April 14, 2024 Letter

Dear Neighbors:

If you were not able to see the total eclipse yourself, I hope you heard a good story (and saw a good picture) from someone who did. Returning to Earth, this week’s letter discusses the need for updates on the Washington Bridge, the sustainability of Medicaid programs after the expiration of federal pandemic relief funds and an upcoming community meeting.

1. Legislating Transparency For The Washington Bridge Project

On Wednesday, the Senate Oversight Committee heard a Bill that would require the Department of Transportation to provide a standard format “snapshot report” each month on its Washington Bridge website providing current data on such issues as (1) the construction timeline, (2) traffic levels, (3) frequency of accidents and breakdowns and (4) travel times. In a different world, it would not be necessary to invoke the legislative process to obtain the regular public disclosure of this type of basic information.

2. Post-COVID Changes In Medicaid Programs

a. Difficult Choice Following The Expiration Of Federal Funds

On Thursday, the Senate Finance Committee reviewed the budget of the Executive Office of Health and Human Services (EOHHS), the agency responsible for operating Rhode Island’s Medicad program. For the past three years, significant federal American Rescue Plan Act funds have paid for expanded Medicaid social and health services to respond to the medical and emotional impacts of the pandemic. The Governor’s budget includes funding to raise the reimbursement rates for Medicaid providers, phasing in an additional $210 million commitment over three years to address some of these gaps, but many remain. The General Assembly will face difficult choices in deciding which remaining gaps to address with the loss of federal funds.

b. Possible Cost Savings

The Committee learned of one area to realize savings without reducing services. Last month, the Office of Auditor General released a Report describing redundant Medicaid capitation coverage during 2019-21. (Capitation coverage refers to payments per person that Medicaid makes for recipients enrolled in health maintenance organizations). The Report revealed that Rhode Island expended over $38 million in Medicaid funds (of which $16.5 million were State funds) during those three years on recipients who resided in a different state and received coverage from that state. EOHHS informed the Committee that it has tightened its controls to prevent these double payments going forward.

While the Committee was pleased to learn this, I believe the federal government is in the best position to prevent these double payments both in Rhode Island and nationally, as it presumably has (or has access to) information to identify every capitation recipient in every state. This information could allow federal Medicaid to screen for matches to end double coverage everywhere. EOHHS officials agreed this solution should exist in theory, but they do not know how to make it happen.

c. Community Meeting

This Monday (April 15) evening at 7:00-8:00 p.m. at the Dr. Martin Luther King Elementary School at 35 Camp Street, the Ward 3 Democratic Committee will host a public meeting of the City and State legislators who represent parts of the Ward. We will discuss our projects during the current session. They describe the meeting in this flyer. I look forward to learning from our neighbors about their priorities and how I can do a better job in the Senate. Please consider joining us.