Overview of VOR Positions on Key Medicaid Proposals

S. 183 and H.R. 1443, Family Opportunity Act (“Dylan Lee James Act”) (FOA): Introduced by Senators Edward Kennedy (D-MA) and Chuck Grassley (R-IA), and Rep. Pete Sessions (R-TX), VOR supports FOA (see http://www.vor.net/FOA.htm). VOR supports this legislation which seeks to allow moderate-income families to purchase Medicaid coverage for children with severe disabilities. Rep. Pete Sessions (R-TX) is the original author of FOA and is expected to re-introduce this legislation. [Note: VOR will oppose any effort that seeks to link FOA with Money Follows the Person and Medicaid offset proposals. We do not support the Money Follows the Person proposal, and we view a Medicaid offset as a “robbing Peter to pay Paul scenario.” As we noted last year, this serves neither Peter nor Paul well].

Temporary Increase to the Federal Medicaid Assistance Percentage: VOR supports the Congressional proposal to increase FMAP (federal Medicaid funding) (see http://www.vor.net/medicaid.htm). Additional federal assistance helps States minimize cuts to important Medicaid-supported residential and health care programs. Even with additional federal assistance, Medicaid services in many states have been cut. People with disabilities, including people with mental retardation, stand to suffer the most if access to residential, health care and other services is cut. VOR encourages Congress to pass another temporary increase in federal Medicaid funding to provide essential fiscal relief to states.

S. 401 and H.R. 910, Medicaid Community Based Services and Supports Act (MiCASSA):

Introduced by Senator Tom Harkin (D-IA) and Rep. Danny Davis (D-IL), VOR opposes MiCASSA (see http://www.vor.net/MiCASSAPosition.htm). This legislation proposes a mandatory Medicaid entitlement for community-based personal attendant care services which the Congressional Budget Office estimated in 1997 would cost $10-20 billion in new federal dollars each year. An optional Medicaid program for personal attendant care services already exists in law and is offered by a majority of the states. Due to the high cost of the proposed mandatory MiCASSA entitlement, VOR is concerned that the effect of passage will be the elimination of necessary services for citizens with severe and profound mental retardation. For States to accommodate this increase in mandatory Medicaid expenditures, funding for optional Medicaid programs, such as the Home and Community-Based Services (HCBS) waiver and ICFs/MR, will have to be cut. VOR supports the expansion of optional personal attendant care programs under current law.

S. 528 and other Money Follows the Person (MFP) proposals:  Introduced by Senators Tom Harkin (D-IA) and Gordon Smith (R-OR), and contained in the President’s budget proposal, VOR opposes MFP proposals (see http://www.vor.net/Money%20Follows%20Position.htm). Past MFP proposals have targeted individuals in Intermediate Care Facilities for Persons with Mental Retardation (ICFs/MR) who are already receiving needed and desired services. MFP proposals also only provide “transition” funding for one year. There are no assurances that the individuals transferred will receive adequate services, especially after one year. MFP proposals should focus on providing services for the more than 200,000 individuals with mental retardation and developmental disabilities on waiting lists for services. VOR also takes exception to the assertion that the system needs rebalancing in favor of community-based services, as is the main intent of MFP. With regard to people with mental retardation and the ICF/MR program, the system is not out of balance (see http://www.vor.net/Institutional%20Bias%201.htm for “The Myth of an Institutional Bias in Medicaid for Persons with Mental Retardation and Developmental Disabilities”).  

VOR * 836 S. Arlington Heights Rd., #351 * Elk Grove Village, Illinois * 60007

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