In another move sure to anger liberal interest groups and Democrats in the House and Senate, the Bush Administration is seeking flexibility to allow states to reshape their Medicaid programs:

"The rule changes would allow states to offer alternative benefit packages called 'benchmark' plans, which would provide Medicaid beneficiaries with health coverage that has the same value as plans offered to other individuals in the same state. Benchmarks would include the standard PPO plan offered to federal government employees, state employee coverage offered by the largest HMO or coverage approved by HHS. States would have the choice of offering additional benefits such as dental coverage. States also would be able to contribute to a beneficiary's employer-sponsored health plan premiums so that the individual could remain insured through the private sector.

"The proposed rule changes also would allow states to revise existing premium and cost-sharing plans to make them more similar to those allowed under SCHIP, according to CQ HealthBeat. The rule change would not affect beneficiaries with incomes below 100% of the federal poverty level, but cost sharing could increase for beneficiaries with incomes between 100% and 150% of the poverty level, and beneficiaries with incomes greater than 150% of the poverty level could be required to contribute copayments. Under the proposed change, all cost sharing would be limited to no more than 5% of a family's income."

Without seeing more details on these rules, it makes it difficult to know how they might impact state reform efforts such as Florida's. The increased cost-sharing looks promising, though. One thing is certain -- this will be greeted by the overheated rhetoric about "Bush hates the poor" that usually follows any announcement of this sort.