Republicans Plan To Proceed With Proposed $10B Reduction in Medicaid Spending Despite Hurricane Katrina
Republican leaders in the Senate on Tuesday said that Congress should continue the fiscal year 2006 budget reconciliation process, which includes determining how to make $10 billion in cuts to Medicaid over five years, despite calls from some Democrats that Hurricane Katrina's "impact on some of the nation's poorest Americans should sideline any Medicaid cuts," CQ HealthBeat reports. The FY 2006 budget resolution calls for the Senate Finance Committee and the House Energy and Commerce Committee to recommend by Sept. 16 how to make the spending reductions to Medicaid (CQ HealthBeat , 9/6).
Some Republicans on Tuesday "defended the planned cuts ... as minimal and done in ways that would not seriously affect care under the program," CongressDaily reports (Heil, CongressDaily, 9/7). However, "enthusiasm might be waning for cuts in Medicaid" in the aftermath of Hurricane Katrina, and "there remains the possibility the package could be amended and scaled back either in committee or on the floor," according to CongressDaily (Cohn, CongressDaily, 9/6).
According to the New York Times, the cost of the relief effort -- about $700 million each day, and the total federal cost could be as high as $100 billion -- is "all but certain to wreak havoc with Bush's plans to reduce the federal deficit and possibly his plans to extend tax cuts" (Andrews, New York Times, 9/7).
Senate Majority Leader Bill Frist (R-Tenn.) said, "We will keep reconciliation on track for now" (Cohn, CongressDaily, 9/6).
Senate Finance Committee Chair Chuck Grassley (R-Iowa) said the budget reconciliation process "ought to proceed" (CQ HealthBeat , 9/6). Grassley added that the proposal would offer states "flexibility ... to serve more people. And that seems to be a worthy goal" (Heil, CongressDaily, 9/7).
Senate Budget Committee Chair Judd Gregg (R-N.H.) said lawmakers' plans for Medicaid cuts were "fairly far down the road" before Hurricane Katrina hit the Gulf Coast, making it more likely that the budget reconciliation process will go forward after Congress addresses the disaster. He added that many of the planned changes to Medicaid would not take effect for several years, thus lessening the impact on the hurricane-affected areas (CQ HealthBeat , 9/6).
Sen. Jon Kyl (R-Ariz.) said, "We need to be careful about making a direct relationship between Medicaid cuts and disaster relief," adding, "There may be little or no connection there."
Sens. Jeff Bingaman (D-N.M.), Blanche Lincoln (D-Ark.), Gordon Smith (R-Ore.) and Olympia Snowe (R-Maine) -- all members of the Finance Committee -- sent a letter to Grassley urging him to postpone the budget reconciliation process. A spokesperson for Snowe said, "It does make it more difficult to cut Medicaid at a time where there is devastation in the Gulf region" (Heil, CongressDaily, 9/7).
Sen. Edward Kennedy (D-Mass.) on Tuesday said the hurricane and its aftermath will "absolutely" affect the budget reconciliation process, but it is too soon to know in what way.
Sen. Richard Durbin (D-Ill.) said that if Medicaid cuts moved forward, it would show "how Republicans have lost sight of the reality of what working and poor families face in this country every single day." Durbin added, "Our hospitals and our doctors and our medical providers in the Medicaid system are going deeper and deeper into debt" (CQ HealthBeat , 9/6).
In related Medicaid news, state and local government groups on Tuesday in anticipation of a federal relief package began calculating how much it will cost Medicaid, unemployment, food stamps, housing and other social programs to care for Hurricane Katrina survivors, CongressDaily reports (Stanton et al., CongressDaily, 9/7). Some state Medicaid directors have called for giving hurricane survivors "refugee" status, which would provide 100% of federal Medicaid funding for their care, CQ HealthBeat reports (CQ HealthBeat , 9/6).
At the same time, Senate Republicans and Democrats are "considering a series of temporary policy changes to ease federal rules that slow or limit the amount of federal assistance available to victims of Hurricane Katrina," CongressDaily reports (Stanton et al., CongressDaily, 9/7). Senate Minority Leader Harry Reid (D-Nev.) and other Democrats have "pressed to pass legislation by the end of this week that would extend federal social programs such as Medicaid, subsidized housing and unemployment insurance" to newly homeless and unemployed residents of Louisiana, Mississippi and Alabama, Roll Call reports (Pierce et al., Roll Call, 9/7).
In addition, Democrats on the Senate Finance Committee have "circulated a proposal" that would quickly enroll hurricane survivors in Medicaid, reimburse providers treating such beneficiaries and protect states that "take in refugees from the Gulf area," CongressDaily reports (Stanton et al., CongressDaily, 9/7).
The Democrats' proposal also would waive Medicaid requirements for proof of residency and assets, as well as eliminate beneficiaries' copayments. The plan also would prohibit penalties for Medicare beneficiaries who miss the deadline to sign up for Medicare Part B, which covers physician and outpatient services (Stanton, CongressDaily, 9/6).
The Louisiana congressional delegation is planning a legislative package to provide immediate relief, which likely will include proposals to ensure that Medicaid, housing and unemployment benefits are available to survivors for an extended period of time (Roll Call, 9/7).
Sen. Trent Lott (R-Miss.) on Tuesday said a congressional relief package must include provisions that would waive laws restricting public health insurance and unemployment benefits (Stanton et al., CongressDaily, 9/7).
NPR's "All Things Considered" on Tuesday reported on the planned Medicaid spending reductions. The segment includes comments from Angus King, former independent governor of Maine and vice chair of the federal Medicaid commission charged with recommending short- and long-term reforms to the program; Kathleen Stoll, health policy director for Families USA; and Sen. Ron Wyden (D-Ore.) (Rovner, "All Things Considered," NPR, 9/6). The complete segment is available online in RealPlayer.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.