House votes to delay regulations imposed by administration on Medicaid

April 23, 2008

By JIM ABRAMS

WASHINGTON, Apr. 23, 2008 (AP Online delivered by Newstex) -- The House has voted to block the Bush administration from cutting federal spending on Medicaid health care for the poor by $13 billion over the next five years.

President Bush has threatened a veto, but supporters have more than enough votes in the House to override him, and maybe in the Senate, too.

The House voted 349-62 to impose a one-year moratorium on seven rules changes. Bill supporters say the changes will merely shift financial burdens to the states and hurt the poor. The administration says they are needed to rectify Medicaid waste and abuse.

THIS IS A BREAKING NEWS UPDATE. Check back soon for further information. AP's earlier story is below.

WASHINGTON (AP) -- The House moved Wednesday to impose a one-year moratorium on new Medicaid rules, with lawmakers arguing that the administration-backed cost-saving measures would add to the burdens of states and health care providers.

Strong bipartisan support was expected for the legislation to delay implementation of the seven rules through March next year, challenging a veto threat from the White House. Congress has overridden a veto only once in the Bush presidency, last November on a water projects bill.

Passage of the legislation in a vote scheduled for later Wednesday would send it to the Senate Finance Committee, where Chairman Max Baucus, D-Mont., is reviewing options for suspending the regulations, his press officer said.

The governors of all 50 states, state Medicaid directors and others oppose the rules, Energy and Commerce Committee Chairman John Dingell, D-Mich., told the House. "They know the devastating effects these rules would have on local communities, upon hospitals, and upon vulnerable beneficiaries." Dingell's committee approved the bill earlier this month on a 46-0 vote.

The Bush administration instituted the rules with the aim of saving the Treasury about $13 billion over five years and $33 billion over 10 years by curbing waste and abuse in the state-federal partnership that provides health coverage and nursing home care to the poor.

The White House, in a statement Tuesday warning of a veto threat, said the bill would "thwart these efforts of the federal government to regain fiscal accountability and integrity in Medicaid." Health and Human Services Secretary Mike Leavitt, in a letter to lawmakers, said it "puts billions of dollars of federal funds at risk, and may turn back progress that has already been made to stop abusive state practices."

But the proposed changes have met opposition from states, health care providers and advocates for poor who say they will shift costs from the federal government to the states and create new hardships for the needy.

"Some of these regulations already have become effective and current state estimates of the impact could be as high as four times the administration's $13 billion estimate," National Governors Association chairman Tim Pawlenty, D-Minn., and other governors wrote lawmakers this month. Timely action to impose the one-year moratorium was "critical to avert significant disruptions in coverage for vulnerable populations," they wrote.

The proposed rules would affect programs involved payment to public safety net institutions, rehabilitation services for people with disabilities, coverage of hospital clinical services, graduate medical education payments and specialized medical transportation to school for children covered by Medicaid.

Rep. Joe Barton of Texas, top Republican on the Energy and Commerce Committee, voiced support for the legislation while noting that not all of the rules were bad. He said the administration was right in trying to address the "shell game" of intergovernmental transfers, where states put up money to receive a federal match but then spend that money for non-health care purposes.

Delaying the rules changes until next year would cost about $1.6 billion. The legislation would make up that revenue loss through improved verification of the financial assets of Medicaid applicants and participants and by borrowing from a reserve fund set up to help pay for fixes to physicians' reimbursement rates.

In 2007, some 48 million people participated in Medicaid programs. The total cost was about $352 billion, with the federal government paying almost $200 billion and states providing the rest.

___

The bill is H.R. 5613

On the Net:

Congress: http://thomas.loc.gov/

Newstex ID: AP-0001-24731060