MAY 20, 2005 -- The Medicaid commission that Health and Human Services Secretary Michael O. Leavitt outlined Friday bears little resemblance to the panel some lawmakers asked Leavitt to create.
Leavitt, rather than the bipartisan leadership of the House and Senate, would have the power to appoint the commission and he did not give the National Academy of Sciences' Institute of Medicine the power to administer the panel as the legislators had sought.
Leavitt will appoint up to 15 voting members to the commission, while lawmakers of both parties will appoint eight members to serve in non-voting positions.
In a statement, Leavitt said he looks forward to "working with this commission in an open and bipartisan manner to reform and modernize Medicaid," a program that Leavitt said is "rigidly inflexible and inefficient, and worst of all, it is not financially sustainable."
Sen. Jeff Bingaman, D-N.M., said Friday Leavitt's panel was not what he had in mind when he proposed legislation along with Sen. Gordon H. Smith, R-Ore., to create a bipartisan commission to recommended changes to Medicaid. Bingaman and Smith were among the lawmakers who wrote to Leavitt with specifics about the Medicaid commission.
"We already know the Bush administration supports deep cuts in Medicaid, and it concerns me that the Health and Human Services secretary will be appointing all of the voting members of the panel," Bingaman said in a statement. "I had hoped for a commission that could produce a report that both sides of the aisle could buy into. I have serious doubts about whether that will happen under this scenario."
Rep. John D. Dingell, D-Mich., another lawmaker who had made recommendations to Leavitt, also expressed his disappointment Friday.
"The commission appears to be a fig leaf for ten billion dollars in Medicaid cuts rather than an independent and credible source of recommendations for changes in the program," he said in a statement. Dingell is the ranking member on the House Energy and Commerce Committee.
Additional requests made by Dingell, Smith, Sen. Max Baucus, D-Mont., and other lawmakers included requiring that a super-majority of panel members agree on recommendations and that all meetings be open to the public.
According to a Federal Register notice, commission meetings "shall be open to the public except when closure is specifically allowed by statute, and after all regulatory requirements for doing so have been met." There will be public notice of all meetings.
Smith succeeded in March in stripping a provision from the Senate budget resolution that would have directed the Finance Committee to cut $15 billion over five years, almost all of it from Medicaid, the federal-state health care program for the poor and disabled.
In talks with the White House and Senate GOP leaders, Smith agreed to accept $10 billion in Medicaid cuts if a presidential commission was created to recommend ways to wring savings from the program without hurting beneficiaries. A Smith spokesman said the senator was traveling Friday and could not be reached for comment.
A Senate Democratic aide said that Leavitt's Medicaid commission design "didn't take a single recommendation" from members of Congress who sought to shape it.
"It would appear the secretary has ignored the priorities laid out by Sen. Baucus and Congressman Dingell," the aide said. "This clearly just doesn't pass the smell test."
The commission must submit two reports to Leavitt. The first, due Sept. 1, will outline recommendations for Medicaid to achieve $10 billion in savings during the next five years as well as "ways to begin meaningful long-term enhancements that can better serve beneficiaries," HHS stated in a news release. The first report will also consider potential performance goals for Medicaid.
The second report, due Dec. 31, 2006, will recommend ways to help ensure the long-term sustainability of Medicaid, addressing areas such as how to expand coverage to more Americans "while still being fiscally responsible" and how to provide long-term care to Americans who need it.
Voting members of the panel will include former or current governors, representatives of public policy organizations involved in major health care policy issues for families and individuals with disabilities, former or current state Medicaid directors, and federal officials who administer Medicaid programs.
The Republican and Democratic leaders of both chambers and the Senate Finance and House Energy and Commerce Committees will appoint members of Congress to serve in the non-voting positions.
That may be a tough job, the Senate aide suggested.
"What they did was the worst of all worlds, which is there's members of Congress but they don't get a vote," the aide said. "What member of Congress is going to want to serve on that panel?"