eNews Archive

May 16, 2003

Senate Supports FMAP and State Fiscal Relief


In response to the growing budget crises faced by the states, the Senate voted 95-3 in favor of a plan to provide $20 billion in federal aid, including additional federal matching funds for Medicaid (the largest and most important source of funding for public sector mental illness treatment and support programs). The Senate's action came as part of an amendment authored by Senator Susan Collins (R-ME) to pending tax cut legislation (S 1054). Last night, the Senate finished its work on the tax cut legislation (S 1054), setting up a confrontation with the House, which did not include fiscal relief in its tax cut package.


NAMI advocates are requested to contact their House members and urge them to support inclusion of the Collins Amendment in the final tax bill that will be sent to President Bush later this spring.

  • Remind them of the importance of Medicaid for children and adults with severe mental illnesses and their families. As noted above Medicaid is the largest source of funding for state and local public sector mental health services – covering prescription medications and supportive services such as case management, rehabilitation and outpatient treatment.
  • Make it clear that cuts to Medicaid at the state level are devastating to access to treatment and services, with limits being imposed on open access to medications and critical supportive services. Additional information about the current threats to Medicaid at the state level is available at: http://www2.nami.org/states/statesincrisis.html
  • Urge your House member to contact House Speaker Dennis Hastert (R-IL) to include state fiscal relief and an increase in the federal share of Medicaid in the final tax bill. Note - if your House member is a Republican, urge them to join Representatives Peter King (R-NY) and Ray LaHood (R-IL) in signing their letter to Speaker Hastert in favor state fiscal relief.

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

Background on the Collins Amendment

The $20 billion state fiscal relief amendment passed by the Senate includes two parts:

  1. $10 billion in increased federal Medicaid matching funds (also known as FMAP) for the states.  Most states would see their match rate (which varies 50% to 80% depending on a state's relative wealth) increase by about 1.5% through the end of FY 2004 to cope with growing costs in Medicaid,
  2.  $10 billion in revenue sharing from the federal government through the end of FY 2003 and all of FY 2004.  These funds would be split with 60% going to the states and 40% to localities.  States and localities would have substantial discretion in how to spend these funds although they would be encouraged to use these funds to cope with the growing costs of federal mandates related to education, homeland security and Medicaid.  Funds would be allocated by population, with every state guaranteed at least $50 million.

The overwhelming bipartisan majority in the Senate that supported the Collins Amendment demonstrates the strong support that fiscal relief for cash strapped states has in Congress. It is also a clear demonstration of the growing concerns related to the impact that budget cuts in health and human service programs are having on vulnerable populations such as children and adults with severe mental illnesses.

Back to top