2020: Fitzpatrick Voted Against Disapproving Of Trump's Guidance
Allowing States To Apply For Medicaid Funding In The Form Of Capped
Block Grants. In February 2020, Fitzpatrick voted against a resolution
that would, according to Congressional Quarterly, "express the sense of
the House of Representatives that the Trump administration has taken
'illegal actions' with respect to Medicaid, including a January 2020
guidance that would allow states to apply for federal Medicaid funding
in the form of capped block grants, for services provided to able-bodied
adults under the age of 65. Under the administration plan, states would
have flexibility in determining coverage for such beneficiaries,
including to modify eligibility, require certain payments, and limit
coverage for certain prescription drugs. The resolution would state that
the administration should withdraw the guidance and that this and other
actions by the administration constitute a 'cruel attack on a program
that provides for the health and wellbeing' of vulnerable individuals.
It would also state that the administration should 'cease its campaign
to undermine and weaken Medicaid' and 'faithfully execute the law,'
including to implement the Medicaid program." The vote was on passage.
The House passed the resolution by a vote of 223-190. [House Vote 51,
2/6/20; Congressional
Quarterly, 2/6/20;
Congressional Actions,
H.Res.826]
CBPP: The Waivers Would Worsen People's Health By Taking Away
Coverage And Reducing Access To Care." According to the Center on
Budget and Policy Priorities, "The proposed waivers are a lose-lose
proposition for people with Medicaid and for states. Far from
promoting better health outcomes, as the Administration has claimed,
the waivers would worsen people's health by taking away coverage and
reducing access to care. For states, they would mean greater
financial risk, with federal funding cuts most likely to occur
during recessions, public health emergencies, and other times when
states face high demand for coverage and strain on other parts of
their budgets." [Center on Budget and Policy Priorities,
2/6/20]
CBPP: The Trump Administration Guidance Would Allow States To Take
Coverage Away From Low Income Individuals And Deny Coverage For
Prescription Drugs. According to the Center on Budget and Policy
Priorities, "The guidance would allow states to: Take coverage away
from people who don't pay premiums, even those with very low incomes
[...] Take coverage away from people who don't report enough hours
of work each month [...] End retroactive coverage [...and] Delay
coverage for new enrollees. States could also: Deny coverage for
prescription drugs [...] Impose higher copayments than Medicaid
law allows, [...and] eliminate coverage for non-emergency medical
transportation." [Center on Budget and Policy Priorities,
2/6/20]
Republicans Supported The Program, Arguing That It Gives States
Flexibility. According to The Hill, "The Trump administration and
congressional Republicans argue the program gives states
unprecedented flexibility with their Medicaid funding. Centers for
Medicare and Medicaid Services Administrator Seema Verma has made
state flexibility a priority during her tenure running the agency."
[The Hill,
2/6/20]
2017: Fitzpatrick Voted Against The FY 2018 Republican Study Committee
Budget Resolution Which In Part Called For Reauthorizing CHIP And
Combining Its Funding With Medicaid Into A Single Block Grant. In
October 2017, Fitzpatrick voted against a budget resolution that would
in part, according to Congressional Quarterly, "provide for $2.9
trillion in new budget authority in fiscal 2018. It would balance the
budget by fiscal 2023 by reducing spending by $10.1 trillion over 10
years. It would cap total discretionary spending at $1.06 trillion for
fiscal 2018 and would assume no separate Overseas Contingency Operations
funding for fiscal 2018 or subsequent years and would incorporate
funding related to war or terror into the base defense account. It would
assume repeal of the 2010 health care overhaul and would convert
Medicaid and the Children's Health Insurance Program into a single block
grant program. It would require that off budget programs, such as Social
Security, the U.S. Postal Service, and Fannie Mae and Freddie Mac, be
included in the budget." The underlying legislation was an FY 2018 House
GOP budget resolution. The House rejected the RSC budget by a vote of
139 to 281. [House Vote 555,
10/5/17; Congressional
Quarterly, 10/5/17; Congressional
Actions, H. Amdt.
455;
Congressional Actions, H. Con. Res.
71]
2017: Fitzpatrick Voted Against The American Health Care Act That
Which Would Result In 23 Million Fewer Americans With Health Insurance
By 2026, In Part By Forcing States To Either Convert Medicaid Into A
Per-Capita Capped Program Or A Block Grant. In May 2017, Fitzpatrick
voted against the American Health Care Act which would have
significantly repealed portions of the Affordable Care Act by cutting
Medicaid, cutting taxes on the rich, removing safeguard for pre-existing
conditions and defunding Planned Parenthood. The overall legislation
would have in part, also according to Congressional Quarterly, "ma[d]e
extensive changes to the 2010 health care overhaul law, by effectively
repealing the individual and employer mandates as well as most of the
taxes that finance the current system. It would [have], in 2020,
convert[ed] Medicaid into a capped entitlement that would provide[d]
fixed federal payments to states and end[ed] additional federal
funding for the 2010 law's joint federal-state Medicaid expansion. It
would prohibit federal funding to any entity, such as Planned
Parenthood, that performs abortions and receives more than $350 million
a year in Medicaid funds. [...] It would [have] allow[ed] states
to receive waivers to exempt insurers from having to provide certain
minimum benefits." The vote was on passage. The House passed the bill by
a vote of 217 to 213. The bill, in modified forms, died in the Senate.
[House Vote 256, 5/4/17;
Congressional Quarterly, 5/4/17;
Kaiser Family Foundation,
5/17;
Congressional Actions, H.R.
1628]
Legislation Would Cut Medicaid By $834 Billon Over The Next Ten
Years, Including A Roll Back Of The Medicaid Expansion. According
to the New York Times, "The House repeal bill was approved on May 4
by a vote of 217 to 213, with no support from Democrats. It would
eliminate tax penalties for people who go without health insurance
and roll back state-by-state expansions of Medicaid, which have
provided coverage to millions of low-income people. And in place of
government-subsidized insurance policies offered exclusively on the
Affordable Care Act's marketplaces, the bill would offer tax credits
of $2,000 to $4,000 a year, depending on age. [...] The bill
would reduce projected spending on Medicaid, the program for
low-income people, by $834 billion over 10 years, and 14 million
fewer people would be covered by Medicaid in 2026 --- a reduction of
about 17 percent from the enrollment expected under current law, the
budget office said." [New York Times,
5/24/17]
Legislation Would Give States The Option Of A Per-Capita Cap On
Medicaid Federal Funding Or A Block Grant; Overall Changes Would
Result In 14 Million Fewer Medicaid Enrollees. According to NPR,
Medicaid accounts for by far the biggest spending reductions under
the American Health Care Act. The bill would roll back the Medicaid
expansion instituted under the Affordable Care Act, which extended
the program to cover some Americans with incomes up to 133 percent
of the poverty line. That expansion increased enrollment by 10
million, as NPR's Alison Kodjak previously reported. Rolling back
that expansion would limit future enrollments. The AHCA would also
give states a choice: Receive Medicaid funding via either a block
grant or a per capita amount per enrollee. Together, these changes
would create major cuts in enrollment for the program: 14 million
fewer people by 2026, and $834 billion in spending cuts over a
decade." [NPR,
5/24/17]
2021: Fitzpatrick Voted For Restoring A Transition Rule Regarding The
Determination Of Payment Adjustments For Disproportionate Share
Hospitals In California. In April 2021, Fitzpatrick voted for
concurring with the Senate amendment to a bill which would, according to
Congressional Quarterly, "restore a transition rule related to
determining payment adjustments for disproportionate share hospitals in
California." The vote was on a motion to concur with the Senate
amendment to the bill. The House concurred with the Senate by a vote of
384-38, sent the bill to the President, and ultimately became law.
[House Vote 98, 4/13/21;
Congressional Quarterly,
4/13/21; Congressional Actions,
H.R.
1868]
2021: Fitzpatrick Voted Against The American Rescue Plan Act Of 2021,
Which Temporarily Increased Federal Medical Assistance Percentages For
Specific Services And Eliminated The Drug Rebate Cap Starting In 2023
For Medicaid. In March 2021, Fitzpatrick voted against concurring in
the Senate amendment to the American Rescue Plan Act of 2021 which
would, according to Congressional Quarterly, "provide for temporary
increases in federal medical assistance percentages for certain services
and eliminate the Medicaid drug rebate cap beginning in 2023." The vote
was on concurring in the Senate amendment to the bill. The House
concurred with the Senate by a vote of 220-211 and sent to the President
and ultimately the bill became law. [House Vote 72,
3/10/21; Congressional
Quarterly, 3/10/21;
Congressional Actions, H.R.
1319]
The American Rescue Plan Provided A Two-Year Incentive For
Medicaid Expansion By Providing States A 90% Federal Match For New
Coverages And An Additional 5% "For All Other Medicaid
Populations." According to Health Law, "The ARP includes a
two-year incentive for states that have not yet expanded Medicaid.
In addition to receiving a 90% federal match for newly covering the
expansion population, states would also receive an additional 5%
federal funding for all other Medicaid populations for two years.
This increase would more than pay for an expansion, providing states
financial support in challenging budget times." [Health Law,
3/12/21]
The American Rescue Plan Granted States A Five-Year Option To
Extend Post-Partum Coverage In Medicaid And Chip From 60 Days To
Twelve Months. According to Health Law, "The ARP gives states a
five-year option to provide extended post-partum coverage to
pregnant people enrolled in Medicaid and CHIP. States can extend the
current 60-day post-partum period to a full twelve months of full
Medicaid coverage." [Health Law,
3/12/21]
2019: Fitzpatrick Voted For Extending Certain Medicaid Programs
Through 2024 That Support Medicaid-Eligible Individuals With Chronic
Illnesses Transitioning Out Of Medical Institutions. In June 2019,
Fitzpatrick voted for a bill that would, according to Congressional
Quarterly, "extend through fiscal 2024 a Health and Human Services
Department state grant program to help Medicaid-eligible individuals
with chronic conditions transitioning out of health care institutions.
It would authorize for the program $417 million for fiscal 2020, $450
million annually from fiscal 2021 through fiscal 2023, and $225 million
for fiscal 2024. It would also shorten from 90 to 60 days institutional
residency requirements for program eligibility and expand application
requirements, requiring states to detail proposed use of funds,
objectives, evaluation and sustainability. Among other Medicaid-related
provisions, the bill would also extend through 2021 a demonstration
program related to community mental health clinics, extend through 2024
rules protecting the financial resources of individuals with spouses in
nursing homes, and increase from $6 million to $45.5 million annual
funds available for the HHS Medicaid Improvement Fund. Finally, it would
modify certain requirements of the Medicaid drug rebate program for
prescription drug manufacturers, including to require manufacturers to
pay rebates based on brand name drug prices as opposed to averaged
prices including generic drugs." The vote was on a motion to suspend the
rules and pass the bill. The House agreed to the motion by a vote of
371-46, and the bill later became law. [House Vote 333,
6/18/19; Congressional
Quarterly, 6/18/19;
Congressional Actions,
H.R.3253]
2017: Fitzpatrick Voted Against The GOP FY 2018 Budget Resolution,
Which Started The Process Towards Tax Reform And Called For Cutting
Medicaid By $1 Trillion. In October 2017, Fitzpatrick voted against a
budget resolution that would have, according to The Hill, "The spending
blueprint is key to Republicans' efforts to pass tax reform because it
includes instructions that will allow the plan to avoid a Democratic
filibuster. [...] The budget, meant to outline spending for the fiscal
year, was widely viewed as a mere vehicle for passing tax reform.
[...] The budget would allow the Senate GOP's tax plan to add up to
$1.5 trillion to the deficit over a decade, a proposal that has raised
concerns with fiscal hawks in the GOP. Its instructions call for the
Senate Finance Committee to report a tax bill by Nov. 13. Still, the
document outlines the Senate GOP's political vision. It maintains
spending at 2017 levels for the year, but would then cut nondefense
spending in subsequent years, leading to a $106 billion cut in 2027. It
would also allow defense levels to continue rising at their current
rates, reaching $684 billion at the end of a decade. The resolution
also proposes $473 billion in cuts to Medicare's baseline spending over
a decade and about $1 trillion from Medicaid, though those provisions
are not enforceable without additional legislation." The vote was on a
motion to concur in the Senate amendment. The House agreed to the
motion, thereby agreeing to the budget by a vote of 216 to 212. [House
Vote 589, 10/26/17; The
Hill,
10/19/17;
Congressional Actions, H. Con. Res.
71]
2017: Fitzpatrick Voted Against The House GOP FY 2018 Budget
Resolution, Which Started The Process Towards Tax Reform And Called For
$1.5 Trillion In Health Care Programmatic Cuts, Including Medicaid.
In October 2017, Fitzpatrick voted against the House GOP FY 2018 budget
resolution. According to Congressional Quarterly, "Adoption of the
concurrent resolution that would provide for $3.2 trillion in new
budget authority in fiscal 2018, not including off-budget accounts. It
would assume $1.22 trillion in discretionary spending in fiscal 2018.
It would assume the repeal of the 2010 health care overhaul law. It also
would propose reducing spending on mandatory programs such as Medicare
and Medicaid and changing programs such as the Supplemental Nutrition
Assistance Program (also known as food stamps). It would call for
restructuring Medicare into a 'premium support' system beginning in
2024. I would also require the House Ways and Means Committee to report
out legislation under the budget reconciliation process that would
provide for a revenue-neutral, comprehensive overhaul of the U.S. tax
code and would include instructions to 11 House committees to trigger
the budget reconciliation process to cut mandatory spending. The
concurrent resolution would assume that, over 10 years, base
(non-Overseas Contingency Operations) discretionary defense spending
would be increased by a total of $929 billion over the Budget Control
Act caps and non-defense spending be reduced by $1.3 trillion." The
vote was on passage. The House passed the budget resolution by a vote of
219 to 206. A modified version was later agreed to by both the House and
the Senate. [House Vote 557,
10/5/17; Congressional
Quarterly, 10/5/17; Congressional
Actions, H. Con. Res.
71]
2017: Fitzpatrick Voted Against The FY 2018 Republican Study Committee
Budget Resolution Which In Part Called For Reauthorizing CHIP And
Combining Its Funding With Medicaid Into A Single Block Grant. In
October 2017, Fitzpatrick voted against a budget resolution that would
in part, according to Congressional Quarterly, "provide for $2.9
trillion in new budget authority in fiscal 2018. It would balance the
budget by fiscal 2023 by reducing spending by $10.1 trillion over 10
years. It would cap total discretionary spending at $1.06 trillion for
fiscal 2018 and would assume no separate Overseas Contingency Operations
funding for fiscal 2018 or subsequent years and would incorporate
funding related to war or terror into the base defense account. It would
assume repeal of the 2010 health care overhaul and would convert
Medicaid and the Children's Health Insurance Program into a single block
grant program. It would require that off budget programs, such as Social
Security, the U.S. Postal Service, and Fannie Mae and Freddie Mac, be
included in the budget." The underlying legislation was an FY 2018 House
GOP budget resolution. The House rejected the RSC budget by a vote of
139 to 281. [House Vote 555,
10/5/17; Congressional
Quarterly, 10/5/17; Congressional
Actions, H. Amdt.
455;
Congressional Actions, H. Con. Res.
71]
2017: Fitzpatrick Voted Against The American Health Care Act That
Which Would Result In 23 Million Fewer Americans With Health Insurance
By 2026, In Part By Reducing Medicaid Spending By $834 Billion Over Ten
Years. In May 2017, Fitzpatrick voted against the American Health Care
Act which would have significantly repealed portions of the Affordable
Care Act by cutting Medicaid, cutting taxes on the rich, removing
safeguard for pre-existing conditions and defunding Planned Parenthood.
The overall legislation would have in part, also according to
Congressional Quarterly, "ma[d]e extensive changes to the 2010 health
care overhaul law, by effectively repealing the individual and employer
mandates as well as most of the taxes that finance the current system.
It would [have], in 2020, convert[ed] Medicaid into a capped
entitlement that would provide[d] fixed federal payments to states and
end[ed] additional federal funding for the 2010 law's joint
federal-state Medicaid expansion. It would prohibit federal funding to
any entity, such as Planned Parenthood, that performs abortions and
receives more than $350 million a year in Medicaid funds. [...] It
would [have] allow[ed] states to receive waivers to exempt insurers
from having to provide certain minimum benefits." The vote was on
passage. The House passed the bill by a vote of 217 to 213. The bill, in
modified forms, died in the Senate. [House Vote 256,
5/4/17; Congressional
Quarterly, 5/4/17; Kaiser Family
Foundation,
5/17;
Congressional Actions, H.R.
1628]
Legislation Would Cut Medicaid By $834 Billon Over The Next Ten
Years, Including A Roll Back Of The Medicaid Expansion. According
to the New York Times, "The House repeal bill was approved on May 4
by a vote of 217 to 213, with no support from Democrats. It would
eliminate tax penalties for people who go without health insurance
and roll back state-by-state expansions of Medicaid, which have
provided coverage to millions of low-income people. And in place of
government-subsidized insurance policies offered exclusively on the
Affordable Care Act's marketplaces, the bill would offer tax credits
of $2,000 to $4,000 a year, depending on age. [...] The bill
would reduce projected spending on Medicaid, the program for
low-income people, by $834 billion over 10 years, and 14 million
fewer people would be covered by Medicaid in 2026 --- a reduction of
about 17 percent from the enrollment expected under current law, the
budget office said." [New York Times,
5/24/17]
Legislation Would Give States The Option Of A Per-Capita Cap On
Medicaid Federal Funding Or A Block Grant; Overall Changes Would
Result In 14 Million Fewer Medicaid Enrollees. According to NPR,
Medicaid accounts for by far the biggest spending reductions under
the American Health Care Act. The bill would roll back the Medicaid
expansion instituted under the Affordable Care Act, which extended
the program to cover some Americans with incomes up to 133 percent
of the poverty line. That expansion increased enrollment by 10
million, as NPR's Alison Kodjak previously reported. Rolling back
that expansion would limit future enrollments. The AHCA would also
give states a choice: Receive Medicaid funding via either a block
grant or a per capita amount per enrollee. Together, these changes
would create major cuts in enrollment for the program: 14 million
fewer people by 2026, and $834 billion in spending cuts over a
decade." [NPR,
5/24/17]
2017: Fitzpatrick Voted For The May 2017 FY 2017 Omnibus
Appropriations Bill That "Stabilized Puerto Rico's Underfunded Medicaid
Program." In May 2017, Fitzpatrick voted for the FY 2017 omnibus
appropriations bill that would keep much of the government open and
would have provided $1.16 trillion in discretionary spending. According
to a statement from Minority Leader Pelosi via Roll Call, "'The omnibus
includes vital funds to stabilize Puerto Rico's underfunded Medicaid
program, which threatened so many of our fellow Americans in Puerto
Rico,' the California Democrat wrote in a 'Dear Colleague' letter to
members of her caucus." Overall, the legislation would have, according
to Congressional Quarterly, "provide[d] $1.16 trillion in
discretionary appropriations through Sept. 30, 2017 for federal
departments and agencies covered by the remaining 11 fiscal 2017
spending bills. [...] The measure would also [have] provide[d]
$608 million for health benefits for retired coal miners, $296 million
for Medicaid payments to Puerto Rico, and $341 million to replace 40
miles of existing fencing along the southwestern border, though the
designs of the fencing must have been 'previously deployed'." The vote
was on a motion to concur in the Senate amendments. The House agreed to
the motion by a vote of 309 to 118. The Senate later also agreed to the
legislation, sending the bill to the president, who signed it into law.
[House Vote 249, 5/3/17;
Roll Call,
5/2/17;
Congressional Quarterly, 5/2/17;
Congressional Quarterly, 5/4/17;
Congressional Actions, H.R.
244]
Puerto Rico's Medicaid Funding Was Supposed To Last Through 2019,
But Might Have Been Depleted As Soon As October 2018. According to
Congressional Quarterly, "A Health and Human Services Department
report from January said Puerto Rico's Medicaid program is projected
to exhaust the last of the $6.4 billion in additional funds
allocated for fiscal 2011 through 2019 as soon as October 2018. The
agreement, therefore, provides $296 million to cover the current
expected shortfall in Puerto Rico's Medicaid program."
[Congressional Quarterly,
5/2/17]
About 50 Percent Of Puerto Rico's Residents Are On Medicaid.
According to Congressional Quarterly, "Approximately half of Puerto
Rico's 3.5 million residents rely on Medicaid, according to the
Centers for Medicare and Medicaid Services. Eligibility for the
program, which functions differently than Medicaid in the 50 states,
is determined by a special income measure called the Puerto Rico
Poverty Level." [Congressional Quarterly,
5/2/17]
2023: Fitzpatrick Voted To Require Medicaid To Cover Treatment For
Substance Use. In December 2023, according to Congressional Quarterly,
Fitzpatrick voted for "the bill, as amended, that would reauthorize,
through fiscal 2028, a number of public health programs that address
opioid use disorders and other aspects of mental health. It would modify
federal Controlled Substances Schedules by defining xylazine as a
Schedule III substance and by requiring the Health and Human Services
Department to determine if products containing a combination of
buprenorphine and naloxone should be placed on the controlled substances
schedule. The bill would also require Medicaid to permanently cover all
forms of medication-assisted treatment for opioid use disorder,
permanently lifts the Medicaid exclusion for treatment of substance use
disorder in institutions for mental diseases, and generally prohibits
states from terminating an individual's enrollment in Medicaid or CHIP
due to incarceration. Among other provisions, it would, as an offset,
permanently extend the existing rate of additional federal funding to
states for electing to apply a minimum medical loss ratio for their
Medicaid managed care organizations." The vote was on passage. The House
passed the bill by a vote of 386 to 37, thus the bill was sent to the
Senate. [House Vote 715,
12/12/23; Congressional
Quarterly, 12/12/23;
Congressional Actions, H.R.
4531]
2023: Fitzpatrick Voted For A GOP Debt Limit Package, Which Would
Expand Or Create Work Requirements For Medicaid Recipients Of The Ages
Between 19 And 55. In April 2023, according to Congressional
Quarterly, Fitzpatrick voted for the Limit, Save, Grow Act of 2023,
which would "expand or establish work requirements for Medicaid
beneficiaries aged 19 to 55." The vote was on passage. The House passed
the bill by a vote of 217 to 215, thus the bill was sent to the Senate.
[House Vote 199,
4/26/23; Congressional
Quarterly, 4/26/23;
Congressional Actions, H.R.
2811]
The Congressional Budget Office Found That The Provisions Over
Medicaid Work Requirements Would Have A "Negligible Effect" On
Getting Individuals Back To Work And Would Make States Pay For
Medicaid Coverage For About 900K People Who Would Lose Access To
Federal Fund Access. According to Congressional Quarterly, "In
response to an inquiry from House Energy and Commerce ranking member
Frank Pallone Jr., D-N.J., the CBO looked at potential impacts of
the measure's new Medicaid work requirements. The agency found that
the rules would have a 'negligible effect' on getting people back
into the workforce or boosting hours worked. The CBO also found that
states which pick up the tab for Medicaid coverage for about 900,000
individuals who'd lose access to federal funds under the provision
would have to pony up about $65 billion extra through fiscal 2033.
For roughly 600,000 people that would lose coverage, states would
save about $5 billion." [Congressional Quarterly,
4/27/23]
The Bill Would Also Require Childless Able-Bodied Adults To Work,
Volunteer Or Participate In Job Training For At Least 80 Hours
Monthly To Remain Medicaid-Eligible. According to Congressional
Quarterly, "That proposal (HR 2811) would require 'able-bodied'
adults without children to work, volunteer or participate in job
training for at least 80 hours per month to remain eligible for
Medicaid." [Congressional Quarterly,
4/27/23]