Subject: Medicaid Still Under Attack
From: [email-masked]
Date: Wed, 29 Nov 1995 15:43:56 -0500

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NEWS from the
Human Rights Campaign

1101 14th Street NW
Washington, DC 20005
email:  [email-masked]
WWW:    http://www.hrcusa.org
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                              MEDICAID STILL UNDER ATTACK

               BUDGET RECONCILIATION: PLAYING POLITICS
                           WITH PEOPLE LIVING WITH AIDS

            GO TO HRC'S WEBSITE TO SEE WHAT YOU CAN DO
                                         http://www.hrcusa.org

The Republican Budget Reconciliation Bill (HR 2491) has been
passed by both the House and Senate and it will be sent on to the
White House.  President Clinton has said he will veto the bill. 
After the veto, the real conflict begins as the Administration
and the congressional Republican leadership negotiate the terms
of the Budget Reconciliation Bill. 

The outcome of the crucial federal safety net programs, including
Medicaid, will be realized within the next three weeks.  In the
words of one public health expert the projected number of
uninsured Americans, by the year 2002, will be 66 million if the
Republican leadership's Medicaid and Medicare proposals are
passed.  For people living with HIV/AIDS the end of health care
means a tragic loss in the most extreme and life threatening
manner.

                       HOW WILL MEDICAID BE IMPACTED? 

The final bill passed by Congress on Friday, November 17 was
passed mainly along straight party-line votes. The proposed bill
both repeals the current Medicaid program and substitutes it with
a Medigrant program to states with very few federal requirements. 
Medigrant also plans to cut $163 billion in projected Medicaid
spending over the next seven years.

Medicaid provides life-sustaining care to nearly half of all men
and women with HIV and AIDS and more than 90 percent of children
with the disease.  Nationwide, a bipartisan poll conducted in
February by the Tarrance Group and Lake Research, Inc., found
that 77 percent of registered voters favor maintaining or
increasing federal funding for the care of people with AIDS --
including more than two-thirds of Republican voters.

The dismantling of Medicaid, contained in the current version of
the Budget Reconciliation Act would eliminate guaranteed health
coverage for all Americans who meet the program's eligibility
guidelines.  If enacted, the Budget Reconciliation Act would deny
health care to millions of Americans who need it most.  The bill
would slash $164 million from Medicaid over the next seven years,
and make states responsible for providing health care to the
poor, while cutting the funds they need to do it.  Health experts
also pass hidden costs along to taxpayers, as Americans who lose
their health coverage would be forced to turn to more expensive
care in hospital emergency rooms -- at public expense.

All states are required to provide some level of coverage to
pregnant women and children under 13 who live at or below the
federal poverty line.  States are also required to provide
coverage for disabled individuals, although each state will have
complete authority to determine its own definition of the
disabled.  Under this bill, there is no guarantee that any
low-income man, woman or child living with HIV/AIDS will receive
the health care services they are now eligible to receive under
the existing Medicaid program.

                        THERE ARE POLITICAL ALTERNATIVES 
                     TO A BLOCK GRANT MEDICAID PROGRAM
 
The Administration and key Democratic members of Congress have
been concerned about the steady growth of Medicaid and have made
realistic proposals to slow the growth as well as the expense of
Medicaid.  One plan is to implement a per capita cap instead of a
block grant.  A per capita cap would allow states to receive a
fixed amount of federal dollars per beneficiary.  A different
amount or cap would be established for each major category of
beneficiaries: i.e., pregnant women, children, disabled
individuals and frail elderly in need of nursing home services. 
The caps would be different for each category and would vary by
state according their current medicaid spending.

A per capita cap would allow for continued growth in the number
of Medicaid beneficiaries and would maintain the current
eligibility criteria and benefits package.  A per capita cap
proposal would also reduce federal spending on the Medicaid
program, but the cuts would neither be as drastic nor the changes
as blatant and disruptive as a traditional block grant.

                                                           -30-

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