Republican senator declines to serve on administration's Medicaid commission

Sen. Gordon Smith, who spearheaded the effort to form a blue-ribbon commission to consider reforms to Medicaid, has turned down an invitation from Senate Majority Leader Bill Frist (R-Tenn.) to sit on the panel, The Hill has learned.

Frist invited Smith last week to serve as a nonvoting adviser to a Medicaid commission being assembled by Health and Human Services (HHS) Secretary Mike Leavitt, but Smith declined.

Patrick G. Ryan
House Speaker Dennis Hastert (R-Ill.)


“Senator Smith feels that he can be a lot more useful” by pursuing Medicaid reforms as a member of the Finance Committee, which has exclusive jurisdiction over the program, and through his chairmanship of the Special Committee on Aging, said a spokesman.

The HHS commission will be part of the overall process, Smith’s spokesman emphasized, but the rejection by the Oregon Republican of the majority leader’s request is the latest to a series of snubs to the commission that could  diminish  its bearing on the policy debate.

Smith’s decision follows decisions by the National Governors Association (NGA) and congressional Democrats not to participate in the Medicaid commission.

House Speaker Dennis Hastert (R-Ill.) has not decided whether to name his own choice for the commission, his spokesman said yesterday. “Because the Democrats have refused to appoint members to the Medicaid commission, we are now reviewing our options,” the spokesman said.

Senate Finance Committee Chairman Chuck Grassley (R-Iowa), meanwhile, has sought a senator to serve as a nonvoting adviser to the commission. Last week, Grassley was unsure whether to take part in the process, according to committee aides.

House Energy and Commerce Committee Chairman Joe Barton (R-Texas) also is entitled to designate a nonvoting member.

Virginia Gov. Mark Warner (D) and Arkansas Gov. Mike Huckabee (R) will present the NGA’s Medicaid recommendations at a Finance Committee hearing tomorrow. Warner and Huckabee also will testify before the Energy and Commerce Committee later in the day. Smith plans a series of Aging Committee hearings as well.

The commission is a product of efforts by Smith and Sen. Jeff Bingaman (D-N.M.) to forestall $15 million in potential cuts to Medicaid, which provides healthcare coverage to low-income and disabled individuals and finances most of the nation’s long-term-care services. In exchange for Smith’s support for up to $10 billion in cuts in the fiscal year 2006 budget-resolution conference report, the Senate GOP leadership promised to back Smith’s Medicaid commission.

Smith has resolutely not rebuked the HHS commission, despite the significant differences between his original idea and the as-yet-unnamed Leavitt commission.

The Smith-Bingaman amendment to the Senate-passed version of the budget spelled out that the voting membership of a bipartisan Medicaid panel be selected jointly by congressional Republicans and Democrats, governors, the White House and other interested groups, rather than exclusively by the Bush administration. Alternatively, Smith advocated that an independent body such as the National Academies’ Institute of Medicine oversee the process.

HHS has not outlined a timetable for the commission’s activities. Its recommendations on how to find $10 billion in Medicaid spending reductions are due Sept. 1.

The administration has begun wooing conservative and liberal think-tank experts to act as a “task force” to produce testimony for the panel and to “line up potential witnesses,” American Enterprise Institute scholar Joseph Antos said.

But Antos expressed skepticism that the commission would have enough influence on the Medicaid debate to justify the effort requested of the think tanks.

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