Congress Might Have To Reconsider Plans to Cut $10B From Medicaid in Light of Hurricane Aftermath, Senate Majority Leader Frist Says

Senate Majority Leader Bill Frist (R-Tenn.) on Monday said it "would be absolutely wrong" for Congress to cut back on Medicaid services in order to reach the Bush administration's goal of reducing Medicaid spending growth by $10 billion over five years, the Palm Beach Post reports. However, Frist -- speaking at a panel discussion sponsored by the bipartisan Alliance for Health Reform, for which he serves as vice chair -- said the desire to cut the program's annual spending growth from 7.4% to 7.1% must be weighed against the need to provide additional coverage to people who lost their health care as a result of Hurricane Katrina (Lipman, Palm Beach Post, 9/13). Frist said Congress still should consider changes to Medicaid that would eliminate waste, fraud and abuse (CQ HealthBeat, 9/12). Frist said Congress also should make state Medicaid and SCHIP programs "more flexible" to deal with future natural or manmade disasters and should address liability issues for health care volunteers. In addition, Frist said Katrina has called attention to the need for better electronic health records because many paper records were destroyed in the hurricane (Heil, CongressDaily, 9/13).

Reconciliation Delayed
In related news, Frist and Senate Budget Committee Chair Judd Gregg (R-N.H.) on Monday announced that the budget panel would report its package of budget reconciliation recommendations by Oct. 26. Frist, Gregg and other Republican leaders previously announced a two-week delay in order to focus on the aftermath of Katrina. Frist and Gregg on Monday in a statement said the later deadline would "allow the Congress and committees to address the immediate concerns related to the recent hurricane and not be encumbered by budget reconciliation requirements in the near term."

Region's Medical Infrastructure 'Gone'
Speakers at the Alliance event said that "[o]ne of the biggest challenges facing emergency personnel ... is that the usual infrastructure that helps handle victims after such a devastating event -- such as hospitals, schools and social service agencies -- no longer exist[s] in New Orleans and other hard-hit areas," CQ HealthBeat reports. Speakers discussed the "many health care challenges" facing Katrina victims, particularly for those with chronic health conditions like diabetes and heart disease, and those who require nursing home care, according to CQ HealthBeat. U.S. Surgeon General Richard Carmona said the infrastructure in the region is "all gone" (CQ HealthBeat, 9/12). Carmona added that the federal government is considering a move to designate Katrina victims as "universal citizens" so that they have access to federal assistance such as Medicaid throughout the nation (Palm Beach Post, 9/13). Ray Scheppach, executive director for the National Governors Association, said, "We've got to go in and almost rebuild that health infrastructure." Scheppach added, "This is a very at-risk, very vulnerable population" that includes frail, elderly people who need a number of medical and social services (CQ HealthBeat, 9/12). Scheppach said Congress should consider increasing the federal share of Medicaid spending for Louisiana, Mississippi and Alabama, which he noted had among the lowest Medicaid reimbursement rates in the country before Katrina struck. Frist said Congress has not yet decided whether the federal government would cover all Medicaid costs related to Hurricane Katrina victims (Palm Beach Post, 9/13).

A HealthCast of the event, also sponsored by the Kaiser Commission on Medicaid and the Uninsured, is available online.

Expanded Eligibility Proposal Expected
The Senate Finance Committee as early as Tuesday planned to introduce a proposal that would expand eligibility to Medicaid for evacuees and provide 100% reimbursement rates to states where Katrina survivors have evacuated, according to committee Chair Chuck Grassley (R-Iowa) and ranking member Max Baucus (D-Mont.). Speaking to reporters, Baucus said new rules are necessary to provide Medicaid to people who lost their homes and jobs in the hurricane. Baucus said lawmakers should say to people affected by Katrina: "You're entitled to Medicaid regardless of income; don't you worry about health care." Baucus added that the provisions would remain in place for "the next several months." A Senate Democratic aide said decisions on determining eligibility for the expanded benefits have not yet been made (CongressDaily, 9/13). Russ Sullivan, Democratic staff director for the Senate Finance Committee, said reimbursing states could cost at least $1 billion.

Relief for Texas
Texas, which has taken in about 200,000 Katrina evacuees, will receive immediate financial relief from the federal government, Frist said on Monday. Lawmakers have said Medicaid costs for evacuees in Texas could surpass tens of millions of dollars each day. Frist said an announcement on the relief will come this week from the Bush administration. Eric Bearse, a spokesperson for Gov. Rick Perry (R), said, "We are hopeful the federal government will do everything it should." In addition, Sen. Kay Bailey Hutchison (R-Texas) on Tuesday planned to introduce a bill that would provide Texas with a 100% Medicaid reimbursement rate for evacuees for six months or until President Bush lifts Texas' disaster designation, which was given to help the state handle the large number of evacuees (Levine, Houston Chronicle, 9/13).

Broadcast Coverage
NPR's "Morning Edition" on Tuesday reported on discussion about federal Medicaid spending in the aftermath of Hurricane Katrina. The segment includes comments from Ruth Kennedy, Louisiana's Medicaid deputy director; Cindy Mann, a professor at Georgetown University's Health Policy Institute and a Medicaid official during the Clinton administration; and CMS Administrator Mark McClellan (Rovner, "Morning Edition," NPR, 9/13).

The complete segment is available online in RealPlayer.