Hurricane Katrina Medicaid Bill ‘Abruptly’ Delayed in Senate
A scheduled Senate floor discussion on a bipartisan bill that would provide federally funded Medicaid coverage to Hurricane Katrina survivors on Thursday was delayed until Monday, Senate Finance Committee Chair Chuck Grassley (R-Iowa) said, CongressDaily reports (Rovner/Heil, CongressDaily, 9/23). Grassley and finance committee ranking member Sen. Max Baucus (D-Mont.) on Sept. 14 introduced the bill, which would have the federal government for five months pay 100% of Medicaid costs for survivors from Louisiana, Mississippi and parts of Alabama who have relocated to other states, with the option of extending the coverage for an additional five months.
The federal government also would pay 100% of Medicaid costs through the end of 2006 for all beneficiaries in Louisiana, Mississippi and counties in Alabama that have been designated as disaster areas. Other states would be assured that their federal Medicaid matching rates would not decline next year. Survivors with annual incomes below the federal poverty level would be eligible for the coverage. Pregnant women and children from families with annual incomes up to 200% of the federal poverty level also would be eligible for Medicaid. The bill would eliminate any asset tests and would measure income moving forward.
Further, the bill would establish a fund to help hurricane survivors with private health insurance pay their premiums and change Medicare and Medicaid laws so that survivors do not face penalties for missed application deadlines. In addition, the bill would eliminate copayments and deductibles for hospital services for elderly Medicare beneficiaries displaced by the hurricane. The bill would not delay the launch of the Medicare prescription drug benefit for dual eligibles, as requested by some lawmakers.
Dual eligibles' prescription drug coverage will be transitioned from Medicaid to Medicare starting on Jan. 1, 2006, as planned. However, HHS would be required to submit by Oct. 7 a written plan for how it will accomplish the transition for dually eligible beneficiaries in states and counties affected by Hurricane Katrina (California Healthline, 9/22).
Grassley and Baucus, who "have been trying to get the bill to the floor all week," were "thwarted by as yet unidentified Republicans who are concerned about the bill's cost," CongressDaily reports. Some also share the Bush administration's concern that expansions of Medicaid coverage to people who are ordinarily ineligible for the program would be difficult to reverse. Baucus, who estimated that the bill would cost about $8.7 billion over five years, said, "This is an emergency. This is not the time for the legislative process as usual."
Grassley said, "People want more time to study it. But they'll come back with the same gripe; ... the question is: Do they want to help victims of Katrina or not?" If the bill reaches the Senate floor next week, it could be merged with a package being developed by the Senate Health, Education, Labor and Pensions Committee, CongressDaily reports. The "less contentious" HELP committee package reportedly includes assistance with health insurance premiums for those who lost their jobs because of the hurricane, help for employers and technical changes to aid community health centers and other clinics treating survivors, according to CongressDaily (CongressDaily, 9/23).
With some Republicans who generally support the Bush administration -- such as Mississippi Gov. Haley Barbour (R) and Sen. Trent Lott (R-Miss.) -- endorsing the Grassley-Baucus plan, there is a "growing fissure" between President Bush and other Republicans over how to care for Katrina survivors, according to the Los Angeles Times. Bush "is proving deeply reluctant to use some of the big-government tools at his disposal, apparently out of fear of permanently enlarging programs that he opposes or has sought to cut," the Times reports.
According to the Times, Bush administration officials are "quietly working to derail" the Grassley-Baucus proposal and instead are pushing "a narrower plan that would not commit the government to covering certain groups of evacuees." Under the plan, hurricane survivors who traditionally would not qualify for Medicaid and who do not have other forms of insurance would have to seek no-cost care at hospital emergency departments, Bush administration officials have said. The administration "has promised to obtain more funding to compensate hospitals that provide the free care," the Times reports (Gosselin/Alonso-Zaldivar, Los Angeles Times, 9/23).
In related news, the Bush administration announced a Medicaid waiver agreement with Mississippi that is "similar to one issued last week to Texas, providing temporary Medicaid eligibility to residents of other states," CongressDaily reports.
However, a separate "memoranda of understanding" signed by federal Medicaid Director Dennis Smith and the Medicaid directors of Louisiana, Mississippi and Alabama makes clear that those states "remain responsible for the state share" for services given to displaced residents in other states. Mississippi Interim Medicaid Executive Director Bobby Moody thanked CMS Administrator Mark McClellan but added, "We think [the Grassley-Baucus bill] is very important to our recovery here" (CongressDaily, 9/23).