TheHonorable Senator Coburn TheUnited States Senate 172Russell Senate Office Building Washington,DC 20510
DearSenator Coburn,
On behalf of the 362,000 members ofthe National Taxpayers Union, I write in support of S.1031, the MedicaidImprovement and State Empowerment Act. Thisbill combines several key reforms of the Medicaid system that will save thefederal government billions while allowing states the flexibility to provideimproved and more efficient health care services to the neediest Americans.
Decades of explosive growth in both thesize and cost of Medicaid are placing an enormous strain on government budgets.Federal spending on the program has doubled in the last ten years and theCongressional Budget Office projects that price tag will grow to more than $4trillion over the next decade. This cost explosion is also impacting states,where Medicaid accounts for an average of nearly 25 percent of their budgets. Sadly,this unsustainable spending growth has not translated into positive outcomesfor Medicaid patients. Low reimbursement rates have given cause for 40 percentof physicians to refuse or restrict access to patients in the program.
Rather than address these maladies,Medicaid’s fiscal situation was inarguably made worse by the Patient Protectionand Affordable Care Act. Not only did that bill dramatically expand Medicaid enrollment,but it also enacted new maintenance-of-effort requirements that restrictedstates’ options to alter eligibility. These changes left states stuck holdingthe tab and consigned many patients to inadequate care.
One of the main drivers of Medicaid’sproblems is its reliance on the flawed Federal Medical Assistance Percentages, whichdetermine the rate that the federal government will match state spending onMedicaid patients. S. 1031 would replace this untenable system, whichencourages bloated spending and top-down mandates, with a pass-through blockgrant model for certain Medicaid eligible population segments. This would allowstates to receive a lump sum grant that would rise over time to reflectinflation and population growth. Freed (at least partially) from the long armof Washington’s bureaucracy, states will be able to more effectively budget, aswell as be empowered to improve patient outcomes. Your bill would alsoalleviate a great deal of budgetary pressure by unshackling the states from thecostly mandates contained in the stimulus and health care reform laws. Finally,to stem the rise of medical costs and ensure as much money as possible is spenton patients, and not lawyers, S. 1031 would create a program to incentivizestates to enact malpractice reforms.
The Medicaid Improvement and StateEmpowerment Act is an important step toward the goal of fixing our brokenentitlement system. NTU urges yourcolleagues to cosponsor S. 1031, and any roll call votes on this legislationwill be significantly weighted in our annualRating of Congress.
Sincerely,
Brandon GreifeFederalGovernment Affairs Manager