Today, U.S. Senators Tom Coburn (R-OK) and Richard Burr (R-NC) introduced S. 963, the Preventing an Unrealistic Future Medicaid Augmentation Plans (FMAP) Act of 2013, a bill that will repeal the Affordable Care Act's enhanced Federal Medical Assistance Percentage (FMAP), or Medicaid FMAP, to prevent the federal government from unfairly committing taxpayer money to incentivize the expansion of state Medicaid programs. Under this bill, States would still be allowed to expand their Medicaid program, but would do so without the commitment of enhanced federal tax dollars.
"Since the Supreme Court's decision last year that the Patient Protection and Affordable Care Act's mandatory Medicaid expansion was unconstitutional, some states have been trying to figure out whether or not to optionally expand their Medicaid programs," Dr. Coburn said. "This bill sends a basic message to governors and state legislatures considering expansion: don't count on the enhanced federal funding for Medicaid expansions, because Congress has overpromised what it cannot deliver. Realistically, the funding will not be there and the check will bounce."
"With federal debt soon to surpass $17 trillion, Congress should be taking steps to curb spending, not making empty promises about future Medicaid funding. Earlier this week, the Congressional Budget said Medicaid spending, if unaltered, would total more than $4.3 trillion over the coming decade, with an average cost increase each year of eight percent. In the next 10 years, our health care entitlements, along with Social Security, will total more than $3 trillion, each year."
"This trajectory is mathematically unsustainable over the long run, so future Congresses will be forced to reduce Medicaid spending, one way or another. In view of the math, it is disingenuous and even deceptive for state or federal politicians to pretend that funding Medicaid on its current path is sustainable. Pledges to expand "coverage' based on unrealistic budget estimates are empty promises.
"Today, too many Medicaid patients already experience access problems in Medicaid. The best way to protect lower-income Americans who depend on Medicaid is to not overstretch the program, but to refocus its mission on those who are truly in need."
"The federal government can barely honor its commitments already on the books, much less fund the expansion of an already broken program," Sen. Burr said. "States should have the flexibility to control their own Medicaid programs so they can better address their needs and the health care needs of their patients, but should not be misled by empty promises we all know cannot be met. While my colleagues and I remain committed to a full repeal of the Affordable Care Act, we should be honest with the American people about what we cannot afford. This bill takes a critical step toward being honest with the American people about the unsustainable costs of the new health care law by repealing one of the law's signature pieces--the unrealistic, and unaffordable enhanced FMAP."
Medicaid spending currently consumes nearly a quarter of every state dollar, passing education as the largest state budgetary commitment. Today, only a fraction of providers accept Medicaid patients. As a result, patients have a hard time accessing care. Expanding this program in its current form will by no means fix this broken program and will only worsen our fiscal situation. This bill will protect the American taxpayer from paying more for a program that too often fails those who rely on it.
Coburn-Burr bill to empower states with flexibility and defined budgets.
Coburn analysis of savings with Medicaid in Back in Black.
Coburn analysis of problems with original (pre-SCOTUS) Medicaid expansion in PPACA.
Coburn work on bipartisan solutions to save Medicaid dollars, reduce Medicaid improper payments, enhance program integrity, catch tax cheats, and reduce vulnerability to fraud.
Coburn applauding OK Gov. Fallin's decision not to expand Medicaid after he warned about problems with expansion, including state costs.
Top ten reasons Medicaid need to be reformed, not expanded.