Delegation tells Gov of "deep concern" on waiver

Rhode Island's Congressional delegation has expressed its "deep concern" to Governor Carcieri about the possibly adverse impact of the federal Medicaid wavier, says US Representative Jim Langevin.

Speaking with me earlier today, Langevin says he "has been concerned with the lack of transparency and specifics about the whole plan." In conversation with House Finance chairman Steven M. Costantino, "I've expressed my concern that we think very carefully before allowing the waiver to go forward. I expressed my concern that it might not be a good thing for the state of Rhode Island," particularly if low-income and elderly Rhode Islanders face diminished access to health-care.

Langevin says the state's Congressional delegation signed onto and offered input for a letter, written by Senator Jack Reed, "expressing our reticence and our deep concern to the governor." Langevin said that he and US Representative Patrick Kennedy sent a similar letter to Michael O. Leavitt, secretary of the US Department of Health and Human Services.

[UPDATE: The delegation's first letter on the topic was apparently in August, although it sent another one today.]

Asked about the response, Langevin says, "It's been more at the staff level."

Another concern, he says, is that Rhode Island might be shortchanged if there is an increase in Medicaid funding for the the state.

Carcieri has described the Medicaid waiver as a significant potential benefit for Rhode Island (I've made an inquiry with his press secretary, Amy Kempe, about the administration's response to the delegation's concern). For his part, Langevin says trying to decrease the reliance on institutional care is positive, "however, it leaves a lot of questions unanswered," such as whether "the infrastructure is in place to support these things. That's what really unclear in this whole process."

Asked what he meant by a lack of transparency, the congressman cited, "The details of how this is going to be implemented and what it's going to be like."   

According to today's ProJo, Costantino holds out the possibility of reacting to the waiver -- which will go into effect this Thursday if the General Assembly doesn't act against it -- by building subsequent safeguards for care. 

Langevin, declining to predict how the legislature will act, says he still has great reservations. "I'm not satisfied that we have the level of detail that we need," he says.