Dems Criticize Bush Changes for Medicaid HMO Patients
Democrats yesterday called the Bush administration's plan to "streamline" regulations that would provide a host of patient protections for Medicaidbeneficiaries enrolled in managed care plans "inconsistent" with the protections that the president "touted" for those with private health insurance in patients' rights legislation (HR 2563) passed in the House earlier this month, CongressDaily reports (Fulton, CongressDaily, 8/15). Under the Medicaid rules, issued during the waning days of the Clinton administration, Medicaid managed care beneficiaries would have guaranteed access to emergency room care and women's health services. The regulations also would have required health plans to provide easily understandable information and establish a complaint process for patients dissatisfied with care, though they would not have to allow patients to sue health plans. But the administration has said it will give states greater flexibility to determine how the protections are carried out (California Healthline, 8/15). "These (Medicaid) regulations are reflective of the administration's failure to do anything in the best interest of the patients," a spokesperson for Rep. Sherrod Brown (D-Ohio) said.
Brown and Reps. Henry Waxman (D-Calif.) and Pete Stark (D-Calif.) sent a letter to Bush Monday accusing him of "retreating on patient protections for about 20 million of the poorest and neediest citizens." However, an HHS official said, "The actual protections are not being touched at all. All the re-publication (of the regulation) will do is streamline the implementation rules on how states are going to have to put these protections in place." The HHS official added that the administration hopes to "work in partnership" with states to "achieve workable protections," asking, "If states can't do it, what good are the protections?" Still, Democrats "remain unconvinced." According to the letter, "Not only are the provisions of HR 2563 similar to the Medicaid rules, the bill also, in section 301, explicitly expresses the 'sense of Congress' that the president should extend key patient rights to Medicaid beneficiaries." Democrats said that the move will allow states and managed care companies, which have "increasingly" enrolled Medicaid beneficiaries, to "get around providing needed care" (CongressDaily, 8/15). Brown said, "Even if the rules are still strong and pro-patient ... the best we are going to do is see them a year from now. There is no reason they have to do it this way" ("Morning Edition," NPR, 8/16).