Federal Medicaid Commission Members Oppose Some Bush Administration Reform Proposals
Members of the federal Medicaid commission charged with recommending short- and long-term reforms to the program "made clear" on Wednesday that the commission "would not rubberstamp proposals" from the Bush administration, which appointed the commission's members, or the National Governors Association, the New York Times reports (Pear, New York Times, 8/18).
The commission is required by Sept. 1 to submit a report with recommendations on how to reduce Medicaid spending growth by $10 billion over the next five years. The second report, due Dec. 31, 2006, will include recommendations for stabilizing Medicaid over the long term.
Congressional leaders of both parties were to select eight lawmakers to serve as nonvoting members. However, congressional Democrats have refused to participate because they fundamentally disagreed with the commission's mission of cutting Medicaid spending. HHS Secretary Mike Leavitt in July announced 13 voting members and 15 nonvoting members of the commission (California Healthline, 7/12).
In addition, doctors attending the meeting on Wednesday in Washington, D.C., "clashed" with Bush administration officials over a plan to increase copayments for goods and services from $3 to $5 for adults and to introduce $3 copays for children, the Times reports. Beneficiaries would pay $4 billion in additional charges over five years, according to the Congressional Budget Office.
Michael O'Grady, assistant secretary of HHS and a commission member, said the changes would make beneficiaries more "price sensitive" and added, "We are talking about the price of a pack of cigarettes." O'Grady said maximum copay levels had not been raised since the early 1980s.
CMS Medicaid Director Dennis Smith said the increased copays were not a large amount of money compared to the $2 trillion the program expects to spend in the next five years.
John Nelson, former president of the American Medical Association and a commission member, said, "If we raise the copayment, some people will not get the care they need." Nelson said people who forego regular medical care could seek treatment in an ED, which costs substantially more.
Carol Berkowitz, president of the American Academy of Pediatrics and a commission member, said copayments could add up considerably for a family with four children (New York Times, 8/18).