Some Senators Say Institute of Medicine Should Have Role in Commission To Study Medicaid

A bipartisan group of senators is urging HHS Secretary Mike Leavitt to allow the Institute of Medicine to lead the Medicaid study commission, CongressDaily reports. The commission, called for in the fiscal year 2006 budget resolution approved by Congress last month, will recommend ways to cut $10 billion from Medicaid over five years and propose longer-term solutions to slow the program's rising costs.

A spokesperson for Sen. Gordon Smith (R-Ore.), who spearheaded the effort to create the panel, said Smith wants Leavitt to give IOM a "big role" in crafting the commission's recommendations. "In order for the commission to be credible, it's got to be independent and bipartisan," the spokesperson said, adding that Smith and Leavitt likely will talk this week about the effort.

A spokesperson for Sen. Jeff Bingaman (D-N.M.), a co-sponsor of the Smith amendment that created the commission, said a panel appointed by Leavitt would not be impartial. "There's no secret as to how the Bush administration wants to proceed on Medicaid," the spokesperson said.

Senate Majority Leader Bill Frist (R-Tenn.), speaking on the Senate floor before the budget was approved, said Leavitt will appoint the commission in a manner that "represent[s] a broad range of ideas and points of view." He added that the commission will be "a fair and balanced forum to discuss the needs and challenges of the Medicaid system."

Although few details about the commission have been finalized, CongressDaily reports that it likely will issue a preliminary report to Congress by Sept. 1. The report then will be available to Congress in time for reconciliation legislation, in which committees recommend levels of savings in the programs they oversee (CongressDaily, 5/10).

Caps in Medicaid spending "could create a serious risk of deepening future recessions," according to preliminary results released on Monday of a study by the Economic and Social Research Institute, CQ HealthBeat reports.

Stan Dorn, a researcher at the institute who spoke at a Washington forum sponsored by the Joint Center for Political and Economic Studies, said, "Medicaid may play a crucial role in helping the country recover from recession." Enrollment and outlays in Medicaid rise during recessions, providing protection against higher rates of uninsured people and an automatic economic stimulus to counter downturns, the report says.

Dorn said that African Americans have "a large stake in this issue" because they rely more heavily on Medicaid than other populations and their unemployment rates rise faster during recessions. For example, the unemployment rate for African Americans was three times the rate for the overall population from 2001 to 2004, according to Department of Labor data.

"African Americans disproportionately suffer from health problems like hypertension and diabetes," Dorn said, adding, "The health consequences from losing Medicaid or losing employment can thus be quite severe."

Dorn credited the Bush administration for proposing measures that would reduce Medicaid growth through tactics other than spending caps, including limits on asset transfers and restrictions on the ability of states to use accounting methods to receive higher federal Medicaid matching funds (CQ HealthBeat, 5/9).

Health policy experts speaking Monday at the forum also suggested other possible ways to reform Medicaid, including fraud and abuse prevention; caps on eligibility, covered services and reimbursement; and additional Medicaid reimbursements for states with poor economic performance, the Washington Times reports.

Former HHS Secretary Louis Sullivan said curbing Medicaid fraud could save a great amount of money.

Warren Jones, executive director of the Mississippi Medicaid program, said, "We would like to have more flexibility to let us do more. I just hope we don't lose sight of what's important" (DeBose, Washington Times, 5/10).

The Dallas Morning News on Tuesday examined how, "amid the desire to cut spending, the nation's most vulnerable may be in the budget cutters' cross hairs -- poor children, the elderly and the disabled."

The Morning News also notes that the Bush administration "denies that Medicaid is being cut, arguing that its rate of growth is being slowed" through spending reductions (Dodge, Dallas Morning News, 5/10).

WAMU's "The Diane Rehm Show," an NPR-syndicated program, on Tuesday in the first hour of the program is scheduled to include a discussion of states' strategies for containing rising Medicaid costs. Guests on the program will include Maryland state Rep. John Adams Hurson (D), president of the National Conference of State Legislatures; and Cheryl Matheis, director of health strategy at AARP (Rehm, "The Diane Rehm Show," WAMU, 5/10). The complete segment will be available online in RealPlayer after the broadcast.