You know those Old Westerns where the hero rides in at that last minute to save the day. That’s what last week’s “clawback” reduction announcement must have felt like to many states trying to maintain their Medicaid programs in the wake of increased need and reduced revenues caused by the recession.
![rodeo.jpg](http://ccf.georgetown.edu/wp-content/uploads/mvmove/rodeo.jpg")
The trailer would go something like this:
While the “clawback” sounds like a character from a horror movie rather than the Western motif I’m trying to conjure up, it’s really not all that scary. “Clawback” is just the stage name for the monthly payments states send to the federal government to pay a portion of the Medicare Part D prescription drug costs for “dual eligibles” or those people who are eligible for both Medicare and Medicaid. It comes into play in this scenario because HHS decided that the temporary increased federal match rate included in the American Recovery and Reinvestment Act (ARRA) should be applied to clawback payments. Now, states will receive about $4.3 billion in financial relief through a temporary reduction in their payments. This is welcome news to Medicaid Directors, state leaders, health care advocates and all the children, families and individuals who are relying on them for help to get through these tough times.
Meanwhile, back at the corral, HHS Secretary Sebelius encouraged states to use the savings to “continue to provide critical health care services to the nearly 60 million beneficiaries who depend upon it”. Some states appear to be heading in that direction already. In Tennessee, which will save about $120 million, the TennCare director said he hopes to use the temporary savings to “mitigate or postpone” recently recommended caps limiting services to adult, nonpregnant enrollees on TennCare, the state’s Medicaid program.
