Bush: No Medicare Rx Benefits for Medicaid Recipients

September 24, 2003
The Bush Administration has told Congress that it does not want to provide a Medicare drug benefit to the six millions poor elderly and disabled Americans who are now covered by the Medicaid program, The New York Times reported.

The White House position is at odds with the House of Representatives, AARP, Consumers Union, the Catholic Health Association and the National Governors Association, which have all urged that Medicare continue to provide benefits to all beneficiaries, regardless of income.

"These seniors are Medicare beneficiaries first and should be afforded equal access to a new prescription drug benefit," said Gov. Jeb Bush of Florida, the President's brother.

The Medicare program's costs are paid entirely by the federal government. Medicaid is financed by the states with some federal assistance. Severely strapped for cash, most states have been steadily trimming Medicaid spending in an attempt to balance their budgets.

By making its position known, the Bush Administration is throwing its support behind the Senate's version of a massive Medicare reform package that has been stuck in conference committee for the last several months.

Among those likely to be piqued by the Administration's position is Rep. Bill Thomas (R-Calif.), who chairs the conference committee. He favors making Medicare drug benefits available equally to all seniors, poor or not.

"They should be treated as seniors first, not as low-income first," he said.

There are about 40 million Medicare beneficiaries. Of those, about 6 million are also eligible for Medicaid because they fall below the poverty limits set by individual states. The states currently spend about $7 billion a year on prescription drugs and, in most cases, provide a more generous program than is contemplated for the general Medicare population.

The Administration says that by leaving responsibility for Medicaid with the states, it will be able to provide a better benefit package to the 34 million elderly who are not eligible for Medicaid.

Privately, Administration officials say that the cost of picking up all the Medicaid patients would be a major stumbling block to passage of a Medicare drug benefit package this year.