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January 23, 2008 The Honorable Nancy Pelosi Dear Madame Speaker: We are writing as members of the Consortium for Citizens with Disabilities (CCD). The CCD is a leading coalition of national organizations working together to advocate for national public policy that ensures the self determination, independence, empowerment, integration, and inclusion of children and adults with disabilities in all aspects of society. As you move forward with an economic stimulus package, we write to ask you to include a temporary increase in the Medicaid Federal Medical Assistance Percentage (FMAP) tied to a requirement that states receiving this increase do not enact any new restrictions in Medicaid eligibility or covered services during this period. We also ask you to support broader state fiscal relief to minimize other cutbacks in essential state services. Medicaid is the cornerstone of this nation’s health care and long term services and supports system and is especially important to people with disabilities—who are concentrated in Medicaid because it is uniquely equipped among all health care programs to meet the health and long-term services needs of people with disabilities. It is also a major source of state spending making it susceptible to reductions when states experience fiscal distress. Including Medicaid in a stimulus package, along with other proposals such as an increase in unemployment and Food Stamps benefits, is important both for its effectiveness at stimulating economic activity—Medicaid is a powerful driver of economic activity at the state level—and to protect low-income beneficiaries who are otherwise at risk of losing Medicaid eligibility or losing access to critical, medically-needed services just to balance a state’s budget. In 2003, the Congress passed and the President signed into law a very modest, temporary increase in the FMAP and this proved to be a powerful instrument to assist states and prevent against shortsighted cutbacks in critical medical assistance. The disability community and other Medicaid stakeholders are also deeply concerned by recent federal rulemaking activities that would result in multi-billion dollar cost shifts to states—to the great detriment of vulnerable people with disabilities. Congressional intervention to prevent harmful rulemaking complements economic stimulus by not adding to state fiscal pressures when general revenues are declining, and in no way supplants the need for economic stimulus to spur the national economy and bolster states’ investments in their Medicaid programs. It is incumbent on the Congress, in the early part of this session, to also enact an extension of the existing Medicaid rehabilitative services and school-based services moratorium through March 2009, and to address the provisions of the recent interim final rule on case management services that go well beyond the statutory provisions enacted by Congress—using whatever legislative vehicle is available to it. As you work to stimulate the economy, we urge you to ensure that no low-income people with disabilities, children, parents, or seniors lose Medicaid coverage or have their services reduced due to the current economic downturn. If you have any questions, please contact the CCD Health Task Force Co-Chairs: Liz Savage, The Arc and United Cerebral Palsy Disability Policy Collaboration (202-783-2229- savage@thedpc.org), Kathy McGinley, National Disability Rights Network (202-408-9514, Kathy.McGinley@ndrn.org or Peter Thomas, ACCSES, (202-466-6550). Sincerely, ACCSES |
