House votes 349-62 to approve legislation that would block new Medicaid regulations

Despite a veto threat from the White House, the House on Wednesday voted 349-62 to approve legislation (HR 5613) that would place a one-year moratorium on seven new Medicaid regulations, the AP/Houston Chronicle reports (Abrams, AP/Houston Chronicle, 4/24).

The legislation would delay implementation of the regulations until April 1, 2009. Under the regulations, proposed by the Bush administration, states could not use federal Medicaid funds to help pay for physician training. The regulations also would place new limits on Medicaid reimbursements to hospitals and nursing homes operated by state and local governments and limit coverage of rehabilitation services for individuals with disabilities and mental illnesses. In addition, the bill would provide $25 million annually for efforts to fight Medicaid fraud (Kaiser Daily Health Policy Report, 4/23).

The measure received about 75 more votes than the two-thirds necessary to override a veto, the Washington Times reports (Lengell, Washington Times, 4/24). According to CongressDaily, "The overwhelming House vote indicates that Republicans who oppose the one-year delay in the Senate might have a difficult time holding back its momentum" (Edney/Johnson, CongressDaily, 4/24). Some Senate Republicans are "eager to avoid any loss in federal funding for Medicaid," but other Republicans "say the new regulations should go forward," CQ Today reports (Stern/Armstrong, CQ Today, 4/23). House Democrats also are considering adding language that mirrors the legislation into a war-funding bill, although some Democrats oppose including domestic spending in the measure, CQ Today reports (Clarke, CQ Today, 4/23).

A Congressional Budget Office cost estimate found that a one-year delay in the rules would cost $1.7 billion (Washington Times, 4/24). The Bush administration says the regulations are necessary to stop states from improperly billing Medicaid for services. HHS spokesperson Kevin Schweers said the House vote "is a victory for budget gimmickry at the expense of U.S. taxpayers," adding, "The legislation invites states to bill federal taxpayers for what are state responsibilities" (Zhang, Wall Street Journal, 4/24).