[Congressional Record (Bound Edition), Volume 151 (2005), Part 22]
[Senate]
[Page 30664]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   INDIAN HEALTH CARE IMPROVEMENT ACT

  Mr. GRASSLEY. Mr. President, I would like to explain my action today 
related to S. 1057, a bill to amend the Indian Health Care Improvement 
Act. I requested that Leader Frist inform me prior to entering into any 
unanimous consent agreement relating to any amendments, motions, or any 
other actions relating to consideration of this bill.
  This legislation exempts American Indians/Alaskan Natives from being 
charged a deductible, copayment, or coinsurance for an item or service 
for which payment may be made under the Medicaid or SCHIP programs in 
the Social Security Act. I am reluctant to treat one group differently 
from other groups. In my opinion, this is a precedent setting change. 
If we start by exempting one group from costsharing, then many other 
groups may start asking for the same exemption.
  This legislation also exempts several types of property from being 
considered in Medicaid eligibility. We understand that there may be 
special circumstances that may necessitate the need for these 
provisions. We have requested additional information from the Indian 
Affairs Committee to facilitate our understanding of these exemptions. 
However, we have not yet received the requested information. In my 
opinion, without further information, these provisions send the message 
that resources are irrelevant to a determination of Medicaid 
eligibility. I don't believe that individuals should have significant 
resources and still be eligible for Medicaid. These provisions would 
create an imbalance by allowing a loophole solely for one group.
  I want to be clear: it is not that I am concerned about making these 
changes for American Indians/Alaskan Natives, I am concerned about 
making these changes for any group. I welcome the opportunity to 
continue to work with the sponsors of this legislation, Senators McCain 
and Dorgan, and with members of the Indian Affairs Committee on this 
matter. My staff has been working with staff from the Indian Affairs 
Committee, but they have not yet resolved my concerns.

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