Raising hopes of health care providers nationwide, both chambers of Congress will include provisions to prevent the implementation of a number of Medicaid regulations to their respective underlying appropriations bills to fund the ongoing wars in Iraq and Afghanistan. Following veto-proof passage by the U.S. House of Representatives, the Protecting the Medicaid Safety Net Act of 2008 (H.R. 5613), sponsored by Energy and Commerce Committee Chairman John Dingell (D-MI), has been included as an amendment to the domestic spending portion of the war bill that is expected to clear the House this week. Specifically, the amendment prevents the Centers for Medicare & Medicaid Services from implementing seven Medicaid regulations that have been proposed or finalized since last year, including regulations to eliminate funding for graduate medical education costs, curtail funding for public providers, restrict the ability of states to raise funds for their Medicaid programs through taxes on providers, and cut funding for hospital outpatient services.      

Similarly, on May 7, Senate Appropriations Chair Robert Byrd (D-WV) announced that his committee would also include the moratoria as part of its supplemental package, which is scheduled for action on Thursday of this week. In response, Senator Charles Grassley (R-IA), Ranking Member of the Senate Finance Committee, sent a letter urging Chairman Byrd to remove the moratoria, as well as a separate controversial provision that would ban new physician-owned specialty hospitals from the Medicare program. Instead Grassley favors taking a “time-out” on two of the regulations (the GME and public provider regulations) until August 1, to give Congress time to legislate on these issues. Such a compromise would leave Medicaid beneficiaries and providers at risk on the other five regulations, and would not guarantee protection against implementation of any of the regulations this year.      

Expedient passage of these provisions through the appropriations bills is critical since the existing moratoria on several of the regulations expire on May 25, threatening billions of dollars in losses to public and teaching institutions in New York and around the country. However, since supplemental funding is necessary to finance the wars in Iraq and Afghanistan, the measure has been expected to move quickly through both chambers despite opposition to the added provisions by the White House. Prior to H.R. 5613’s passage in the House, the Bush Administration had issued a veto threat underscoring its desire to implement the Medicaid regulations without delay. Grassley’s latest appeal to Chairman Byrd, however, may slow progress of the measure’s passage by the Senate.      

GNYHA and its allies—1199 SEIU Healthcare Workers East, the American Hospital Association, HANYS, and others—have advocated aggressively for the moratoria on these Medicaid regulations and are grateful to the entire New York delegation for its steadfast support on this important issue.