Congress pon­ders Med­i­caid cuts

Med­i­caid scru­ti­nized as both sides look for cuts

Modern Healthcare - - Front Page - Rich Daly

The po­lit­i­cal tox­i­c­ity of pro­pos­als to change Medi­care as part of deficit re­duc­tion ef­forts has in­creased the fo­cus in Wash­ing­ton on pos­si­ble cuts to Med­i­caid and the Chil­dren’s Health In­surance Pro­gram.

The Obama ad­min­is­tra­tion has launched ini­tia­tives it says will help con­trol spend­ing growth in the $400 bil­lion Med­i­caid pro­gram, which is the third costli­est en­ti­tle­ment pro­gram af­ter So­cial Se­cu­rity and Medi­care. A com­ple­men­tary ef­fort by con­gres­sional Democrats pushed for in­creas­ing fed­eral taxes to pay for growth in the pro­gram, which cov­ers about 68 mil­lion peo­ple and is ex­pected to ex­pand by at least 16 mil­lion in 2014 un­der pro- vi­sions of the Pa­tient Pro­tec­tion and Affordable Care Act. An­other 8 mil­lion mi­nors are cov­ered by the $11 bil­lion chil­dren’s pro­gram.

But ef­forts to main­tain and ex­pand Medic-

“Cuts in Med­i­caid will just mean costs are trans­ferred to hos­pi­tal ERs, which ev­ery­one else pays for.”

—Rep. John Din­gell (D-Mich.)

aid and CHIP en­roll­ment are run­ning into an in­creas­ing fo­cus by con­gres­sional Repub­li­cans on re­duc­ing the size of the pro­grams, which are du­ally funded by the fed­eral and state gov­ern- ments, or at least al­low­ing gov­er­nors to do so.

The lat­est leg­isla­tive ini­tia­tive aimed at cut­ting Med­i­caid and CHIP growth be­gan to ad­vance last week. That leg­is­la­tion, spon­sored by Rep. Phil Gin­grey (R-Ga.), a physi­cian, would al­low state gov­ern­ments to re­duce their Med­i­caid and CHIP en­roll­ments as a way to close state bud­get deficits. States are barred from cut­ting their en­roll­ments be­low lev­els raised with the help of one-time fund­ing pro­vided through the 2009 Amer­i­can Re­cov­ery and Rein­vest­ment Act, which is known as the main­te­nance-of-ef­fort re­quire­ment.

“Nearly ev­ery gov­er­nor has asked for ei­ther re­peal or flex­i­bil­ity in main­te­nance of ef­fort,” Rep. Michael Burgess (R-Texas) said Thurs­day be­fore the first con­gres­sional panel voted to ad­vance the main­te­nanceof-ef­fort leg­is­la­tion.

The com­ment was based on the re­quest of 33 Repub­li­can gov­er­nors, who wrote HHS Sec­re­tary Kath­leen Se­be­lius in Jan­uary to ask that she lift the en­roll­ment re­quire­ment. Also, Wash­ing­ton Gov. Chris-

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