Medicaid HHS Holds Off on Releasing Public Details of Medicaid Commission
May, 2005

The Department of Health and Human Services still is working to finalize the details surrounding the planned commission to examine reforms needed in the Medicaid program, an HHS spokesman said May 19.

The HHS spokesman said he could not discuss the Bush administration's time line for unveiling the Medicaid commission.

However, House and Senate aides have heard different target dates for the administration's unveiling of the Medicaid commission. For instance, a House Democratic aide said HHS has indicated that it will unveil its proposals for a Medicaid commission after Congress returns from the Memorial Day recess, which runs from May 30-June 2.

Meanwhile, a Senate GOP aide said it is rumored that an announcement on the Medicaid commission could appear in the Federal Register in the coming days.

Meanwhile, it appears as though the Medicaid commission will be appointed by the Bush administration, according to Medicaid stakeholders.

Baucus: 'Deep Concerns.'

After having been briefed on the Medicaid commission, Sen. Max Baucus (D-Mont.), ranking member on the Senate Finance Committee, told reporters May 16 that he has "deep concerns about the formation" of the commission. Baucus said he has shared his concerns about the Medicaid commission with HHS Secretary Michael O. Leavitt. "I told the secretary that it has got to pass the smell test. It has got to look like it doesn't have a political ax to grind. It has to come across as real, and my sense is this commission does not pass this test," Baucus said.

In particular, Baucus said, he is concerned that the Bush administration will be in total control of choosing who serves on the commission.

Also, Baucus said he is concerned that the commission will be charged with making recommendations on how Congress should achieve the $10 billion Medicaid cuts ordered under the fiscal year 2006 budget resolution.

"It is like it's telling the Senate what to do on Medicaid," Baucus said, expressing a sentiment among Republicans and Democrats who oversee Medicaid that the commission may try to supersede congressional authority on deciding how to reform Medicaid.

Sen. Gordon Smith (R-Ore.) urged the Bush administration to agree to a Medicaid commission as part of negotiating an agreement on the level of Medicaid cuts in the FY 2006 budget resolution.

Reaching $10 Billion

Meanwhile, Congress must move quickly to decide how to achieve the $10 billion in Medicaid savings, despite the budget resolution's Sept. 16 deadline for making the Medicaid cuts. There are only eight working weeks to reach an agreement on Medicaid cuts, before the House and Senate oversight committees act on legislation implementing the Medicaid cuts, the Senate GOP aide said.

Under the FY 2006 budget resolution, the House Energy and Commerce and Senate Finance committees were instructed to reduce spending by $10 billion in programs under the committees' jurisdiction. It is assumed that the spending reductions will come from Medicaid, but other programs can be targeted for savings.

The Senate Finance Committee will try to reduce Medicaid spending by $9 billion, and may focus on reductions in unemployment insurance for the additional $1 billion, the Senate aide said.

Meanwhile, Baucus said it is too early in the process to determine how the Senate Finance Committee would make the Medicaid cuts. He added it also was premature to say whether some of the savings should come from the Medicare program.

Stabilization Fund

However, Baucus said the $10 billion stabilization fund in the new Medicare drug program designed to encourage preferred provider organizations to participate in the drug benefit should be considered for savings. "I do think the stabilization fund should be on the table," Baucus said, adding that it appears that PPOs may not need to use this funding.

The use of the PPO stabilization fund would take $5.8 billion off the table over five years, a Senate Democratic aide has said (No. 87 HCDR 5/6/05 ). The stabilization fund does not go into effect until 2007, with the some plans indicating that they are not depending on this funding because the rules for accessing the money are not clear.

In addition to making the Medicaid cuts, the Senate Finance Committee will try to move Medicaid and State Children's Health Insurance Program bills that faltered in previous sessions of Congress, the Senate aide said.

This plan may include bills which would expand coverage to disabled children whose families would not normally qualify for Medicaid, and legislation to return expired SCHIP money to states. In addition, the Senate may try to move money follows-the-person legislation that was left pending as the Congress adjourned in 2004, he said. CMS describes money follows-the-person efforts as a system of flexible financing for long-term care services, which allows available long-term care Medicaid funding to move with the beneficiaries to appropriate settings, as the individual's needs and preferences change.

Spending offsets must be found for Congress to approve the Medicaid and SCHIP legislation, the Senate aide said.

Member Benefits | About AAPD | Join | Disability Resources | News | Contact Us | Calendar | Home