House blocks Medicaid rules with veto-proof majority / White House Pledges Veto of Bill Delaying Medicaid Rule Changes

CAL/AAEM News Service calaaem_news at yahoo.com
Sun Apr 27 18:44:55 PDT 2008


House blocks Medicaid rules with veto-proof majority.
 
Source: The American Medical Association ( http://www.ama-assn.org/ )
Date: April 24, 2008-04-27


In continuing coverage from previous editions of Morning Rounds, the Wall Street Journal (4/24, A4, Zhang) reports that on Wednesday, the U.S. "House voted overwhelmingly to block Medicaid rules that would cut federal healthcare spending on the poor, and likely shift billions of dollars of costs to states." While President Bush has threatened to veto the legislation, the 349 to 62 vote represented "two-thirds of Republicans and all Democrats in the chamber," making it veto-proof. But, whether "Congress can override a Bush veto...depends on the Senate." President Bush intends the "regulations to stop states from abusing the program, and to keep the Medicaid program afloat." Still, "[g]overnors of all states and state Medicaid directors" believe "the new regulations would stop longtime practices, such as the use of federal Medicaid funds to pay for physician training." Moreover, the proposed rules "would also limit federal payments to some hospitals and
 nursing homes." 

Opponents of the Centers for Medicare and Medicaid Services rules also say that the changes would "reduc[e] access to healthcare for the country's neediest people," the New York Times /AP (4/24, A23, Abrams) adds. The seven rule changes which the Bush administration proposed would "curb waste" by "cutting federal spending on Medicaid healthcare for the poor by $13 billion over the next five years." In response to the House vote, the White House said that the bill would "thwart these efforts of the federal government to regain fiscal accountability and integrity in Medicaid." 

Bloomberg (4/24, Faler) further explains that the House bill, HR 5613, "would cost the Treasury about $1.6 billion during the next 18 months, according to the nonpartisan Congressional Budget Office (CBO). Under congressional rules, lawmakers are required to find offsetting savings elsewhere in the budget to avoid adding to the deficit." Those savings would be generated "by requiring more stringent examinations of Medicaid applicants' assets to ensure they don't exceed program restrictions." The CBO expects that "those provisions would save $1 billion over the next five years by denying or delaying eligibility for some people, especially those seeking coverage for nursing-home care." 

Modern Healthcare (4/23, Lubell, DoBias) noted that Health and Human Services Secretary Michael Leavitt "predicted a much tougher fight" in the Senate. 


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White House Pledges Veto of Bill Delaying Medicaid Rule Changes
 
Source: The California Healthline ( http://www.californiahealthline.org ) 
Date: April 23, 2008


The Bush administration on Tuesday issued a formal veto threat against legislation (HR 5613) that would place a one-year moratorium on seven new Medicaid regulations, CongressDaily reports (CongressDaily, 4/22). The legislation would delay implementation of the regulations until April 1, 2009. 

Under the regulations, proposed by the Bush administration, states could not use federal Medicaid funds to help pay for physician training. 

The regulations also would place new limits on Medicaid reimbursements to hospitals and nursing homes operated by state and local governments and limit coverage of rehabilitation services for individuals with disabilities and mental illnesses. 

In addition, the bill would provide $25 million annually for efforts to fight Medicaid fraud (California Healthline, 4/17).

The Bush administration cited reports from the HHS Office of Inspector General and the Government Accountability Office that found states have been inappropriately increasing Medicaid spending to draw down more federal matching funds. 

In a statement, the administration said, "Blocking the [CMS] regulations ignores the policy recommendations and investigatory findings of the GAO and the OIG and will put billions of dollars of federal funds at risk" (CongressDaily, 4/22). 

Prospects in House, Senate

On Wednesday, the House is expected to pass the measure with a veto-proof margin after Republican lawmakers reached an agreement with Democratic co-sponsors to scale back an earlier version of the bill (Johnson, CongressDaily, 4/23). 

The House was scheduled to vote on the legislation on Tuesday, but lawmakers delayed action so that representatives campaigning in the Pennsylvania primary could participate. 

It is unclear whether the Senate will pass the measure with a veto-proof margin, which "means the veto battle will almost certainly be decided in the Senate," CQ Today reports (Armstrong, CQ Today, 4/22). 

Senate Finance Committee Chair Max Baucus (D-Mont.) said Tuesday that he believes the Senate will have the votes to override a veto. "A lot of Republicans want those regulations repealed," Baucus said (CongressDaily, 4/23).

For more information, please visit:
http://www.californiahealthline.org/articles/2008/4/23/White-House-Pledges-Veto-of-Bill-Delaying-Medicaid-Rule-Changes.aspx?topicID=37

Abid Mogannam &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service
University of California, Irvine

The CAL/AAEM Archives are available at: http://maillists.uci.edu/mailman/public/calaaem/


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