H.R. 5621 MEDICAID DISPROPORTIONATE SHARE (DSH) -- HON. BOBBY L. RUSH
(Extensions of Remarks - December 05, 2000)
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HON. BOBBY L. RUSH
OF ILLINOIS
IN THE HOUSE OF REPRESENTATIVES
Tuesday, December 5, 2000
- Mr. RUSH. Mr. Speaker, on November 1, 2000 I introduced H.R. 5621, the
Medicaid Disproportionate Share Hospital (DSH) Fairness Act of 2000. This
legislation is identical to a bill which was introduced last month by the
senior Senator from Illinois, with the full support of the Administration.
- In 1997, Congress enacted the Balanced Budget Act (BBA) of 1997 (P.L.
105-33). The stated intent of the legislation was to slow the rate of growth
in the Medicare program Unfortunately, the reductions enacted through the BBA
went much deeper than expected. As a result, the net and cumulative effects of
the Act have severely reduced Medicare reimbursements to hospitals and health
service providers.
- I opposed the Balanced Budget Act when it was debated by the House of
Representatives in 1997. I believed that it was a bad policy then, and believe
that it is a bad policy now.
- The BBA reductions have been particularly severe on hospitals in Illinois.
In my district, which encompasses the south and west sides of the city of
Chicago, there are eleven major hospital facilities which have been devastated
by BBA reductions. Multiply the losses across the state, and the impact on
services is staggering. In the First Session of the current Congress, I
introduced the Health Care Preservation and Accessibility Act of 1999, H.R.
3145,
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to provide relief to hospitals, community
health centers, and skilled nursing facilities harmed by the excessive
reductions of the Balanced Budget Act. Although my legislation was not
enacted, the intent of many of its provisions were included in the Medicare
Balanced Budget Refinement Act of 1999 (P.L. 106-113). That legislation helped
relieve some of the financial strain placed on hospitals and health providers.
However, while hospitals and health care providers still struggle under the
economic pressures imposed the BBA reductions, a new series of proposed
reductions threaten financial solvency.
- In May of this year, the Health Care Financing Administration (HCFA)
issued a notice to state Medicaid directors advising of its intent to revise
the Medicaid funding formula known as Intergovernmental Transfers (IGT). This
proposed rule would slash an additional $375 million a year in Medicaid
funding for Illinois--a state in which the healthcare system is already
devastated by the effects of the Balanced Budget Act--and further endanger
critical health services for children, senior citizens and the poor.
- Both the state of Illinois and Cook County have diligently and
constructively used the IGT funding to enhance the health care system,
especially for low-income, uninsured and under insured Chicagoans, over the
last 10 years. Although under the Health Care Financing Administration's
Notice of Proposed Rulemaking, the IGT program changes would be phased-in over
a 5 year period, the proposed change would severely cripple the State's
ability to provide needed health care services to Illinois citizens.
- The legislation, which I have introduced with my colleague in the Senate,
is designed to increase the Medicaid Disproportionate Share payments to all
states and encourage states to use the DSH program as it was intended--to fund
uncompensated health care. By increasing the Medicaid DSH payments, we are
acknowledging the burden placed on hospitals that treat a large number of
Medicaid and uninsured patients by the Balanced Budget Act and the proposed
HCFA regulations.
- Enactment of H.R. 5621 would allow Illinois, and all of the states, to
continue to make inroads towards ensuring that an extensive safety net of
hospitals and health care providers exist to provide care to the most
vulnerable groups of society.
- I urge my colleagues to join me in support H.R. 5621, and if this Congress
fails to act on this legislation, I hope my colleagues will join me in making
it a priority in the 107th Congress.
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