[Congressional Record (Bound Edition), Volume 151 (2005), Part 20]
[Senate]
[Pages 27099-27100]
[From the U.S. Government Publishing Office, www.gpo.gov]




     SENATE CONCURRENT RESOLUTION 65--RECOGNIZING THE BENEFITS AND 
  IMPORTANCE OF FEDERALLY-QUALIFIED HEALTH CENTERS AND THEIR MEDICAID 
                       PROSPECTIVE PAYMENT SYSTEM

  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:

                            S. Con. Res. 65

       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

[[Page 27100]]

     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
       Resolved by the Senate (the House of Representatives 
     concurring), 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.
  Mr. OBAMA. Mr. President, today, Senator Burr and I are introducing a 
resolution that reaffirms the importance of the Medicaid prospective 
payment system for federally qualified health centers.
  Federally qualified health centers--community, migrant, public 
housing, and homeless health centers--form the backbone of the Nation's 
health care safety net. FQHC's provide cost-effective, high-quality 
health care to the Nation's poor and medically underserved, including 
the working poor, the uninsured, and many high-risk and vulnerable 
populations.
  Federally qualified health centers serve nearly 1 of 5 low-income 
children. Two-thirds of health center patients are members of racial 
and ethnic minority groups. And over 675,000 homeless persons receive 
care at health centers every year.
  FQHC's play a particularly critical role in serving patients enrolled 
in Medicaid. Health centers provide care to nearly 6 million of the 53 
million people enrolled in the Medicaid Program nationwide. Thirty-six 
percent of all FQHC patients are Medicaid beneficiaries compared to 12 
percent nationally. Notably, the cost of treating Medicaid patients at 
FQHCs is about one-third less than the cost for those receiving care 
elsewhere, with drug costs alone about 25 percent lower.
  In 2000, a bipartisan majority of the Congress established a 
prospective payment system, or PPS, to ensure that FQHC's receive fair 
Medicaid reimbursement. This system strikes a balance between 
protecting Federal investment in such health centers and allowing State 
flexibility in designing the payment system for these centers. The PPS 
allows health centers to provide and expand primary care services to 
more people in need, promotes efficient operation of FQHC's, and 
ensures they receive adequate Medicaid reimbursement.
  Today, PPS has allowed health centers to provide quality health care 
to nearly 15 million people nationally, while also delivering 
significant cost savings to the Medicaid Program. Congress should 
recognize the critical role of such health centers as the primary 
source of care for millions of Medicaid recipients and uninsured 
Americans and support continuation of the prospective payment system.

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