(from 2007 Legislative Agenda)
As the largest funding source for health and long-term supports in the federal system, Medicaid continues to be a lifeline for millions of children and adults with disabilities and their families. While some important improvements are needed – such as removing the institutional bias – the Medicaid program has successfully provided health care and long-term supports to low-income individuals and people with disabilities for over 40 years. The passage of the Deficit Reduction Act in the 109th Congress, placed Medicaid services – and the health and welfare of individuals who depend on them – at risk.
For Medicaid reform to be responsive to the needs of beneficiaries with disabilities, the First Session of the 110th Congress must take the following actions to restore protections and funding for Medicaid beneficiaries:
- Roll back changes made to the Medicaid program in the Deficit Reduction Act (DRA).
- Maintain the individual entitlement to a full range of Medicaid health and long-term supports and services for all children and adults with disabilities – no matter how they access Medicaid – by ensuring they are not limited to services in “benchmark” plans. This includes continued access to needed mandatory and optional Medicaid benefits.
- Restore the entitlement to seamless delivery of the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program, and reject the bifurcated system established by the budget reconciliation process.
- Repeal federal policy that increases recipient cost-sharing through co-payments and premiums.
- Repeal legislative language that prohibits individuals with disabilities who live in provider -owned or -operated housing from participating in “Cash and Counseling” and other consumer-directed programs.
- Repeal federal policy that gives states the option of putting a capped program within a Medicaid State Plan, and pass legislation – such as the Medicaid Community-based Attendant Services and Support Act – to reduce institutionalization and increase home- and community-based long-term services and supports.
- Direct the Centers for Medicare and Medicaid Services (CMS) to cease making regulatory and policy changes detrimental to individuals with disabilities, such as reduced access to habilitation, targeted case management, and school-based services.
- Strengthen the Medicaid Waiver and Medicaid State Plan processes by requiring states to establish public notification, opportunity for comment, and reporting mechanisms for applications for proposed waivers and state plan changes.
- Require CMS to hold states accountable for the quality of supports and services provided to individuals in all settings.
- Require CMS to issue guidance to states that leads to the expanded coverage of appropriate assistive technology for Medicaid beneficiaries.
- Ensure that any changes based upon the Medicaid Commission’s recommendations for long-term reform of the Medicaid program increase the quality of life of individuals with disabilities.
- Monitor implementation of recent federal policy changes to assure that individuals with disabilities are not negatively affected.
- Oppose Medicaid block grants, global or per capita caps, or any other mechanisms that lead to reductions in eligibility, supports and services, and protections for individuals with disabilities.
More Medicaid Links:
Draft NHELP Comments on Proposed Medicaid Rules Concerning Rehabilitation Services (September 2007)
Kaiser Family Report on Medicaid's Rehabilitation Services Option (August 2007)
Key Disabilitiy Improvements in the CHAMP Act (August 2007)
Citizenship Documentation Interim Final Rule
Monitoring the Effects of the Medicaid Citizenship Documentation Requirement
Next Steps on Citizenship Issue for National Groups
Providing Documentation of Citizenship for Medicaid
Key Issues on Interim Final Regulations on Medicaid Citizenship Documentation
Medicaid Program; Citizenship Documentation Requirements
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. (07/06)
Medicaid Factsheet: HHS Issues final Regulations with comment on Citizenship Guidelines for Medicaid Eligibily (07/06)
HHS Guidance will exacerbate problems caused by New Medicaid Documentation Requirement: Judith Solomon and Andy Schneider (06/16/06)
SMD Letter - Citizenship (06/09/06)
Medicaid Factsheet: HHS Issues Citizenship Guidelines for Medicaid Eligibiity (06/09/06)
Deficit Reduction Act of 2005 Reference Chart: Prepared by Jamie Brooks, National Health Law Program
CRS Report for Congress: Medicaid’s Home and Community-Based Services State Plan Option: Section 6086 of the Deficit Reduction Act of 2005
Advocacy Tips for Responding to The Deficit Reduction Act of 2005 (Prepared by: Jane Perkins, National Health Law Program )
Memo on CMS Draft Guidance on Documentation Requirements
Letter to Secretary Leavitt from Senator Grassley and Representative Barton on Cost-sharing and EPSDT
Letter to Secretary Leavitt from Senator Grassley on Targeted Case Management
HHS Letter to State Medicaid Directors on Benefits
HHS Letter to State Medicaid Directors Transportation
HHS Letter to State Medicaid Directors on Emergency Services
HHS Letter to State Medicaid Directors on SCHIP and Adults
HHS Letter to State Medicaid Directors on State High Risk Pools