by, Heather Foster, MPH

The Medicaid battles are picking up steam here at NACHC as efforts to cut, tinker with, or fundamentally change the Medicaid program are becoming ubiquitous on Capitol Hill.  Just last week new legislation was introduced in both the House and Senate to roll-back the Medicaid “maintenance of effort” (MOE) provisions enacted in the Affordable Care Act, which would require that states keep their eligibility levels and enrollment procedures in place until 2014. 

However, the most significant threat facing Medicaid is a proposal that would tie a block grant or spending cap to this summer’s vote to raise the Federal debt ceiling.  Congress must vote to raise the debt ceiling or the United States will default on loans to foreign countries, causing severe and likely lasting economic damage to the country. This makes the debt-limit vote the ultimate “must-pass” vote, increasing   the odds that in this period of sharply divided government, the debt limit vote will attract significant riders. 

While the debt ceiling is a moving target, best indications are that United States will hit the current debt ceiling sometime around May 16, but that the Treasury will be able to take measures to avoid default through August 2.  Congress must pass this legislation before it departs for the August recess, so a final vote will likely occur in July.  We will be sure to keep you apprised as these efforts move forward, but in the meantime you can find information about what the different threats to the Medicaid program would mean to health centers here.  NACHC will be working to fight these global threats as a member of the Partnership for Medicaid, but regardless of what changes are made to the Medicaid program in the coming months, protecting health centers’ unique Medicaid payment, the Health Center Prospective Payment System (PPS), will be vital to continued health center solvency.  We will be looking to you to help educate your Senators and Members of Congress on the importance of the PPS.  A one-pager on the issue can be found here.

As part of the ongoing effort to prevent a block grant or global spending cap (which would essentially function just like a block grant), NACHC recently joined with over 150 other national organizations in sending a letter to Congress urging them to reject any such proposals. Other organizations signing included groups such as AARP and the Catholic Health Association (CHA).

Similarly, Senator Jay Rockefeller (D-WV) is leading a sign-on letter to President Obama about the devastating impact a block grant or global spending cap would have on the Medicaid program.  So far 34 Democratic Senators have agreed to sign the letter, but more signatures are needed—please contact your Senator if she or he has not yet agreed to sign the letter.  Democratic Senators that have not yet agreed to sign the letter are Baucus, Bennet, Carper, Conrad, Feinstein, Hagan, Klobuchar, Kohl, Lieberman, Levin, Manchin, McCaskill, Ben Nelson, Pryor, Mark Udall, Tom Udall, Warner, and Webb.  Please contact your Senator and ask them to sign the letter if they are listed above.  Senators Feinstein, Bennet, and Mark Udall have sent their own state-specific letters but have not yet agreed to sign Senator Rockefeller’s letter.