation. For several decades, many state Medicaid agencies have been operating successful managed care programs for a large and growing number of Medicaid enrollees," NAMD's letter says. "However, historically these efforts have been focused primarily on Medicaid's least expensive populations."

NAMD also said the supercommittee should do more to let states coordinate care for people who receive both Medicare and Medicaid. The letter endorses a framework that would allow states and the federal government to share savings from the coordination effort. NAMD Director Matt Salo recently said shared savings is one of his group's top priorities for the supercommittee.