National Alliance on Mental Illness
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March 14, 2003

NAMI Urges Grassroots to Call in Opposition to Medicaid Cuts

House Leaders Push Budget Resolution Calling for Over $100 Billion in Cuts to Medicaid - YOUR CALLS IN OPPOSITION ARE NEEDED!

Next week the U.S. House of Representatives plans to vote on legislation setting parameters for budget and spending legislation for FY 2004 that currently includes a requirement for Congress to cut future federal spending on Medicaid by more than $100 billion over the next decade. House leaders plan to bring this measure - known as the FY 2004 budget resolution - to the full House on March 19. Efforts are now underway by supporters of the Medicaid program in Congress to force congressional leaders to remove these cuts to Medicaid from the budget resolution before it is passed.


NAMI advocates are strongly encouraged to contact their House member and urge them to oppose the cuts to Medicaid proposed in the House budget resolution. Urge them to contact House Speaker Dennis Hastert (R-IL) and House Budget Committee Chairman Jim Nussle (R-IA) and demand that these deep cuts to Medicaid be removed from the budget resolution. Remind your member of Congress that Medicaid has become the most important source of funding for mental illness treatment and supportive services. Included below is background material on the budget resolution and NAMI's letter to Budget Chairman Nussle objecting to these proposed Medicaid reductions.

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

Background on the Budget Resolution

Under the 1974 Budget Act, Congress is required to pass an annual budget resolution that sets overall parameters for mandatory and discretionary spending over the next 10 years. While the budget resolution does not encompass actual spending or authorization legislation, it does contain binding instructions to House and Senate Committees to produce legislation to meet specific spending and budget savings goals. The budget resolution the House will consider next week would require the House Energy & Commerce Committee to cut $101 billion over the next decade from projected federal spending on Medicaid.

This unprecedented cut would have devastating consequences for children and adults with severe mental illnesses who depend on Medicaid for access to treatment and supportive services. While states have primary responsibility for setting eligibility and benefits for their Medicaid programs, Congress plays an important role in setting federal guidelines. In order to meet a specific target for federal savings under Medicaid, the House Energy & Commerce Committee would be forced to pass legislation either cutting federal matching funds or limiting the ability of states to offer optional services to mandatory and optional populations.


March 12, 2003

The Honorable Jim Nussle
Chairman, Committee on the Budget
U.S. House of Representatives
Washington, DC 20515

Dear Chairman Nussle:

On behalf of the 210,000 members and 1,200 affiliates of the National Alliance for the Mentally Ill (NAMI), I am writing to express concern about the reconciliation instruction in the proposed FY 2004 budget resolution that would require the Energy & Commerce Committee to cut $110 billion in mandatory spending over the next decade. In particular, NAMI is very concerned that this proposed reconciliation instruction would require the Energy & Commerce Committee to cut as much as $101 billion from the Medicaid program within Function 550. As the nation's largest national organization representing individuals with severe mental illnesses and their families, NAMI would like to urge the Budget Committee to reject this shortsighted proposal.

NAMI is very concerned that this proposed reconciliation instruction would lead to devastating cuts in the Medicaid program. Medicaid has increasingly become the most important source of funding for public mental health services in our country - encompassing more than 50% of funding nationally. States use their Medicaid programs to cover critical services such as medications, case management and supportive services for children and adults with severe and persistent mental illnesses. Individuals with mental illnesses eligible for Medicaid are some of the most vulnerable and disabled beneficiaries who rely on the program for the most basic of treatment services. As you know, in 2003 many states are already cutting their Medicaid programs to cope with unprecedented budget shortfalls. Cutting the federal share of Medicaid by an additional $101 billion over the next decade would make this disastrous situation even worse.

Currently, the Energy & Commerce Committee is working with governors and advocates representing Medicaid beneficiaries (including NAMI) to craft changes to the program to create more flexibility for the states, while protecting the interests of the most vulnerable beneficiaries (including mandatory populations such as individuals on SSI). Forcing the Energy & Commerce Committee to cut an additional $101 billion over the next 10 years would make this effort to improve the program through enhanced state flexibility very difficult. Further, a cut of this magnitude would make the goal of protecting severely disabled and vulnerable Medicaid beneficiaries all but impossible.

NAMI urges you and your colleagues to reject this requirement for the Energy & Commerce Committee to cut future Medicaid funding.


Richard C. Birkel, Ph.D.