MaryAnne Lindeblad has held a variety of leadership positions at NASHP, including serving as Chair of the executive committee since 2016. During her long tenure, she not only brought leadership and insights to NASHP but also a broad health care and administrative background to the top position as Medicaid Director in Washington State, as one of the longest serving Medicaid Directors in the country. Her career spans most aspects of health care including acute care, long-term care, behavioral health, elder care, and services for people with disabilities. Prior to her appointment as Medicaid Director, she served as the Assistant Secretary for Aging and Disability Services Administration in the Department of Social and Health Services. Previously, she was Director of the Health Care Services Division of the Medicaid program.
With MaryAnne retiring at the end of July, NASHP wanted to honor her incredible contributions to health care policy. NASHP’s Executive Director Hemi Tewarson had an opportunity to speak with MaryAnne about her greatest achievements, her toughest decisions, and what kept her going through the years.
You have had such a long and distinguished career serving in state government, what is your biggest takeaway in how state government policies can affect the health of its citizens?
For me, it has been what government can do about coverage and access, and investments that state legislators are able to make that improve the health of individuals and the health of their residents. If you want to make a difference in your communities, you need access to quality, affordable health care. State legislators can make the most difference when acknowledging equitable access is for all. Health care is a right and not a privilege. Lower income individuals should have the same access to health care as everyone else. I have seen the difference extending coverage can make in people’s lives, first to pregnant women, then children and now adults with the Affordable Care Act (ACA). Seeing individuals get ready access to the services they need has been incredibly rewarding.
Medicaid Directors typically have a short tenure, but you have survived numerous administrations and lots of change and controversy. What kept you going?
Interest and passion kept me going. I have a nursing and public health background and early in my career I found working for the state Medicaid program gave me the opportunity to influence state health policy. And upon becoming the state Medicaid Director, there were even more opportunities to influence how care is provided, how services are delivered, and the ability to influence policies that improve the lives of those we serve. There are not many positions that afford that opportunity. Washington hasn’t seen a lot of churn in their Medicaid Directors so that has provided even more opportunity to influence policy and direction. We also have had great legislative champions that have supported the Medicaid program.
What was the toughest decision you had to make as a Medicaid Director?
The toughest decisions were anytime we had to make cuts. When budgets get tight, we had to make difficult choices about reducing benefits and eligibility. Those decisions that required cuts were always gut wrenching.
You have served as the long-time chair of NASHP’S Academy, what moments stand out to you the most from that experience?
The conference experiences really stand out to me. Every conference is different – they have their own personalities. It’s so exciting to be a part of the process from the first planning meetings where we discuss fresh ideas and sessions and then going to conference and seeing the fruits of that labor. Seeing that repeated year after year was amazing. Getting together as a group, attending baseball games or the boat rides around the city was a great opportunity to get to know other health care leaders from various states and hear different perspectives. The connections that I made with individuals who attended NASHP conferences have been strong and important relationships; lifelong connections that will last long after I retire.
You have accomplished so much, but what do you consider your greatest achievement?
Hard to pick, there have been several, but I think my greatest achievement was a move. Washington started several years ago to integrate behavioral and physical health and build a more client centered, holistic approach to care. We started planning in 2014, implementing in 2016 and continue to improve our approach to integrated care. It wasn’t easy to bring the physical and behavioral health systems together and figure out how to best work effectively in delivering care. Bringing together our community behavioral health and physical health partners into a single delivery system is making a difference in making behavioral health services more accessible. For me, this has been some of the most meaningful work I have been a part of.
In addition, I also want to mention the implementation of the ACA in Washington State. Seeing over 600,000 people get coverage and access to services was incredibly rewarding. All the work to make sure that people have coverage and have a benefit design that looks at people holistically, is what I will remember most.
Any additional thoughts to share?
I have been so fortunate to be a part of NASHP since 1999. I still remember that first conference planning meeting in DC. The opportunity to participate in the Academy has been one of the best parts of my career and resulted in some of the most meaningful times in my professional life.