Family Opportunity Act To Allow Medicaid Buy-In for Families With Disabled Children Stalled in House
The "[h]igh hopes" for the quick passage of a "popular but oft-delayed" measure to allow middle-income families to buy Medicaid coverage for their disabled children are "fading a bit" as House Republicans and Democrats attempt to negotiate funding for the legislation, CongressDaily reports (Rovner, CongressDaily, 6/18). The Family Opportunity Act, sponsored by Senate Finance Committee Chair Chuck Grassley (R-Iowa), would allow families with annual incomes at or less than 250% of the federal poverty level -- $47,125 for a family of four -- to purchase Medicaid coverage for their disabled children. Under the legislation, states would charge families premiums for Medicaid coverage on a sliding scale and would have authority over the operation of the expanded coverage. Private health insurance and Medicaid premiums combined could not exceed 7.5% of annual family income. The bill, which would cost about $7 billion over 10 years, also would establish centers to help families with disabled children obtain information about services and programs available to them (California Healthline, 5/7). The Senate passed its version of the Family Opportunity Act (S 622) in May under last year's budget resolution, CongressDaily reports.
House action on a similar bill (HR 1811) has been delayed because House Energy and Commerce Committee Chair Joe Barton (R-Texas) wants funding for the measure to be offset by other cuts in Medicaid. Barton and House sponsor Rep. Pete Sessions (R-Texas) added some other language to the bill and decided to offset cost of the bill by making Medicaid "targeted case management" services payable as an administrative expense, which are funded by a 50-50 match between states and the federal government. Targeted case management is currently considered a "service," meaning that states with higher Medicaid matching rates get more than half of the cost for the service from the federal government. The House was scheduled to vote on the measure last Monday. However, the vote was postponed after Rep. Henry Waxman (D-Calif.), the bill's lead co-sponsor, said that House Energy and Commerce Committee Democrats needed more time to examine the changes to the bill, CongressDaily reports.
According to CongressDaily, House Democrats are "divided" over the funding offset, with some saying that they want to see which populations would be affected by it and others contending that a funding offset is not required. In addition, the Children's Defense Fund, a key backer of the legislation, withdrew its support of the House measure on Monday because of the offset provision. In a letter sent to Sessions and Waxman on Monday, CDF Director of Government Relations Bethany Little wrote, "It pains us to have to withhold our support for the version of the Family Opportunity Act that is expected to be on the House suspension calendar today, but the $1.4 billion it would take from the Medicaid program would hurt some children in order to help others." A spokesperson for Sessions said, "We're looking at next week" for a vote on the legislation (CongressDaily, 6/18).