Lawmakers spar over Medicaid bill for storm victims

Benjamin Grove

Wednesday, Sept. 28, 2005 | 10:02 a.m.

WASHINGTON -- The Senate is in the midst of an emotional spat over a Medicaid bill that pits President Bush and Sen. John Ensign on one side and Gov. Kenny Guinn and Senate Minority Leader Harry Reid on the other.

The legislation, with a price tag of roughly $8 billion, would expand Medicaid to poor hurricane victims for at least the next five months in the states where they now reside, reimbursing the states for 100 percent of Medicaid costs.

The federal government and states typically split Medicaid costs 50-50. But state leaders are arguing that the federal government should pick up the full Medicaid tab -- at least for a while -- for the hurricane victims who have taken up residence in their states.

The legislation, sponsored by Sens. Charles Grassley, R-Iowa, and Max Baucus, D-Mont., has bipartisan support and was to be considered as an amendment to a broader bill aimed at Hurricane Katrina relief.

The Grassley legislation has the support of Reid, Guinn and the National Governors Association.

"I think the need to act is very obvious," Finance Committee Chairman Grassley said in remarks Monday night as he and Baucus sought support for the legislation. "The bottom line is that this is a responsible package."

But with the backing of the White House, Ensign and a group of Republican senators have blocked the legislation. The senators balked at its cost, arguing that the money could come out of the $62 billion Congress has already allocated for Katrina relief.

"We as a Congress need to get a better handle on the money being spent," Ensign said during floor debate Monday. "We have an obligation to those affected by the hurricane as well as to those Americans we are asking to help pay the costs of relief. We must ensure this money is spent wisely."

Moments later Baucus said he was "astounded" by Ensign's statements. He said the $62 billion was not approved to cover Medicaid and was committed through the Federal Emergency Management Agency to contracts for projects such as road and bridge repair.

"FEMA was projects, contracts," Baucus said. "This is people. This is people's health care."

But Ensign and his allies still believe that it is possible to use some of the $62 billion for Medicaid costs, Ensign spokesman Jack Finn said Tuesday.

Ensign and five other GOP senators last week, including Sen. John McCain, of Arizona, at a press conference demanded responsible hurricane relief spending, as well as spending cut off-sets.

"We don't want to write blank checks," Finn said. "The senator is concerned we are mortgaging our children's future and not making sure that the money is being spent wisely with some accountability attached to it."

Ensign also argued that the White House has already arranged for states to get Medicaid waivers that would cover some state-incurred Medicaid expenses.

But the waivers would not guarantee states full Medicaid reimbursements, Guinn chief-of-staff Mike Hillerby said.

"We don't know how much it (waivers) would cover, but we know it would not be complete reimbursement," Hillerby said. "There are a lot of unknowns."

Nevada has taken in about 2,500 Gulf Coast hurricane victims, about 2,400 of whom are in the Las Vegas area, Hillerby said. It's not clear how many are Medicaid recipients, or how long they plan to stay in the state.

Grassley quoted surveys that suggest four in 10 hurricane victims are disabled or have chronic illnesses and six in 10 may have incomes less than $20,000.

Hillerby said state officials understand Ensign's concerns about the money being well spent, but Hillerby said the Medicaid money would not be wasted.

"We know this money is going to be spent appropriately," Hillerby said. "It's a good, tight program."

Reid said it was "laughable" that Republicans are talking about saving money by blocking Medicaid legislation that would help the "poorest of the poor" hurricane victims, when the GOP led a fight for multibillion dollar tax cuts.

"You talk about the huddled masses that we saw -- that's where the money goes," Reid said of the Grassley-Baucus legislation. "For lack of a better description, the Republicans objecting to that is pretty cold."

President Bush declared a state of emergency in Nevada earlier this month to make the state eligible for federal aid to deal with its influx of hurricane victims, but it is up to Congress in some cases to decide how much states will receive.