Bush Proposals on Medicaid Matching Funds Scrutinized
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 HealthBeat reports.
According to committee Chair Henry Waxman (D-Calif.), the six proposals would restrict coverage of rehabilitation services for those who have disabilities and are eligible for Medicaid; eliminate the ability of schools to help enroll eligible children in Medicaid; eliminate Medicaid funding for schools that provide Medicaid services to severely disabled children; limit the services states can cover under Medicaid outpatient programs; eliminate Medicaid payments for graduate medical education; and limit how states can raise money to pay their portion of Medicaid costs.
Waxman said the rules are part 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 administration officials say the regulations are needed to keep the states from overbilling the federal government. Congress has passed a one-year moratorium on one of the regulations, and legislation proposed by Rep. Eliot Engel (D-N.Y.) would extend the moratorium. Witnesses at the hearing urged Congress to work to prevent the rules from being implemented (CongressDaily, 11/1).
Dennis Parella, chair of the National Association of State Medicaid Directors, said a "retrenchment by Medicaid will only make ... struggles more difficult for millions of Americans at a time when no comprehensive health care system is even on the horizon," adding that "it is surprising that this philosophy" of fiscal conservatism "should come when most experts in the field would say that the nation's health care system is in a state of crisis." Many local officials testified about the 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 Medicaid programs and said, "Such financial arrangements ... threaten the fiscal integrity of Medicaid's federal and state partnerships" (CongressDaily, 11/1). Rep. Tom Davis (R-Va.) responded to allegations that the regulations were being passed without congressional involvement by saying, "If you wait for Congress to act on this, there won't be any money left in the federal budget."
Dennis Smith, director of Medicaid for CMS, said the Clinton administration also sought to eliminate excessively funded state Medicaid programs. He said, "We believe these rules reflect the long-standing work of CMS and others ... to restore greater accountability to the Medicaid program while safeguarding the limited resources for actual services to those individuals who rely on" the program (CQ HealthBeat, 11/1).