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NATIONAL POLITICS & POLICY | House Passes Funding Package That Delays Medicaid Rules, Drops Birth Control Pricing Provision

NATIONAL POLITICS & POLICY | House Passes Funding Package That Delays Medicaid Rules, Drops Birth Control Pricing Provision
[June 20, 2008]

The House on Thursday approved a supplemental war funding package along with a domestic funding package that would delay implementation of six new Bush administration Medicaid regulations, the New York Times reports (Hulse, New York Times, 6/20). The domestic funding portion passed by a 416-12 vote, and the war funding portion passed by a 268-155 vote.

According to CQ Today, the House-approved version of the domestic package does not include a provision -- included in an earlier Senate version of the war supplemental bill that also contained domestic spending provisions -- that allows pharmaceutical companies to sell deeply discounted birth control products to college health centers and certain family planning clinics without impacting the Medicaid drug rebate program. According to House Appropriations Committee Chair David Obey (D-Wis.), President Bush likely would have vetoed the package if it included the birth control pricing provision (Higa/Rogin, CQ Today, 6/19). The dropped provision was modeled after legislation (S 2347) introduced by Sen. Barack Obama (D-Ill.) in November 2007. The cost of birth control at college clinics, as well as about 400 community-based family planning clinics, increased last year as the result of a change included in the Deficit Reduction Act of 2005 (Daily Women's Health Policy Report, 5/23).

Medicaid Regulations

The original House version of the bill would have delayed implementation of all seven new Bush administration Medicaid regulations (Daily Women's Health Policy Report, 6/19). However, the final House version would delay six of the rules and allow a rule limiting services Medicaid will cover in outpatient settings to stay in effect. The rule will prohibit payments for some services, including dental care and preventive care. The rule is estimated to save about $300 million over five years (Freking, AP/Minneapolis Star Tribune, 6/19).

The rule changes in the House version would delay services covered by some states' case management plans; limit Medicaid reimbursement to public hospitals; bar federal reimbursement for transportation to school and school-based care for Medicaid-eligible children; restrict the types of "rehabilitative" services covered by federal funding; reduce federal Medicaid reimbursement for students at teaching hospitals; and limit taxes some states charge health providers (Daily Women's Health Policy Report, 6/19). Obey said House Democrats agreed to drop the rule on outpatient services because it was the smallest of the seven regulations.

Outlook, Comments

The bill now moves to the Senate, where Senate Majority Leader Harry Reid (D-Nev.) has said he will bring it to a vote next week (Rogin, CQ Today, 6/19). According to CongressDaily, there are concerns about whether the Senate will attempt to add domestic funding that was included in the Senate-passed version but removed by the House. The White House in a statement said the Bush administration supports the measure (Sanchez, CongressDaily, 6/20).

Sen. Ben Nelson (D-Neb.) said the final version is "not everything" Democrats "were looking for" in the overall package. House Speaker Nancy Pelosi (D-Calif.) said the measure's passage in the House is a victory for Democrats. "You don't do everything in one bill," she said, adding, "It is important for us to have a bill that will be signed because we have to get the job done" (Rogin, CQ Today, 6/19).

House Minority Leader John Boehner (R-Ohio) said that although Republicans might not be fully satisfied with the compromise, they should "just suck it up and vote yes" on the measure. Reid would not say whether the measure likely will pass in the Senate, adding, "I'm not a dictator over here. The individual senators will have to make a decision on what they will do on this" (Higa/Rogin, CQ Today, 6/19).