Federal Budget Bill Would Cause Loss of Medicaid Coverage, CBO Says
About 45,000 Medicaid beneficiaries would lose coverage in 2010 because of premiums included in the fiscal year 2006 budget reconciliation bill (S 1932), and 65,000 would lose coverage in 2015, according to a new report from the Congressional Budget Office, the New York Times reports. The bill would save $38.8 billion over five years and $99.3 billion over 10 years.
Medicaid and Medicare spending reductions would account for 50% of the savings, with 27% from Medicaid and 23% from Medicare over 10 years (Pear, New York Times, 1/30).
The House on Dec. 19, 2005, voted 212-206 to approve the bill, but procedural moves in the Senate require the House to vote on the bill a second time before the legislation can move to President Bush for consideration. The Senate on Dec. 21, 2005, voted 51-50 to approve the legislation (California Healthline, 1/9). The second House vote is expected on Wednesday.
"In response to the new premiums, some beneficiaries would not apply for Medicaid, would leave the program or would become ineligible due to nonpayment," the CBO report states. Children would account for 60% of the Medicaid beneficiaries who would lose coverage, according to the report.
The report also estimates that 13 million Medicaid beneficiaries would have new or higher copayments for services such as physician visits and hospital care. In addition, 13 million Medicaid beneficiaries would pay more for prescription drugs by 2010, and 20 million would pay more by 2015, the report states.
According to the report, "About 80% of the savings from higher cost-sharing would be due to decreased use of services." The report estimates that 1.3 million Medicaid beneficiaries would have to pay premiums and that 1.6 million would lose benefits, most likely for dental, vision and mental health services.
In addition, the report estimates that 15% of Medicaid long-term care beneficiaries would have their coverage delayed because of additional restrictions on asset transfers.
The CBO report "gives Democrats new ammunition to attack" the budget reconciliation bill, but they "appear unlikely to defeat it," the Times reports (New York Times, 1/30). However, opponents have "stepped up their attacks on legislation they contend is written to protect insurance companies, drug manufacturers and other entrenched corporate interests," CQ Today reports (Dennis, CQ Today, 1/27).
Rep. Rob Simmons (R-Conn.), who had supported the bill, last week announced his opposition to the legislation, a move that has led to some "nervousness about more potential GOP defections," CongressDaily reports.
Rep. John Sweeney (R-N.Y.), who had supported the bill, said that currently he is undecided on the legislation, and Reps. Jim Gerlach (R-Pa.), Jim Ramstad (R-Minn.) and Frank LoBiondo (R-N.J.) also are "seen as potential vote-switchers," CongressDaily reports. In addition, Rep. Walter Jones (R-N.C.), who last month did not vote on the bill, is expected to vote against the legislation because of spending reductions for rural pharmacies (CongressDaily, 1/27).
Boston Globe: The Globe on Monday examined how provisions in the budget reconciliation bill that would place additional restrictions on Medicaid asset transfers could deny long-term care coverage to "needy seniors" who "gave a modest gift to a child or a charity as much as five years before they applied for Medicaid," according to opponents of legislation. AARP chief health care lobbyist Kirsten Sloan said, "People who had no intention of defrauding the government ... are going to find themselves in trouble." Scott Plumb, senior vice president of the Massachusetts Extended Care Federation, recommended the purchase of private long-term care insurance to avoid such problems (Dembner , Boston Globe, 1/30). The Globe on Monday also outlined the asset transfer provisions (Dembner , Boston Globe, 1/30).
- Milwaukee Journal Sentinel: The Journal Sentinel on Sunday examined how, under provisions in the budget reconciliation bill that would place additional restrictions on Medicaid asset transfers, seniors "could have a harder time passing on modest inheritances to their children" (Boulton, Milwaukee Journal Sentinel, 1/29).