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House Set to Vote on Budget Bill That Includes Cuts to Medicaid

January 27, 2006

The House of Representatives is expected to vote next week on final passage of a massive package of budget cuts that includes some of the most important changes to the Medicaid program in years.  The package – known as the Budget Reconciliation bill (S 1932) – would cut Medicaid by more than $11.4 billion over the next five years (and as much as $30 billion over ten years) as well as provide states with new authority to impose reductions on the most vulnerable beneficiaries, including mandatory recipients eligible for SSI.  Among the provisions of greatest concern to NAMI are the options for imposing higher cost sharing and premium requirements on Medicaid beneficiaries.   

Both the House and Senate previously passed this current version of S 1932.  However, because of several minor changes made in the final package by the Senate (through procedural objections raised in December), the House must vote on the legislation again before it is sent to the White House – where President Bush has made it clear that he intends to sign the bill.   

When the House first voted on the budget reconciliation measure on December 19, it passed by a vote of 212-206, with 17 members absent (a number of members who were absent for the vote have made clear that they intend to vote in favor of the bill next week).  Thus, at least six, or as many as eight to ten members, would need to switch their votes in order to defeat the entire package next week.

Action Needed

Advocates are strongly encouraged to contact their House members to urge them to oppose passage of the Medicaid Budget Reconciliation bill (S 1932).  Explain that the Medicaid cost-sharing requirements contained in S 1932 will prevent impoverished people living with severe mental illnesses from receiving needed treatment and will therefore lead to increased homelessness, hospitalizations, criminalization, and suffering.  Advocates are especially encouraged to participate in a national call-in day scheduled for Tuesday, January 31.

A priority should be placed on reaching House members who voted yes and those who were not present on December 19.  Advocates can find out how their House member previously voted on S 1932 by clicking here.

All House members can be reached through the U.S. Capitol Switchboard at 202/224-3121. 

Remind your House member of how the proposed reductions to Medicaid in the package would adversely impact beneficiaries living with mental illness.  Among the most significant reductions are: 

  • New authority that will allow states to require beneficiaries (including adults with mental illness on SSI) to pay higher cost sharing for services, including "non-preferred" prescription medications and "non-emergency services" delivered in emergency rooms;
  • A proposal to permit states to require certain beneficiaries (those above 100% of poverty) to pay higher enrollment premiums; and
  • New discretion for states to offer alternative benefit packages to Medicaid eligible populations that could exclude mental illness treatment and community supports. 

A detailed analysis of the Medicaid Budget Reconciliation Conference Report can be viewed on the NAMI Web site.

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