Medicaid

The federal Medicaid agency awarded $75 million in funding Tuesday for a program that looks for cheaper, more effective ways to treat mental illness.

Eleven states and Washington, D.C., were selected to take part in the demonstration program, the Centers for Medicare and Medicaid Services (CMS) said. States will use the money to provide Medicaid coverage for inpatient psychiatric hospitals.

Medicaid does not pay for mentally ill patients to be admitted to psychiatric hospitals, largely because of historical concerns that states would warehouse those patients in large facilities. Medicaid patients who are experiencing a mental-health emergency — such as suicidal or homicidal thoughts — are instead admitted to hospital emergency rooms.

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The Obama administration confirmed Friday that it will stop funding a Medicaid family-planning and preventive care program for 130,000 low-income Texas women after the state barred Planned Parenthood and other "affiliates of abortion providers" from participating.

The Health and Human Services Department will "let Texas know that that waiver will not be extended," HHS Secretary Kathleen Sebelius said Friday, according to The Associated Press. 

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The top Republicans with jurisdiction over Medicaid demanded Thursday that the Obama administration provide them with an update on the program's financial status that was due Jan. 1.

Energy and Commerce Chairman Fred Upton (R-Mich.) and Senate Finance ranking member Orrin Hatch (R-Utah) point out in a letter to Health and Human Services Secretary Kathleen Sebelius that the federal government's share of Medicaid spending is expected to reach $4.4 trillion over the new 10 years. Over that time period, Medicaid spending as a percentage of the national economy is projected to grow by 35 percent, they add.

"These statistics are alarming and unsustainable, especially given Washington's record debt and deficit levels and the increasing burden on states to sustain their Medicaid programs," the letter says. "As we consider ways to address these challenges, it is essential to understand the underlying Medicaid spending trends and enrollment patterns."

The letter goes on to ask HHS to provide a rationale for its tardiness in releasing the report, an update on where it is in the process and an estimate of when Congress can expect to see it delivered.

House Republicans are floating dueling Medicaid reform bills as Budget Committee Chairman Paul Ryan (R-Wis.) prepares to unveil his own proposal in the coming weeks.

Leaders of the conservative Republican Study Committee will introduce legislation on Wednesday that gives states maximum flexibility to run the program as they see fit. The "State Health Flexibility Act" would combine Medicaid and the Children's Health Insurance Program (CHIP) into a single block grant, while reducing federal spending on the two programs by $1.8 trillion over 10 years by freezing spending at current levels.

The bill would allow states to determine eligibility, benefits, provider reimbursement rates and many other aspects of the program. That makes it incompatible with the healthcare reform law, which calls on the Medicaid programs of all 50 states to cover everyone up to 133 percent of the federal poverty level.

"It's not compatible with the [healthcare reform law]," Rep. Paul Broun (R-Ga.) told The Hill. "There's no question."

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A GOP proposal would replace Medicaid with block grants giving states more flexibility, while cutting federal funds for health programs.

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Liberal firebrand Bernie Sanders (I-Vt.) released a report Wednesday that concludes America faces a "dental crisis" and urgently needs to boost the number of dentists and dental assistants while expanding Medicaid's dental benefit to cover adults.

According to the report: 

• more than 47 million people live in places where it is difficult to access dental care;

• more than 130 million Americans do not have dental insurance;

• about 17 million low-income children see a dentist less than once a year; and 

• only 45 percent of Americans age 2 and older saw a dental provider in the past 12 months.

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A federal judge in California has temporarily blocked a 10 percent cut to California's Medicaid rates that the Obama administration approved in October.

California adopted a budget slashing the payment rates for doctors, pharmacists and other healthcare providers last spring in an effort to close the state's $26.6 billion budget hole, the largest in the nation. But Judge Christina Snyder concluded in a 25-page tentative order Monday that the cuts violate federal law because they put Medicaid beneficiaries' access to care in jeopardy; a final ruling enjoining the cuts is expected shortly.

A wide array of California healthcare groups immediately applauded the judge's decision.

"The court's tentative ruling is encouraging to those of us practicing medicine," James Hay, president of the California Medical Association, said in a statement. "The state's repeated attempt to slash Medi-Cal reimbursement rates is a short-sighted solution that balances the budget on the backs of the poorest and most vulnerable Californians. Rather, we need to be addressing long-term solutions relative to the cost of healthcare."

Healthcare law supporters say the states made significant missteps in their brief on Medicaid expansion filed with the Supreme Court.

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The federal government on Tuesday extended a Medicaid waiver in Massachusetts, which was first implemented as part of then-Gov. Mitt Romney's healthcare overhaul.

The waiver will now run through 2014. It is focused primarily on efforts to improve the cost and quality of the Medicaid program and better coordinate care. The waiver provides incentives for hospitals to improve their efforts to integrate their services.

Earlier this year, the Centers for Medicare and Medicaid Services approved a controversial Medicaid waiver for California, which allowed the state to make massive cuts in its payments to doctors. CMS also approved a high-profile Medicaid waiver for Texas, while denying a separate proposal to cut off Medicaid funding to Planned Parenthood.

The Republican senator is taking hits from all sides on a children's healthcare program long touted as his legislative legacy.

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