Democrats Split on Medicaid Changes

The National Governors Association, whose membership includes both Republican and Democratic governors, sent a letter to Congress on Monday mostly endorsing the House's budget reconciliation package that contains changes to Medicaid transfer rules. The endorsement of the House bill by Democratic governors is a split with Democratic members of Congress. Every Democratic member of Congress voted against the bill when it passed by a slim 217 to 215 vote in November.

Among other things, the House bill includes a measure that would extend Medicaid's "lookback" period for all asset transfers from three to five years and change the start of the penalty period for transferred assets from the date of transfer to the date of Medicaid application. In addition, the House version allows states to increase co-payment increases on Medicaid beneficiaries with incomes above the federal poverty level. The House version differs from the Senate budget bill, which makes only modest changes in the asset transfer rules and doesn't include an increase in co-payments. The two bills now have to be hashed out in a joint House-Senate conference committee.

The NGA's letter specifically approved of the changes to transfer penalties in the House bill, saying the final bill should "include critical House provisions that would increase the look-back period and begin the penalty period at the time of application for services." The letter also endorsed the co-payments provision and a provision in the house bill making any individual with home equity above $750,000 ineligible for Medicaid nursing home care.

For the full letter, click here.

An article in the Dec. 12, 2005, New York Times reports that "Medicaid is a flash point" as House and Senate conferees sit down to reconcile the two budget bills. The article focuses on provisions in the House bill that would allow states, for the first time, to deny care or services because of a person's inability to pay premiums or co-payments. To read the article, click here. (Free registration required and article is available free of charge for one week.)