Medicaid and Medicare

Medicaid is one of our nation's most important health care programs. It was created in 1965 as a cooperative effort between states and the federal government to provide health insurance to needy Americans, including children, pregnant women, disabled individuals and the elderly poor.

More than 40 million Americans currently depend on Medicaid coverage, including more than 20 million children, more than 4 million seniors, and more than 7 million blind or disabled individuals. Medicaid also pays for about half of the nursing home care provided in this country and helps many poor elderly with Medicaid premiums and other costs.

Chronology

Monday, October 04, 2004
Republican ‘Modernization’ Act Behind Record Increase in Medicare Premiums
An analysis by the minority staffs of the House Government Reform, Ways and Means, Energy and Commerce, and Budget Committees finds that the 2003 Medicare Modernization Act is responsible for more than half of the record increase in Medicare premiums that seniors will pay in 2005.
- Fact Sheet

Friday, September 24, 2004
CMS Urged to Reconsider Citizenship Records Requirement
Rep. Waxman, Sen. Kennedy, Sen. Bingaman, and Rep. Solis urge the Centers for Medicare and Medicaid Services to reconsider a proposal that would require hospitals seeking reimbursement to maintain records on the citizenship of patients who are undocumented immigrants.
- Letter to CMS

Thursday, July 15, 2004
HHS IG Summary Fails to Answer Critical Questions
Following the release of an HHS IG summary that consists of only a superficial recitation of limited facts, Reps. Waxman, Dingell, Rangel, Stark and Sherrod Brown ask that the acting IG and staff investigators meet with them to discuss the scope, focus, and results of their investigation into the withholding of the Medicare cost estimates.
- Letter to HHS IG

Tuesday, June 22, 2004
Failure to Investigate Withholding of Medicare Cost Estimates is Dereliction of Constitutional Duties
In a letter to Senate Majority Leader Frist and Speaker Hastert, Senate Democratic Leader Daschle, House Democratic Leader Pelosi, Rep. Waxman, and ten other congressional leaders call the failure to investigate the Administration’s withholding of Medicare cost estimates from Congress a gross abdication of Congress’ constitutional oversight responsibility. In a letter to the President, the members ask the President to provide complete answers to straightforward questions on his role in the matter.
- Letter to Leader Frist and Speaker Hastert
- Letter to the President

Monday, May 17, 2004
Members File Suit To Force Administration To Release Medicare Cost Estimates
All 19 members of the Government Reform Committee minority file suit against the Secretary of Health and Human Services to compel the Administration to release cost estimates prepared by the HHS Actuary during congressional consideration of Medicare reform legislation.
- Complaint: Waxman v. Thompson
- Press Release

Monday, April 26, 2004
HHS Refuses to Release Medicare Cost Estimates
All 19 minority members of the Committee write Secretary Thompson to protest HHS's obstruction of their investigation into the withholding of the cost data. The members officially expand their Seven Member request to include the communications between HHS and congressional leadership.
- Letter to HHS
- April 16 HHS Response

Wednesday, March 17, 2004
Rep. Waxman Asks for Hearings on Medicare Cost Estimates, Threatens Suit over Documents
In a letter to Chairman Davis, Rep. Waxman requests a hearing on the allegations that the HHS Actuary was told he would be fired if he shared with Congress estimates on the true costs of the Medicare prescription drug proposal. In a letter to HHS Secretary Thompson, Rep. Waxman threatens legal action under the "Seven Member Rule" if the Secretary continues to refuse to release the cost estimates.
- Letter to Chairman Davis
- Letter to HHS

Tuesday, March 02, 2004
Members Demand Information on Medicare Cost Estimates
In response to reports that the true cost of the Medicare prescription drug legislation was concealed, 19 committee members demand the release of the cost estimates prepared by the Administration during congressional consideration of the legislation.
- Letter to HHS
- Feb. 3 Letter to HHS

Tuesday, February 24, 2004
Drug Benefits CEO May Have Helped Write Medicare Law Provisions
Reps. Waxman and Sherrod Brown write HHS Secretary Thompson, OMB Director Bolten, and White House Counsel Alberto Gonzales about reports that a pharmaceutical benefits management company CEO may have helped write provisions of the recent Medicare law that govern the prescription drug card program.
- Letter to HHS

Tuesday, February 03, 2004
Administration Asked to Release Medicare Cost Estimates
Ranking Members Waxman, Rangel, and Dingell ask HHS to release cost estimates prepared by the Administration during congressional consideration of the Medicare prescription drug legislation.
- Letter to HHS

Tuesday, July 23, 2002
Administration's Changes Undermine Medical Privacy Rule
Six members write Health and Human Services Secretary Tommy Thompson with questions on the Administration's proposed changes to the medical privacy rule, including the creation of a broad loophole through which drug companies could access patient health records without patient permission.
- Letter to Secretary Thompson

Wednesday, May 15, 2002
HHS Letter: CDC to Guide Lead Screening Policy
In response to an April 17 letter from Rep. Waxman and other members, HHS Secretary Thompson has promised to be guided by the experts at CDC in determining policies for testing children for lead poisoning, rejecting an ill-advised proposal to end universal screening under Medicaid for lead poisoning.
- May 15 Letter to Secretary Thompson
- May 14 Letter to Rep. Waxman
- April 17 Letter to Secretary Thompson

Monday, March 18, 2002
New Mexico Youth Incarcerated Due to Lack of Treatment Services
Senator Jeff Bingaman, Rep. Tom Udall, and Rep. Waxman released a report revealing that hundreds of New Mexico youth suffering from mental health problems were incarcerated in juvenile detention centers because treatment spots were not available. The report finds that from January to December 2001, an estimated 718 youth were collectively incarcerated for 31.3 years even after being cleared to leave to obtain mental health services. Inadequate federal oversight of the state's Medicaid program is a key cause of this problem.
- The Report

Monday, March 04, 2002
Preserving Financial Protections in Medicare
On March 4, Rep. Waxman, along with Rep. Sherrod Brown, Rep. Pete Stark, Rep. Ben Cardin, and Sen. Dick Durbin, wrote to Secretary Tommy Thompson with concerns about the growing number of "concierge" physician practices that are charging seniors annual membership fees. Secretary Thompson wrote back that these practices do not necessarily violate Medicare billing laws. On May 16, Rep. Waxman became an original co-sponsor of H.R. 4752, which would bar membership fees to Medicare patients.
- Bill Text: H.R. 4752
- Letter to Secretary Thompson
- Secretary Thompson's Response

Monday, August 13, 2001
Medicaid Managed Care Protections
On August 13, Rep. Waxman, along with Reps. John Dingell and Sherrod Brown, sent a letter to President Bush regarding the Administration´s attempts to undermine key measures to protect against managed care abuses. On August 2, President Bush publicly endorsed H.R. 2563, a patient rights bill that calls for the same patient protections for patients covered by Medicaid as for those with privately insurance. However, just two weeks later, on August 16, the Administration moved to delay and weaken patient rights in the Medicaid program. Rep. Waxman, along with Reps. John Dingell and Sherrod Brown, exposed this glaring contradiction in a letter to President Bush. Reps. Waxman, Dingell, and Brown prepared a comparison between H.R. 2563 and pending Medicaid patient protections.
- Letter to the President
- Rep. Waxman's Statement
- Minority Comments on the Medicaid Managed Care Rule
- Comparison Between H.R. 2563 and Pending Medicaid Patient Protections

Sunday, July 01, 2001
Children's Access to Health Screening Services
At the request of Reps. Waxman and Dingell, the General Accounting Office (GAO) investigated the extent to which children in Medicaid are receiving important health screening and other preventive services. In July 2001, GAO reported that many children are not receiving the services required by law and that managed care plans participating in Medicaid do a poor job of providing data to states and the federal government about the provision of these required services.
- GAO Report

Friday, February 16, 2001
Medicaid Drug Price Manipulation
At Rep. Waxman's request, the Inspector General of HHS and the Special Investigations Division have examined allegiations allegations that drug companies have circumvented the requirement that they provide the Medicaid program with rebates based on their “best” or lowest drug prices. In February 2000, at Rep. Waxman’s request, the Inspector General (IG) of HHS and the Special Investigations Division completed an initial investigation of allegations that drug companies have circumvented the requirement that they provide the Medicaid program with rebates based on their “best” or lowest drug prices. The IG examined a small sample of drugs and found that drug companies avoided providing Medicaid with significant rebates by allowing certain favored customers to “repackage” the drugs before use. The IG found that when a drug company used this practice in the sale of just one drug, state and federal taxpayers lost over $24 million in one year. In March 2001, the Office of the Inspector General of HHS forwarded Rep. Waxman the results of an expanded investigation of drug company repackaging schemes. This investigation examined Medicaid drug rebates for the top 200 Medicaid reimbursed drugs for 1999. The IG found that some drug manufacturers excluded sales to repackagers from their best price determinations, including sales to three HMOs. According to the IG, the exclusion of these low-price sales to HMOs cost American taxpayers over $80 million in lost rebates in 1999. In total, the two reports reveal that the Medicaid rebate program lost more than $100 million in rebates in 1998 and 1999.
- Letter to Secretary Shalala
- March 2001 IG Report
- Press Release

Friday, February 20, 1998
Children's Access to Lead Screening
At the request of Rep. Waxman, GAO investigated whether children in Medicaid receive necessary screening for lead poisoning. In February 1998, GAO found that most Medicaid children had never been screened, and that an estimated 352,000 children covered by Medicaid probably had lead poisoning that was undetected.
- GAO Report