Medicaid Fiscal Relief Q&A

The new game in DC these days seems to be naming every other bill coming out of Congress a "jobs bill."  While the provisions in each of these bills may indeed focus on job creation, it has become nearly impossible to keep the different bills straight. It becomes particularly perplexing when tracking an issue many of us have been watching: the six-month extension of increased Medicaid reimbursements that were initially part of the economic stimulus package.

Here is a Q&A to help you decipher where it stands.

Has the Senate passed an extension of Medicaid fiscal relief?
Yes. Last week, March 10th, the Senate passed HR 4213. The bill provides $26.7 billion in additional Medicaid fiscal relief funds through June 30, 2011 (the original provision was slated to expire at the end of this year). The extension would still require states accessing the funding to maintain their Medicaid eligibility and enrollment rules. The bill also extends unemployment benefits and COBRA subsidies through the end of the year.

Is this the same bill that President Obama signed today?
No. The bill that President Obama signed today does not include Medicaid fiscal relief but instead provides tax breaks to businesses hiring unemployed workers and extends infrastructure and transportation projects.

Has the House passed an extension of Medicaid fiscal relief?
Yes. In December 2009, the House passed a similar six-month extension of federal assistance for state Medicaid programs, and the "maintenance of effort requirement, as part of another "jobs bill," HR 2847.

Are there any differences between the House and Senate versions?
There is one difference between the House and Senate Medicaid fiscal relief provisions. The Senate bill includes a provision that would require Governors to affirmatively request the additional help from the federal government. There is some discussion on ways to ensure that this language does not unduly harm residents if a Governor does not want make such a declarative statement.

When will we see a final bill with the Medicaid fiscal relief provision?
The House and Senate need to reconcile their bills (which include many other provisions beyond state fiscal relief) before a final package can be sent to President Obama to be signed into law. The House could either pass the Senate bill or convene a conference committee. There is some urgency to moving this forward quickly since unemployment benefits and COBRA subsidies (included in both bills) are set to expire at the end of March. However, if Congress cannot reach agreement on a final bill before the two-week Easter recess they can pass a temporary extension of these benefits (which it has done twice before).  
 

For additional information, read CCF's analysis of the implications of the Medicaid fiscal relief on children and families.