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Medicaid Eases Sign-up for Katrina Evacuees

The federal government is relaxing Medicaid rules in an effort to spread medical coverage to low-income people who fled the aftermath of Hurricane Katrina, officials announced Friday.

The move is designed to cut red tape in the program’s application process and make it easier for some of the estimated 1 million Katrina evacuees to get government health insurance.

The federal government shares the cost of Medicaid and the State Children’s Health Insurance Program with states, though individual states run both programs. The mass evacuations that followed Katrina last week threw the system into some disarray as beneficiaries and their families fled to many other states.

The moves made it unclear how “host” states would provide health care to evacuees who usually get their care in Louisiana, Alabama, or Mississippi.

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Cutting Red Tape

Washingtonofficials said they would let states forgo normal application rules and instead allow states to enroll Medicaid and SCHIP beneficiaries without normal checks of assets and income.

“It’s just not feasible to provide that information in many of these circumstances,” Medicaid chief Mark McClellan, MD, told reporters Friday.

At the same time, the agency is planning a system to reimburse state governments that provide the extra care used by new residents, they said. Still, details on how those costs would be covered -- or whether the federal government will refund the entire cost of care -- remain to be worked out by Congress.

Nineteen percent of Louisiana’s 4.4 million residents with health insurance use Medicaid, 4 percent higher than the national average, according to the Henry J. Kaiser Family Foundation. More than 22 percent of the state’s residents live under the federal poverty level, about $16,000 for a family of three.

Ruth Kennedy, Louisiana’s deputy Medicaid director, told reporters Friday that the rate of uninsured children in her state fell from 25 percent in the late 1990’s to 8 percent in 2004. “Of course all of that now is all at stake, that progress,” she said.

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Emergency Spending

Lawmakers have begun efforts to form a plan for spending emergency funds for Medicaid and SCHIP coverage in affected states.

McClellan said the emergency procedures would apply to evacuees with existing public insurance and also to those without coverage who think they may be eligible. People left destitute by the storm’s destruction may also be newly eligible, he said.

Still, the policy is not designed to expand Medicaid’s income and asset thresholds for eligibility.

McClellan said that his agency has no estimate for how many beneficiaries would sign up under the relaxed rules or what the enrollments would cost.

By Todd Zwillich, reviewed by Brunilda Nazario, MD

SOURCES: Mark McClellan, MD, administrator, Centers for Medicare and Medicaid Services. Henry J. Kaiser Family Foundation. Ruth Kennedy, Medicaid deputy director, Louisiana.