programs by cutting payment rates for doctors, hospitals, or nursing homes; reducing the scopeof benefits covered; or limiting eligibility.”
On May 12, 2011, the Subcommittee on Health of the House Committee on Energy andCommerce reported legislation (H.R. 1683) to repeal Medicaid responsibility “maintenance of effort” provisions in Medicaid. These provisions prevent states from eliminating coverage forseniors, individuals with disabilities, children, pregnant women, and others currently enrolledin Medicaid. The full House of Representatives is expected to vote soon on this legislation. If it becomes law, this bill would allow states to make significant cuts immediately in Medicaidcoverage.
Impacts in Rep. Grimms’s District
This analysis provides information on the impact of the Republican Medicaid proposals in the13th Congressional District of New York, which is represented by Rep. Michael G. Grimm.Currently, 125,000 individuals in the district receive health care coverage under Medicaid.
Impacts on Seniors.
Medicaid provides health care coverage for over 22,000 seniors andindividuals with disabilities in the district who are “dual eligible” for both Medicare andMedicaid. The Medicaid benefits received by these individuals include payment of theirMedicare Part B premiums, coverage of Medicare cost-sharing, dental and vision benefits, andlong-term care. There are 2,900 nursing home residents in the district -- 77% of all nursinghome residents -- whose care is paid for by Medicaid. Medicaid cuts of the magnitudeproposed by House Republicans could lead to both eligibility and coverage restrictions forthese seniors and individuals with disabilities, including reduced nursing home staffing andother cuts that affect quality of care and put seniors at risk.
Impacts on Infants and Children.
Medicaid provides health care coverage, includingvaccinations, well-child visits, and vision and dental benefits, for 52,000 children in thedistrict. Last year, Medicaid also paid for the births of 2,800 children in the district. Cuts inMedicaid funding or eligibility could place coverage for these infants and children at risk.
Impacts on Hospitals.
There are 249,000 emergency room visits each year in the 13thCongressional District. Last year, Medicaid paid for 38,000 of these ER visits. If Medicaideliminated coverage for these visits or reduced its reimbursement rates, local hospitals wouldexperience a significant increase in uncompensated care, which could lead to cutbacks in theavailability of emergency care and compromise readiness for terrorist events and other large-scale emergencies.There are also 79,000 hospital visits annually in the district. An estimated 13% of these visits -- 10,400 hospital visits annually -- are paid for by Medicaid. If Medicaid payments were cut,hospitals would lose funds needed to maintain and provide critical services; if Medicaideligiblity were rolled back, many sick residents would be unable to pay for necessary care,increasing the amount of uncompensated care provided by hospitals.
Letter from Douglas W. Elmendorf, Director, Congressional Budget Office, to Paul Ryan, Chairman, Committeeon the Budget (April 5, 2011).