GOP Doctors Caucus

Floor Speech

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Mr. GINGREY of Georgia. Mr. Speaker, I thank the gentleman from Maryland, my physician colleague, for yielding.

I missed some of the hour. I regret that, and hopefully I'm not repeating some remarks that have already been made. Even if I am, I think it's important for people to understand that Medicaid expansion is threatening each and every one of our 50 States and the territories.

The provision in the Affordable Care Act, ObamaCare, that's titled, ``Maintenance of Effort''--actually, this maintenance of effort provision, Mr. Speaker, began even before the passage of ObamaCare. ObamaCare passed March 23, 2010, a little more than 2 years ago. It just extended this.

But what happened with the stimulus package back in 2008 is that States were told that they would not be allowed to purge their rolls of people that were, at that point in time, under Medicaid to see if, per chance, they were in this country illegally and not eligible or their income level had risen to the point that they were doing just fine, thank you, maybe making $50,000 a year and could afford their own health insurance premiums not to be paid for by we, the taxpayer and the citizens of the State of Georgia, my great State. And then it was extended with the passage of ObamaCare to say that, through the year 2013, these States could not do that.

Well, what's happened is, I've got some statistics. And just to quote from the National Governors' Association report, ``States are facing a collective $175 billion budget shortfall through 2013'' in large part because of this maintenance of effort requirement under Medicaid, that they're not allowed to make sure that the people on the Medicaid program are the ones that need to be there, the most needy that can't afford--their children can't afford health care. And now these rolls are sort of set in stone until the year 2013. And in many cases, Mr. Speaker, they include childless adults, childless adults who maybe were eligible to get on the program at a point where their income was very low or maybe they were out of work. But now, shouldn't the Governors be allowed--at least on an annual basis, if not every 6 months--to look at those rolls and make sure that the dollars for health care are going to the folks that really need it and their children? That's what the Medicaid program was all about when it was started as an amendment to the Social Security Act back in 1965.

So I wanted to mention that. It may have already been talked about earlier. My colleagues in the Doctors Caucus of the House know of what they speak with regard to health care. There are a lot of other issues in Medicaid. But I thought, in particular, I would want to discuss that.

But in conclusion, on this point, if allowing a State to improve its enrollment and its verification system saves enough money to keep our children's education program intact and the safety of its citizens, with regard to police and fire protection, intact, then why wouldn't we support this change? Why wouldn't we repeal this maintenance of effort?

If giving Governors the ability to manage their own Medicaid programs prevents drastic cuts to education or job creation programs, why in the world would we not support that? The only reason I can think of would be to force, under ObamaCare, more and more people into the Medicaid program, where the States have to eventually do that FMAP and that sharing of the cost because, otherwise, they would be in the exchanges, and the subsidies, as we know, go up to 400 percent of the Federal poverty level. It's all part of this grand scheme to eventually have national health insurance, Medicare for all, if you will, and it's got to stop.

Mr. HARRIS. I thank my colleague, the obstetrician from Georgia, who points out that on the graph, as the gentleman from Louisiana showed before, Medicaid expenditures now exceed K-12 education. And as the other chart we've seen shows, we're over at the left-hand side. It will only get worse over time.

I yield to the obstetrician from Texas.

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