Capitol Hill Update: Advocates Win Victories on Medicaid, Public Health Fund

As Congress adjourned in early October to return to the campaign trail, advocates could look back at two hard-earned legislative victories: an extension of an enhanced rate of federal funding for Medicaid; and the defeat of an amendment that would have decimated the new health reform law's Prevention and Public Health Fund.

The drive to extend an increase in federal Medicaid matching funds has been a priority of our advocacy efforts because it provides a critical link to needed mental health services for millions of low-income Americans. The American Recovery and Reinvestment Act (ARRA), enacted in February of 2009, included additional Medicaid funding for states by providing higher federal matching rates through the end of December 2010.

However, states are still facing decreased revenues and increased demand for health care assistance as wages have declined and high rates of unemployment continue. In addition, because many states' fiscal years begin in July, the increase was slated to end halfway through the 2011 cycle, leading many to consider cutting benefits and provider reimbursement rates.

To address this problem, an extension of the Medicaid funding increase through June of 2011 was included in legislation introduced in the House and Senate in May (the American Jobs and Closing Tax Loopholes Act of 2010). Anticipating these funds would be available, a number of states have incorporated the increase in their 2011 budgets.

However, the legislation faced opposition because of concerns over its cost and the impact on the deficit.

After the legislation failed to win approval in the Senate on three different occasions, a bill including $16.1 billion in Medicaid funding passed that chamber on August 5. The House returned from its summer recess to approve the bill the following week and the President later signed it into law. Although the bill scaled back the original amount of funding to win needed votes, the aid will help ensure that states can continue providing vital behavioral health care services.

A second victory occurred in September when the Senate defeated by a vote of 46-52 an amendment offered by Sen. Mike Johanns (R-Neb.) to a small business bill that would have gutted the new Prevention and Public Health Fund created under the health reform law. The Fund represents an unprecedented investment in much-needed preventive services, community level prevention and public health. It is urgently needed to address the many emerging health threats our country faces and the persistent chronic disease rates, including behavioral health conditions, which we must begin to control.

Congress is currently scheduled to return to work on November 15 for a lame duck session that could include consideration of a fiscal year 2011 Labor, Health and Human Services and Education spending bill. While neither the House nor Senate versions of that legislation are final, both include increases above the President's request for CMHS, SAMHSA and the National Institutes of Health. Your advocacy efforts are likely to be needed over the lame duck session to reject any efforts to strip away these proposed increases.