AUGUSTA, Maine — State officials are exploring ways to encourage veterans on Medicaid to shift some or all of their health care to the federal Department of Veterans Affairs, saving the state money and potentially improving benefits for veterans.
“Clearly we should have been exploring this before, but we are looking at it now,“ said Department of Health and Human Services Commissioner Mary Mayhew. “People who are on Medicaid who have military service are eligible for Medicaid, but clearly there are opportunities for individuals to move into the veterans health benefits programs and there are clearly savings for the Medicaid program.”
Maine has approximately 150,000 veterans, one of the highest per capita in the nation. Peter Ogden, director of the state Bureau of Veterans Services, said only about 40,000 of them are taking advantage of the various Veterans Affairs health programs.
“We have some data-sharing problems under federal law,“ he said. “But I think there are ways that we can make this work.“
Several states are using the federal database of the Public Assistance Reporting Information System set up to help stop fraud in Medicaid. The database has information identifying recipients who are also veterans and that has been used to provide information to those veterans about VA programs.
“In Washington state, where it has been used the longest, it has been successful because they have someone on the DHS staff that works with veterans to provide them the information about VA benefits,” Ogden said. “We have been trying to figure out how we could fund a position to do that here.”
It does cost to set up such a system, but other states have already realized significant savings. For example, Montana had $900,000 savings in its first year of use, 2008. Washington state estimates that since it first implemented the program in 2003, the state has saved $27 million and 9,500 veterans have been moved from Medicaid to VA programs.
“There is no doubt the savings here can be significant, “Mayhew said. ”We hope to at least start with some of the changes we can do in the next six to nine months.”
What is frustrating to some lawmakers is that the idea was first discussed two years ago by lawmakers on the Veterans and Legal Services Committee and members of the Appropriations Committee. Rep. Peggy Rotundo, D-Lewiston, has served on the panel several terms and is now the Democrat lead on the budget panel.
“We tried but couldn’t seem to get much traction with the department two years ago after members of the veterans committee came to us with this suggestion,“ she said. “I am very pleased Commissioner Mayhew is looking at this in a serious way.”
Mayhew said she had objected to moving forward and projecting savings in the current budget because she was not confident of the numbers. She said her agency is working with Ogden and his staff to develop a plan and a budget estimate.
“I am concerned that we do this right,” Ogden said. “We don’t want to do anything that would hurt a veteran or in any way affect other benefits they are already receiving.”
For example, he said, some veterans would be concerned that some other income-determined benefit they are receiving would be affected if they were getting additional VA benefits. He said it may be that a veteran may only want to get some of the VA benefits they are due because they like the care they are getting where they live.
“A lot of veterans are on some sort of maintenance medications like for blood pressure or diabetes,“ he said. “We could have those prescriptions provided through the VA.”
In other states, veterans have found they can get more generous benefits through the VA than through Medicaid. Most benefits in Maine are through the Togus VA center in Augusta, but a growing number of regional clinics also are being established. Ogden expects the new clinic in the Lewiston area will draw veterans from throughout that region of the state.
“This will be up to the veterans,“ Mayhew said. “We are not going to force anyone to move to VA health benefits unless they want to.”
In general, anyone who has served in a branch of the military for 24 continuous months of the full period for which they were called to active duty is eligible for VA benefits. Ogden said he believes the state could double the 40,000 who now receive some VA health benefits and still not reach all who are eligible.