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Kennedy fights for state's Medicaid

Move is most aggressive by senator since cancer diagnosis and brain surgery

Kennedy is working behind the scenes. Kennedy is working behind the scenes.
Email|Print|Single Page| Text size + By Matt Viser
Globe Staff / June 20, 2008

Senator Edward M. Kennedy, who is beginning treatment in his battle with brain cancer, made a major push on a key issue for Massachusetts yesterday, placing a flurry of phone calls to top Bush administration officials in a bid to make sure the state continues receiving hundreds of millions of dollars in Medicaid money.

It was the type of behind-the-scenes political work - using his powerful position and his deep knowledge of healthcare policy - that would seem almost routine in the past.

But in this case, it was the most aggressive action the senator has taken since being diagnosed with brain cancer last month and undergoing brain surgery more than two weeks ago. He also was working to protect one of the state's signature initiatives: its landmark effort to expand healthcare coverage.

Kennedy spent the late morning and early afternoon on his cellphone as he was on the road from Boston back to Hyannis Port.

He spoke with Health and Human Services Secretary Michael Leavitt and Josh Bolten, the chief of staff to President Bush, according to sources with knowledge of the discussions.

He also had a 20-minute conversation yesterday afternoon with Governor Deval Patrick, who is meeting this morning with Leavitt to discuss extending a Medicaid waiver that is set to expire June 30. It's unclear exactly how much money Massachusetts would lose if the waiver negotiations fall through, but it would probably be at least $600 million.

"He said: 'I'm available. Just use me,' " Patrick said last night in a telephone interview. "There's nobody like him. He is just a lion, and he was roar ing today. He was upbeat, he was lucid, he was strong, he was informed. He was excited, fired up, and ready to go."

Bolten and Leavitt did not respond to requests for comment.

Kennedy, who is chairman of the Senate Committee on Health, Education, Labor, and Pensions, was a major force behind Massachusetts' landmark healthcare overhaul.

The law has resulted in new healthcare coverage for 355,000 residents, a higher number than anticipated that is stretching funds.

To help, the state has been asking for a special waiver of federal Medicaid rules.

In 2006, the federal government agreed to provide the $385 million in annual Medicaid waivers for two years. The agreement also includes an additional $225 million annually to expand Medicaid programs. Kennedy played a leading role in those negotiations, joining then-Governor Mitt Romney in several meetings in Washington.

State officials have argued that the money, which helps subsidize coverage for low-income residents, is crucial to carrying out the state's landmark healthcare overhaul.

"The momentum for national healthcare is coming out of Massachusetts, and the senator sees the importance of keeping that going," said a source with knowledge of the discussions.

The governor is expected to arrive in Washington, D.C., today to meet with Leavitt and discuss the Medicaid waivers. Kennedy called Patrick yesterday to strategize with him about the meeting and to let him know about the discussions with Leavitt and Bolten.

"It's a perfect tee-up for the conversations I'm going to have," said Patrick, who plans to call Kennedy today to update him on how the meetings went. "He's totally committed to working with us through the renewal of this waiver. He's the absolute best ally you can have."

The chief of staff of US Senator John F. Kerry will sit in on the discussions, as will several Kennedy aides.

"He's stayed in close touch with it," said a second source with knowledge of the discussions. "Now it's time for a final push. He definitely wanted to be part of that final push."

Kennedy has been working on a variety of issues and has frequently been briefed by his staff, but he has mostly been concentrating on his treatment.

Kennedy's office has declined to talk about the specifics involving his treatment, although doctors not involved with his care said he would have started receiving doses of chemotherapy and radiation shortly after his June 2 brain surgery at Duke University Medical Center in Durham, N.C.

The standard chemotherapy for brain tumors is a pill called temozolomide, which patients typically take for six months to a year as doctors monitor the response.

If that approach is not working, brain cancer specialists say, patients could then choose to opt for more experimental treatments.

The senator's son, US Representative Patrick Kennedy, a Rhode Island Democrat, told the Associated Press this week that his father was considering a pill form of chemotherapy that would allow him to stay home for treatment.

Matt Viser can be reached at maviser@globe.com.

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