[Congressional Record Volume 144, Number 11 (Thursday, February 12, 1998)]
[Senate]
[Page S766]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. FORD:
  S. 1649. A bill to exempt disabled individuals from being required to 
enroll with a managed care entity under the medicaid program; to the 
Committee on Finance.


        medicaid managed care exemption for disabled individuals

  Mr. FORD. Mr. President, today I am introducing legislation to exempt 
certain disabled individuals from mandated managed care coverage under 
Medicaid. During consideration of last year's budget legislation, this 
issue arose but was not addressed in a satisfactory manner. That 
legislation provided a broad grant of authority to states to require 
individuals eligible for Medicaid to enroll in managed care plans. 
Prior to this change, states were required to obtain waivers from the 
federal government in order to initiate such cost savings measures 
which would shift large portions of their Medicaid populations into 
managed care.
  However, states have generally not been interested in shifting 
certain categories of individuals into managed care, such as 
individuals in nursing homes or special needs children. In fact, last 
year's legislation specifically exempted certain categories of special 
needs children under age nineteen.
  Mr. President, I believe for certain categories of individuals it 
does not make sense to limit this exemption to individuals under age 
nineteen. For example, mentally retarded individuals receiving Medicaid 
benefits do not enter into a new health care category once they reach 
their nineteenth birthday. I believe limiting the exemption for such 
individuals is arbitrary and unwise policy. My legislation would simply 
remove the age limitation for severely disabled individuals.
  I want to express my thanks to the Voice of the Retarded for their 
leadership on this issue and their willingness to bring it to my 
attention. I ask unanimous consent that a letter in support of this 
legislation from that organization be inserted into the Record. I also 
want to thank Louise Underwood, a constituent of mine who has been a 
tireless advocate over the years for the rights of mentally retarded 
and other disabled individuals. It is my hope that this straightforward 
correction to last year's legislation will be viewed as 
noncontroversial, and can be enacted into law in the months ahead.
  There being no objection, the letter was ordered to be printed in the 
Record, as follows:

                                        Voice of the Retarded,

                                                 February 3, 1998.
     Hon. Wendell H. Ford,
     Senate Russell Office Building,
     Washington, DC.
       Dear Senator Ford: On behalf of all members of Voice of the 
     Retarded (VOR) nationwide, I wish to thank you for your long-
     standing attention to the many intense needs of society's 
     most-impaired people. More than any other public figure, you 
     have consistently championed the causes of those who cannot 
     speak for themselves. We, their family members and only 
     spokespersons, are eternally grateful to you.
       We come once again to seek your assistance in correcting 
     what seems to have been an unintentional oversight in the 
     language of the Balanced Budget Act of 1997.
       As you know, the ability of traditional managed care models 
     to meet the unique health care requirements of people with 
     disabilities is uncertain. Congress recognized this when it 
     exempted SSI-eligible special needs children from mandatory 
     managed care provisions of the Balanced Budget Act of 1997. 
     This exemption reconciled the states' interest in maintaining 
     cost control and flexibility in program management with the 
     disability community's concern that managed care would 
     negatively impact access to appropriate specialized health 
     care.
       It is our belief that age is an arbitrary, artificial 
     barrier to the provision of health care services. Mental 
     retardation is a life-long impairment that does not disappear 
     at age 19. We, therefore, respectfully request that you 
     support corrective legislation to ensure that adults with 
     mental retardation can receive the specialized health care 
     that they need throughout their lives unimpaired by managed 
     care.
       Thank you for your consideration.
           Sincerely,
                                                      Polly Spare,
                                                        President.
                                 ______