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Thursday, May 26, 2005

Democrats to Boycott Medicaid Commission

Congressional Democrats have found the details of the Medicaid Commission to be established by the U.S. Department of Health and Human Services (HHS) so objectionable that they have already announced that they will not fill the four seats reserved to them on the 38-member panel.

A Federal Register notice published this week, reveals that the commission will comprise three separate "member groups." The first group, fifteen "voting members," will be the only commission members who can vote on recommendations. This group will be made up of former or current governors, three representatives of public policy organizations "involved in major health care policy issues"; former or current state Medicaid directors; individuals with "expertise in health, finance, or administration"; federal officials who administer programs that serve the Medicaid population; the HHS Secretary or his designee; and ex official members. All fifteen of these voting members will be appointed by HHS Secretary Michael Leavitt.

Leavitt also will have the exclusive authority to appoint the second member group, fifteen "nonvoting" members. These individuals "will include State and local government officials" and "consumer and provider representatives." The third member group, also without voting rights, was to consist of eight individuals currently serving in-an appointed by-Congress. In the Senate, the majority leader, minority leader, and chairman and ranking member of the Senate Finance Committee would appoint one person each. In the House, the speaker, minority leader, and chairman and ranking member of the House Committee on Energy and Commerce would each make an appointment.

However, at least half of the seats designated for congressional representatives will not be filled due to the Democrats' objection over the monopoly Leavitt will have on the commission's voting membership. The Democrat minority leaders in the Senate and House and ranking members of the Senate and House Committees announced that they will not exercise their authority to appoint members to the commission. Senate Minority Leader Harry Reid (D-NV) and House Minority Leader Nancy Pelosi (D-CA) claimed in their statements that "an invitation to Democrats to select four Members of the Senate and House to advisory roles without a vote is wholly inadequate to lend any Commission even the air of bipartisanship."

Democratic criticism of the commission is not limited to its membership but extends to its mission as well. The commission's first order of business will be to recommend to Leavitt by September 1, 2005, where $10 billion should be cut from Medicaid. Reid and Pelosi object to that assignment:

We fundamentally disagree with the premise that this Commission should make recommendations on how to cut Medicaid outlays by $10 billion by September 1...If Congress can decide how much to cut, it does not need a Commission to figure out how to cut the program. To the contrary, it is the responsibility of the elected Congress to make such cuts, and members who support those cuts should be held accountable for those decisions.

After submitting its initial recommendations, the commission will be charged with "making longer-term recommendations on the future of the Medicaid program that ensures the long-term sustainability of the program." The latter recommendations will be due by December 31, 2006.

Source: National Senior Citizens Law Center, Washington Weekly, Vol. XXXI, Issue No. 21.

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