Medicaid
Grassley-Baucus
Emergency Health Care Relief Legislation
Summary
Immediate Access to
Medicaid for Displaced Individuals: Displaced
victims need immediate access to medical care, and Medicaid, which
exists in all 50 states, is there to provide it. To ensure the fastest
possible coverage, normal documentation and eligibility requirements
would be waived and other application requirements streamlined and
simplified. Katrina survivors with incomes below federal poverty
level (twice that level for pregnant women and children) would be
eligible for Disaster Relief Medicaid, a temporary program available
for five months, with a possible five-month extension by the Secretary.
To respond to the intense need for mental health and home- and community-based
services among survivors, current state limits on these benefits
would be waived and an extended package of mental health services
would be available. To ensure continuity of care for vulnerable survivors,
states would have to provide survivors with notice and assistance
with Medicaid enrollment once their period of Disaster Relief Medicaid
ends; pregnant women would continue eligibility until 60 days after
giving birth.
- Federal Support for Affected States’ Medicaid Programs: States
affected by Hurricane Katrina (Louisiana, Mississippi and Alabama)
are suffering significant financial losses, affecting their ability
to fund critical services for their citizens. The federal government
must ensure that states can continue to provide Medicaid and SCHIP
benefits to low-income individuals. Affected states and areas should
get 100 percent federal match during this crisis to sustain Medicaid
and CHIP programs. Full federal funding would continue through December
31, 2006. Federal funding for state Medicaid programs scheduled to
drop in 2006 will be postponed for the fiscal year to ensure that
states struggling to meet the new demand for services do not lose
funds at this critical time.
- Compensation to Affected Health Providers: Health providers caring for evacuees should receive
federal add-on payments to alleviate the burden of uncompensated
care.
- Private-Coverage Assistance: Some survivors may have private job-based
coverage that will continue during this emergency period. Individuals
who want to continue their job-based coverage will be eligible for
assistance with premiums under a new Disaster Relief Fund, to be
administered by state insurance commissioners. Technical changes
will also be made to ensure that individuals who would have otherwise
been eligible for continuation coverage under COBRA or portable coverage
under HIPAA have those protections despite this emergency.
- Assistance for Medicare Beneficiaries: Hurricane Katrina has displaced hundreds of thousands
of people with Medicare who will need special help as a result. First,
the Medicare Part B late-enrollment penalty would be temporarily
suspended so that Katrina survivors are not unfairly penalized. Second,
Medicare-eligible Katrina survivors who are also eligible for Medicaid
are due to transition to the new Medicare prescription drug benefit
on January 1, 2006. The Secretary of HHS will be required to submit
to Congress by October 7 a written plan detailing how these survivors
will be informed of and transitioned to the new drug benefit program.
- Temporary Assistance for Needy Families (TANF)
Contingency Fund and Other Funds Accessible for Affected States:
(to be decided, pending resolution of House-passed
TANF package) Alabama,
Louisiana and Mississippi would have immediate access to the TANF
Contingency Fund, which currently has $2 billion for states impacted
by financial crises. Sates providing services to evacuees could
draw down from the Contingency Fund. The work and time limit rules
in TANF would be eased to ensure that families in crisis have access
to assistance immediately.
- Emergency Unemployment Compensation Extension: provides an immediate extension of unemployment
benefits for 13 weeks for individuals in Alabama, Louisiana and Mississippi who have exhausted their
unemployment benefits. These benefits will be fully paid for by the
Federal Unemployment Trust Fund.
- Ensure that Hospitals in the Disaster Areas Are
Not Penalized for a Failure to Submit Quality Data: Section 501 of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 provided acute-care
hospitals a full inflationary update if they submitted data of
10 measures of quality care. Failure to submit this would result
in a reduced update of market basket less 0.4 percentage points.
This provision would permit the Secretary to waive quality reporting
requirements for hospitals in disaster areas under Section 1135.
- Fully reimburse hospitals for Medicare bad debt. Currently, Medicare reimburses hospitals 70 percent
of the cost of co-payments and deductibles that are left unpaid by
Medicare beneficiaries. This amount should be increase to 100 percent
of allowable costs for all hospitals in public health emergency states
as well as for those hospitals outside the disaster area who treat
evacuees.
- Ensure that families who require benefits and services
as a result of Hurricane Katrina would not lose access to future
assistance. Families
who have had their lives disrupted by this disaster and who are
unable to find work because of compromised economic state infrastructures
and a lack of support services should not have their ability to
secure assistance in the future compromised.
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