National Alliance on Mental Illness
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Victory on Medicaid Regulations Moratoria
June 27, 2008
By a vote of 92-6, the Senate last night cleared a massive emergency supplemental funding package for war and domestic funding for the current fiscal year (HR 2642). The House passed the measure on June 19, as separate packages for military and domestic spending. This package is the product of months of difficult negotiations between congressional leaders and the White House. President Bush has agreed to sign the measure into law.
Included in the domestic spending package is a prohibition on a series of Bush Administration regulations that would have severely impaired the ability of states to use Medicaid to finance critical mental health services. These "moratoria" on enforcement of six separate regulations will run through March 2009, after a new Administration takes office. In final negotiations with the Bush Administration the moratorium for a regulation on outpatient hospital services was dropped from the legislation.
However, among the regulations that are included in the moratoria are those for case management, rehabilitation and school-based services – the backbone of community-based services for children and adults with serious mental illness. Collectively, these regulations (if fully enforced) would have resulted in reductions of $1.65 billion in federal matching funds for the states in 2008 and 2009 and $15 billion over the next 5 years (through 2012). Recent estimates from the Congressional Budget Office (CBO) indicate the reductions would have been larger, $21 billion over five years. Further, most of these costs would simply have been shifted to state and local governments, at a time when states have less capacity to absorb added costs given the economic slowdown and their weakening fiscal conditions.
This is a tremendous victory for NAMI. Thanks goes to the thousands of NAMI advocates that called and wrote to their members of Congress in opposition to these Medicaid regulations. Your advocacy made an enormous difference.
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HR 2642 also includes $73 million for rent subsidies for permanent supportive housing units for communities in