EDITORIAL: Benefit cuts threaten vulnerable children: CONGRESS RIGHT TO BLOCK MEDICAID COST SHIFT TO THE STATES

May 03, 2008 (The Miami Herald - McClatchy-Tribune Information Services via COMTEX) -- -- The U.S. House did exactly the right thing last week by approving legislation to block new Medicaid rules that will have devastating consequences. The rules will cut critical services to the nation's neediest children and disabled people. This appears to be a backdoor way of cutting Medicaid benefits and expenses without Congressional approval.

In the process, the rules will shift more costs to states at the worst time: when an economic downturn is swelling Medicaid rolls, and shrinking state coffers hamper states' ability to cover the shortfall in federal subsidies.

Severe consequences

Lawmakers had every reason to pass the measure (HR 5613), which would block the rule changes until April 2009. The bill garnered overwhelming support, passing by a margin of 349 to 62. This level of approval suggests the House could override a presidential veto, which the White House has threatened. Now it's up to the Senate to approve the legislation.

The seven rules in question would have severe consequences in states such as Florida with large Medicaid populations. For example:

One rule would limit Medicaid payments to public hospitals, like Jackson Memorial Hospital, and decrease rehabilitation services that are eligible for federal subsidies.

Another will hurt children in foster care by reducing funds for case-management, which is crucial for many who need medical and mental-health care.

A third rule would cut federal Medicaid funds for care provided to poor and disabled children by public schools, among them schools in Miami-Dade and Broward counties. Those services include health screenings, medical care and transportation for special-needs children who get health services at school.

The White House says the rules are needed to address waste and abuses in state Medicaid programs. But the problems it cites have been largely corrected by enforcing existing rules or new regulatory measures. Some complaints are questionable. For example, the administration says Medicaid law doesn't allow subsidies for training medical residents in hospitals that treat many poor patients. Yet these subsidies have been paid for 40 years.

A $21 billion cut

The Congressional Budget Office estimates the rules will cut $21 billion in federal Medicaid funding over five years, more than the White House projects. These cuts will inflict a lot of pain on people and communities who suffer economic hard times the most.

The administration's rule changes wrongly target critical Medicaid benefits without offering real solutions for curbing costs. It is Congress' job to debate and approve fixes for Medicaid. The prospects for doing so will be better with a new administration next year.

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