A bill to express the sense of the Senate regarding Medicaid reconciliation legislation to be reported by a conference committee during the 109th Congress.

        [Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 1969 Placed on Calendar Senate (PCS)]

Calendar No. 283
109th CONGRESS
1st Session
S. 1969

To express the sense of the Senate regarding Medicaid reconciliation
legislation to be reported by a conference committee during the 109th
Congress.

_______________________________________________________________________

IN THE SENATE OF THE UNITED STATES

November 7, 2005

Mr. Baucus introduced the following bill; which was read the first
time

November 8, 2005

Read the second time and placed on the calendar

_______________________________________________________________________

A BILL

To express the sense of the Senate regarding Medicaid reconciliation
legislation to be reported by a conference committee during the 109th
Congress.

Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

SECTION 1. TO EXPRESS THE SENSE OF THE SENATE REGARDING MEDICAID
RECONCILIATION LEGISLATION TO BE REPORTED BY A CONFERENCE
COMMITTEE.

(a) Findings.--The Senate makes the following findings:
(1) The Medicaid program provides essential health care and
long-term care services to more than 50,000,000 low-income
children, pregnant women, parents, individuals with
disabilities, and senior citizens. It is a Federal guarantee
that ensures that the most vulnerable will have access to
needed medical services.
(2) The Medicaid program provides critical access to long-
term care and other services for the elderly and individuals
living with disabilities, and is the single largest provider of
long-term care services. The Medicaid program also pays for
personal care and other supportive services that are typically
not provided by private health insurance or under the Medicare
program, but are necessary to enable individuals with spinal
cord injuries, developmental disabilities, neurological
degenerative diseases, serious and persistent mental illnesses,
HIV/AIDS, and other chronic conditions to remain in the
community, to work, and to maintain independence.
(3) The Medicaid program supplements the Medicare program
for more than 6,000,000 low-income elderly or disabled Medicare
beneficiaries, assisting those beneficiaries with their
Medicare premiums and co-insurance, wrap-around benefits, and
the costs of nursing home care that the Medicare program does
not cover. The Medicaid program spent nearly $40,000,000,000 in
2002 on services not covered under the Medicare program.
(4) The Medicaid program provides health insurance for more
than \1/4\ of America's children and is the largest purchaser
of maternity care, paying for more than \1/3\ of all the births
in the United States each year. The Medicaid program also
provides vital access to care for children with disabilities,
covering more than 70 percent of the poor children with
disabilities in the United States.
(5) Medicaid's benefits for children are comprehensive,
including mandatory coverage for Early and Periodic Screening
Diagnosis and Treatment benefits covering all medically
necessary care. Medicaid ensures that children have the
benefits, health services and health care support they need to
be fully immunized and that children can secure eyeglasses,
dental care, and hearing aids when necessary, and that children
have access to comprehensive, regularly scheduled, and as-
needed health examinations, as well as preventive
interventions, to correct physical and mental conditions that
threaten to delay proper growth and development.
(6) More than 16,000,000 American women depend on the
Medicaid program for their health care. Women comprise the
majority of seniors (71 percent) on Medicaid. Half of
nonelderly women with permanent mental or physical disabilities
have health care coverage under the Medicaid program. The
Medicaid program also provides critical access to treatment for
low-income women diagnosed with breast or cervical cancer.
(7) The Medicaid program is the Nation's largest source of
payment for mental health services, HIV/AIDS care, and care for
children with special needs. Much of this care is either not
covered by private insurance or is limited in scope or
duration. The Medicaid program is also a critical source of
funding for health care for children in foster care and for
health care services provided in schools.
(8) Funds under the Medicaid program help to ensure access
to care for all Americans. The Medicaid program is the single
largest source of revenue for the Nation's safety net
hospitals, health centers, and nursing homes, and is critical
to the ability of these providers to adequately serve all
Americans.
(9) The Medicaid program serves a major role in ensuring
that the number of Americans without health insurance,
approximately 45,000,000 in 2003, is not substantially higher.
The system of Federal matching for State Medicaid expenditures
ensures that Federal funds will grow as State spending
increases in response to unmet needs, enabling the Medicaid
program to help buffer the drop in private coverage during
recessions. More than 4,800,000 Americans lost employer-
sponsored health care coverage between 2000 and 2003, during
which time the Medicaid program enrolled an additional
8,400,000 Americans.
(10) Many individuals living below the Federal poverty
level are ineligible for Medicaid because of stringent income
eligibility rules. For parents, eligibility levels are often
very far below the Federal poverty level. On average, a working
parent in a family of three would have to make less than $224
per week and a non-working parent in a family of three would
have to make less than $150 per week to qualify. Single
individuals with disabilities would be ineligible if they have
more than $147 per week in income.
(11) Eligibility levels for pregnant women and children are
generally at or just above the Federal poverty level, but a
family with income just over minimum wage can be disqualified
for Medicaid. At the minimum eligibility levels for pregnant
women, earning as little as $8.80 per hour at a full-time job
could disqualify a pregnant woman from Medicaid eligibility. A
working parent in a family of three earning less than $8.40 per
hour at a full-time job could make their child 6 years-old or
older ineligible for Medicaid.
(12) Title III of the budget reconciliation bill of the
House of Representatives, as reported out by the Committee on
Energy and Commerce, would adversely affect these low-income
beneficiaries, many of whom are children or have special health
care needs, by increasing beneficiary cost-sharing, limiting
access to benefits, and restricting eligibility for long-term
care services that the Medicaid program covers. These new
limits make up \2/3\ of the House of Representative's projected
Medicaid spending reductions, accounting for $30,100,000,000 of
the total $45,300,000,000 in Medicaid reductions over 10 years.
(13) Making beneficiaries pay more for more limited
benefits under Medicaid may put a significant financial burden
on these very low-income individuals. Research also
demonstrates that increasing beneficiary cost-sharing can make
prescription drugs and other essential health services
unaffordable for beneficiaries, can cause the health of
children and adults to deteriorate, and can lead to higher
emergency room and hospital costs.
(14) By contrast, while S. 1932, as passed by the Senate on
November 3, 2005, includes substantial cuts to the Medicaid
program, it does not include direct limits on beneficiary
access to Medicaid services. Even so, enactment of S. 1932
would result in a net Medicaid cut of $14,200,000,000 over 10
years, less than \1/3\ of the projected Medicaid reductions
contained in the House of Representative's budget
reconciliation bill.
(b) Sense of the Senate.--It is the sense of the Senate that the
conferees for any budget reconciliation bill of the 109th Congress
shall not report a reconciliation bill that would--
(1) with respect to low-income children, pregnant women,
disabled individuals, elderly individuals, individuals with
chronic illnesses like HIV/AIDS, cancer, and diabetes,
individuals with mental illnesses, and other Medicaid
beneficiaries--
(A) impair access to Medicaid services;
(B) undermine eligibility for such Medicaid
beneficiaries;
(C) make Medicaid services unavailable by making
them unaffordable to such Medicaid beneficiaries; or
(D) cut health care services for such Medicaid
beneficiaries; or
(2) undermine the Federal guarantee of health insurance
coverage that the Medicaid program provides, which would
threaten not only the health care safety net of the United
States, but the entire health care system of the United States.
Calendar No. 283

109th CONGRESS

1st Session

S. 1969

_______________________________________________________________________

A BILL

To express the sense of the Senate regarding Medicaid reconciliation
legislation to be reported by a conference committee during the 109th
Congress.

_______________________________________________________________________

November 8, 2005

Read the second time and placed on the calendar