In an effort to decrease entitlement spending, the Center for Medicare and Medicaid Services (CMS) recently issued regulations that would curtail many Medicaid services and further shift costs to the states. One regulation would eliminate federal funding for various Medicaid services if they are performed by school personnel. Other regulations would cut funding for targeted case management services that help beneficiaries identify and access care and limit Medicaid coverage for the rehabilitation services that most adult beneficiaries rely on for mental health care.
On April 28, 2008, the House of Representatives passed H.R. 5613, the “Protecting the Medicaid Safety Net Act of 2008.” The bill was passed by an overwhelmingly veto-proof margin of 349-62, showing that this is an issue that affects everyone across the nation, not a partisan issue. H.R. 5613 has been placed on the calendar in the Senate and is expected to be considered in the coming weeks.
Background Notes
Although it was not designed as a mental health program, Medicaid has evolved to become an important financing vehicle for a range of mental health services for both children and adults. Medicaid covers approximately 52 million Americans—including children, older persons, individuals with disabilities, and individuals who are eligible for federally assisted income maintenance payments—with substance abuse and mental health beneficiaries representing 10 to 20% of all Medicaid beneficiaries.
Reforms are needed to help Medicaid embrace its growing role in national mental health care; unfortunately, most of the recently issued regulations will subvert this effort by making the program less efficient and forcing beneficiaries to forgo needed health care.