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Medicaid
Budget
Reconciliation * Budget
Resolution * Wilson Letter
* Bipartisan Medicaid Commission
Budget Reconciliation
Back in November, I voted against the House version of the
bill, which would have reduced entitlement spending by $50
billion. On December 12, 2005, I voted for the revised bill
(conference report), which reduces the growth of entitlement
spending by $39 billion over five years. I voted again for
this legislation on February 1, 2006, and the President signed
the bill into law on February 8.
I would like to respond to some of the criticisms I have
heard about the Medicaid provisions of this legislation.
First, the law does not require co-payments or premiums for
people on Medicaid. It gives states the option to implement
co-payments or premiums, but state governments will have to
enact these through each of their respective governments.
If states do implement cost sharing, they can charge no more
than 5 percent of a family's income for a month or quarter.
Second, the bill does not end or significantly scale back
health programs for children on Medicaid. State governments
have the option of altering their coverage from a benefit
with many guaranteed benefits to a structure similar to a
Health Maintenance Organization. A statement from Mark McClellan,
the Administrator of the Centers for Medicare and Medicaid
Services (CMS), indicates that CMS' reading of the statute
is that children will still qualify for the these benefits.
Third, the bill does not take away nursing home care for
impoverished seniors. The bill prevents wealthy seniors who
deliberately transfer assets to qualify for Medicaid nursing
home care benefits from receiving this coverage. Exemptions
were written into the bill so seniors who have hardship or
helped a grandchild pay for school costs will not lose access
to this care.
Budget Resolution
On April 28, 2005, I voted against H.Con.Res.
95, the Fiscal Year 2006 Budget Resolution, which
passed the House by a vote of 214 to 211. The legislation
included instructions for the Energy and Commerce Committee,
which oversees Medicaid, to find $10 billion in savings over
the next five years. The Budget Resolution does not mention
Medicaid specifically, but it is likely the program would
face some reductions in spending.
While I appreciate the commitment to getting our financial
house in order, particularly in difficult fiscal times, I
believe this budget relies too heavily on programs urban areas
rely on to achieve savings without making necessary reforms
in burgeoning entitlement programs.
Although I voted against H.Con.Res.
95, I realize to slow the growth of government
spending and reduce our deficit, we must slow the growth of
entitlements, which make up two-thirds of federal spending.
Considering Medicaid will cost the federal government well
over $1 trillion in just the next five years, it seems to
me that savings can be achieved in this program.
As you may know, the President's Budget called for $45 billion
in savings from Medicaid over 10 years. While many have characterized
this as a cut, the fact is, this would only slow Medicaid's
growth of spending from 7.6 percent per year from FY 06 to
FY 15 to 7.3 percent per year. It seems to me to get our federal
deficit under control, we must exercise precisely this type
of restraint.
Wilson Letter
I joined 43 of my colleagues in writing to House Budget Chairman
Nussle expressing opposition to including cuts to Medicaid
in the conference report to the Budget Resolution. In our
letter, we stated:
We are concerned that the inclusion of up to $20 billion
in reductions from projected growth in the Medicaid program
included in the House-passed FY06 Budget Resolution will negatively
impact people who depend on the program and the providers
who deliver health care to them while not putting us on the
path to comprehensive reform and improvement that the program
needs.
Motion to Instruct Conferees
On April 26, 2005, I voted for a motion to instruct conferees
to H.Con.Res.
95 opposing the inclusion of the $20 billion
in cuts proposed by the House which could have come out of
Medicaid. The motion passed by a vote of 348 to 72.
Bipartisan
Medicaid Commission
Additionally, to ensure any Medicaid reform that occurs is
conducted in a thoughtful, bipartisan manner, I am a cosponsor
of H.R.
985, which would establish a bipartisan commission
which would study the issue for one year and report back to
Congress with recommendations on how savings can be achieved.
The bottom line is we simply can't afford to downgrade health
care services to our nation's most vulnerable citizens. I
am willing to consider proposals that make the program work
more efficiently, but I want to ensure any savings come from
the program as a result of thoughtful consideration and not
simply because we need to save money from the budget.
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