Thursday, April 24, 2008

House Republicans lined up with Democrats yesterday to brush aside a threatened White House veto and overwhelmingly approved a one-year moratorium on a series of Bush administration restrictions on how states spend federal Medicaid money.

The moratorium passed by a vote of 349-62, about 75 votes more than the two-thirds majority needed to override a veto. The measure was supported by 221 Democrats and 128 Republicans.

The White House says the restrictions are needed to rectify waste and abuse, and has accused states of using Medicaid grants for purposes other than to provide health care for seniors and the poor.

Supporters of the moratorium argue that the new regulations would shift too many costs to the states and the poor during a difficult economic time.

“Rather than cutting services to beneficiaries, this bill allows for a ‘time-out’ so that Congress can evaluate what is happening in the states and address any concerns,” said a “dear colleague” letter dated Tuesday from Energy and Commerce Committee Chairman John D. Dingell, Michigan Democrat, and committee member Rep. Tim Murphy, Pennsylvania Republican.

“Congress has an obligation to responsibly oversee the Medicaid program, rather than eliminate services,” the letter said.

The Congressional Budget Office estimated that the changes would save Medicaid more than $30 billion over 10 years, and that a one-year delay would cost $1.7 billion.

The measure now goes to the Senate Finance Committee, where Chairman Max Baucus, Montana Democrat, applauded the House for passing the bill. But the committee’s ranking Republican, Sen. Charles E. Grassley of Iowa, has voiced concerns about delaying action to root out wasteful spending.

The legislation, which cleared the House committee last week by a vote of 46-0, would place a one-year moratorium on seven new rules issued by the Centers for Medicare and Medicaid Services.

The regulations would restrict or eliminate Medicaid coverage and payments to many hospitals, clinics, rehabilitation centers and individuals — a politically unpalatable move for House members during an election year.

“In a perfect world, some of these regulations that we’re placing a moratorium on in my opinion should go into effect,” said Rep. Joe L. Barton of Texas, the ranking Republican on the House committee, but “I don’t support all of the regulations, which is one of the reasons I am supportive of the moratorium.”

Medicaid is joint program that gives states considerable flexibility to decide what medical services and individuals to cover, as well as how much to pay providers. The federal government reimburses a portion of states’ expenditures according to a formula established by law.

The Government Accountability Office has accused many states of using “creative” ways to collect excessive Medicaid money from the federal government.

Health and Human Services Secretary Michael O. Leavitt said in a letter to the House Energy and Commerce Committee that the moratorium “puts billions of dollars of federal funds at risk, and may turn back progress that has already been made to stop abusive state practices.”

State governors and hospital groups have opposed the new limits. Medical school hospitals say some children would be denied critical medical care under a rule that prohibits reimbursements for transportation.

During his presidency, Mr. Bush has vetoed nine bills, eight of them since Democrats took control of Congress in January 2007. Congress has succeeded in overriding only one of the vetoes: a bill authorizing $23 billion in new water projects, in November.

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