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February 20, 2008

The Honorable Mitch McConnell
Minority Leader
U.S. Senate
Washington, D.C. 20510

The Honorable John Boehner
Minority Leader
U.S. House of Representative
Washington, D.C. 20515

The Honorable Harry Reid
Majority Leader
U.S. Senate
Washington, D.C. 20510

The Honorable Nancy Pelosi
Speaker
U.S. House of Representatives
Washington, D.C. 20515

Dear Senator Reid, Senator McConnell, Speaker Pelosi, and Representative Boehner:

We are writing to urge you to help pass and extend legislative moratoria to prevent serious harm both to vulnerable Medicaid beneficiaries — especially children, people with disabilities, and children in foster care — and to our nation's health care system, in particular its health care safety net. Over the last year the Administration has proposed or issued a series of Medicaid regulations that, if implemented, will have a sharp, adverse impact on beneficiaries, providers, states and localities. The President's FY 2009 budget includes additional regulatory changes.

Last year, at the behest of the nation's governors and a wide array of providers and beneficiary advocates, Congress repeatedly acted on a bipartisan basis to pass legislation to temporarily delay implementation of proposals that would have significantly restricted federal support for services provided to children in schools and rehabilitation services provided to children and people with disabilities. Congress also delayed major changes in payments to public hospitals and other health care providers that would have significantly damaged our health care safety net. If these moratoria are not extended this year, the impact of the regulations will be felt not just by low-income people, but across wide swaths of our communities as states and localities have to find ways to deliver critical services without the support of the longstanding federal-state Medicaid partnership. At a time when many states are facing recessions, they can ill afford to pick up these costs.

Extending the existing moratoria on changes in school-based and rehabilitation services and hospital payments and passing new moratoria to address other recent Administration actions that endanger health care by limiting access to services and harming providers’ ability to provide needed services will help protect Medicaid beneficiaries and the health care providers they rely on. This will also prevent state and local governments from cutting other health and social services to cover the added costs of essential services for which federal reimbursement is no longer available. We hope that you will make addressing these regulations one of your highest health care priorities in 2008.

Sincerely, ACCSES
AFL-CIO
AFSCME
Alexander Graham Bell Association for the Deaf and Hard of Hearing
Alliance for Children and Families
American Academy of Child and Adolescent Psychiatry
American Academy of HIV Medicine
American Academy of Pediatrics
American Association of Homes and Services for the Aging
American Association of People with Disabilities
American Association of School Administrators
American Association on Intellectual and Developmental Disabilities
American Dance Therapy Association
American Federation of Teachers
American Foundation for the Blind
American Friends Service Committee
American Health Care Association
American Hospital Association
American Humane Association
American Network of Community Options and Resources
American Nurses Association
American Occupational Therapy Association
American Physical Therapy Association
Association of Assistive Technology Act Programs
Association of Educational Service Agencies
Association of Maternal and Child Health Programs
Association of State and Territorial Health Officials
Association of University Centers on Disabilities
Autism Society of America
Bazelon Center for Mental Health Law
Brain Injury Association of America
Catholic Health Association of the United States
Center for Law and Social Policy
Center for Medicare Advocacy
Center for the Study of Social Policy Center on Budget and Policy Priorities
Child Welfare League of America
Children's Defense Fund
Children's Dental Health Project
Children's Rights
Coalition on Human Needs
Committee of Ten Thousand
Community Action Partnership
Community Catalyst
Corporation for Supportive Housing
Council for Exceptional Children
Disability Rights Education and Defense Fund
Easter Seals
Epilepsy Foundation
Families USA
Family Voices
First Focus
Foster Care Alumni of America
Foster Family-based Treatment Association
HIV Medicine Association
IDEA Infant Toddler Coordinators Association
Inter-National Association of Business, Industry and Rehabilitation
International Union, United Auto Workers
Jewish Council for Public Affairs
Leadership Conference of Women Religious
Learning Disabilities Association of America
Lutheran Services in America
Medicaid/SCHIP Dental Association
Mental Health America
National Advocacy Center of the Sisters of the Good Shepherd
National Alliance on Mental Illness
National Alliance to End Homelessness
National Asian Pacific American Women's Forum
National Association for Children’s Behavioral Health
National Association for the Dually Diagnosed
National Association of Children's Hospitals
National Association of Community Health Centers
National Association of Councils on Developmental Disabilities
National Association of Counties
National Association of County and City Health Officials
National Association of County Behavioral Health and Developmental Disability Directors
National Association of County Human Services Administrators
National Association of Private Special Education Centers
National Association of Public Hospitals and Health Systems
National Association of Social Workers
National Association of State Directors of Developmental Disability Services
National Association of State Directors of Special Education
National Association of State Head Injury Administrators
National Association of Urban Hospitals
9to5, National Association of Working Women
National Center for Law and Economic Justice
National Community Action Foundation
National Consumer Voice for Quality Long-Term Care
National Council for Community Behavioral Healthcare
National Council of Jewish Women
National Council on Independent Living
National Disability Rights Network
National Down Syndrome Congress
National Down Syndrome Society
National Education Association
National Health Law Program
National Immigrant Solidarity Network
National Multiple Sclerosis Society
National Partnership for Women & Families
National Priorities Project
National Puerto Rican Coalition
National Rehabilitation Association
National Research Center for Women & Families
National Respite Coalition
National Rural Education Advocacy Coalition
National WIC Association
National Women’s Law Center
NETWORK: A National Catholic Social Justice Lobby
NISH
OMB Watch
Premier, Inc.
Presbyterian Church (U.S.A.) Washington Office
Private Essential Access Community Hospitals (P.E.A.C.H., Inc.)
Rebecca Project for Human Rights
RESULTS
Sargent Shriver National Center on Poverty Law
School Social Work Association of America
Service Employees International Union
The Arc of the United States
Ukrainian Autocephalous Orthodox Church
Union for Reform Judaism
United Cerebral Palsy
United Jewish Communities
United Neighborhood Centers of America
United Spinal Association
USAction
Voices for America's Children
VOR - Speaking out for people with mental retardation
Wider Opportunities for Women
Youth Law Center
YWCA USA

cc: Senate Finance Committee Chairman Max Baucus
Senate Finance Committee Ranking Member Charles Grassley
House Energy & Commerce Committee Chairman John Dingell
House Energy & Commerce Committee Ranking Member Joe Barton