Sen. Gordon Smith, HHS Secretary Mike Leavitt Near Agreement on Presidential Medicaid Commission
HHS Secretary Mike Leavitt and Sen. Gordon Smith (R-Ore.) on Thursday after two meetings came "close to an agreement" on a proposal to establish a presidential commission to study Medicaid and "assume cuts" to the program as part of the fiscal year 2006 budget resolution, CQ Today reports.
Smith -- who sponsored an amendment passed last month as part of the Senate budget resolution to eliminate an instruction for the Senate Finance Committee to find $15 billion in Medicaid funding reductions over five years -- represents a "pivotal vote" on the final budget resolution, according to CQ Today. The proposed commission would report recommendations in September before the deadline for a final budget bill.
An unnamed Senate Republican source said the final budget bill likely will include at least $8 billion in Medicaid funding reductions over five years -- less than the at least $12 billion sought by Senate Budget Committee Chair Judd Gregg (R-N.H.). An unnamed senior Senate Republican aide said, "Gregg has kind of drawn this line in the sand. And we hope that (Medicaid) number is large enough to bring the chairman back into the conversation a little bit."
Smith after the meeting said, "This is a very delicate stage. There is progress, but anything I say at this point would be unwise. There's no decision that can be announced" (Taylor, CQ Today, 4/21).
Rep. Heather Wilson (R-N.M.) and Del. Donna Christensen (D-Virgin Islands) on Thursday said they have the signatures of 221 House members in support of a bill (HR 985) that would establish a bipartisan Medicaid commission to make recommendations on possible funding reductions for the program.
However, Rep. Jeb Hensarling (R-Texas) said he has the support of 71 House members for a letter that asks House Budget Committee Chair Jim Nussle (R-Iowa) to "stand firm on Medicaid savings" in the final budget resolution (CQ HealthBeat, 4/21).
On Wednesday, Leavitt in a speech at the University of Washington School of Medicine said that states should have more flexibility in the administration of their Medicaid programs. Leavitt said that states should have the ability to charge copayments for some Medicaid beneficiaries.
In addition, he said that states should have the ability to extend basic Medicaid coverage to more low-income residents rather than provide more comprehensive coverage to fewer residents (Song, Seattle Times, 4/21).
NPR's "Morning Edition" on Friday reported on the debate over Medicaid eligibility and "loopholes" that allow middle-class seniors to receive benefits. The segment includes comments from Donna Bashaw, vice president of the National Academy of Elder Law Attorneys; Leavitt; Stan Rosenstein, deputy director of the California Department of Health Services; Jack Stephens, an estate planning and elder law attorney who counsels U.S. residents on how to qualify for the program and shelter their assets from Medicaid estate recovery programs, which allow states to recoup expenses by collecting beneficiaries' homes and other assets after they die; a woman who paid out of pocket for her husband's long-term nursing care costs until she placed their assets into a trust so he qualified for Medicaid; and a woman whose husband qualified for Medicaid coverage of his long-term nursing care despite moderate assets (Horsley, "Morning Edition," NPR, 4/22). The complete segment is available online in RealPlayer.
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