Democrats Say Bush Overstepped Authority on Medicaid Eligibility

House and Senate Democrats on Tuesday in a letter to HHS Secretary Mike Leavitt wrote that CMS does not have the authority to limit states' ability to expand Medicaid coverage to more children, CQ HealthBeat reports (Carey, CQ HealthBeat, 1/15).

CMS has reportedly imposed restrictions on the ability of states to expand their Medicaid programs that mirror a policy directive announced in August 2007 that limits states' abilities to expand the State Children's Health Insurance Program. The SCHIP guidelines state that before expanding SCHIP eligibility to children in families with incomes greater than 250% of the federal poverty level, states must demonstrate that they have "enrolled at least 95% of children in the state below 200% of the federal poverty level" who are eligible for Medicaid or SCHIP, according to a letter sent by Dennis Smith, director of the Center for Medicaid and State Operations (California Healthline, 1/4).

CMS has imposed the directive on several states that were considering Medicaid expansions, including Ohio, Louisiana, New York, Wisconsin and Oklahoma (CQ HealthBeat, 1/15).

According to the letter, recent denials of state requests to expand Medicaid eligibility above 250% of the poverty level "are just the latest in a growing list of unilateral changes to longstanding law and policy without statutory authority. ... The president has made repeated statements about his desire to cover more uninsured children. However, the actions of your department contradict those statements. Moreover, the department's actions are inconsistent with federal law" (Johnson, CongressDaily, 1/15).

The lawmakers requested that CMS reverse the decision and that Leavitt respond by Jan. 31 (CQ HealthBeat, 1/15).