NGA Supports Medicaid Cost-Sharing Provisions

The National Governors Association on Monday in a letter to congressional leaders voiced support for a provision in the House budget reconciliation package (HR 4241) that would allow states to increase cost-sharing for some Medicaid beneficiaries, CQ HealthBeat reports (CQ HealthBeat, 12/5).

Arkansas Gov. Mike Huckabee (R), chair of NGA, and Arizona Gov. Janet Napolitano (D), vice chair of NGA, in the letter to Senate Majority Leader Bill Frist (R-Tenn.), Senate Minority Leader Harry Reid (D-Nev.), House Speaker Dennis Hastert (R-Ill.) and House Minority Leader Nancy Pelosi (D-Calif.) write that governors "broadly support" the House provision that would increase states' ability to increase cost-sharing. The letter adds, "These provisions will allow states to use financial incentives commonly used throughout the health care system to provide care in the most appropriate setting."

Huckabee and Napolitano say that NGA also supports the House provision that would allow states "to implement tiered copays for prescription drugs."

In addition, the governors say they were "strongly encouraged" that the House and Senate (S 1932) proposals "acknowledge the need for federal reinvestments for the Medicaid costs of individuals displaced by Hurricane Katrina," but they add that governors are "concerned" that neither proposal includes funding for uncompensated care pools, which "are a critical part of efforts in states to provide health care services to survivors and evacuees" (NGA letter, 12/5).

The governors also say they support provisions in the House bill that would give states that provided health care to Katrina survivors a 100% federal funding match "directly from the federal government without having to further inconvenience the three home states." The governors say they oppose Senate provisions that would mandate coverage of podiatry services and place new limits on states' ability to tax Medicaid managed care organizations.

They also say they oppose provisions in both bills that would reduce federal financial support for targeted case management services for certain people, including foster care children and children with developmental disabilities (CQ HealthBeat, 12/5).

The House returns from recess on Tuesday facing "a difficult two-to-three week stretch of trying to lasso reluctant Republican votes" for the reconciliation package, CongressDaily reports. House and Senate committee aides are "combing through their respective reconciliation bills to find common ground," and cuts to Medicare "are increasingly likely," CongressDaily reports.

The cuts in part could pay for a Senate provision to increase Medicare payments to physicians. CongressDaily reports that House cost-cutting provisions that would impact health care for Medicaid beneficiaries have run "into stiff opposition in the Senate and might be scaled back" (Cohn, CongressDaily, 12/6).