House Focuses On Bush Administration Cuts To Medicaid

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A House Oversight and Government Reform Committee hearing on Thursday examined six rules proposed by HHS that would affect matching funds for state Medicaid programs, CQ HealthBeatreports. According to committee Chair Henry Waxman (D-Calif.), the sixproposals would restrict coverage of rehabilitation services for thosewho have disabilities and are eligible for Medicaid; eliminate theability of schools to help enroll eligible children in Medicaid;eliminate Medicaid funding for schools that provide Medicaid servicesto severely disabled children; limit the services states can coverunder Medicaid outpatient programs; eliminate Medicaid payments forgraduate medical education; and limit how states can raise money to paytheir portion of Medicaid costs.

Waxman said the rules arepart of a "thinly disguised assault of the health care safety net,"also calling them "lawless regulation, not anchored in statute"(Reichard, CQ HealthBeat, 11/1). Bush administrationofficials say the regulations are needed to keep the states fromoverbilling the federal government. Congress has passed a one-yearmoratorium on one of the regulations, and legislation proposed by Rep.Eliot Engel (D-N.Y.) would extend the moratorium. Witnesses at thehearing urged Congress to work to prevent the rules from beingimplemented (CongressDaily, 11/1).

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Dennis Parella, chair of the National Association of State Medicaid Directors,said a "retrenchment by Medicaid will only make ... struggles moredifficult for millions of Americans at a time when no comprehensivehealth care system is even on the horizon," adding that "it issurprising that this philosophy" of fiscal conservatism "should comewhen most experts in the field would say that the nation's health caresystem is in a state of crisis." Many local officials testified aboutthe impact the rules would have (CQ HealthBeat, 11/1).

Marjorie Kanof, the managing director of health care for the Government Accountability Office,cited questionable matching fund arrangements by state Medicaidprograms and said, "Such financial arrangements ... threaten the fiscalintegrity of Medicaid's federal and state partnerships" (CongressDaily,11/1). Rep. Tom Davis (R-Va.) responded to allegations that theregulations were being passed without congressional involvement bysaying, "If you wait for Congress to act on this, there won't be anymoney left in the federal budget." Dennis Smith, director of Medicaidfor CMS, said theClinton administration also sought to eliminate excessively fundedstate Medicaid programs. He said, "We believe these rules reflect thelong-standing work of CMS and others ... to restore greateraccountability to the Medicaid program while safeguarding the limitedresources for actual services to those individuals who rely on" theprogram (CQ HealthBeat, 11/1).

Reprinted with permission from kaisernetwork.org. Youcan view the entire Kaiser DailyHealth Policy Report, search the archives, and sign up for email deliveryat kaisernetwork.org/email. The Kaiser Daily HealthPolicy Report is published for kaisernetwork.org, a free service of The HenryJ. Kaiser Family Foundation.

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