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VOR MEDICAID ACTION ALERT
December 2, 2004
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Table of Contents
1. Introduction
2. Target States
3. Families USA Request for Action and Background
4. VOR Template Letter
5. Congressional Contact Information
6. VOR's Do Not Cut Medicaid Position Paper
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1. Introduction
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Dear VOR Friends,
Yesterday VOR received an urgent plea from Families USA. You will recall
from past VOR communications that VOR has participated along with Families
USA in a Medicaid Coalition. The purpose of the coalition is to preserve,
protect and strengthen Medicaid. The Coalition has been called upon to
respond to threats over the past couple of years and VOR's membership has
always come through.
We are calling on you again. As you will read in the Families USA release,
the 109th Congress, to convene in January 2005, will be considering
Medicaid reform. The Administration's block grant proposal, considered (and
defeated) last year, will be up for debate again in Congress. Cuts to
Medicaid are also threatened.
If Medicaid is cut, block granted and/or capped, all optional programs -
especially long term care programs such as the Intermediate Care Facilities
for Persons with Mental Retardation (ICFs/MR) and home and community-based
waiver programs -- will be in terrible jeopardy. Most states have already
taken or proposed deep cuts to all of Medicaid. Federal cuts, block grants
and/or caps will ensure the demise of these critical long term care
programs.
Now is the time to begin speaking out against these efforts to reform
Medicaid. Families USA references several target states where Senate
Republican votes will prove especially important, but ultimately every
Senator and Representative will have a say in the outcome of this debate.
It is important that every Member of Congress hear from constituents.
Below for your convenience is a template letter and contact information.
Thank you in advance for your participation. Let your voices be heard!
Sincerely,
Tamie Hopp
Executive Director
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2. Target States
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Murkowski Alaska
McCain AZ
Allard CO
Martinez FL
Isakson GA
Lugar IN
Grassley IA
Bunning KY
Coleman MN
Collins ME
Snowe ME
Talent MO
Bond MO
Lott MS
Cochran MS
Hagel NE
Dole NC
Burr NC
Ensign NV
DeWine OH
Voinovich OH
Smith OR
Specter PA
Chafee RI
Alexander TN
Hutchison TX
Warner VA
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3. Families USA Request for Action and Background
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November 30, 2004
From Families USA . . .
Regrouping from the election, we are trying to strategize about the coming
year. Would love to hear from you about your ideas and issues of prime
concern.
In future e-mails, we'll talk about the very difficult implementation of
the new Medicare Rx law that will dominate much of the fall of 2005. The
President and many in Congress will proceed to push medical liability caps,
Association Health Plans, and more tax breaks for Health Savings Accounts.
We are concerned that several of these proposals will hurt more than help,
by leaving more and more of the sick and disabled with higher and higher
costs.
But the main point in this message is: Medicaid is in DEEP Trouble.
Yet there are ways to save it. Before the budget is set in stone, now is
the time to let the President and Congress know that your moral choice is
to maintain and protect the Medicaid program for the 51 million seniors,
children and people with disabilities who depend on it for their health
care life line.
Background: Why Medicaid is facing trouble -- big time!
Over the next three months, it is critical that all organizations
representing seniors focus on the impending cuts to Medicaid, and possible
federal legislation to cap or block grant the program. While it is unclear
precisely how deep the cuts will be, or what form a block grant might take,
it's clear that Medicaid is facing troubleùbig time.
In his second term, the President is requesting that all tax cuts be made
permanent (a ten year cost of about $1.65 trillion) and that Social
Security be restructured without cutting any benefits to current retirees
(perhaps another $2 trillion over 10 years). The Defense Department is
momentarily expected to ask for another $70 billion for Iraq in 2005. Most
tax experts expect Congress to soften the blow of millions of middle class
families about to be hit by the Alternative Minimum Tax (ATM) formula (a
cost of about $603 over ten years).
And the President says he wants to cut the $422 billion in FY 2004 annual
deficits in half by the end of his second term.
Looking at the Federal budget, it is utterly, mathematically impossible to
see how this can all be accomplished without massive cuts in the two
largest programs after Social Securityùthe Medicare program and/or the
Medicaid program. Medicare Federal costs are about $300 billion per year
and Medicaid's Federal cost is about $190 billion per year. Medicaid is
more vulnerable than Medicareùmostly because kids don't vote!
In his fiscal year 2003 and 2004 budgets, President Bush requested that the
Medicaid program's growth be capped. The FY 2003 proposal promised the
states a "loan" of about $12.7 billion in higher payments, but recovered
all those extra payments by the end of the ten year budget window. The plan
promised the states more flexibility in how they administer Medicaid and
the State Children's Health Insurance Program (SCHIP), but then set the
amount that the states would have to spend to receive their federal "block
grant" at considerably less than they are projected to spend under current
law. Families USA estimated that the proposal would have resulted in a
reduction from baseline spending on Medicaid of $492 billion, or about
one-out-of-every-six dollars. If these cuts were made totally by
proportionally reducing eligibility of children, disabled, aged, etc.,
(rather than reducing already low payment rates to providers or cutting
individual services), it would result in 7,453,000 people losing health
coverage.
The issue here is about priorities and moral values. This Administration
favors taking away insurance from children with severe disabilities and
widows who have exhausted a lifetime of savings because they lived longer
than expected in favor of continued tax breaks for millionaires and other
upper income individuals.
Immediate Tactics
We will need all 44 Democrats and Senator Jeffords, plus a minimum of 6
Republicans in order to sustain a filibuster and halt any block grant
legislation. We will need 51 ironclad commitments because neither a Budget
Resolution nor a Budget Reconciliation bill can be filibustered (which
takes 60 votes to overcome), and they can be passed with limited debate and
only a bare majority.
This is win-able.
Last week Senators Bingaman (NM) and Murray (WA) organized a letter to the
President similar to the 2003 letter saying, "don't cut Medicaid." Senator
Jeffords and all returning Democratic Senators have signed, except 2 --
Senators Bayh (IN) and Byrd (WV) -- so FAR. If your Senator signed this
letter, we encourage you to send a thank you letterùthank them for their
support and urge them to stay strong on this issue.
In order to fight off a block grant, though, we need ironclad commitments
from at least 6 Republican Senators that they will oppose any budget
resolution/reconciliation bill which implements or carries out the numbers
set by a budget resolution that cut and caps Medicaid. They will be under
tremendous pressure to go along with their President's proposals in the
name of "his mandate."
During the holiday recess, we encourage you to contact your Senators, set
up meetings if you can. Tell them that, while you understand that the
federal budget is tight, Medicaid is a critical support for the most
vulnerable people in your state as well as an economic generator. Thank
them for their support and get their commitment to vote against any efforts
to cut or cap the Medicaid program.
Historically Senators Chafee of RI, Collins of Maine, Smith of Oregon, and
Snowe of Maine have been very helpful on Medicaid issues. We urge advocates
in those States to make a major effort to reach these Senators, and if they
receive a commitment, extend warm thanks.
But we need to reach out to every Senator and urge them to oppose block
grants. We have begun to compile a list of targets who seem the most
ôgettableö for one reason or another.
Murkowski Alaska
McCain AZ
Isakson GA
Lugar IN
Grassley IA
Bunning KY
Coleman MN
Talent MO
Bond MO
Hagel NE
Dole NC
Burr NC
DeWine OH
Voinovich OH
Specter PA
Hutchison TX
Warner VA
There are others who are also strong targets, such as Allard of CO, Ensign
of NV, and Martinez of FL, or Lott and Cochran of Mississippi and Alexander
of Tennessee. These Senators represent rapidly growing states that would
be disadvantaged by a block grant that locks in a too-low level of Federal
help, or states that have been in turmoil because of already scheduled
Medicaid cuts that might not want to see their states further hurt by cuts
at the Federal level.
This is a moving targetùand all Senators are involved. If you get feed
back from your Senator, please let us know. Or if you think your Senator,
not mentioned, here, should be a target, let us know.
We are also working with national groups to form various coalitions --
provider groups, religious, disability, disease, children's, women's -- who
will present focused messages about the harm of cutting and capping
Medicaid. We will be making a major effort to reach out to the media to
explain the situation, and will be offering sample op eds, and letters to
the editors, in the coming weeks.
This will be one of the toughest fights we've ever had, but together we can
win.
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4. VOR Template Letter
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The Honorable Jane Doe
U.S. Senate
Washington, D.C. 20510
OR
The Honorable Jane Doe
U.S. House of Representatives
Washington, D.C. 20515
OPPOSE MEDICAID BLOCK GRANT AND CUTS
Dear Senator/Representative Doe,
I strongly oppose any proposal to cut or cap (block grant) the Medicaid
program.
Medicaid provides health insurance to America's most vulnerable seniors,
children, pregnant women, working families, and people with disabilities.
Medicaid provides the crucial services such as long-term supports and
services and therapy that people with disabilities need -- people like my
SON/DAUGHTER/COUSIN/FRIEND/ETC with mental retardation. HE/SHE receives
crucial, life-sustaining supports from the Medicaid program (DESCRIBE YOUR
FAMILY MEMBER/FRIEND AND THE SERVICES THEY NEED).
Cuts or caps to Medicaid will create enormous hardship for states and
threaten the health security of the Americans who rely on Medicaid for
their essential health care services. These cuts would occur as states are
beginning to recover from the most severe budget crisis since World War II.
States need more, not less, federal Medicaid funding to sustain their
current Medicaid programs and avoid greater cutbacks that add to the ranks
of the uninsured and further cost shifts to health care providers.
We urge you and your SENATE/HOUSE colleagues to oppose any Medicaid cuts
and/or caps in coming session. Thousands of constituents in our state,
including my family, and around the country, are counting on you to do the
right thing. Thank you in advance for your support.
Sincerely,
NAME
ADDRESS
PHONE/FAX/E-MAIL
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5. Congressional Contact Information
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To obtain fax numbers, e-mail addresses, or building addresses, visit
http://www.congress.org.
You may also get this information by calling the US Capitol Switchboard at
202-224-3121.
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6. VOR's Do Not Cut Medicaid Position Paper
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Do Not Cut Medicaid
Medicaid is the primary and largest public source of funding for long term
services and supports for over 7 million people with disabilities,
including people with mental retardation.
Most Medicaid services for people with mental retardation are considered
"optional.ö This list of services includes such basic acute health care
benefits as prescribed drugs, clinic services, dental care, physical
therapy, prosthetic devices, and specified medical and remedial care. Long
term care "optional" benefits include home and community based services
(HCBS) waiver, personal attendant care, case management, and Intermediate
Care Facilities for Persons with Mental Retardation (ICFs/MR).
As stated by the Consortium for Citizens with Disabilities (February 14,
2003 letter to President Bush), "What the Medicaid program calls 'optional'
services are, in reality, mandatory disability services for the children
and adults who need them."
Policymakers must consider quality of life. Most people now living in
ICFs/MR, for example, experience severe and profound mental retardation
with complex medical conditions and/or behavioral challenges. Without the
essential skilled care they now receive they might perish. These "lifeline"
services are not considered "optional" by recipients and must not be
curtailed.
With a sinking ship, lifelines must be thrown, not cut
We are in the midst of a national crisis. The waiting list continues to
grow with more than 200,000 individuals with disabilities waiting for
services. Cutting Medicaid will mean that even more people are going
without needed services, including health care supports. The former Surgeon
General, David Satcher, documented this concern noting that a growing
number of individuals with mental retardation are experiencing significant
difficulty in gaining access to quality medical and dental care ("CLOSING
THE GAP: A National Blueprint to Improve the Health of Persons with Mental
Retardation," February of 2002).
Help the states
VOR supports continuing the federal commitment to the states by extending
the temporary increase in the Federal Medical Assistance Percentage (FMAP)
(federal Medicaid match). Advocates and consumers applauded recent
congressional action to temporarily increase FMAP to assist the states
through difficult financial times. A renewal of this action will help to
ensure the continuation of critical services.
Please do the right thing
Strengthen Medicaid. Preserve Medicaid. Embrace Medicaid. It truly is a
lifeline for millions of Americans. Our collective challenge is great.
There are many demands for limited financial resources. Strong
Congressional leadership is necessary to ensure that our nation's admirable
history of supporting our most vulnerable citizenry will not be subject to
the chopping block. For most persons with mental retardation who relay on
Medicaid for basic health care and support needs, doing the right thing is
truly a matter of life or death. Thank you in advance for your leadership.
FMI contact: Tamie Hopp, 605-399-1624; 605-399-1631 fax;
vor@compuserve.com.
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THANKYOU FOR YOUR PARTICIPATION!!!!!!!!!!
