Highway Technical Corrections Act of 2007

Floor Speech

HIGHWAY TECHNICAL CORRECTIONS ACT OF 2007 -- (Senate - April 16, 2008)

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Mr. GRASSLEY. Mr. President, today the House Energy and Commerce Committee is taking up--or maybe has already taken up--consideration of a bill, H.R. 5613. This bill seeks to place a moratorium on seven Medicaid regulations until the next administration.

I know some people have concerns, because I have discussed those concerns, with these CMS Medicaid regulations. So let me be very clear that I am not unsympathetic with those concerns. I am not here to argue the regulations put forth by the administration are perfect. I have issues with some of them that I wish to see addressed.

However, the regulations do address areas where there are real problems with Medicaid. CMS is taking care of those problems, and we ought to let them move forward instead of delaying all of these Medicaid regulations at once.

As everyone knows, Medicaid is a Federal-State partnership that provides a crucial health care safety net for some very vulnerable populations, people whom we all agree we have a social responsibility to look out for--low-income seniors, the disabled, pregnant women, and children. These classes of people depend on Medicaid, and it does generally serve them well.

Medicaid is also a program with a checkered history of financial challenges that we, as fiscal conservatives--and we all brag about fiscal conservatism--ought to be concerned about, these financial challenges coming from

Medicaid, sometimes not being administered the way it should be.

Quite frankly, using the term ``fiscal challenges'' is a gentle way of putting it sometimes. A more severe way of putting it would be that Medicaid has a history in our respective States--not every State but a lot of States--of abusively pushing the limits of what should be allowed to maximize Federal dollars that we send to them under various formulas.

I am not going to devote time in my remarks today to issues of fraud and abuse in Medicaid, but that is legitimate to talk about. I will be back with that at another time. Instead, I want to focus on a very simple concept, and that simple concept is that Medicaid program integrity depends upon the setter for Medicaid services and the States and providers and ultimately beneficiaries having a clear understanding of the rules of the road. That is what we ought to expect out of any government program, that everybody knows how that program operates.

In this instance, States have not had clear guidance. In that case, they could be inappropriately spending taxpayers' dollars. Improper payments, wasteful spending--what does it do? It only increases the financial pressure on a very worthwhile safety net.

The Medicaid regulations that H.R. 5613 attempts to halt would halt all efforts by CMS to provide clear rules, rules of the road in very critical areas where there have been well-documented problems and most of those problems costing the taxpayers more money.

During the recent debate on the budget resolution, I entered into the Record a Congressional Research Service memo that showed some of the issues that exist under current law. I am not going to go into all of those issues today in detail because they are in the Record, but when CMS does not know how a State is billing for a service and States do not have clear guidance for how they should bill, neither Medicaid beneficiaries nor the taxpayers at the Federal or State levels are well served.

We should be, in fact, talking about fixing the regulations so that they better address real problems in Medicaid. But instead, the House of Representatives is trying to kick this can down the road to next year.

What does that mean for the taxpayers? H.R. 5613 spends $1.7 billion to place a short moratorium on these regulations. This is only to delay the regulations until March of next year--$1.7 billion to delay the regulations for 1 year.

I know supporters hope the next administration, whichever party that might be, whichever of the three candidates still in the race might be, will completely cancel the regulations. If these regulations were canceled, what would it cost if we tried to completely prevent these regulations from ever taking effect? It would not cost just this $1.7 billion that is going to be spent between now and next March. It would actually cost the taxpayers almost $20 billion over the next 5 years and almost $50 billion over the next 10 years.

It is absolutely a farce for anyone to argue that all of those dollars are being appropriately spent and that Congress ought to walk away from these issues. But that is what this bill, H.R. 5613, does; it walks away. Let's say it another way. It kicks the can down the road hoping the next President might walk away.

I know supporters of that bill will say they need more time. They say hey have not had enough time to study the regulations and to respond. That argument is starting to strain credibility. The public provider rule was proposed well over a year ago to study and react. The rehabilitation services rule was proposed 9 months ago for people in the House of Representatives to respond to and react.

Supporters of that bill have had plenty of time; that is, plenty of time if they wanted to make new policy. But it is obvious by these actions that their only real interest is in making these regulations go away.

This is very unfortunate because finding solutions is what we should be doing instead of kicking the can down the road. When we start talking about the integrity of the Medicaid Program, it is clarity of the rules that is most needed between the Center for Medicaid Services and our 50 States. So if you do not like the rules, that is fine, but there are tens of billions of dollars involved in this delay.

I say to my colleagues: Roll up your sleeves, or maybe I should say roll up our sleeves and let us all get to work to solve a problem that the regulations try to solve instead of kicking the can down the road. That is what we should be doing for the taxpayers. That is what we should be doing for the credibility of the Medicaid Program, a Medicaid Program that is needed, a Medicaid Program, for the most part, that serves people well. Contrariwise, putting moratoriums on all the Medicaid regulations issued by the Center for Medicaid Services is not the right answer.

I yield the floor, Mr. President, and I suggest the absence of a quorum.

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