WASHINGTON WIRE
February 29, 2008
Issue 161
Medicare “Trigger” Legislation
HHS Secretary Denies Request to Rescind Medicaid Rule
SCHIP/Medicaid Policy Criticized by State Governors
Hearings
Top Story
Medicare "Trigger" Legislation
The White House, via the Department of Health and Human Services (HHS) and Congressional leaders, introduced legislation on February 25 that aims to lower Medicare spending and limit program growth. The legislation (S. 2662, H.R. 5480) mandates that general revenues not exceed 45% of Medicare spending. HHS Secretary Leavitt stated that the 45% funding cap, known as the "trigger," would be met by increasing prescription drug charges for wealthier beneficiaries, increasing consumer control of the program, and limiting medical malpractice awards.
Democrats have voiced concerns and skepticism over the proposal and criticized the White House's unwillingness to discuss other options. House Majority Leader Steny Hoyer (D-MD), for instance, expressed "strong reservations about the basic approach of the trigger. The trigger establishes an arbitrary limit on general revenues and does not provide a meaning measure of Medicare's fiscal health." Republicans, however, promised that the legislation would preserve Medicare's viability.
The legislation will be expedited as required by the 2003 Medicare prescription drug law. Accordingly, the House is expected to vote on its bill this summer.
Health Care News
HHS Secretary Denies Request to Rescind Medicaid Rule
Health and Human Services (HHS) Secretary Michael Leavitt stated this week that he does not plan to rescind a recently proposed regulation which many claim will significantly reduce case management services under Medicaid.
Members of the House Budget Committee stated on Wednesday that, under the new rule, HHS is attempting to cost-shift case management funding to states in order to save federal Medicaid dollars. However, Secretary Leavitt told Committee Members that many states are using "contingency consultants" to draw down more federal Medicaid money under the targeted case management services benefit and that he is being forced to "push back."
In early December, the agency released an interim final rule to implement provisions of the Deficit Reduction Act of 2005 (DRA) regarding changes to targeted case management services under Medicaid. However, stakeholders state that the interim final rule goes far beyond Congressional intent and will harm beneficiaries with disabilities and others populations that depend on case management services. The rule is scheduled to take effect on March 4th. For instance, the rule limits case management services to 60 days (down from 180 days) jeopardizing the ability of case managers to effectively move people out of institutions and into community living arrangements
Also on Wednesday, Senators Stabenow (D-MI), Mikulski (D-MD), and Klobuchar (D-MN) hosted a briefing to educate Congressional staff on the impact of the case management rule at the state level. Senator Coleman (R-MN) has introduced legislation to place a one-year moratorium on implementation of the TCM rule. Congressman Keith Ellison (D-MN) has introduced similar legislation in the House.
The Senate recently passed a one-year moratorium on the targeted case management rule which was included as part of the Indian Health Care Improvement Act. However, the House companion legislation, in Committee, does not yet include the same provision and President Bush has threatened to veto the Indian Health bill.
SCHIP/Medicaid Policy Criticized by State Governors
In August 2007, the Centers for Medicare and Medicaid Services (CMS) released a directive requiring states to enroll 95% of children from families below 200% of the poverty level in the State Children's Health Insurance Program (SCHIP) before expanding coverage to other children. This policy has recently been expanded to include Medicaid, as well. President Bush has vetoed legislation to expand SCHIP enrollment on two separate occasions, and many see these enrollment limitations as another attempt to limit the reach of these programs.
Democratic governors told Congress on February 26 that they could not reach the 95% requirement and asked that the policy be rescinded. The governors argued that the CMS mandate is overly restrictive, contrary to Congressional intent, and that it thwarts states' efforts to provide health insurance to all children. The National Governors Association told Congressional leadership by letter dated February 25, that the policy "will effectively end the federal government's participation in many crucial components of the Medicaid program and inappropriately sift those costs to states."
Republican governors also testified before Congress and asserted that the SCHIP allotment formula is flawed. They argued, however, that it does not provide enough funding for some states (namely, Mississippi and Georgia) to cover all eligible children and thus should not be expanded in other states to cover more than the lowest-income children. Both sets of governors testified before the House Energy and Commerce Health Subcommittee, but Congress has yet to announce any decision regarding the policy.
Upcoming Events
Hearings
Tuesday, March 4, 2008
Legislative Agenda of Veterans' Organizations
House Veterans' Affairs Committee; Senate Veterans' Affairs Committee
9:30 a.m., 216 Hart Bldg.; 2 p.m., 345 Cannon Bldg.
Thursday, March 6, 2008
Legislative Agenda of Veterans' Organizations
House Veterans' Affairs Committee; Senate Veterans' Affairs Committee
9:30 a.m
For More Information
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