In late May, following a request from Congress, the Centers for Medicare and Medicaid Services announced that a Medicaid Commission would be established to do two things: 1) recommend ways to cut $10 billion from the program over five years (by September 1, 2005); and 2) propose long-term solutions to address Medicaid’s escalating costs (by December 31, 2006). The commission will be comprised of 15 voting members, 15 non-voting members, and eight congressional non-voting members. HHS Secretary Mike Leavitt will be appointing all of the voting members on the panel.
Once commission members are selected they will have a major task before them. The Federal Charter states that commission members must develop proposals that address the following issues:
• Eligibility, benefits design, and delivery;
• Expanding the number of people covered with quality care while recognizing budget constraints;
• Long-term care;
• Quality of care, choice, and beneficiary satisfaction;
• Program administration; and
• Other topics that the Secretary may submit to the commission.
The establishment of the commission has not been without its critics. Democratic senators that sponsored the legislation for the HHS-led commission wanted it to be administered by the Institute of Medicine in order to maintain an objective stance on this very politicized issue. Democrats in the House and Senate have announced that they do not plan to participate in the Commission due to disagreement over the lack of voting rights for Congressionally-selected members (the Administration will appoint all 15 voting members) as well as disagreement over the premise that the Commission should be making recommendations about cuts to the program at all.
The issue of Medicaid reform has been in the spotlight for quite some time. Last year, the National Governors Association (NGA) developed a Medicaid working group, comprised of 11 governors, to develop recommendations for Medicaid reform. NGA Chairman Virginia Gov. Mark Warner (D) and NGA Vice Chairman Arkansas Gov. Mike Huckabee (R) will be testifying before the Senate Finance Committee on June 15 to present the workgroup’s specific recommendations.
In the meantime, the executive committee of the NGA approved an interim policy on Medicaid Reform developed by the workgroup. The policy states “comprehensive Medicaid reform must focus both on reforming Medicaid and on strengthening other forms of health insurance and long-term care coverage. Governors believe that meaningful Medicaid reform should include both short-term flexibilities that allow states to more efficiently manage the program and subsequently serve all those in need, as well as long-term structural reforms that will make Medicaid sustainable going forward.”
While the NGA has said that it would like to assist the Commission in accomplishing its objectives, no Governors will be participating in the Commission.
