National Alliance on Mental Illness
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Budget Update: House to Take Up Budget Resolution Including $2.2 Billion in Medicaid Cuts

Later this week, the House is expected to vote on its version of the FY 2005 budget resolution that includes $2.2 billion in reductions to future Medicaid spending over the next five years, through unspecified efforts to curb “waste, fraud and abuse.”  The House action follows Senate approval of its version of the budget resolution two weeks, rejecting a proposal to cut $11 billion from Medicaid over the same period.

While the proposed cut to Medicaid in the House budget resolution is much smaller than the cuts that were rejected by the Senate, $2.2 billion is still a substantial reduction.  NAMI remains concerned that such a cut would fall hardest on optional populations and services.


NAMI advocates are urged to contact their House member and urge them to support efforts to strip these proposed Medicaid cuts from the FY 2005 budget resolution.  Remind your member of Congress that:

  • Medicaid is the critical safety net program for children and adults with severe mental illness, offering coverage of medications and community-based services and supports,
  • Many states are already moving to reduce Medicaid coverage and benefits by limiting access to the full range of mental illness treatments and limiting eligibility for services, and
  • Further cuts in the federal share of Medicaid would be devastating to states and their public mental health systems that depend on Medicaid to meet the treatment and support needs of the vulnerable.

All members of the Congress can be reached by calling the Capitol Switchboard toll free at 1-800-839-5276 or at 202-224-3121 or online through

While the budget resolution does not have the force of law, its provisions do provide binding guidance to House and Senate Committees to produce specified reductions and policy changes to entitlement programs such as Medicaid.  These cuts take the form of binding instructions to the House Energy and Commerce Committee to reduce federal matching funds to Medicaid program without specifying where to make the reductions.  Under congressional budget rules these assumptions carry enormous weight and result in a procedural requirement for cuts later in the year.  It is therefore critically important to maintain pressure on the House to reject cuts to Medicaid just as the Senate did last week on a bipartisan basis.

NAMI is especially grateful to the 29 House Republican members that last week sent a letter to House leaders urging that these proposed reductions to Medicaid be stripped from the budget resolution.  If your member of Congress signed this letter, you are urged to contact them and express appreciation for their standing up to defend Medicaid as a critical health care safety net for low-income individuals with mental illness.  View the letter written to House Budget Committee Chairman Nussle.