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Grassley Sticks to His Guns in Debate over Medicaid in Hurricane-Hit Areas

SEPTEMBER 28, 2005 -- Lawmakers pressed ahead Wednesday with more efforts to aid victims of hurricanes Katrina and Rita, clearing legislation that would give assistance to people with disabilities and sparring with the Bush administration over the broader question of providing health care for displaced residents.

At a Wednesday hearing on Gulf Coast rebuilding efforts that included testimony from Louisiana Gov. Kathleen Babineaux Blanco, members of the Senate Finance Committee continued to knock the administration for opposing their legislation (S 1716) to expand Medicaid to cover low-income residents of the Gulf Coast region affected by the hurricanes.

Chairman Charles E. Grassley, R-Iowa, introduced the bill (S 1716) on Sept. 15. It would provide five months of Medicaid coverage to anyone from Louisiana, Mississippi, and parts of Alabama whose income is below the federal poverty level. Unlike traditional Medicaid—in which states share the costs—the federal government would pick up the tab for the hurricane victims. The Congressional Budget Office has scored the measure's cost at $8.9 billion.

Administration officials oppose the bill, saying they prefer to provide waivers to individual states so they can address the problems themselves and avoid the precedent of expanding eligibility for the entitlement program.

At the hearing, Grassley underscored his displeasure with the administration's handling of the Medicaid question by hinting the issue could complicate the committee's work on a package of spending cuts the White House wants and that GOP leaders hope to advance this year. Grassley said getting the package—expected to include up to $10 billion in cuts over five years to Medicaid—through his committee would be "very difficult" if the hurricane bill is not given sufficient backing, particularly because leaders have encountered problems getting GOP moderates behind those plans to trim Medicaid spending.

Sen. Trent Lott, R-Miss., pledged to forge ahead with the Grassley legislation despite the administration's objections. He encouraged White House support for their effort, but said they would try to pass the bill "with or without" it.

"I'm going to look after our people first," Lott said.

Whether Grassley and Lott have enough votes to get the bill through the Senate is unclear. An effort to bring the measure to the floor by unanimous consent the last two nights was blocked by Republican senators who objected to its costs.

Lawmakers and administration officials spent the early part of the week trading blunt letters outlining their positions. On Sept. 27, Grassley and other lawmakers sent a letter to Health and Human Services Secretary Michael O. Leavitt pointing out senators' problems with the administration's proposal to provide Medicaid waivers to states. They wrote the costs of caring for evacuees would be charged back to their home states.

"The States of Louisiana, Mississippi and Alabama have suffered tremendous devastation that will drastically affect their ability to meet state obligations," the lawmakers wrote. In addition, they expressed concern that evacuees would not get equal coverage if states offered different benefits.

In a letter to Senate leaders, Leavitt explained his opposition to Grassley's bill, namely that it would allow people who would typically be ineligible to join the Medicaid rolls.

"The legislation requires a new Medicaid entitlement for Katrina survivors . . . . This new program is unnecessary," he wrote.

Funds for the Disabled
Also Wednesday, the House passed and the Senate cleared by voice votes a bill (HR 3864) that would give preferences to hurricane-affected states in receiving additional funds from the Rehabilitation Services Administration. The legislation, sponsored by Rep. Charles Boustany Jr., R-La., was passed under suspension of the rules, which limits debate, bars amendments, and requires two-thirds support for passage.

Typically, the administration provides unused rehabilitation funds to states each fiscal year. The bill would waive a requirement that those additional funds may go to a state only if all other states not receiving the extra money are able to pay for their vocational services. Under the bill, the additional funding has to be used to pay for training, mentoring, or job-shadowing opportunities for people with disabilities.

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