PI Action alerts & updates ... 1997

Update on Medicaid and the Budget Resolution

President Clinton and the Republican leadership have reached an agreement on a broad outline for a plan to balance the budget by the year 2002. While there are still many unresolved issues to be worked, some details have become available that are of particular interest to the HIV/AIDS community.

Medicaid:
The good news is that the President withdrew his proposal for a “per capita cap” system, which would have limited the amount of federal Medicaid dollars a state could receive per beneficiary. This proposal would have had a profound impact on the amount of Medicaid funds available for individuals living with HIV/AIDS, since their overall cost of health care is higher than many other Medicaid recipients. Fortunately, news of last-minute revenue increases allowed budget negotiators to eliminate this proposal and to restore some of the proposed cuts in spending.

However, Medicaid will still face $15-17 billion in cuts over the next five years. It appears that the majority of these cuts will be in the Disproportionate Share Hospital Program (DSH) payments. These payments are designed for hospitals that serve large numbers of uninsured and Medicaid patients. Many public and children’s hospitals rely on these payments to provide services to indigent patients, including people living with HIV and AIDS. Advocates will continue to monitor the ongoing Medicaid battle to ensure that the DSH cuts do not result in inadequate care.

While there are still serious concerns about the future of Medicaid, we have come a long way since the initial proposal of $182 billion in Medicaid cuts. Thank you to everyone who wrote, called, and met with their elected officials on this issue. Your grassroots efforts have made a difference!

Discretionary spending:
As part of the budget deal, discretionary spending will be cut by $60-65 billion over the next five years. This includes all HIV/AIDS-specific research, care, prevention, and housing programs. However, negotiations are continuing on this issue. You are encouraged to contact your federal legislators and urge them not to support a budget proposal that will result in decreased funding for these and other crucial health and education programs.

Benefits for immigrants:
The budget agreement restores Medicaid and Supplemental Security Income (SSI) benefits to disabled legal immigrants and child legal immigrants. These benefits were eliminated last year with the passage of the welfare reform bill.