Today, the House Energy and Commerce Committee voted out of committee the 21st Century Medicaid Reform Act as part of the reconciliation process. Congressman Michael C. Burgess, the only doctor on the committee, played an integral role in developing the language of the bill. The bill passed 33-17.

“The purpose of our work today is not about money,” said Congressman Michael Burgess. “It is about saving a vital, federal program.”

Medicaid is a federal-state program that provides medical care to 53 million low-income and/or elderly patients which constitutes nearly one in five Americans. Medicaid is already the biggest item in state budgets exceeding elementary and secondary education combined. Health and Human Services and the Centers for Medicare and Medicaid Services estimate that the federal government would pay $1 trillion over the next five years on Medicaid if something reforms were not made now.

“Medicaid is hemorrhaging red ink,” said Congressman Michael Burgess. “We have an historic opportunity to improve it now or ultimately risk exsanguination.”

The bipartisan National Governors Association has been pushing for reform to the Medicaid system that is overtaking the budgets of their respective states. A number of governors, both Republicans and Democrats, from across the nation, participated in committees hearings on Medicaid Reform. Each governor was constituent on the message that Medicaid, as it is currently structured, was “unsustainable.”

The goals of Medicaid reform include:
- Giving greater flexibility to provide services
- Ensuring expenditures are not misdirected from their intended purpose
- Encouraging personal responsibility
- Eliminating duplicate spending, and
- Ensuring a more rational pricing system for pharmaceuticals

Significant portions of the bill were authored by Congressman Michael C. Burgess. Language from H.R. 3757, Medicaid Health Savings Accounts is included in the mark-up. Currently, Medicaid does nothing to promote cost-conscious behavior or provide a sense of personal responsibility for health care decision-making. Medicaid Health Savings Accounts, introduced by Rep. Mike Rogers (MI-08) along with Rep. Burgess, provides flexibility to the consumer to make health care choices with their money. Beneficiaries can self-direct a pre-funded account for medical care, roll over unspent balances and retain a portion of account funds after leaving Medicaid to spend not only on medical care but also on health insurance, job training and tuition expenses. States will have the option of setting up these accounts.

“Giving Medicaid beneficiaries more control over their care will not only improve their health in the long-run, but will also help shore up a floundering Medicaid program,” said Congressman Michael Burgess. “Medicaid Savings Accounts are just what states need return the focus on Medicaid on quality health outcomes, not the same inflated program that will become more and more of a burden for all involved.”

The Medicaid reform bill also includes much needed changes on how we handle long term care in America. Originally introduced by Congressman Burgess as stand-alone legislation, H.R. 3511, the Medicaid State Long-Term Care Partnership Program Act of 2005 protects enrollees’ assets if their insurance coverage is exhausted, and they have to look to state Medicaid programs to cover their long term care expenses.

“The fact remains that most of us are anesthetized to the true cost and true value of long term care insurance,” stated Congressman Burgess. “Those of us who can should consider the purchase of long term care insurance as the socially responsible thing to do. Providing this additional incentive to the purchase of long term care coverage may allow some of the burden to be shifted from the government to the private sector.”

Congressman Burgess also addressed issues relating to Hurricane Katrina with two amendments that were accepted by the committee on voice vote. The first amendment would ensure Texas will not lose federal Medicaid dollars in the future as a result of additional income to Katrina evacuees that relocated to Texas. Assistance to evacuees in the form of FEMA payments, Unemployment Insurance and other payments will artificially inflate the state’s per capita income leading to a decline in federal Medicaid payments.

Governor Rick Perry, supports the amendment and applauds the work of Congressman Burgess. “Today’s action by the House Energy and Commerce Committee will ensure that Texas’ share of federal Medicaid funding is held harmless and not reduced as a result of Hurricane Katrina. I commend Representative Burgess and Chairman Barton for their work and leadership on this issue of great importance to Texas.”

Congressman Burgess’ second amendment would streamline the community health center qualification requirements and also provide immediate public health assistance to hospitals in the New Orleans metropolitan areas and give them the ability to retain essential medical personnel.

Ultimately, the bill will be brought before the House of Representatives for a final vote sometime before the end of the first session of Congress.

“This bill reforms a system so that it will not bankrupt America,” remarked Congressman Burgess. “We can make Medicaid a cost-effective, efficient and stable program for those groups of people who truly need it.”