Unfunded Medicaid Expansion in Health Bill Would Hurt States Enzi Fights to Protect States from Costly Federal Mandate

Finance Committee health care bill to protect states facing budget shortfalls from unfunded,mandatory Medicaid expansions. Democrats rejected the amendment on party lines.

“The unfunded, mandatory Medicaid expansion in the Finance bill is going to bankruptour states,” Enzi said. “The bill already provides additional funding to a select few states,including the Majority Leader’s home state. I think we need to give every state that’s facing abudget shortfall in this tough economy an exemption from the costly mandates in this bill.”

The Finance bill would significantly expand the Medicaid program and pass much ofthe cost along to the states, which are required to pay a share of all Medicaid expenses. TheEnzi amendment would exempt states whose revenues have declined for two consecutivefiscal year quarters from any mandatory Medicaid expansions.

In 2006, Medicaid accounted for nearly one-fourth of the average state budget, andthat number is climbing – Medicaid spending is the fastest growing line item in nearly everystate’s budget. As a result, state budgets are sagging under the burdens of Medicaid and theweak economy, with more than 20 states imposing furloughs on state employees, and othersbeing forced to cut jobs.

A 2002 report by MedPAC, an independent Congressional agency, found that “40percent of physicians restricted access for Medicaid patients because of concerns aboutreimbursement and billing paperwork.” Enzi has fought to allow Medicaid beneficiaries to optout of the program and receive subsidies to purchase quality, private health plans that meettheir needs

“We need to expand health care coverage, but Medicaid is a terrible program tochoose as a foundation for any expansion. Instead of trapping poor Americans in asubstandard health care plan, we should be giving everyone more options to find the carethey need. Senators get to choose between competing private plans; so should low-incomeAmericans.”

Governors across the country have cried out against a federal mandate to expandMedicaid. Montana Governor Brian Schweitzer, a Democrat, stated in July, “one of the leasteffective programs in terms of health care, in the history of this country, is something calledMedicaid . . . Now Medicaid is a system that isn't working, almost everyone agrees. But whatCongress intends to do is increase the number [of people] on Medicaid so they could do it forthe cheap. It is not working for anybody.”


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