A bill to keep a set of harmful Medicaid regulations from taking effect passed the House with overwhelming veto-proof support, 349-62, on April 23. H.R. 5613, introduced by Representative John Dingell (D-MI), would delay the implementation of seven Medicaid regulations proposed by the Bush Administration until April 1, 2009. These regulations, some which have already gone into effect, restrict federal funding for a number of services that assist vulnerable populations, including children, seniors and people with disabilities. (For more details, see the Center on Budget and Policy Priorities’ chart summarizing the regulations and their status).
The bill’s prospects in the Senate are not as clear. Senate Majority Leader Harry Reid (D-NV) fast-tracked the bill on April 24 by invoking a parliamentary rule that allows for it to be brought directly to the Senate floor, bypassing committee review. Senator Max Baucus (D-MT), Chairman of the Finance Committee with jurisdiction over the Medicaid program, agreed with Senator’s Reid approach.  This means that the bill could be taken up as early as this week. However, this may not happen since Senate Democrats are still searching for sufficient Republican votes to override an expected Administration veto.

Due to the uncertainty in the Senate, House leaders are also considering other vehicles to attach moratoria on the Medicaid regulations. A potential vehicle is the war supplemental spending bill, which Congress plans to consider as early as next week.

August 17 SCHIP Directive

On a related note, the Government Accountability Office and the Congressional Research Service found that the Centers for Medicare and Medicaid (CMS) violated federal law when it issued a directive last August restricting states from covering children through the State Children’s Health Insurance Program with family incomes above 250% of the federal poverty level (FPL) unless they meet certain standards. According to the Congressional Review Act, before such a rule can take effect, it must be submitted to Congress for review, which CMS did not do. The August 17 directive has affected at least 23 states.

Senators John Rockefeller (D-WV) and Olympia Snowe (R-ME) have asked the Administration to rescind the August 17th directive and work with Congress to reach a consensus. The Senators are also the authors of a bill, the “Economic Recovery in Health Care Act of 2008”, S. 2819, that would suspend the Medicaid regulations and the August 17 directive until April 1, 2009 and provide state fiscal relief to target states experiencing budget shortfalls.

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