Questions sent yesterday for today’s meeting about SIM’s risky, new Medicaid proposal have been posted. One asks why a dangerous 1115 waiver is necessary? Did SIM planners explore other, less dangerous options? 1115 waivers necessarily include a cap on federal reimbursement (to meet the federal budget neutrality requirement) endangering the state budget and potential future Medicaid cuts if health costs continue to rise. The two stated reasons for a waiver – covering community health worker preventive services, and providing air conditioners for people with asthma – are not compelling. As of Jan. 1st federal rules changed to allow Medicaid payment for CHW services and the extra state cost of air conditioners for 75% of Medicaid adults with asthma is minimal. Advocates have many concerns about the skeletal proposal rushed out to win a federal grant. The MAPOC will hear from SIM proponents about their plan this morning at 9:30 in Room 2C of the LOB.