U.S. Medicaid commission draws unusual interest
When it comes to the Medicaid health program for the poor, the question in Washington has moved from whether to cut the program to how.
The budget blueprint approved by the U.S. Congress late last month calls for legislation to trim Medicaid spending by $10 billion over five years. But, in a compromise with moderate Republicans in the Senate, the deadline for that legislation to be written was pushed back to September, and the Bush administration agreed to appoint a bipartisan commission to make recommendations for how the program should be restructured.
Now, however, the debate has turned to what type of commission will be created - and how seriously Congress will take those recommendations.
Six Republican and six Democratic senators wrote Health and Human Services Secretary Michael Leavitt earlier this week, urging that he turn the entire enterprise over to the nonpartisan Institute of Medicine.
“We believe that this is the best way to ensure that the Administration and Congress receive credible, long-range recommendations on how to improve coverage and access to care, quality, and cost-effective of services for low-income and vulnerable populations served by Medicaid,” said the letter, whose lead signer was Republican Sen. Gordon Smith of Oregon.
Smith had earlier proposed legislation to set up an IoM commission to study Medicaid.
That, however, is apparently not what the administration has in mind. Leavitt said Wednesday he is moving “rapidly” to establish the commission, which sources say he will appoint himself rather than delegate the task to the IoM.
An HHS spokeswoman, however, would not confirm a report in Thursday’s New York Times that Leavitt has settled on an 18-member panel.
Sen. Smith Wednesday said that based on a private meeting earlier this week with Leavitt, he was “hopeful” about prospects for the commission. But he warned that “the burden is on this administration to do this in a credible way.”
Some consumer advocates have already reached their own conclusions. “The Medicaid Commission created by the Bush Administration...is...likely to be a sham that will only rubber-stamp predetermined conclusions designed to cut back vital health services for America’s elderly, children, and other vulnerable groups,” said a statement from the group Families USA.
Other lawmakers said that regardless of the commission’s recommendations, they will still need to be approved by Congress - and that may not be easy.
“It will be difficult, if not impossible, to achieve $10 billion in Medicaid savings without undue harm to vulnerable beneficiaries. Thus, we will urge our Committees to look elsewhere in order to meet the budget target,” wrote Sen. Max Baucus of Montana and Rep. John Dingell of Michigan, the senior Democrats on the committees that oversee Medicaid.
“Both the Senate Committee on Finance and the House Committee on Energy and Commerce have jurisdiction over other areas that could generate savings. There is no reason to believe that the full amount must come from Medicaid,” Baucus and Dingell warned.
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