2020: Schweikert Voted Against Disapproving Of Trump's Guidance Allowing States To Apply For Medicaid Funding In The Form Of Capped Block Grants. In February 2020, Schweikert 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: Schweikert Voted For 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, Schweikert voted for 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: Schweikert Voted For 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, Schweikert voted for 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]
2015: Schweikert Voted Against The FY 2016 Budget Resolution Which Called For Cutting And Block Granting Medicaid. In March 2015, Schweikert voted against the FY 2016 budget resolution which called for cutting and block granting Medicaid. According to Congressional Quarterly, the resolution, "assumes that the federal share of the joint federal-state Medicaid program will be converted into block grants to states and that the 2010 health care overhaul is repealed --- including its expansion of Medicaid to cover more Americans under the program, which the committee says will otherwise increase the eligible population for the program and significantly increase Medicaid costs. The committee proposes that Medicaid be combined with the State Children's Health Insurance Program (SCHIP, which is already block-granted)." The vote was on the budget resolution. The House passed the resolution 228 to 199. The budget resolution died in the Senate, but a similar concurrent resolution did pass both Houses. [House Vote 142, 3/25/15; Congressional Quarterly, 3/23/15; Congressional Actions, S. Con. Res. 11; Congressional Actions, H. Con. Res. 27]
2015: Schweikert Voted Against A FY 2016 Budget Resolution Which Called For Cutting And Block Granting Medicaid. In March 2015, Schweikert voted against a FY 2016 Budget Resolution which called for cutting and block granting Medicaid. According to Congressional Quarterly, the resolution, "assumes that the federal share of the joint federal-state Medicaid program will be converted into block grants to states and that the 2010 health care overhaul is repealed --- including its expansion of Medicaid to cover more Americans under the program, which the committee says will otherwise increase the eligible population for the program and significantly increase Medicaid costs. The committee proposes that Medicaid be combined with the State Children's Health Insurance Program (SCHIP, which is already block-granted)." The vote was on the adopting the substitute amendment. The House passed the amendment 219 to 208 and later passed the budget resolution. The budget resolution died in the Senate, but a similar concurrent resolution did pass both Houses. [House Vote 141, 3/25/15; Congressional Quarterly, 3/23/15; Congressional Actions, S. Con. Res. 11; Congressional Actions, H. Amdt. 86; Congressional Actions, H. Con. Res. 27]
2015: Schweikert Voted For A FY 2016 Budget Resolution Which Called For Cutting And Block Granting Medicaid. In March 2015, Schweikert voted for a FY 2016 Budget Resolution which called for cutting and block granting Medicaid. According to Congressional Quarterly, the resolution, "assumes that the federal share of the joint federal-state Medicaid program will be converted into block grants to states and that the 2010 health care overhaul is repealed --- including its expansion of Medicaid to cover more Americans under the program, which the committee says will otherwise increase the eligible population for the program and significantly increase Medicaid costs. The committee proposes that Medicaid be combined with the State Children's Health Insurance Program (SCHIP, which is already block-granted)." The vote was on the adopting the substitute amendment. The House rejected the amendment 105 to 319. The House later adopted a substitute amendment identical to this except for a change in defense spending and then later passed the budget resolution. The budget resolution died in the Senate, but a similar concurrent resolution did pass both Houses. [House Vote 140, 3/25/15; Congressional Quarterly, 3/23/15; Congressional Quarterly, 3/30/15; Congressional Actions, S. Con. Res. 11; Congressional Actions, H. Amdt. 85; Congressional Actions, H. Con. Res. 27]
2015: Schweikert Voted To Block Grant Medicaid At Pre-Affordable Care Act Levels As Part Of The FY 2016 Republican Study Committee Budget Resolution. In March 2015, Schweikert voted for block granting Medicaid. According to the Republican Study Committee, the budget proposes "combining Medicaid and CHIP funding into a single, streamlined block grant at the pre-Obamacare levels." The underlying budget resolution would have, according to Congressional Quarterly, "provide[d] for $2.804 trillion in new budget authority in fiscal 2016, not including off-budget accounts. The substitute would call for reducing spending by $7.1 trillion over 10 years compared to the Congressional Budget Office baseline." The vote was on the substitute amendment to a Budget Resolution. The House rejected the amendment by a vote of 132 to 294. [House Vote 138, 3/25/15; Republican Study Committee, FY 2016 Budget; Congressional Quarterly, 3/25/15; Congress.gov, H. Amdt. 83; Congressional Actions, H. Con. Res. 27]
2014: Schweikert Voted To Cut Medicaid Funding By 26 Percent In 2024 By Block Granting The Program And Limiting Future Funding, As Part Of Rep. Paul Ryan's Budget Proposal; Cuts Would Be In Addition To Those Caused By Repealing ACA. In April 2014, Schweikert voted for House Budget Committee Chairman Paul Ryan's (R-WI) proposed budget resolution covering fiscal years 2015 to 2024. According to the Center on Budget and Policy Priorities, "The Medicaid block grant proposal in the budget plan proposed by House Budget Committee Chairman Paul Ryan on April 1 would cut federal Medicaid (and the Children's Health Insurance Program, or CHIP) funding by 26 percent by 2024, because the funding would no longer keep pace with health care costs or with expected Medicaid enrollment growth as the population ages. [...] These cuts would come on top of repealing the health reform law's Medicaid expansion." The House adopted the budget resolution by a vote of 219 to 205, but the Senate did not. [House Vote 177, 4/10/14; Center on Budget and Policy Priorities, 4/4/14; Congressional Actions, H. Con. Res. 96]
2014: Schweikert Voted To Turn Medicaid Into A Block Grant, But Cuts $460 Billion More Than The Ryan Budget By Freezing The Grant Amount For 10 Years. In April 2014, Schweikert voted for the Republican Study Committee's proposed budget resolution for fiscal years 2015 to 2024. According to the Committee for a Responsible Federal Budget, "[T]he Republican Study Committee has come out with its own proposal to balance the budget in just four years. [...] The RSC budget gets its savings in a similar way to the Ryan budget, but it goes further in a number of areas. [...] Like the Ryan budget, it block grants Medicaid, but freezes the grants at FY 2015 levels for ten years, saving almost $460 billion more than Ryan's proposal." The House considered the RSC budget as a substitute amendment to House Republicans' FY 2015 budget resolution; the amendment was rejected by a vote of 133 to 291. [House Vote 175, 4/10/14; Committee for a Responsible Federal Budget, 4/9/14; Congressional Actions, H. Amdt. 615; Congressional Actions, H. Con. Res. 96]
2013: Schweikert Voted For Replacing Guaranteed Medicaid Payments To States With A Block Grant As Part Of The FY 2014 Ryan Budget. In March 2013, Schweikert voted for converting Medicaid to a block grant, as part of House Budget Committee Chairman Paul Ryan's (R-WI) proposed budget resolution covering fiscal years 2014 to 2023. According to the House Budget Committee, "The budget resolution proposes to transform Medicaid from an open-ended entitlement into a block-granted program like State Children's Health Insurance Program." The resolution passed the House by a vote of 221 to 207, but died in the Senate. [House Vote 88, 3/21/13; House Budget Committee, 3/12/13; Congressional Actions, H. Con. Res. 25]
Currently, Medicaid Is An Entitlement Program, Which Means States Have Guaranteed Funding For Part Of The Costs Of Coverage And All Who Legally Qualify Are Entitled To Medicaid Coverage. According to the Center on Budget and Policy Priorities, "Medicaid is an 'entitlement' program, which means that anyone who meets eligibility rules has a right to enroll in Medicaid coverage. It also means that states have guaranteed federal financial support for part of the cost of their Medicaid programs." [Center on Budget and Policy Priorities, 5/8/13]
Medicaid Programs Are Operated By The States With Minimum Eligibility Requirements Set By The Federal Government. According to the Center on Budget and Policy Priorities, "In order to receive federal funding, states must cover certain 'mandatory' populations: children under age 6 in families with income below 133 percent of the federal poverty line ($25,975 for a family of three in 2013); children aged 6-18 in families with income below the poverty line; pregnant women with income below 133 percent of the poverty line; parents whose income is within the state's eligibility limit for cash assistance that was in place prior to welfare reform; and most seniors and persons with disabilities who receive cash assistance through the Supplemental Security Income (SSI) program. States may also receive federal Medicaid funds for the costs of covering additional, 'optional' populations, including: pregnant women, children, and parents with income above 'mandatory' coverage income limits; seniors and persons with disabilities with income below the poverty line; and 'medically needy' people --- those whose income exceeds the state's regular Medicaid eligibility limit but who have high medical expenses (such as for nursing home care) that reduce their disposable income below the eligibility limit." [Center on Budget and Policy Priorities, 5/8/13]
Ryan's Medicare Block Grant Proposal In His FY2014 Budget Was Similar To His FY 2013 Proposal. According to The Center on Budget And Policy Priorities, "As the Congressional Budget Office concluded when it analyzed the similar Medicaid block grant proposal from last year's Ryan budget plan, 'the magnitude of the reduction in spending . . . means that states would need to increase their spending on these programs, make considerable cutbacks in them, or both.'" [Center on Budget and Policy Priorities, 5/8/13]
CRS Said That The Conversion Of Medicaid To A Block Grant "Would Make It Very Difficult For States To Maintain Their Current Medicaid Program," Potentially Leading To Reduced Payments To Providers, Benefits Cuts Or Eligibility Restrictions. According to the Congressional Research Service, "However, even with significant efficiency gains, the magnitude of the federal Medicaid spending reductions under this proposal would make it difficult for states to maintain their current Medicaid programs. As a result, states would have to weigh the impact of maintaining current Medicaid service levels against other state priorities for spending. They could choose to constrain Medicaid expenditures by reducing provider reimbursement rates, limiting benefit packages, and/or restricting eligibility. These types of programmatic changes could also affect the access to and the quality of medical care for Medicaid enrollees." The report was about Ryan's budget resolution for FY2013, which contained similar Medicaid block grant provisions. [CRS, 3/29/12]
Under Ryan's Similar FY2012 Block Grant Proposal, Estimated That Between 14 And 27 Million People Would Lose Medicaid Coverage By 2021. According to the Center on Budget and Policy Priorities, "The Urban Institute estimated that a similar Medicaid block grant proposal that Chairman Ryan included in his budget last year would lead states to drop between 14 million and 27 million people from Medicaid by 2021 (on top of the coverage losses resulting from repealing the health reform law's Medicaid expansion)." [Center on Budget and Policy Priorities, 3/20/12]
Medicaid Provided Coverage To 67 Million People In 2012, Including 32 Million Children, 19 Million Adults, 6 Million Seniors And 11 Million Disabled. According to the Center on Budget and Policy Priorities; "In 2012, Medicaid provided health coverage for 67 million low-income Americans over the course of the year, including 32 million children, 19 million adults (mostly low-income working parents), 6 million seniors, and 11 million persons with disabilities, according to Congressional Budget Office estimates." [Center on Budget and Policy Priorities, 5/8/13]
Children Account For About Half Of Medicaid Enrollees. According to the Center on Budget and Policy Priorities; "Children account for nearly half of all Medicaid enrollees but just one-fifth of Medicaid spending." [Center on Budget and Policy Priorities, 5/8/13]
2013: Schweikert Voted To Replace Guaranteed Medicaid Payments To States With A Block Grant Set at FY2014 Levels. In March 2013, Schweikert voted to support converting Medicaid to a block grant, as part of the Republican Study Committee's proposed budget resolution covering fiscal years 2014 to 2023. According to the Republican Study Committee, "The RSC proposes combining Medicaid and CHIP funding into a single, streamlined block grant at FY 2014 levels and giving states maximum flexibility to address the unique health care needs of their vulnerable citizens." The vote was on an amendment to the House budget resolution replacing the entire budget with the RSC's proposed budget; the amendment failed by a vote of 104 to 132 with 171 Democrats voting present. According to Congressional Quarterly, "Repeating a strategy from last year, 171 Democrats voted "present" to push Republicans to vote against the RSC plan to make sure it did not have enough support to replace the Ryan plan." [House Vote 86, 3/21/13; Republican Study Committee, 3/18/13; Congressional Quarterly, 3/25/13; Congressional Actions, H. Amdt. 35; Congressional Actions, H. Con. Res. 25]
The Center On Budget And Policy Priorities Estimated That A Similar Proposal In The FY2013 Republican Study Committee Budget Would Cut Medicaid Funding In Half By 2022. According to the Center on Budget and Policy Priorities, "Because the block grant would be frozen at 2012 levels and not adjust annually for increases in enrollment (e.g., as the population ages) or rising health care costs, the RSC budget would slash Medicaid funding by $1.1 trillion --- or 30 percent --- over the next ten years, relative to current law. (This does not count the loss of the substantial additional federal Medicaid funding that states would receive under the ACA to expand Medicaid but that they wouldn't receive under the RSC budget because it would repeal the ACA.) By 2022, federal funding would be 47 percent below what states would otherwise receive through Medicaid that year. These funding cuts are even larger than those required under the severe proposal to convert Medicaid to a block grant and sharply cut its funding included in the Ryan budget plan." [CBPP, 3/28/13]
Currently, Medicaid Is An Entitlement Program, Which Means States Have Guaranteed Funding For Part Of The Costs Of Coverage And All Who Legally Qualify Are Entitled To Medicaid Coverage. According to the Center on Budget and Policy Priorities, "Medicaid is an 'entitlement' program, which means that anyone who meets eligibility rules has a right to enroll in Medicaid coverage. It also means that states have guaranteed federal financial support for part of the cost of their Medicaid programs." [Center on Budget and Policy Priorities, 5/8/13]
Medicaid Programs Are Operated By The States With Minimum Eligibility Requirements Set By The Federal Government. According to the Center on Budget and Policy Priorities, "In order to receive federal funding, states must cover certain 'mandatory' populations: children under age 6 in families with income below 133 percent of the federal poverty line ($25,975 for a family of three in 2013); children aged 6-18 in families with income below the poverty line; pregnant women with income below 133 percent of the poverty line; parents whose income is within the state's eligibility limit for cash assistance that was in place prior to welfare reform; and most seniors and persons with disabilities who receive cash assistance through the Supplemental Security Income (SSI) program. States may also receive federal Medicaid funds for the costs of covering additional, 'optional' populations, including: pregnant women, children, and parents with income above 'mandatory' coverage income limits; seniors and persons with disabilities with income below the poverty line; and 'medically needy' people --- those whose income exceeds the state's regular Medicaid eligibility limit but who have high medical expenses (such as for nursing home care) that reduce their disposable income below the eligibility limit." [Center on Budget and Policy Priorities, 5/8/13]
CRS Said That The Conversion Of Medicaid To A Block Grant "Would Make It Very Difficult For States To Maintain Their Current Medicaid Program," Potentially Leading To Reduced Payments To Providers, Benefits Cuts Or Eligibility Restrictions. According to CRS, "However, even with significant efficiency gains, the magnitude of the federal Medicaid spending reductions under this proposal would make it difficult for states to maintain their current Medicaid programs. As a result, states would have to weigh the impact of maintaining current Medicaid service levels against other state priorities for spending. They could choose to constrain Medicaid expenditures by reducing provider reimbursement rates, limiting benefit packages, and/or restricting eligibility. These types of programmatic changes could also affect the access to and the quality of medical care for Medicaid enrollees." [CRS, 3/29/12]
Under Ryan's Similar FY2012 Block Grant Proposal, Estimated That Between 14 And 27 Million People Would Lose Medicaid Coverage By 2021. According to the Center on Budget and Policy Priorities, "The Urban Institute estimated that a similar Medicaid block grant proposal that Chairman Ryan included in his budget last year would lead states to drop between 14 million and 27 million people from Medicaid by 2021 (on top of the coverage losses resulting from repealing the health reform law's Medicaid expansion)." [Center on Budget and Policy Priorities, 3/20/12]
Medicaid Provided Coverage To 67 Million People In 2012, Including 32 Million Children, 19 Million Adults, 6 Million Seniors And 11 Million Disabled. According to the Center on Budget and Policy Priorities; "In 2012, Medicaid provided health coverage for 67 million low-income Americans over the course of the year, including 32 million children, 19 million adults (mostly low-income working parents), 6 million seniors, and 11 million persons with disabilities, according to Congressional Budget Office estimates." [Center on Budget and Policy Priorities, 5/8/13]
Children Account For About Half Of Medicaid Enrollees. According to the Center on Budget and Policy Priorities; "Children account for nearly half of all Medicaid enrollees but just one-fifth of Medicaid spending." [Center on Budget and Policy Priorities, 5/8/13; Congressional Quarterly, 3/25/13]
2015: Schweikert Voted Against Cutting Medicaid By About $500 Billion Over Ten Years, $1.35 Trillion Relative To Current Law By Including Obamacare Reductions As Part Of The FY 2016 Conference Report Budget Resolution. In April 2015, Schweikert voted against cutting Medicaid by about $500 billion over ten years as part of the FY 2016 conference report budget resolution. According to the Center for Budget and Policy Priorities, "The budget agreement would also deeply cut the rest of Medicaid. While it doesn't clearly say by how much, the cut appears to be roughly $500 billion (or about 13 percent) over ten years. (The total Medicaid cut, including repeal of the Medicaid expansion, would be about $1.35 trillion, relative to current law, over that period.)." The vote was on the Conference Report; the Conference Report passed by a vote of 226 to 197. The Senate also passed the budget resolution. [House Vote 183, 4/30/15; Center for Budget and Policy Priorities, 5/1/15; Congressional Actions, S. Con. Res. 11]
Budget Also Calls For Unspecified Reforms, Possibly Block Granting Medicaid. According to the Conference Report, "The agreement accommodates legislation from the committees of jurisdiction in the House and Senate to continue to develop health care solutions that lower costs and improve access to care. It envisions Medicaid reform, based on a framework proposed by the chairmen of the committees of jurisdiction in the House and the Senate, to modernize and improve the program while increasing State flexibility and protecting the most vulnerable populations." [Conference Report, 4/29/15]
Chairman Of Committees Of Jurisdiction Have Called For A Block Grant Or Per-Capita Grant. According to the Center for Budget and Policy Priorities, "Nor does the agreement clearly specify how this cut would be achieved, stating only that it envisions Medicaid proposals supported by the chairmen of the Senate Finance and House Energy and Commerce Committees, which have jurisdiction over the program. Those chairmen, Senator Orrin Hatch and Rep. Fred Upton, have proposed to fundamentally restructure Medicaid by capping federal funding through block grants or a 'per capita cap.'" [Center for Budget and Policy Priorities, 5/1/15]
Currently, Medicaid Is An Entitlement Program, Which Means States Have Guaranteed Funding For Part Of The Costs Of Coverage And All Who Legally Qualify Are Entitled To Medicaid Coverage. According to the Center on Budget and Policy Priorities, "Medicaid is an 'entitlement' program, which means that anyone who meets eligibility rules has a right to enroll in Medicaid coverage. It also means that states have guaranteed federal financial support for part of the cost of their Medicaid programs." [Center on Budget and Policy Priorities, 5/8/13]
Medicaid Programs Are Operated By The States With Minimum Eligibility Requirements Set By The Federal Government. According to the Center on Budget and Policy Priorities, "In order to receive federal funding, states must cover certain 'mandatory' populations: children under age 6 in families with income below 133 percent of the federal poverty line ($25,975 for a family of three in 2013); children aged 6-18 in families with income below the poverty line; pregnant women with income below 133 percent of the poverty line; parents whose income is within the state's eligibility limit for cash assistance that was in place prior to welfare reform; and most seniors and persons with disabilities who receive cash assistance through the Supplemental Security Income (SSI) program. States may also receive federal Medicaid funds for the costs of covering additional, 'optional' populations, including: pregnant women, children, and parents with income above 'mandatory' coverage income limits; seniors and persons with disabilities with income below the poverty line; and 'medically needy' people --- those whose income exceeds the state's regular Medicaid eligibility limit but who have high medical expenses (such as for nursing home care) that reduce their disposable income below the eligibility limit." [Center on Budget and Policy Priorities, 5/8/13]
The Congressional Research Service Said Of Rep. Ryan's FY 2013 Medicaid Block Grant "Option" That The Conversion "Would Make It Very Difficult For States To Maintain Their Current Medicaid Program," Potentially Leading To Reduced Payments To Providers, Benefits Cuts Or Eligibility Restrictions. According to the Congressional Research Service, "Another 'illustrative policy option' included in the House Budget Committee report (H.Rept. 112-421) is restructuring Medicaid from an individual entitlement program to a block grant program. Few details are available regarding the specific design of the proposed block grant. The proposal indicates that (1) federal funding to states would increase annually according to inflation (CPI-U) and population growth, and (2) states would be provided additional flexibility to design and administer their Medicaid programs. [...] According to CBO, the implications of converting Medicaid to a block grant program would depend on how states respond to the change. With the added flexibility provided under Chairman Ryan's proposal, states could improve the efficiency of their Medicaid programs. However, even with significant efficiency gains, the magnitude of the federal Medicaid spending reductions under this proposal would make it difficult for states to maintain their current Medicaid programs. As a result, states would have to weigh the impact of maintaining current Medicaid service levels against other state priorities for spending. They could choose to constrain Medicaid expenditures by reducing provider reimbursement rates, limiting benefit packages, and/or restricting eligibility. These types of programmatic changes could also affect the access to and the quality of medical care for Medicaid enrollees." [CRS Report #42441, 3/29/12]
Medicaid Provided Coverage To 67 Million People In 2012, Including 32 Million Children, 19 Million Adults, 6 Million Seniors And 11 Million Disabled. According to the Center on Budget and Policy Priorities; "In 2012, Medicaid provided health coverage for 67 million low-income Americans over the course of the year, including 32 million children, 19 million adults (mostly low-income working parents), 6 million seniors, and 11 million persons with disabilities, according to Congressional Budget Office estimates." [Center on Budget and Policy Priorities, 5/8/13]
Children Account For About Half Of Medicaid Enrollees. According to the Center on Budget and Policy Priorities; "Children account for nearly half of all Medicaid enrollees but just one-fifth of Medicaid spending." [Center on Budget and Policy Priorities, 5/8/13]
2015: Schweikert Voted Against The FY 2016 Budget Resolution Which Called For Cutting And Block Granting Medicaid. In March 2015, Schweikert voted against the FY 2016 budget resolution which called for cutting and block granting Medicaid. According to Congressional Quarterly, the resolution, "assumes that the federal share of the joint federal-state Medicaid program will be converted into block grants to states and that the 2010 health care overhaul is repealed --- including its expansion of Medicaid to cover more Americans under the program, which the committee says will otherwise increase the eligible population for the program and significantly increase Medicaid costs. The committee proposes that Medicaid be combined with the State Children's Health Insurance Program (SCHIP, which is already block-granted)." The vote was on the budget resolution. The House passed the resolution 228 to 199. The budget resolution died in the Senate, but a similar concurrent resolution did pass both Houses. [House Vote 142, 3/25/15; Congressional Quarterly, 3/23/15; Congressional Actions, S. Con. Res. 11; Congressional Actions, H. Con. Res. 27]
2015: Schweikert Voted Against A FY 2016 Budget Resolution Which Called For Cutting And Block Granting Medicaid. In March 2015, Schweikert voted against a FY 2016 Budget Resolution which called for cutting and block granting Medicaid. According to Congressional Quarterly, the resolution, "assumes that the federal share of the joint federal-state Medicaid program will be converted into block grants to states and that the 2010 health care overhaul is repealed --- including its expansion of Medicaid to cover more Americans under the program, which the committee says will otherwise increase the eligible population for the program and significantly increase Medicaid costs. The committee proposes that Medicaid be combined with the State Children's Health Insurance Program (SCHIP, which is already block-granted)." The vote was on the adopting the substitute amendment. The House passed the amendment 219 to 208 and later passed the budget resolution. The budget resolution died in the Senate, but a similar concurrent resolution did pass both Houses. [House Vote 141, 3/25/15; Congressional Quarterly, 3/23/15; Congressional Actions, S. Con. Res. 11; Congressional Actions, H. Amdt. 86; Congressional Actions, H. Con. Res. 27]
2015: Schweikert Voted For A FY 2016 Budget Resolution Which Called For Cutting And Block Granting Medicaid. In March 2015, Schweikert voted for a FY 2016 Budget Resolution which called for cutting and block granting Medicaid. According to Congressional Quarterly, the resolution, "assumes that the federal share of the joint federal-state Medicaid program will be converted into block grants to states and that the 2010 health care overhaul is repealed --- including its expansion of Medicaid to cover more Americans under the program, which the committee says will otherwise increase the eligible population for the program and significantly increase Medicaid costs. The committee proposes that Medicaid be combined with the State Children's Health Insurance Program (SCHIP, which is already block-granted)." The vote was on the adopting the substitute amendment. The House rejected the amendment 105 to 319. The House later adopted a substitute amendment identical to this except for a change in defense spending and then later passed the budget resolution. The budget resolution died in the Senate, but a similar concurrent resolution did pass both Houses. [House Vote 140, 3/25/15; Congressional Quarterly, 3/23/15; Congressional Quarterly, 3/30/15; Congressional Actions, S. Con. Res. 11; Congressional Actions, H. Amdt. 85; Congressional Actions, H. Con. Res. 27]
2013: Schweikert Voted For Cutting Over $800 Brillion In Medicaid Spending Over Ten Years As Part Of The FY 2014 Ryan Budget. In March 2013, Schweikert voted for cutting $2.6 trillion in Medicaid spending over ten years, as part of House Budget Committee Chairman Paul Ryan's (R-WI) proposed budget resolution covering fiscal years 2014 to 2023. According to the Center on Budget and Policy Priorities, "The plan shows Medicaid cuts of $810 billion, plus savings of $1.8 trillion from repealing the health reform law's Medicaid expansion and its subsidies to help low- and moderate-income people purchase health insurance." The resolution passed the House by a vote of 221 to 207, but died in the Senate. [House Vote 88, 3/21/13; CBPP, 3/15/13; Congressional Actions, H. Con. Res. 25]
2021: Schweikert Voted Against Restoring A Transition Rule Regarding The Determination Of Payment Adjustments For Disproportionate Share Hospitals In California. In April 2021, Schweikert voted against 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: Schweikert 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, Schweikert 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: Schweikert Voted For Extending Certain Medicaid Programs Through 2024 That Support Medicaid-Eligible Individuals With Chronic Illnesses Transitioning Out Of Medical Institutions. In June 2019, Schweikert 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: Schweikert Voted For The GOP FY 2018 Budget Resolution, Which Started The Process Towards Tax Reform And Called For Cutting Medicaid By $1 Trillion. In October 2017, Schweikert voted for 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: Schweikert Voted For 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, Schweikert voted for 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: Schweikert Voted For 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, Schweikert voted for 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: Schweikert Voted For 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, Schweikert voted for 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: Schweikert Voted Against The May 2017 FY 2017 Omnibus Appropriations Bill That "Stabilized Puerto Rico's Underfunded Medicaid Program." In May 2017, Schweikert voted against 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: Schweikert Voted To Require Medicaid To Cover Treatment For Substance Use. In December 2023, according to Congressional Quarterly, Schweikert 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: Schweikert 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, Schweikert 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]