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Thursday, April 24, 2008

House Moves Bill to Stop Medicaid Changes

Yesterday the House passed a bill that would stop the Bush administration from going forward with several regulations intended to cut Medicaid services. The administration developed the regulations under the guise of "fiscal integrity," arguing state Medicaid programs are using loopholes to inappropriately claim federal funds. Bush has threatened to veto the bill.

Fortunately, the bill passed the House in a 349-62 vote which, if the margin holds, would be enough to override a veto. State governments also support the bill. According to the Associated Press, "The governors of all 50 states…oppose the rules."

If all this bipartisanship and widespread agreement make you uncomfortable, fear not — the U.S. Senate is on the case.

The bill will now move to the Senate Finance Committee where ranking member Charles Grassley (R-IA) is railing against it. (Grassley also has the support of the Senate's Republican leadership.) The AP reports:

"It is an absolute farce for anyone to argue that all of those dollars are being appropriately spent and that Congress ought to just walk away from these issues," [Grassley] said in a recent speech. He said the Finance Committee should fix the problems "instead of just making the regulations go away."

Of course, the true farce would be to shift to state governments a $21 billion burden over the next five years and jeopardize health services for thousands, all because of the impropriety of a few state Medicaid programs. Here are some of the policies Grassley thinks Congress should be supporting [Source: Center on Budget and Policy Priorities]:

• "The regulations will significantly limit Medicaid coverage for rehabilitation services provided to people with serious mental illness."
• "The regulations will eliminate coverage for therapeutic foster care, in which children are placed in a private home with foster parents who are specially trained to help them improve a child's condition."
• "The regulations will eliminate coverage for "day habilitation" programs, which are designed to help people with intellectual disabilities (formerly called mental retardation) and other developmental disabilities to acquire the skills they need to live in community-based settings and remain out of institutions."
• "[T]he regulations will likely increase the number of poor children who are eligible for Medicaid but remain uninsured, as well as the number of children with Medicaid coverage who do not get certain health care services they need."

If Grassley thinks his Committee should fix the problem of improper Medicaid reimbursement, he should use his position as ranking member to do just that, and not to cut health services. Unfortunately for him, under parliamentary procedures, inane complaining cannot be substituted for introducing legislation.