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Calendar No. 283 

109TH CONGRESS 

1ST SESSION S. 1969 

To express the sense of the Senate regarding Medicaid reconciliation legislation to be reported by a conference committee during the 109th Congress. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 7, 2005 

Mr. BAUCUS introduced the following bill; which was read the first time 

NOVEMBER 8, 2005 

Read the second time and placed on the calendar 

A BILL 

To express the sense of the Senate regarding Medicaid reconciliation legislation to be reported by a conference committee during the 109th Congress. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 
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1 SECTION 1. TO EXPRESS THE SENSE OF THE SENATE RE2 GARDING MEDICAID RECONCILIATION LEGIS3 LATION TO BE REPORTED BY A CONFERENCE 

4 COMMITTEE. 

5 (a) FINDINGS.—The Senate makes the following 

6 findings: 

7 (1) The Medicaid program provides essential 

8 health care and long-term care services to more than 

9 50,000,000 low-income children, pregnant women, 

10 parents, individuals with disabilities, and senior citi11 zens. It is a Federal guarantee that ensures that the 

12 most vulnerable will have access to needed medical 

13 services. 

14 (2) The Medicaid program provides critical ac15 cess to long-term care and other services for the el16 derly and individuals living with disabilities, and is 

17 the single largest provider of long-term care services. 

18 The Medicaid program also pays for personal care 

19 and other supportive services that are typically not 

20 provided by private health insurance or under the 

21 Medicare program, but are necessary to enable indi22 viduals with spinal cord injuries, developmental dis23 abilities, neurological degenerative diseases, serious 

24 and persistent mental illnesses, HIV/AIDS, and 

25 other chronic conditions to remain in the commu26 nity, to work, and to maintain independence. 
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1 (3) The Medicaid program supplements the 

2 Medicare program for more than 6,000,000 low-in3 come elderly or disabled Medicare beneficiaries, as4 sisting those beneficiaries with their Medicare pre5 miums and co-insurance, wrap-around benefits, and 

6 the costs of nursing home care that the Medicare 

7 program does not cover. The Medicaid program 

8 spent nearly $40,000,000,000 in 2002 on services 

9 not covered under the Medicare program. 

10 (4) The Medicaid program provides health insurance for more than 1 11 ⁄4 of America’s children and 

12 is the largest purchaser of maternity care, paying 

for more than 1 13 ⁄3 of all the births in the United 

14 States each year. The Medicaid program also pro15 vides vital access to care for children with disabil16 ities, covering more than 70 percent of the poor chil17 dren with disabilities in the United States. 

18 (5) Medicaid’s benefits for children are com19 prehensive, including mandatory coverage for Early 

20 and Periodic Screening Diagnosis and Treatment 

21 benefits covering all medically necessary care. Med22 icaid ensures that children have the benefits, health 

23 services and health care support they need to be 

24 fully immunized and that children can secure eye25 glasses, dental care, and hearing aids when nec-
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1 essary, and that children have access to comprehen2 sive, regularly scheduled, and as-needed health ex3 aminations, as well as preventive interventions, to 

4 correct physical and mental conditions that threaten 

5 to delay proper growth and development. 

6 (6) More than 16,000,000 American women de7 pend on the Medicaid program for their health care. 

8 Women comprise the majority of seniors (71 per9 cent) on Medicaid. Half of nonelderly women with 

10 permanent mental or physical disabilities have health 

11 care coverage under the Medicaid program. The 

12 Medicaid program also provides critical access to 

13 treatment for low-income women diagnosed with 

14 breast or cervical cancer. 

15 (7) The Medicaid program is the Nation’s larg16 est source of payment for mental health services, 

17 HIV/AIDS care, and care for children with special 

18 needs. Much of this care is either not covered by pri19 vate insurance or is limited in scope or duration. 

20 The Medicaid program is also a critical source of 

21 funding for health care for children in foster care 

22 and for health care services provided in schools. 

23 (8) Funds under the Medicaid program help to 

24 ensure access to care for all Americans. The Med25 icaid program is the single largest source of revenue 
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1 for the Nation’s safety net hospitals, health centers, 

2 and nursing homes, and is critical to the ability of 

3 these providers to adequately serve all Americans. 

4 (9) The Medicaid program serves a major role 

5 in ensuring that the number of Americans without 

6 health insurance, approximately 45,000,000 in 2003, 

7 is not substantially higher. The system of Federal 

8 matching for State Medicaid expenditures ensures 

9 that Federal funds will grow as State spending in10 creases in response to unmet needs, enabling the 

11 Medicaid program to help buffer the drop in private 

12 coverage during recessions. More than 4,800,000 

13 Americans lost employer-sponsored health care cov14 erage between 2000 and 2003, during which time 

15 the Medicaid program enrolled an additional 

16 8,400,000 Americans. 

17 (10) Many individuals living below the Federal 

18 poverty level are ineligible for Medicaid because of 

19 stringent income eligibility rules. For parents, eligi20 bility levels are often very far below the Federal pov21 erty level. On average, a working parent in a family 

22 of three would have to make less than $224 per 

23 week and a non-working parent in a family of three 

24 would have to make less than $150 per week to 

25 qualify. Single individuals with disabilities would be 
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1 ineligible if they have more than $147 per week in 

2 income. 

3 (11) Eligibility levels for pregnant women and 

4 children are generally at or just above the Federal 

5 poverty level, but a family with income just over 

6 minimum wage can be disqualified for Medicaid. At 

7 the minimum eligibility levels for pregnant women, 

8 earning as little as $8.80 per hour at a full-time job 

9 could disqualify a pregnant woman from Medicaid 

10 eligibility. A working parent in a family of three 

11 earning less than $8.40 per hour at a full-time job 

12 could make their child 6 years-old or older ineligible 

13 for Medicaid. 

14 (12) Title III of the budget reconciliation bill of 

15 the House of Representatives, as reported out by the 

16 Committee on Energy and Commerce, would ad17 versely affect these low-income beneficiaries, many of 

18 whom are children or have special health care needs, 

19 by increasing beneficiary cost-sharing, limiting ac20 cess to benefits, and restricting eligibility for long21 term care services that the Medicaid program covers. 

These new limits make up 2 22 ⁄3 of the House of Rep23 resentative’s projected Medicaid spending reductions, 

24 accounting for $30,100,000,000 of the total 
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1 $45,300,000,000 in Medicaid reductions over 10 

2 years. 

3 (13) Making beneficiaries pay more for more 

4 limited benefits under Medicaid may put a signifi5 cant financial burden on these very low-income indi6 viduals. Research also demonstrates that increasing 

7 beneficiary cost-sharing can make prescription drugs 

8 and other essential health services unaffordable for 

9 beneficiaries, can cause the health of children and 

10 adults to deteriorate, and can lead to higher emer11 gency room and hospital costs. 

12 (14) By contrast, while S. 1932, as passed by 

13 the Senate on November 3, 2005, includes substan14 tial cuts to the Medicaid program, it does not in15 clude direct limits on beneficiary access to Medicaid 

16 services. Even so, enactment of S. 1932 would result 

17 in a net Medicaid cut of $14,200,000,000 over 10 

years, less than 1 18 ⁄3 of the projected Medicaid reduc19 tions contained in the House of Representative’s 

20 budget reconciliation bill. 

21 (b) SENSE OF THE SENATE.—It is the sense of the 

22 Senate that the conferees for any budget reconciliation bill 

23 of the 109th Congress shall not report a reconciliation bill 

24 that would— 
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1 (1) with respect to low-income children, preg2 nant women, disabled individuals, elderly individuals, 

3 individuals with chronic illnesses like HIV/AIDS, 

4 cancer, and diabetes, individuals with mental ill5 nesses, and other Medicaid beneficiaries— 

6 (A) impair access to Medicaid services; 

7 (B) undermine eligibility for such Medicaid 

8 beneficiaries; 

9 (C) make Medicaid services unavailable by 

10 making them unaffordable to such Medicaid 

11 beneficiaries; or 

12 (D) cut health care services for such Med13 icaid beneficiaries; or 

14 (2) undermine the Federal guarantee of health 

15 insurance coverage that the Medicaid program pro16 vides, which would threaten not only the health care 

17 safety net of the United States, but the entire health 

18 care system of the United States. 

Calendar No. 283 

109TH CONGRESS 

1ST SESSION S. 1969 

A BILL 

To express the sense of the Senate regarding Medconference committee during the 109th Congress. icaid reconciliation legislation to be reported by a 

NOVEMBER 8, 2005 

Read the second time and placed on the calendar