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Health Subcommittee Explores Options for Reforming Medicaid to Protect Nation's Most Vulnerable

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Location: Washington, DC

The Subcommittee on Health, chaired by Rep. Joe Pitts (R-PA), today continued its examination of reforms to the Medicaid program with a hearing on "Making Medicaid Work for the Most Vulnerable." The hearing, the third of an ongoing series, builds on the subcommittee's efforts to review Medicaid's weaknesses and identify responsible, reasonable reforms to protect the program and deliver quality services to the vulnerable Americans who rely on it. Earlier work includes an IDEA LAB -- Making Medicaid Work -- by full committee Chairman Fred Upton (R-MI), which offers sensible solutions to fix Medicaid's troubling fiscal state and provides states opportunities for patient-centered reforms and flexibility. The IDEA LAB stems from a joint blueprint "Making Medicaid Work" released in May by Upton and Sen. Orrin Hatch (R-UT).

"Medicaid was designed to protect the most vulnerable Americans, including pregnant women, dependent children, the blind, and the disabled. Nearly one in four Americans was enrolled in the Medicaid program at some point in 2012, making Medicaid the largest government health care program surpassing Medicare," stated Pitts. "We have an obligation to ensure that the program provides quality health care to beneficiaries and has the flexibility to innovate to better serve this population. As we have seen we are failing on both counts."

The president's health care law could increase Medicaid enrollment by nearly 26 million over the next 10 years if fully implemented, further threatening the ability of Medicaid to achieve its original and important goal of providing health coverage to the nation's neediest population. Currently, 72 million individuals are already enrolled in Medicaid -- nearly 25 percent of Americans -- and the program already faces fundamental challenges, limited resources, and reduced flexibility. Rather than weakening the program and thus putting already-vulnerable Americans at even greater risk, the committee is committed to fixing and strengthening Medicaid in line with the program's initial goal.

Nina Owcharenko, Director for Health Policy Studies at the Heritage Foundation, testified that Medicaid's expansion under the president's health care law, "did not address the long-term challenges facing the Medicaid program." Owcharenko added, "The ACA adds to this growing government health program by expanding eligibility to all individuals with incomes below 138 percent of the Federal Poverty Level… Unlike traditional Medicaid, with incomes and categorical eligibility requirements such as disability, eligibility for the expansion population is based solely on income."

Tarren Bragdon, President and Chief Executive Officer for the Foundation for Government Accountability, discussed the role states are already playing in providing Medicaid options for patients. Bragdon noted that when given options, patients "choose the health plans that work best for them." He noted, "When given meaningful choices and adequate, objective information, Medicaid patients take more control over their health. In Florida's Reform Pilot and Louisiana's Bayou Health, for example, independent counselors assist Medicaid patients in navigating the plan selection process, providing neutral comparisons based on patients' specific needs and concerns."

Upton added, "Instead of allowing state and local officials the flexibility to best administer Medicaid to fit the needs of their own populations and improve the quality of care, the federal government has created an extensive, "one-size fits-all' maze of federal mandates and administrative requirements. The program needs true reform, and we can no longer tinker around the edges with policies that add on to the bureaucratic layers and continue the failure to provide access to quality care."


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