AUCD Warns Medicaid Commission Misdirected

June 3, 2005

Kim E. Musheno
Director of Public Policy

The Association of University Centers on Disabilities (AUCD) has decided not to nominate members to the Medicaid Commission being established by the Administration as a result of negotiations on the FY 2006 congressional budget resolution.

"AUCD would enthusiastically support a forum intended to make positive reforms to the Medicaid program," stated AUCD's president, Fred Palmer. "Unfortunately, AUCD does not support the premise of this commission. We believe this commission has a pre-determined outcome -- to make $10 billion in cuts to Medicaid and possibly to fundamentally alter the program."

During the budget negotiations, Senators Gordon Smith (R-OR) and Jeff Bingaman (D-NM) urged Congressional leaders not to make any cuts to Medicaid. Smith and Bingaman proposed a bipartisan commission to review and make recommendations with respect to comprehensive, positive long-term reforms, including financial sustainability, interaction with Medicare, health care disparities, how the current financing impacts the territories, and the quality of care provided. AUCD strongly supported this effort.

Budget reconciliation instructions direct the Senate Finance Committee to achieve $10 billion and the House Energy and Commerce to achieve $15 billion in cuts to programs within their jurisdiction. However, instructions do not require cuts to come solely through the Medicaid program. AUCD feels strongly that cuts of this magnitude will be difficult if not impossible to achieve through the Medicaid program without hurting beneficiaries.

The commission that is now being appointed by the U.S. Secretary of Health and Human Services is tasked with finding $10 billion in Medicaid cuts over five years by September 1, 2005, an extremely tight timeframe. By December 1, 2006, the Commission is tasked with making "recommendations on the future of Medicaid to ensure the long-term sustainability of the program."

"AUCD disagrees with the presumption that Medicaid is broken," stated the association's Executive director, George Jesien. "While it is true that the growing cost of health care in our country is an issue that must be resolved, Medicaid has been a huge success in providing access health and long-term supports and services in the community. Medicaid is the nation's largest program serving the needs of low-income Americans with disabilities, serving 7.5 million people with disabilities. We have a health care crisis, not a Medicaid crisis."

Furthermore, AUCD feels the independence of the commission is compromised through appointment of members by the Administration and structure that assigns important constituent groups the status of "non-voting" members. This casts serious doubt that the commission will take necessary time, care, and caution when making significant changes to a vital safety net program for millions of Americans.

AUCD continues to strongly support the Administration's New Freedom Initiatives providing new Medicaid models for integrating people with disabilities into American society by providing a range of community living services. These include the "Money Follows the Person" initiatives, Real Choice Systems Change grants, and proposals for demonstrations to provide respite care through Medicaid, among others.

Any Medicaid reforms enacted by Congress must protect the entitlement nature of the program; maintain requirements for comparable services and other essential consumer protections; protect the critical EPSDT program for children with disabilities; ensure that Medicaid fully meets the health and long term care needs of all eligible children and adults with disabilities; and continue to shift the major focus of Medicaid long term support services from institutional to community services.

The Association of University Centers on Disabilities, located in Silver Spring, MD, is a national, non-profit organization that promotes and supports the national network of interdisciplinary centers advancing policy and practices through research, education and services for and with individuals with developmental and other disabilities, their families, and communities.