Bingaman Offers Medicaid
DSH Amendment to Tax Bill
May 9, 2003 - During the May 8 Senate Finance Committee
mark-up of the "Jobs and Growth Tax Act" (S.
2), Sen. Jeff Bingaman (D-N.M.) offered a Medicaid Disproportionate
Share Hospital (DSH) amendment that would have increased the
Medicaid DSH allotments of "extremely low DSH states"
from 1 percent of Medicaid spending to 3 percent of spending.
The Bingaman amendment would have affected Alaska, Ark., Del.,
Hawaii, Iowa, Idaho, Kan., Md., Minn., Mont., Neb., N.M.,
N.D., Okla., Ore., S.D., Tenn., Utah, Wis., and Wyo. The amendment
was defeated by a party line vote.
The AAMC May 7 joined the American Hospital Association,
Federation of American Hospitals, National Association of
Children's Hospitals, and National Association of Public Hospitals
and Health Systems in delivering a letter in support of the
Bingaman amendment. The Senator referenced the group letter
during the Committee markup. The amendment was based on the
AAMC-supported "Medicaid Safety Net Improvement Act)
(S.204),
which had been introduced earlier this year by Sen. Bingaman
and Sen. Michael Enzi (R-Wyo.). Financing for the amendment
(expected to cost about $300 million in FY 2004) would have
come from the $20 billion in state fiscal relief funds identified
in S. 2.
Referencing procedural concerns and plans to place Medicaid
provisions in the upcoming Medicare package, Finance Committee
Chairman Charles Grassley (R-Iowa) opposed passage of the
amendment. Several Committee members, including Gordon Smith
(R-Ore.), expressed concern about waiting for a Medicare vehicle.
Sen. Grassley ultimately offered assurances that he would
attempt to have the amendment raised during floor debate on
S. 2
Similarly, Sen. John Kerry (D-Mass.) had planned to offer
an amendment that would have (retroactively to Oct. 1, 2003)
prevented reductions to state DSH allotments scheduled in
the Balanced Budget Act of 1997 (BBA). The "Medicare,
Medicaid, and SCHIP Benefits Improvement and Protection Act
of 2000" (BIPA) had prevented BBA-related DSH reductions
until FY 2003. The Kerry amendment was based on the AAMC-supported
"Access to Hospitals Act" (S.
652), which was originally introduced by Sens. Lincoln
Chaffee (R-R.I.) and Bob Graham (D-Fla.). The AAMC May 7 joined
the American Hospital Association, Federation of American
Hospitals, National Association of Children's Hospitals, and
National Association of Public Hospitals and Health Systems
in delivering a letter of support for the amendment. However,
Sen. Kerry did not offer the amendment.
Information:
Christiane Mitchell, Senior Legislative Affairs Manager
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
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