III 109th CONGRESS 1st Session S. CON. RES. 65 IN THE SENATE OF THE UNITED STATES November 17, 2005 Mr. Burr (for himself, Mr. Obama, Mr. Bingaman, Mr. Bond, Mr. Kerry, Mr. Smith, Mr. Salazar, Mr. Schumer, Mr. Durbin, Ms. Collins, and Ms. Snowe) submitted the following concurrent resolution; which was referred to the Committee on Finance CONCURRENT RESOLUTION Recognizing the benefits and importance of federally-qualified health centers and their Medicaid prospective payment system.

Whereas community, migrant, public housing, and homeless health centers form the backbone of the health care safety net of the United States, providing health care to nearly 6,000,000 of the 53,000,000 people enrolled in the Medicaid Program nationwide; Whereas health center patients are more likely than the general population to be enrolled in Medicaid, with 36 percent of all health center patients enrolled in Medicaid compared to 12 percent nationally; Whereas in 1989, Congress established the services of the federally-qualified health center (FQHC) program as a guaranteed benefit under Medicaid to protect the valuable resources intended to assist health centers in caring for the uninsured; Whereas health centers have doubled the number of uninsured people served since 1989, a growth rate more than twice that of the uninsured population of the United States; Whereas health centers provided 17 percent of all Medicaid and State Health Insurance Program office visits in 2001; Whereas Medicaid on average contributes 36 percent of a health center's budget, with the remainder provided by Federal grants, State and local governments, Medicare, private contributions, private insurance, and patient fees; Whereas the cost of treating health center Medicaid patients is 30 to 34 percent less than the cost of treating those that receive care elsewhere, and similarly, 26 to 40 percent lower for prescription drug costs, 35 percent lower for diabetics, and 20 percent lower for asthmatics; Whereas health center Medicaid patients are 22 percent less likely to be hospitalized for conditions that were potentially avoidable than those obtaining care elsewhere; Whereas a bipartisan majority of Congress in 2000 established a prospective payment system (PPS) to ensure that federally-qualified health centers receive sufficient Medicaid funding, thereby striking a balance between protecting the Federal investment in health centers and providing State flexibility in designing the payment system for these centers; Whereas the prospective payment system has allowed States to appropriately predict and budget the cost of health center Medicaid expenditures; Whereas the prospective payment system has allowed health centers to provide and expand primary care services to more people in need, while promoting efficient operation of and ensuring adequate Medicaid reimbursement for these centers; Whereas without the assurance of sufficient Medicaid funding under the prospective payment system, health centers would be forced to cross-subsidize Medicaid underpayments with Federal grant dollars intended to care for the uninsured; Whereas if the PPS were eliminated or changed, entire communities could be left without any access to primary and preventive health care services, thus undoing decades of investment by Congress in providing a health care safety net; Whereas health centers provide cost-effective, high-quality health care to the poor of the Nation and the medically underserved, including the working poor, the uninsured, and many high-risk and vulnerable populations; and Whereas health centers act as a vital safety net in the health delivery system of the Nation, meeting escalating health needs, and reducing health disparities: Now, therefore, be it

That— (1)it is the sense of Congress that the Medicaid prospective payment system for the federally-qualified health center program is critical to ensuring that both Medicaid recipients and the uninsured population of the Nation have access to quality affordable primary and preventive care services; and (2)Congress recognizes the critical role of health centers as an essential source of health care for millions of Medicaid recipients and uninsured Americans and supports continuation of the prospective payment system in helping to maintain this system of health care.