Merkley presses administration to drop Medicaid cuts

Says it could take coverage from 1 in 5 Oregonians in program

WASHINGTON (KTVZ) -- Sen. Jeff Merkley, D-Ore., demanded Thursday that the Trump administration reverse course on a proposed rule change that threatens to take away Oregon Health Plan benefits and coverage from one in five Oregonians who currently rely on the program.

The new rule proposes significant funding cuts to providers and states, he said in a news release, which continues below.

The Centers for Medicare and Medicaid Services (CMS) have admitted that the broad and complex proposed rule change, which would alter how states finance their share of Medicaid, and how state Medicaid programs will provide payments to hospitals, nursing homes, and other health care providers, will have “largely unknown” fiscal effects. 

“Based on OHA’s analysis, this proposed rule could cut approximately 60 percent of state and federal financing for Oregon’s Medicaid system,” Merkley wrote. “In order to maintain current funding with CMS’ proposed changes, Oregon would need to generate $1.3 billion per year in general fund dollars through increased state taxes.”

“If finalized, this rule would significantly undermine Oregon’s ability to finance its Medicaid program, further sabotaging health care for Oregonians and vulnerable communities. Accordingly, I request that this proposed rule be withdrawn in its entirety,” Merkley concluded.

Oregon’s Medicaid program, the Oregon Health Plan, provides comprehensive coverage to nearly one million Oregonians, including more than 300,000 individuals who gained coverage through the Affordable Care Act’s Medicaid expansion. This includes many pregnant women, newborns, nursing home residents, people with disabilities and low-income adults.

In addition to federally mandated coverage for emergency services and hospital care, Oregon provides vital health benefits through OHP such as prescription drugs, mental health services, and dental care. This proposed rule would jeopardize access to these and more services.

The letter is one of a series of recent actions taken by Senator Merkley to fight for the programs Oregonians rely on for their health care. Following President Trump’s comments signaling an openness to Social Security, Medicare, and Medicaid cuts at the World Economic Forum in Devos, Switzerland, the senator joined his Democratic colleagues in pressing the President to keep his promise to maintain the programs.  

The full text of the Senator’s letter appears below.

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January 31, 2020

RE: Proposed Rule: CMS–2393–P, Medicaid Program: Medicaid Fiscal Accountability Regulation

Dear Administrator Verma,

I write to express significant concern with the Centers for Medicare and Medicaid Services’ (CMS) proposed rule, Medicaid Fiscal Accountability Regulation (MFAR), that would affect Oregon’s Medicaid Program, the Oregon Health Plan (OHP), a critical safety net. CMS’ proposed changes would put health benefits at risk for the one in five Oregonians who are covered by Medicaid and rely on it for care.

OHP provides comprehensive coverage to nearly one million Oregonians including more than 300,000 individuals who gained coverage through the Affordable Care Act’s Medicaid expansion. In addition to federally mandated coverage for emergency services and hospital care, Oregon provides vital health benefits through OHP such as prescription drugs, mental health services, and dental care. This proposed rule would jeopardize access to these and more services.

CMS has proposed changes to how states pay their share of Medicaid costs including prohibiting states from using established and CMS-approved funding agreements, such as Oregon’s voter-approved provider taxes, and adding new limitations to inter-governmental transfers from Oregon’s teaching hospital to the Oregon Health Authority (OHA), which help fund OHP. Based on OHA’s analysis, this proposed rule could cut approximately 60 percent of state and federal financing for Oregon’s Medicaid system. In order to maintain current funding with CMS’ proposed changes, Oregon would need to generate $1.3 billion per year in general fund dollars through increased state taxes.

The complexity of the changes have made it difficult for stakeholders, beneficiaries, and advocates to fully understand the proposed rules’ potential impact. CMS’ regulatory impact analysis also states that the fiscal impact on Medicaid is “unknown.” I am concerned that CMS is moving forward with the proposed changes without fully understanding what effects the changes will have on Medicaid beneficiaries. If finalized, this proposed rule would significantly undermine Oregon’s ability to finance its Medicaid program, further sabotaging health care for Oregonians and vulnerable communities. Accordingly, I request that this proposed rule be withdrawn in its entirety.

Sincerely,