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

SECTION 1. TO EXPRESS THE SENSE OF THE SENATE REGARDING MEDICAID 
              RECONCILIATION LEGISLATION TO BE REPORTED BY A CONFERENCE 
              COMMITTEE.

    (a) Findings.--The Senate makes the following findings:
            (1) The Medicaid program provides essential health care and 
        long-term care services to more than 50,000,000 low-income 
        children, pregnant women, parents, individuals with 
        disabilities, and senior citizens. It is a Federal guarantee 
        that ensures that the most vulnerable will have access to 
        needed medical services.
            (2) The Medicaid program provides critical access to long-
        term care and other services for the elderly and individuals 
        living with disabilities, and is the single largest provider of 
        long-term care services. The Medicaid program also pays for 
        personal care and other supportive services that are typically 
        not provided by private health insurance or under the Medicare 
        program, but are necessary to enable individuals with spinal 
        cord injuries, developmental disabilities, neurological 
        degenerative diseases, serious and persistent mental illnesses, 
        HIV/AIDS, and other chronic conditions to remain in the 
        community, to work, and to maintain independence.
            (3) The Medicaid program supplements the Medicare program 
        for more than 6,000,000 low-income elderly or disabled Medicare 
        beneficiaries, assisting those beneficiaries with their 
        Medicare premiums and co-insurance, wrap-around benefits, and 
        the costs of nursing home care that the Medicare program does 
        not cover. The Medicaid program spent nearly $40,000,000,000 in 
        2002 on services not covered under the Medicare program.
            (4) The Medicaid program provides health insurance for more 
        than \1/4\ of America's children and is the largest purchaser 
        of maternity care, paying for more than \1/3\ of all the births 
        in the United States each year. The Medicaid program also 
        provides vital access to care for children with disabilities, 
        covering more than 70 percent of the poor children with 
        disabilities in the United States.
            (5) Medicaid's benefits for children are comprehensive, 
        including mandatory coverage for Early and Periodic Screening 
        Diagnosis and Treatment benefits covering all medically 
        necessary care. Medicaid ensures that children have the 
        benefits, health services and health care support they need to 
        be fully immunized and that children can secure eyeglasses, 
        dental care, and hearing aids when necessary, and that children 
        have access to comprehensive, regularly scheduled, and as-
        needed health examinations, as well as preventive 
        interventions, to correct physical and mental conditions that 
        threaten to delay proper growth and development.
            (6) More than 16,000,000 American women depend on the 
        Medicaid program for their health care. Women comprise the 
        majority of seniors (71 percent) on Medicaid. Half of 
        nonelderly women with permanent mental or physical disabilities 
        have health care coverage under the Medicaid program. The 
        Medicaid program also provides critical access to treatment for 
        low-income women diagnosed with breast or cervical cancer.
            (7) The Medicaid program is the Nation's largest source of 
        payment for mental health services, HIV/AIDS care, and care for 
        children with special needs. Much of this care is either not 
        covered by private insurance or is limited in scope or 
        duration. The Medicaid program is also a critical source of 
        funding for health care for children in foster care and for 
        health care services provided in schools.
            (8) Funds under the Medicaid program help to ensure access 
        to care for all Americans. The Medicaid program is the single 
        largest source of revenue for the Nation's safety net 
        hospitals, health centers, and nursing homes, and is critical 
        to the ability of these providers to adequately serve all 
        Americans.
            (9) The Medicaid program serves a major role in ensuring 
        that the number of Americans without health insurance, 
        approximately 45,000,000 in 2003, is not substantially higher. 
        The system of Federal matching for State Medicaid expenditures 
        ensures that Federal funds will grow as State spending 
        increases in response to unmet needs, enabling the Medicaid 
        program to help buffer the drop in private coverage during 
        recessions. More than 4,800,000 Americans lost employer-
        sponsored health care coverage between 2000 and 2003, during 
        which time the Medicaid program enrolled an additional 
        8,400,000 Americans.
            (10) Many individuals living below the Federal poverty 
        level are ineligible for Medicaid because of stringent income 
        eligibility rules. For parents, eligibility levels are often 
        very far below the Federal poverty level. On average, a working 
        parent in a family of three would have to make less than $224 
        per week and a non-working parent in a family of three would 
        have to make less than $150 per week to qualify. Single 
        individuals with disabilities would be ineligible if they have 
        more than $147 per week in income.
            (11) Eligibility levels for pregnant women and children are 
        generally at or just above the Federal poverty level, but a 
        family with income just over minimum wage can be disqualified 
        for Medicaid. At the minimum eligibility levels for pregnant 
        women, earning as little as $8.80 per hour at a full-time job 
        could disqualify a pregnant woman from Medicaid eligibility. A 
        working parent in a family of three earning less than $8.40 per 
        hour at a full-time job could make their child 6 years-old or 
        older ineligible for Medicaid.
            (12) Title III of the budget reconciliation bill of the 
        House of Representatives, as reported out by the Committee on 
        Energy and Commerce, would adversely affect these low-income 
        beneficiaries, many of whom are children or have special health 
        care needs, by increasing beneficiary cost-sharing, limiting 
        access to benefits, and restricting eligibility for long-term 
        care services that the Medicaid program covers. These new 
        limits make up \2/3\ of the House of Representative's projected 
        Medicaid spending reductions, accounting for $30,100,000,000 of 
        the total $45,300,000,000 in Medicaid reductions over 10 years.
            (13) Making beneficiaries pay more for more limited 
        benefits under Medicaid may put a significant financial burden 
        on these very low-income individuals. Research also 
        demonstrates that increasing beneficiary cost-sharing can make 
        prescription drugs and other essential health services 
        unaffordable for beneficiaries, can cause the health of 
        children and adults to deteriorate, and can lead to higher 
        emergency room and hospital costs.
            (14) By contrast, while S. 1932, as passed by the Senate on 
        November 3, 2005, includes substantial cuts to the Medicaid 
        program, it does not include direct limits on beneficiary 
        access to Medicaid services. Even so, enactment of S. 1932 
        would result in a net Medicaid cut of $14,200,000,000 over 10 
        years, less than \1/3\ of the projected Medicaid reductions 
        contained in the House of Representative's budget 
        reconciliation bill.
    (b) Sense of the Senate.--It is the sense of the Senate that the 
conferees for any budget reconciliation bill of the 109th Congress 
shall not report a reconciliation bill that would--
            (1) with respect to low-income children, pregnant women, 
        disabled individuals, elderly individuals, individuals with 
        chronic illnesses like HIV/AIDS, cancer, and diabetes, 
        individuals with mental illnesses, and other Medicaid 
        beneficiaries--
                    (A) impair access to Medicaid services;
                    (B) undermine eligibility for such Medicaid 
                beneficiaries;
                    (C) make Medicaid services unavailable by making 
                them unaffordable to such Medicaid beneficiaries; or
                    (D) cut health care services for such Medicaid 
                beneficiaries; or
            (2) undermine the Federal guarantee of health insurance 
        coverage that the Medicaid program provides, which would 
        threaten not only the health care safety net of the United 
        States, but the entire health care system of the United States.

Summary: Expresses the sense of the Senate that the conferees for any budget reconciliation bill of the 109th Congress shall not report a reconciliation bill that would with respect to low-income children, pregnant women, disabled individuals, elderly individuals, individuals with chronic illnesses like HIV/AIDS, cancer, and diabetes, individuals with mental illnesses, and other Medicaid beneficiaries: (1) impair access to Medicaid services; (2) undermine eligibility for such beneficiaries; (3) make Medicaid services unaffordable, hence unavailable, to them; or (4) cut health care services them.

 Expresses the sense of the Senate, also, that the conferees shall not report a reconciliation bill that would undermine the federal guarantee of health insurance coverage that the Medicaid program provides, which would threaten not only the health care safety net of the United States, but the entire health care system of the United States.