Efforts To Block Changes to Medicaid Gain Steam in Congress

By voice vote on Wednesday, the House Energy and Commerce Health Subcommittee approved a bill (HR 5613) that would delay implementation of seven new Medicaid regulations for one year, the Wall Street Journal reports.

The legislation, sponsored by House Energy and Commerce Committee Chair John Dingell (D-Mich.), would delay implementation of the regulations until April 1, 2009, when a new president will have taken office (Zhang, Wall Street Journal, 4/10).

Under the regulations, proposed by the Bush administration, states could not use federal Medicaid funds to help pay for physician training. The regulations also would place new limits on Medicaid reimbursements to hospitals and nursing homes operated by state and local governments and limit coverage of rehabilitation services for individuals with disabilities and mental illnesses (California Healthline, 4/1).

The Congressional Budget Office has estimated that the legislation would cost $1.65 billion, the amount that the federal government would save as a result of the regulations during one year.

The bill includes provisions that would require electronic verification of the assets of Medicaid applicants and would shift finances for the Physician Quality Improvement Fund to help offset the cost. In addition, the bill would provide $25 million annually for efforts to fight Medicaid fraud.

Prior to the passage of the bill, the subcommittee by voice vote approved a substitute amendment sponsored by Dingell. The amendment, part of a compromise with subcommittee Republicans, clarifies language in the bill to ensure that the legislation would apply only to the seven new Medicaid regulations and not future rules (Armstrong [1], CQ Today, 4/9).

Subcommittee Chair Frank Pallone (D-N.J.) said that lawmakers might attach the legislation to an appropriations bill to help increase prospects for passage (Wall Street Journal, 4/10). He said, "We obviously think this bill is important and want to get it moved. Whether it goes separately or as part of the supplemental hasn't been determined."

Pallone added that he hopes to have the full committee mark up the bill next week (Johnson, CongressDaily, 4/9).

Committee ranking member Joe Barton (R-Texas) said that he will ask President Bush not to veto the legislation (Armstrong [1], CQ Today, 4/9). He added that he is "reasonably confident" Bush would not veto the bill because of the focus on efforts to fight Medicaid fraud.

However, CMS spokesperson Mary Kahn said, "The Bush administration has and will continue to oppose any moratorium on enactment of our pending regulations" (Wall Street Journal, 4/10).

A "veto threat could prove hollow if large numbers of Republicans support the legislation because Congress might be able to override any veto," according to CQ Today (Armstrong [1], CQ Today, 4/9).

Sens. Edward Kennedy (D-Mass.), John Rockefeller (D-W.Va.) and Olympia Snowe (R-Maine) have introduced a similar bill (S 2819) that would delay implementation of the seven new Medicaid regulations, as well as two other rules (Armstrong [2], CQ Today, 4/9).

In a letter to members of the California congressional delegation, Gov. Arnold Schwarzenegger (R) urged them to support the legislation, arguing that the proposed rules would cost California $12.5 billion over five years, according to the San Diego Union-Tribune's "Newsblog."

Schwarzenegger wrote that the proposed rule changes would "result in an unprecedented cost shift to California taxpayers" (Ainsworth, "Newsblog," San Diego Union-Tribune, 4/9).