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Grassley Push to Hike Medicaid Payments Is Shot Down

Amandeep Coleman
Last updated: Jul 31, 2020 | Sep 25, 2009

As we mentioned in this piece earlier this week, the reluctance of the country’s physicians to accept new Medicaid patients is a real threat to undermining the effectiveness of the Democrats’ plans to expand the low-income health coverage program. After all, what good is insurance if no one accepts it?

There’s some debate about the reasons behind that reluctance. But few dispute that the meagerness of Medicaid payments, which average 72 percent of Medicare payments, plays a decisive role.

Sen. Charles Grassley (Iowa), senior Republican on the Finance Committee, offered an amendment yesterday to encourage physician participation in Medicaid by hiking Medicaid rates to match those in Medicare. It went exactly nowhere. Importantly, however, the opposition didn’t attack the amendment on its merits, but instead went after Grassley’s funding mechanism, which would have cut insurance subsidies to families earning between 300 percent and 400 percent of the federal poverty level — a central component of the Democrats’ health reform strategy.

By killing the amendment, Grassley said in a statement, the finance panel missed “an opportunity to improve access for the poorest kids.”

It could have happened by reducing subsidies to families that in some cases earn more money than the national median income. Instead, we’re leaving the poorest kids with the Medicaid program as is, which means they’re lucky to find doctors, hospitals, and dentists to treat them. Maybe they’re covered, but if they don’t have access to treatment, that’s not an improvement on what we have today.

There will be other opportunities for Grassley to have his way. The health bill moving through the House includes a provision to match Medicare and Medicaid rates by 2012. But just as Democrats took issue with Grassley’s funding mechanism, Grassley is sure to oppose the House Democrats’ proposal, which would hike taxes on the wealthiest Americans.

This is a common theme of Washington sausage making — finding ways to pay for new policy is often tougher than finding agreement on the policy itself.

Amandeep Coleman | Amandeep had never known a moment when she wasn't reading or making up stories, having been born into a family of readers. She took out a pencil and notebook during the now-famous blizzard and started writing down one of those stories. It was there that I began my professional life. Her first book was written after several rejections and manuscripts. She is a member of many writers' organizations and has received several accolades from her peers and the publishing industry. The New Yorker recently dubbed her "America's favorite novelist".


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