Medicaid Reform Efforts Not Likely To Pass This Year

With the chances of Congress approving a Medicaid reform bill this year "dim," governors and federal legislators "anticipate returning to Medicaid reform efforts next year," CongressDaily/AM reports. Reform efforts "stalled" this year because of disagreement among governors about which Medicaid changes to endorse, according to CongressDaily/AM. Members of a National Governors Association Medicaid task force this year failed to agree on whether to endorse a Medicaid plan proposed by President Bush (Heil, CongressDaily/AM, 9/8). For beneficiaries covered at the state's discretion, the Bush administration plan would give states' Medicaid programs a fixed amount of funding, rather than matching funds, and would no longer require states to apply for federal waivers to deviate from federal eligibility and benefits standards. In addition, states would only be required to maintain comprehensive Medicaid coverage for the two-thirds of beneficiaries whose income levels are low enough that the federal government mandates that they be covered (California Healthline, 6/13). Governors' "biggest Medicaid front" now is ensuring that a final Medicare prescription drug bill includes a provision in the House bill (HR 1) that would require Medicare to pay for prescriptions for beneficiaries eligible for both Medicare and Medicaid, CongressDaily/AM reports (CongressDaily/AM, 9/8). A bipartisan group of governors in early August wrote a letter to House Ways and Means Committee Chair Bill Thomas (R-Calif.) asking Congress to "take responsibility" for the cost of dual-eligibles' medications and expressing their support for the House bill provision (California Healthline, 8/18). Congress' focus on Medicare reform also has affected progress on Medicaid reform, as the same lawmakers' staff members would be working on both efforts, according to CongressDaily. Tim Westmoreland, a Georgetown University professor and former director of Medicaid under the Clinton administration, said, "As long as the Medicare debate drags on, there is little chance that Medicaid will be a focus."

Despite slim chances of Medicaid reform this year, lawmakers are "already looking ahead" to future efforts, CongressDaily/AM reports. Rep. Billy Tauzin (R-La.) said, "It's not a question of whether, it's a question of when" Congress will pass Medicaid reform, adding, "I think we'll just get to a point where something has to be done, and that's when there'll be compromise." The NGA Medicaid task force likely will resume work after Congress adjourns for the year, with the expectation of a "multiyear process," an NGA spokesperson said (CongressDaily/AM, 9/8).