Congress May Order Major Medicaid Review

APA is backing legislation in Congress that would establish a bipartisan Medicaid commission to conduct a comprehensive review of the nation's largest public health care program.

Medicaid, which is funded through federal matching grants to states, in combination with state-provided funds, serves more than 50 million low-income individuals, including people with disabilities, according to the February 8 Congressional Record.

“For millions of Americans with mental illnesses, Medicaid is a critical source of care,” APA stated in letters of support for the Bipartisan Commission on Medicaid Act of 2005. “Medicaid is especially important to states as they face deficits that threaten the stability of Medicaid funding for patients.”

There is considerable bipartisan support in Congress for the legislation. It was introduced by Sen. Gordon Smith (R-Ore.) and Rep. Heather Wilson (R-N.M.) in February, and by mid-March there were 97 cosponsors in the House and 26 cosponsors in the Senate.

The legislation also has support from several professional organizations representing state and local elected officials, physicians and other health care professionals, and patient advocates, according to Smith in the Congressional Record.

The bills were introduced in Congress in response to growing concerns about proposed Medicaid budget cuts by President George W. Bush that would take effect in Fiscal 2006 (Psychiatric News, March 18).

“Extreme reforms should not be instituted simply to save money. Medicaid is expensive but so is private health care coverage,” Smith said. “And in comparison, Medicaid is a pretty good deal.”

The cost per person in the Medicaid program rose just 4.5 percent a year from 2000 to 2004. That compares with a 12 percent rise in the average annual cost of premiums in the private sector, according to the Congressional Record.

“The problem is that Medicaid's enrollment is growing, and a lot more money is being spent on long-term care compared to previous years,” Smith said.

APA is also concerned about the impact of Medicaid budget cuts on dual-eligible patients—that is, individuals who are eligible for both Medicaid and Medicare—and their transition from Medicaid outpatient prescription drug coverage to Medicare Part D coverage. Dual-eligible individuals lose their Medicaid benefits on December 31 (see Original article: page 13).

“We are concerned that during the transition, these particularly vulnerable individuals will encounter disruptions in treatment as they shift from Medicaid to Medicare. This bears close attention,” stated APA in its letter.

APA's Department of Government Relations plans to continue working with the bills' sponsors to move the legislation forward in Congress.

The text of the Bipartisan Commission on Medicaid Act of 2005 can be accessed online at<thomas.loc.gov> by inserting the bill name or number, S 338 or HR 985. ▪