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 Protect Medicaid Funding and Repeal Harmful Deficit Reduction Act (DRA) Provisions

Issue Overview | AMCHP's Position | Title V's Role | Pending Legislation | AMCHP's Voice

Issue overview

Medicaid Funding Cuts – The President’s FY 2009 budget proposes over $17 billion in Medicaid cuts over the next five years. These cuts include reducing the federal match rate for certain services, making changes to managed care, and other administrative changes.  Read an analysis of the president’s budget by the Georgetown University Center for Children and Families here.

Medicaid RegulationsIn recent years, the Centers for Medicare and Medicaid Services (CMS) has issued regulations and guidance to implement the Deficit Reduction Act (DRA) of 2005. Many DRA provisions allow states to choose whether or not to decrease benefits and increase costs for families in Medicaid. The total impact the DRA will have on families will largely depend on how states interpret and implement provisions within the legislation. 

Of primary concern to Title V programs is the interim final rule Targeted Case Management (TCM) which became effective on March 3. TCM assists beneficiaries in securing and coordinating access to necessary medical, social, educational and other services. Other recent Medicaid regulations include new limits on:

  1. outreach and enrollment in schools as well as specialized medical transportation to school for children covered by Medicaid;
  2. coverage of rehabilitation services for people with disabilities;
  3. graduate medical education payments;
  4. coverage of hospital clinic services;
  5. state provider tax laws; and,
  6. appeals filed through the Department of Health and Human Services.

Additional analysis on the impact of recent Medicaid regulations by the Center on Budget and Policy Priorities can be found here.

AMCHP's Position

AMCHP supports vital Medicaid funding for mothers, children and families, and the repeal of counter-productive Deficit Reduction Act (DRA) provisions.  AMCHP is opposed to the implementation of any rules that would shift costs to states or impede eligible beneficiaries from gaining access to needed medical, social, educational and other services.

Title V’s Role

AMCHP members administer statewide programs such as newborn screening, home visiting, school-based health centers and clinics for children with special health care needs, as well as many other vital health programs. State Title V Maternal and Child Health (MCH) programs coordinate closely with Medicaid’s Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program to assure the provision of all medically necessary services to children covered under Medicaid.

Pending Legislation

Next week, Congress returns to make decisions on how to move the Iraq supplemental spending bill. Both the House and Senate passed bills contain the moratorium on all 7 harmful Medicaid regulations. In addition, the Senate bill contains a rescission on the August 17 CHIP directive, limiting eligibility for children. The House amendment containing the Medicaid regulations passed 256-166. The Senate bill passed by a veto-proof margin with a vote of 75 to 22. 
The Administration remains opposed to the moratoria and have issued a veto threat, so the outcome is still uncertain. AMCHP will continue to work with coalitions supporting the regulatory moratoria and push for final passage as soon as possible.

AMCHP’s Voice