While You Are Busy Watching President Trump’s Endless Stream of Shenanigans, The House is Quietly Working to Dismantle Medicaid
February 04, 2017
February 04, 2017
This past Wednesday, the House Committee on Energy and Commerce, Subcommittee on Health held a legislation hearing entitled, “Strengthening Medicaid and Prioritizing the Most Vulnerable.” The purpose was to discuss three discussion drafts including the “Prioritizing the Most Vulnerable Over Lottery Winners Act”; “Close Annuity Loopholes in Medicaid Act”; and the “Verify Eligibility Coverage Act.”
This all sounds fairly innocuous, right? I mean, with a title like “Strengthening Medicaid and Prioritizing the Most Vulnerable,” clearly the intent would be on how to make Medicaid stronger, right?
The focus of this hearing was all about exclusion, continuing the troubling drumbeat we are hearing from Republican leaders about strategies for capping Medicaid or moving to state block grants to “prioritize the most vulnerable” as the title of the hearing euphemistically suggested.
Of the three bills under discussion at this hearing, the one that I found most troubling was the “Verify Eligibility Coverage Act.” Here is the description of the bill from the official memo announcing the hearing:
Let’s dig a bit deeper to understand the underlying meaning of the statement above.
Under current law, states are obligated to provide applicants who attest to being U.S. citizens or to having satisfactory immigration status and are determined otherwise eligible for Medicaid, a reasonable opportunity period (ROP) to provide documentation that would verify their citizenship or eligible immigration status. During this ROP, states are required to enroll applicants in Medicaid and are eligible to receive federal matching funding for their care. This bill proposes eliminating federal funding during the ROP.
The memo prepared by the Committee on Energy and Commerce Democratic Staff describes the process well:
For those of you who work with immigrant families, you know the chilling effect this would have. I contacted Sheila Pires, Human Service Collaborative, one of the nation’s foremost experts on Medicaid EPSDT, and asked her what this trend toward exclusion and the unrelenting desire to move to block granting Medicaid meant for children. Her quote should be a wake-up call for all:
“As Congress considers various proposals to ‘update Medicaid,’ it is critical that the Early Periodic Screening, Diagnostic and Treatment provisions in Medicaid remain intact. Over 30 million children and youth rely on Medicaid EPSDT to access comprehensive and preventive health and behavioral health care, and the courts consistently have reaffirmed the importance of EPSDT to ensuring that children and youth have access to appropriate preventive, dental, behavioral health, developmental and specialty care. Congress also is considering various proposals to block grant Medicaid. The history of block grants over time has meant significant cuts in funding for the states. Such a fundamental change in the Medicaid program would make it virtually inevitable that states will not be able to meet the comprehensive mandate of EPSDT.”
~ Sheila Pires, Human Service Collaborative ~
The most damaging part of this bill is the removal of federal funding during the reasonable opportunity period, leaving vulnerable families and children dangling in the wind. The proposal in this bill is just another assault on the fundamental essence of who we are as a welcoming nation. This law proposes a hard line approach of not even giving an individual the chance to pull together the necessary information needed to qualify for Medicaid.
Hearings like the “Strengthening Medicaid and Prioritizing the Most Vulnerable” that took place this past week are nothing more than thinly veiled attempts to erode the most important safety net for children and families this country offers.
Stay vigilant, stay informed, and speak out.
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President & CEO
Children’s Mental Health Network