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Administration Policy Change Threatens Health Care Coverage for Poor Infants
Revised December 11, 2006
Since 1984, federal Medicaid law has required that states provide one year of automatic Medicaid eligibility to babies whose mothers are sufficiently poor that the baby’s birth was covered by Medicaid.[2] For the past 22 years, these babies have been able to get check-ups and other health care services that can be … -
Fourteen States Face SCHIP Shortfalls This Year Totaling Over $700 Million
December 11, 2006
New estimates, based on the latest available data, show that 14 states face federal funding shortfalls this year in the State Children’s Health Insurance Program. These states lack sufficient federal funding to maintain current enrollment levels through the end of fiscal year 2007. The shortfalls in these states total more than … -
Congress Expands High-Income Tax Shelters, Drops Children’s Health Care from Final "Tax Extenders" Bill
December 7, 2006
Revise December 8, 2006 CONGRESS EXPANDS HIGH-INCOME TAX SHELTERS, DROPS CHILDREN’S HEALTH CARE FROM FINAL "TAX EXTENDERS" BILL In closed-door negotiations on the “tax extenders” package, bipartisan House and Senate negotiators added an expansion of Health Savings … -
Last-Minute Addition To Tax Package Would Make Health Savings Accounts More Attractive As Tax Shelters For High-Income Individuals
Revised December 7, 2006
As part of the last-minute deal making today on the “tax extenders” package, House and Senate negotiators have agreed to include an expansion of Health Savings Accounts that would make these accounts more lucrative as tax shelters for high-income individuals. The HSA expansion is identical to legislation (H.R. 6134) … -
New Provision in “Tax Extenders” Bill Would Make Health Savings Accounts More Attractive as Tax Shelters
December 7, 2006
In closed-door negotiations on the “tax extenders” package, bipartisan House and Senate negotiators agreed to include an expansion of Health Savings Accounts (HSAs) that would make these accounts more lucrative as tax shelters for high-income individuals. The HSA expansion, which … -
Medicaid Commission Recommendations Raise Serious Concerns
November 16, 2006
On November 8, the Medicaid commission created by the Administration last year released a “chairman’s mark” setting forth broad recommendations designed to “promote Medicaid’s long-term fiscal sustainability, while also emphasizing quality of care.” The commission will consider these recommendations at its final meeting on November 16 and 17. In … -
Medicaid Costs Are Growing More Slowly Than Costs for Medicare or Private Insurance
November 13, 2006
Are Medicaid expenditures growing “out of control”? This paper reports new data showing that Medicaid expenditures did not grow at all in fiscal year 2006 and are expected to grow only modestly in 2007. There are good reasons to be concerned about projected increases in Medicaid expenditures over the long term, since health … -
Coverage of Parents Helps Children, Too
October 20, 2006
The nation has made an important commitment to reducing the number of uninsured children. Over the past decade, the creation of the State Children’s Health Insurance Program (SCHIP) and related changes made by states in their Medicaid programs have boosted children’s enrollment and led to a marked reduction in the … -
New Developments In Health Savings Accounts
Revised September 28, 2006
On September 27, the House Ways and Means Committee approved H.R. 6134, which would make Health Savings Accounts (HSAs) more attractive as tax shelters for high-income individuals. Ways and Means Chairman Bill Thomas (R-CA) stated that the bill could be enacted before the 109th Congress adjourns. The bill is particularly disturbing … -
Is Medicaid Responsible for the Erosion of Employer-Based Health Coverage?
September 22, 2006
The Census Bureau recently reported that employer-sponsored health insurance coverage in the United States has continued to erode. Between 2000 and 2005, the percentage of Americans with job-based insurance slipped from 63.6 percent to 59.5 percent. Michael Cannon, director of health policy studies at the Cato Institute, has blamed … -
GAO Study Confirms Health Savings Accounts Primarily Benefit High-Income Individuals
September 20, 2006
A groundbreaking new study by the Government Accountability Office (GAO) demonstrates that Health Savings Accounts (HSAs) — tax-favored savings accounts attached to high-deductible health insurance plans established under the 2003 Medicare drug law — are heavily skewed toward affluent individuals. The GAO findings also … -
The Illusion of Choice: Vulnerable Medicaid Beneficiaries Being Placed In Scaled-Back “Benchmark” Benefit Packages
September 14, 2006
The Deficit Reduction Act, signed into law in February 2006, permits states to vary the benefit packages they offer to some groups of Medicaid beneficiaries.[1] States can require most children and parents to enroll in new “benchmark” benefit packages that do not provide all the benefits covered by regular Medicaid. … -
Documenting Citizenship and Identity Using Data Matches
September 1, 2006
Under the Deficit Reduction Act of 2005 (DRA), U.S. citizens must document their citizenship and identity when applying for Medicaid or renewing their coverage. The new requirement, which took effect on July 1, could jeopardize the health coverage of substantial numbers of eligible citizens who are unable to secure the required … -
The Number of Uninsured Americans Is At An All-Time High
August 29, 2006
Data released today by the Census Bureau show that the number of uninsured Americans stood at a record 46.6 million in 2005, with 15.9 percent of Americans lacking health coverage. “The number of uninsured Americans reached an all-time high in 2005,” said Robert Greenstein, executive director of the Center on Budget and … -
Budget Process Bill Would Result In Deep Cuts In Medicare and Medicaid
Revised August 9, 2006
The Senate Budget Committee has approved a bill (S. 3521) that would radically alter federal budget procedures and could lead to deep cuts over time in the vast majority of domestic programs, including Medicaid, Medicare, and SCHIP. While the odds are slim that the legislation will be considered by the full Senate this year, the … -
New HHS Regulations Focus Medicaid Documentation Requirement On U.S. Citizen Families
July 13, 2006
On July 6, the Centers for Medicare & Medicaid Services (CMS) at the U.S. Department of Health and Human Services released interim final regulations implementing a new documentation requirement for Medicaid beneficiaries.[1] (The interim final regulations supersede the CMS guidance issued to state Medicaid agencies on June 9.… -
Revised Medicaid Documentation Requirement Jeopardizes Coverage For 1 To 2 Million Citizens
July 13, 2006
The Deficit Reduction Act signed by the President in February contains a new mandate requiring the 50 million U.S. citizens who receive Medicaid coverage, as well as all future citizen applicants for Medicaid, to prove their citizenship by providing documents such as birth certificates or U.S. passports. In January, the Center on … -
Children In Foster Care May Have To Delay Health Care Because of Federal Regulations On Citizenship Requirement
July 7, 2006
Children removed from their homes because of neglect or abuse and placed in foster care may face delays in getting medical care because of the manner in which the federal government is implementing a provision of the Deficit Reduction Act (DRA) of 2005. The DRA requires that all U.S. citizens applying for, or renewing their … -
Press Release: Change In Medicaid Rules “Commendable,” But Further Changes Needed To Prevent Loss Of Health Care Coverage By Poor Children And Parents
July 7, 2006
A July 6 announcement by the Department of Health and Human Services that it will exempt 8 million elderly or disabled people from new citizenship documentation requirements for receiving Medicaid “is an important and commendable action that will prevent many vulnerable low-income citizens from losing essential health care services for which … -
Press Releease: Medicaid ID Rule Could Put Health Coverage At Risk For 3 To 5 Million U.S. Citizens Starting July 1
June 30, 2006
A new rule requiring U.S. citizens to prove their citizenship when applying for or renewing Medicaid benefits is expected to jeopardize coverage for several million qualified citizens, from elderly people in nursing homes to foster children, according to a national survey conducted by the Center on … -
Senate Budget Process Legislation Embraces "Misguided 45 Percent Trigger"
June 26, 2006
Executive Summary Major budget-process legislation approved by the Senate Budget Committee on June 20 seeks to limit the share of Medicare expenditures that are financed by general revenues. The legislation (S. 3521), crafted by Senate Budget Committee Chairman Judd Gregg (R-NH), would establish a new Senate … -
Using Information Technology To Document Citizenship In Medicaid
June 20, 2006
HHS Secretary Michael Leavitt has stated that federal programs like Medicaid should be leaders in the adoption of information technology to modernize health care systems.[1] On June 9, the Centers for Medicare and Medicaid Services (CMS) issued federal guidance with directions to states on how to implement a new requirement that … -
Hhs Guidance Will Exacerbate Problems Caused By New Medicaid Documentation Requirement
June 16, 2006
This report has been updated. You will automatically be redirected to the revised analysis posted to: http://www.cbpp.org/7-13-06health.htm. -
Administration Medicaid Rule Would Put Pressure On States To Reduce Benefits Or Eligibility Or To Lower Payments To Providers Reduce Health Care Spending
June 13, 2006
Medicaid, which provides health and long-term care insurance to more than 50 million low-income Americans, is paid for jointly by the federal government and the states. States have the option of raising some of their share of Medicaid expenditures by using revenue from taxes on hospitals, nursing homes, managed care organizations, … -
Informing The Debate About Health Savings Accounts
June 13, 2006
Click on the text of the questions below to go directly to the corresponding answer. Are there now 3.2 million HSAs in use? Do employers offering high-deductible health insurance plans and HSAs to their employees contribute to the HSAs to help their employees cover the higher out-of-pocket costs related to the high … -
Health Savings Accounts Unlikely To Significantly Reduce Health Care Spending
June 12, 2006
Proponents of Health Savings Accounts (HSAs) — tax-favored savings accounts attached to high-deductible health insurance plans — have long argued that widespread adoption of HSAs will contain health care costs substantially over time. The theory is that the high deductibles required under HSAs (at least $1,050 for … -
SCHIP Financing Update
June 5, 2006
The State Children’s Health Insurance Program (SCHIP), jointly financed by states and the federal government, provides comprehensive health insurance coverage to more than four million low-income children, most of whom would otherwise be uninsured.[1] In a prior analysis, we estimated that under current law, a number of states … -
West Virginia’s Medicaid Changes Unlikely To Reduce State Costs Or Improve Beneficiaries’ Health
May 31, 2006
The federal Deficit Reduction Act of 2005 (DRA), signed into law in February 2006, gives states new options to scale back health-care benefits for children and parents enrolled in Medicaid.[1] On May 3, 2006, West Virginia received federal approval to provide a scaled-back basic benefit package for most children and parents in its … -
Statement of Robert Greenstein, Regarding The Social Security and Medicare Trustees’ Report
May 1, 2006
Today’s report is another reminder of the serious long-term fiscal challenges the nation faces. Overall federal budget deficits will swell as the baby boom generation retires, medical costs continue their rapid ascent, and the growth of the U.S. workforce slows as a result of the aging … -
Trustees’ Report Focuses Attention On Misguided Medicare “45-Percent Trigger”
Revised May 1, 2006
The Social Security and Medicare Trustees report issued May 1 includes an estimate that the portion of Medicare funding that comes from general revenues will exceed 45 percent in 2012. This estimate is likely to be cited by some as an indication of Medicare’s growing problems, with the implication being that Medicare’s … -
Lessons From New Hampshire: Senate Health Bill Could Drive Up Health Insurance Premiums for Many Small Businesses
April 26, 2006
In early May, Senate Majority Leader Bill Frist is expected to bring to the Senate floor the “Health Insurance Marketplace Modernization and Affordability Act of 2005” (S. 1955), introduced by Senator Enzi (R-WY) and reported out of the Senate Health, Education, Labor and Pensions Committee on March 15. While the intent … -
Senate Health Bill Would Preempt States’ Small Group Rating Rules
April 26, 2006
On March 15, 2006, on a party-line vote, the Senate Health, Education, Labor and Pensions Committee reported out S. 1955, the “Health Insurance Marketplace Modernization and Affordability Act” (HIMAA), which could be brought to the Senate floor as early as the first week of May. This brief analysis examines how S. 1955 … -
The New Medicaid Citizenship Documentation Requirement
April 20, 2006
Under a new federal requirement that took effect July 1, most U.S. citizens applying for Medicaid or renewing their coverage must prove their citizenship by submitting a passport or a combination of a birth certificate and an ID. This new requirement, part of budget legislation enacted in February, … -
A Brief Overview of the Major Flaws With Health Savings Accounts
April 5, 2006
Established under the 2003 Medicare drug legislation, Health Savings Accounts (HSAs) are individual accounts in which individuals who have a high-deductible health policy can save money to pay out-of-pocket health expenses. In tax year 2006, any individual who enrolls in a health plan with a deductible of at least $1,050 for individual … -
The Slowdown In Medicaid Expenditure Growth
March 16, 2006
It is sometimes claimed that Medicaid expenditures are “out of control.” A careful analysis of recent data and projections indicates, however, that Medicaid growth has slowed considerably in the last year or so, even before the enactment of the Deficit Reduction Act of 2005. Both the Administration and the Congressional … -
Administration's Fiscal Year 2007 Budget Is Likely Still To Leave Schip Coverage For Low-Income Children In Jeopardy
Revised March 14, 2006
The State Children’s Health Insurance Program (SCHIP), jointly financed by states and the federal government, provides comprehensive health insurance coverage to more than 4 million low-income children who would otherwise be uninsured.[1] In fiscal year 2007, under current law, 18 states will have insufficient federal funding … -
President and Senate Budget Committee Embrace Misguided “45-Percent Trigger”
March 13, 2006
Both the President and the Senate Budget Committee have embraced the notion that increases in the share of Medicare expenditures that are funded by general revenues are problematic and should be limited. The President’s fiscal year 2007 budget calls for Medicare to be subject to automatic cuts in any year in which more than … -
Survey Indicates Deficit Reduction Act Jeopardizes Medicaid Coverage For 3 To 5 Million U.S. Citizens
Revised February 17, 2006
The Deficit Reduction Act signed by the President on February 8th contains a new mandate requiring U.S. citizens covered by Medicaid to prove their citizenship by submitting a birth certificate or passport (or a limited set of similar documents) or else lose their Medicaid coverage. Beginning July 1, 2006, this provision will apply … -
Administration Defense of Health Savings Accounts Rests on Misleading Use of Statistics
February 16, 2006
To encourage wider use of Health Savings Accounts (HSAs), tax-free individual accounts for health-related expenses that must be coupled with a high-deductible insurance policy, the Administration is proposing significant new HSA-related tax breaks that it estimates would cost $156 billion over ten years. Several important concerns … -
Press Release: Administration’s Health Savings Accounts Proposals Would Cause Net Increase In Number Of Uninsured
February 15, 2006
A new analysis by one of the nation’s leading health economists finds that the Administration’s proposals to expand tax breaks for Health Savings Accounts (HSAs) would cause a net increase in the number of uninsured Americans. The analysis, conducted by Jonathan Gruber of M.I.T., projects that while 3.8 million previously uninsured people would gain health coverage through HSAs as a result of the President’s proposals, 4.4 million people would … -
The Cost and Coverage Impact of the President’s Health Insurance Budget Proposals
February 15, 2006
In this analysis I report the results of my efforts to assess the impact that the President’s health insurance budget proposals on government costs and insurance coverage in the U.S. The results reported here are from the microsimulation model that I developed with the generous assistance of the Kaiser Family Foundation. I … -
The Administration’s Medicaid Proposals Would Shift Federal Costs To States
February 14, 2006
In its new budget, the Administration proposes net federal Medicaid funding cuts equal to $14 billion over the next five years and $35.5 billion over ten years through a combination of legislative changes and regulatory action. [1] These reductions follow on the heels of significant federal Medicaid cuts ($4.9 billion over five … -
Administration’s Budget Would Cut Federal Medicaid Costs By Shifting Costs To States
February 14, 2006
More than four-fifths of the Medicaid savings proposals in the Administration’s new budget would reduce federal Medicaid expenditures by shifting costs directly to the states, according to a new report from the Center on Budget and Policy Priorities. The proposals would save the federal government … -
President Greatly Reduced His Health Proposals For Lower-Income Families While Expanding Health Benefits For The More Affluent
February 8, 2006
President Bush’s budget includes $156 billion in tax cuts over the next ten years (2007-16) to promote Health Savings Accounts and associated high-deductible insurance policies, with the large majority of this money going to more affluent households. This is slightly larger than the $133 billion in tax cuts for health care that the President … -
Expansion in HSA Tax Breaks is Larger – and More Problematic – Than Previously Understood
Revised February 7, 2006
In conjunction with the State of the Union Address, the President proposed an expansion of tax breaks both for Health Savings Accounts (HSAs) and for premiums for the high-deductible insurance policies that are purchased in conjunction with HSAs. The President is proposing a large increase in the amount that can be contributed to a HSA on a … -
President's Health Care Tax Cut Proposals Are Likely To Weaken Employer-Based Health Insurance, Primarily Benefit High-Income People, and Worsen Deficits
January 31, 2006
In tonight’s State of the Union address and as part of the upcoming fiscal year 2007 budget, President Bush is expected to propose major new tax cuts related to health care.[1] Chief among them could be major expansions of Health Savings Accounts (HSAs) and a new income tax deduction for out-of-pocket medical costs. These … -
New Congressional Budget Office Estimates Indicate Millions of Low-Income Beneficiaries Would Be Harmed by Medicaid Provisions in Budget Bill
January 29, 2006
On January 27, the Congressional Budget Office issued a new analysis of the Medicaid provisions of the budget reconciliation conference agreement,[1] on which the House of Representatives is expected to vote February 1. The conference agreement, which the Senate passed 51-50 in late December with Vice President Cheney breaking the … -
New Survey Finds 3 To 5 Million Citizens’ Medicaid Coverage Jeopardized By Budget Reconciliation Bill
January 26, 2006
On February 1, the House of Representatives is scheduled to vote on the budget reconciliation agreement, which contains a little-noticed mandate requiring U.S. citizens covered by Medicaid to prove their citizenship by submitting a birth certificate or passport or lose their Medicaid coverage. … -
Press Release: South Carolina’s Revised Medicaid Plan Unlikely To Cut State’s Costs
January 11, 2006
New details contained in South Carolina’s revised proposal to replace its Medicaid program with a system of state-funded personal health accounts show the plan is unlikely to save the state money even as it deprives many beneficiaries of needed health care services, according to a new analysis by the Center on Budget and Policy Priorities. … -
Still Risky Business: South Carolina’s Revised Medicaid Waiver Proposal
January 11, 2006
On November 16, 2005, South Carolina requested federal permission to make radical changes in its Medicaid program. The request, which took the form of a proposed waiver of federal Medicaid rules, would affect more than 700,000 low-income South Carolina children, parents, and people with disabilities.[1] The November proposal revises … -
Assessing the Effects of the Budget Conference Agreement on Low-Income Families and Individuals
Revised January 9, 2006
Some Congressional leaders are claiming that the low-income provisions in the conference agreement on the budget reconciliation bill are modest and will not harm vulnerable families. Many of the legislation’s key provisions were altered behind closed doors in weekend negotiations, and the legislation was not released until after 1:00 the morning of December 19, just hours before … -
State Budgets Would Be Squeezed Under Budget Conference Agreement
Revised January 6, 2006
The budget reconciliation conference agreement which passed the Senate would have a significant impact on state budgets. The agreement includes numerous changes to low-income programs in which states share costs with the federal government, such as Medicaid, Child Support Enforcement, and TANF. On the whole, CBO estimates indicate that over the next five years, the loss to states from reductions in … -
New Requirement for Birth Certificates or Passports Could Threaten Medicaid Coverage for Vulnerable Beneficiaries
January 5, 2006
The Deficit Reduction Act, which was signed by the President on February 8th, contains a provision that would require all citizens applying for Medicaid or renewing their coverage to produce a passport or birth certificate to prove they are U.S. citizens. There would be no exceptions for any Medicaid applicants or beneficiaries, not even individuals … -
Press Release: New Documentation Rule Threatens Medicaid Coverage For Many
January 5, 2006
A bill nearing final passage in Congress that would cut programs such as Medicaid, student loans, and child support enforcement contains a little-noticed provision that would require all citizens applying for Medicaid to produce a passport or a birth certificate to prove they are U.S. citizens. The …




