Statement of Congressman John D. Dingell, Ranking Member
Committee on Energy and Commerce

COMMITTEE ON ENERGY AND COMMERCE
HEARING ON “MEDICAID REFORM: THE
NATIONAL GOVERNORS ASSOCIATION'S ROADMAP”

June 15, 2005

I welcome Governors Warner and Huckabee and thank you for testifying before our Committee today. We are very interested in learning about your working group’s preliminary proposal to change Medicaid and how these changes will help you with your State fiscal problems. We have heard for some time the concerns of the States regarding their budgets and how much of them is consumed by Medicaid. I want you to know that I am sympathetic to your financial plight, but may have a different perspective on how to fix it within the broader health system.

Congress has tried to alleviate this situation many times, including a major victory in June 2003 when we were able to provide the States with $10 billion to assist them through the economic downturn by temporarily boosting the Federal Medicaid funding. But now we are going in the opposite direction. Congress is looking to cut $10 billion in Federal dollars, keeping in mind that cutting $10 billion of Federal funding equals a $17.5 billion cut overall to Medicaid because of the shared State-Federal financing of the program.

The National Governors Association (NGA) has come out strongly against the “cost shift” by the Federal Government that would place a greater financial burden on the States. I wholeheartedly agree with the Governors and would support giving the States $10 billion rather than taking it away. But we must also take care not to “cost shift” the burden onto the backs of the poor. Unfortunately, I am afraid that much of the NGA proposal will do just that – shift costs to the poorest and most vulnerable citizens who depend on this program.

It appears that in the name of “personal responsibility” the NGA proposal will make it much more difficult for children and pregnant women to get needed services. Do we really want to set policies that make it more difficult for a child diagnosed with diabetes to get insulin? In the end we as a Nation will pay the financial and social costs of any complications that result for such a child.

The proposed cost-sharing increases and benefit changes will apparently result in many going with no services at all. I understand that the NGA proposal would eliminate the Medicaid requirement that low-income children who are screened and diagnosed with health problems get the treatment they need. Why are we turning our backs on them? Equally troubling is the proposal to take away from senior citizens, individuals with disabilities, pregnant women, and children the ability to enforce their right to promised benefits, which serves as a backstop to guarantee that they get the services they need. We should not kid ourselves – rights without enforcement are not rights at all.

I understand that this is a preliminary agreement between a group of Governors which meant concessions were no doubt made on both sides. I am just curious, however -- how many seniors, people with disabilities, pregnant women, and children were included in your negotiations? And where will these folks be when the Republican Leadership decides whose health services will get cut while doling out tax cuts for the most fortunate among us? It is a very sad day when Republican budget priorities require folks like the witnesses before us today to figure out how to hurt people the least, rather than to help them the most.

Before I yield back, Mr. Chairman, I wish to express the concern of the Democratic Members that we are not hearing today from those who would be hurt by these proposals. I note that our colleagues in the other body are hearing today from experts on the perspectives of beneficiaries and providers. Will the Committee be holding full and adequate hearings to obtain testimony from beneficiaries and providers on these proposals before it votes on the $10 billion in cuts?

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(Contact: Jodi Seth, 202-225-3641)