The 2005 Federal Medicaid Battle
Where We Are Now
On Capitol Hill: The battle over the future of Medicaid has now moved to the Senate Finance Committee and the House Energy and Commerce Committee. The final budget resolution requires those committees to make at least $10 billion in cuts -- all or most of which will presumably come from the Medicaid program. The committees must finalize their recommendations about specific cuts by the middle of September so that they can be included in the final budget reconciliation bill, which must be enacted before the end of the fiscal year (September 30th). Families USA and the Center on Budget and Policy Priorities have drawn up a set of principles to guide Congress in the reconciliation process; other organizations are encouraged to use the document in their advocacy efforts.
Medicaid Commission: During debate on its version of the budget resolution, the Senate adopted an amendment offered by Senators Gordon Smith (R-OR) and Jeff Bingaman (D-NM) on a 52-48 vote. The Smith-Bingaman amendment stripped all Medicaid cuts from the Senate's budget resolution and, instead, called for the creation of a Medicaid Commission to look more broadly at the future of the program. Senators who voted for the Smith-Bingman amendment for a list of all the Senators who voted for the Smith-Bingaman amendment (pdf). |
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Unfortunately, the final budget resolution included the $10 billion in cuts noted above, but no details on a Medicaid commission. Now HHS Secretary Leavitt has announced his intention to appoint a Medicaid commission -- a move that has generated considerable controversy. Click here for Families USA's statement, "Bush Administration Creates 'Sham Commission' to Study Future of Medicaid Program." Click here for a side-by-side comparison of the Medicaid commission proposals offered by the Administration and the Smith-Bingaman amendment.
Governors Chime In: The National Governors Association (NGA) has announced that it will join Democratic congressional leaders in boycotting the Administration's commission. The NGA has adopted a new interim policy on Medicaid "reform." The NGA policy includes several proposals that would hurt the people who rely on Medicaid, such as signficantly increasing cost-sharing and allowing providers to turn patients away if they cannot afford care; allowing states to offer different benefit packages to different groups of people and/or in different parts of a state; allowing states to make major Medicaid changes without a waiver; and undermining the ability of the courts to enforce federal Medicaid law.
The governors will vote at their summer meeting at the end of July about whether to make this permanent policy of the NGA.
How We Got Here
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