Sens. Baucus, Grassley Raise Concerns About Proposed Rule on Copayments for Some Medicaid Beneficiaries

A rule proposed by CMS that would allow states to revise premiums and cost-sharing for some Medicaid beneficiaries could make those payments higher than Congress intended, Sens. Max Baucus (D-Mont.) and Chuck Grassley (R-Iowa) wrote in a letter to HHS Secretary Mike Leavitt on Tuesday, CQ HealthBeat reports. According to the senators, the rule could violate language in a 2006 budget reconciliation law that allowed states to establish copayments for Medicaid beneficiaries and directed the HHS secretary to increase those payments annually based on the annual percentage increase in the medical care component of the consumer price index and round up in an "appropriate manner."

The senators wrote that, because the rule would index copays for inflation after the round up, "the effect of applying the annual increase to the previous limit after rounding would grow steadily over time." They wrote, "That, in turn, would make Medicaid copayments increasingly burdensome for beneficiaries," adding, "We are concerned that the approach that the rule takes may harm the health of some of the nation's poorest individuals."

HHS spokesperson Christina Pearson said that the concern raised by the senators "is a technical issue that we became aware of through the comment period, rather than a difference in policy." She added, "We recognize this part of the rule may not be as clear as it should be and therefore could be interpreted differently" (CQ HealthBeat, 3/18).