Medicaid and Medicare

Medicaid is one of our nation's most important health care programs. It was created in 1965 as a cooperative effort between states and the federal government to provide health insurance to needy Americans, including children, pregnant women, disabled individuals and the elderly poor.

More than 40 million Americans currently depend on Medicaid coverage, including more than 20 million children, more than 4 million seniors, and more than 7 million blind or disabled individuals. Medicaid also pays for about half of the nursing home care provided in this country and helps many poor elderly with Medicaid premiums and other costs.

Latest News

New GAO Report Reveals Continuing Problems Resolving Medicare Drug Plan Complaints and Grievances

A new GAO report released today finds that almost three years after the Part D drug program went into effect, CMS still faces significant and continuing problems resolving complaints and grievances filed by seniors and the disabled. The report was requested by Reps. Henry A. Waxman, John Dingell, Charles Rangel, Pete Stark, and Frank Pallone, and Sen. Sherrod Brown.

Committee Holds Hearing on Medicare Part D

The Committee on Oversight and Government Reform held a hearing titled, “The Medicare Drug Benefit: Are Private Insurers Getting Good Discounts for the Taxpayer?” on Thursday, July 24, 2008, in 2154 Rayburn House Office Building.

The Administration's Medicaid Regulations: State-By-State Impacts

Today Chairman Henry A. Waxman released a new report: The Administration’s Medicaid Regulations: State-by-State Impacts. The report details the state-by-state impacts of seven regulations issued by the Centers for Medicare & Medicaid Service (CMS) that would make major, wide-ranging changes in Medicaid, the nation’s largest low-income health care program.

The Administration’s Regulatory Actions on Medicaid: The Effects on Patients, Doctors, Hospitals, and States

The committee held a hearing to examine a range of regulatory changes regarding the Medicaid program that have recently been made by the Department of Health and Human Services (HHS). If all of these regulations were implemented, federal Medicaid funds to states would be cut by over $11 billion over five years.

Private Medicare Drug Plans: Seniors and Taxpayers Hurt by High Expenses, Low Rebates

A new report on the Medicare Part D program reveals that the high administrative costs of the private Part D insurers, combined with their inability to negotiate significant drug savings, will cost taxpayers and seniors $15 billion in 2007.

Medicaid Citizenship Documentation Requirements Deny Coverage to Citizens and Cost Taxpayers Millions

Today Chairman Waxman released two new analyses -- one by GAO and one by the majority staff -- that examine the impact of the Medicaid citizenship documentation requirements that went into effect in 2006. The analyses show that the requirements have caused eligible U.S. citizens to lose Medicaid coverage and have not achieved the goal of saving taxpayers money.

Alterations to the Guide to Children's Dental Care in Medicaid

A Domestic Policy Subcommittee hearing on Wednesday revealed that in 2001, the Centers for Medicare and Medicaid Services (CMS) issued a contract to update a twenty-year-old guide to Medicaid and pediatric dentistry. Between the draft in late 2001 and the guide's publication in 2004, the document was significantly changed, with major portions deleted.

Oversight Adequacy of the Pediatric Dental Program for Medicaid Eligible Children

This hearing will examine the adequacy of CMS oversight mechanisms used to evaluate the ability of Medicaid programs to ensure children’s access to dental health. Although infallible oversight will not redress the inadequacy of Medicaid administered dental care, achieving such redress is elusive without adequate oversight.

153 Members of Congress Ask HHS to Withdraw Medicaid Payment Rule

Chairman Waxman leads a large bipartisan group in requesting that the Department of Health and Human Services withdraw a proposed rule that would fundamentally alter the financing and payment arrangements of many state Medicaid programs. HHS estimates show that safety net providers would lose at least $3.8 billion in federal Medicaid payments over the next five years, undercutting emergency and trauma care capacity in many of our nation's strategic cities.

Democratic Medicare Drug Reforms Could Save Seniors Billions of Dollars

Democratic members of Congress have proposed reforms of the Medicare drug benefit that could save the average senior almost $500 per year and eliminate the donut hole, without any increased costs to the taxpayer.

HHS Misled Public about Medicare Drug Premiums; Seniors Will Pay Significantly More in 2007

The Department of Health and Human Services erred when it claimed that seniors would not face premium increases for their Medicare Part D coverage in 2007. A new analysis released by Rep. Waxman shows that for the average senior, premiums will increase by over 10%, with some seniors enrolled in the lowest-priced plans facing even larger increases.

Update: Includes Rep. Waxman's Reponse to Administrator McClellan's Statement

Drug Company Profits Soar Under Medicare Drug Plan

Today the Democratic Truth Squad released a new analysis that reveals pharmaceutical industry profits increased by over $8 billion in the first six months after the Medicare drug plan went into effect.

Rep. Waxman Requests Medicaid Documents to be Properly Posted on Website

Rep. Waxman asks that guidance letters provided to state Medicaid programs be provided on the Center for Medicare and Medicaid Services website in a format generally accessible to standard computer users.

Federal Government Red Tape Soaring Under Medicare Prescription Drug Plan

A new study released by Reps. Henry A. Waxman and Stephen F. Lynch shows that the federal paperwork burden has grown to record levels under the Bush Administration, with the new Medicare prescription drug program adding over 200 million hours of government red tape.

GAO Finds Medicare Drug Plans Fail to Accurately Answer Consumer Questions

A new GAO report finds that call centers run by private Medicare drug plans provide inaccurate and incomplete information to consumers. GAO found that in most instances, prescription plan providers were unable to accurately respond to simple questions about plan costs, low-income coverage, plan formulary procedures, and plan utilization management techniques.

Democrats Ask GAO to Examine Whether Part D Plans Employ Management Techniques

Ranking Members Dingell, Brown, Rangel, Stark, and Waxman ask GAO to look into whether Medicare Part D Prescription Drug Plans use management techniques to prevent patients from getting their medicines.

New GAO Report Finds Widespread Problems With Information Provided By Bush Administration About New Medicare Drug Benefit

Rep. Waxman, along with Reps. Dingell, Rangel, Stark, and Sherrod Brown, releases a GAO report that finds that the information provided by the Center for Medicare and Medicaid Services about the complicated new drug benefit is rife with problems. According to GAO, the federal handbooks, website, and 1-800 Medicare hotline failed to provide information that was “consistently clear, complete, accurate, and usable.”

New Medicare Drug Plans Restrict Access to Important Drugs

Rep. Waxman releases a new report finding that 97% of plans restrict access to important drugs on their formularies through the use of prior authorization, step-therapy, and quantity limits. A telephone survey of the plans finds that they fail to adequately inform seniors of these restrictions, often providing information that is conflicting or erroneous.

Fact Sheet: Comparison of Medicare Drug Price Analyses

Rep. Waxman releases a fact sheet outlining the differences between minority staff's analyses of the new Medicare drug plan prices and the analyses offered by CMS.

New Medicare Drug Plans Fail to Provide Meaningful Drug Price Discounts in the San Francisco Bay Area

At the request of Reps. Honda, Lantos, Lee, Lofgren, Miller, Pelosi, Stark, Tauscher, Thompson, and Woolsey, this report examines whether the Republican promises of low drug prices have been achieved in the San Francisco Bay Area.

New Reports Show Medicare Drug Prices Are High and Rising Rapidly

Rep. Waxman releases three new reports that show (1) Medicare drug plans have raised prices for popular brand-name drugs by more than 4% since January 1; (2) Medicare drug plans now charge 14% more for these drugs than the discredited Medicare drug cards previously charged; and (3) Medicare drug card providers negotiated negligible discounts of at most 3% to 5% from drug manufacturers. One of the three reports was prepared by GAO; it also finds that the Administration had advance warning that its systems would not be able to reconcile enrollment and eligibility data satisfactorily.

New GAO Report Raises Questions About President's Health Proposals

Rep. Waxman and Rep. Stark release a new GAO study of enrollees in Health Savings Accounts, a centerpiece of his domestic agenda. The report validates a number of concerns about the President's proposals.

Democrats Announce Bill to Get Needed Medicines for Seniors

Leader Pelosi and Reps. Waxman, Dingell, Stark, Sherrod Brown, and Marion Berry unveiled their legislation to provide emergency relief to senior citizens and people with disabilities who are having trouble navigating the new Medicare prescription drug program.

Rep. Waxman Gives Radio Address on Medicare Drug Plan Flaws

Rep. Waxman delivers the Saturday Democratic Radio Address, discussing the crisis surrounding the Medicare Prescription Drug benefit that went into effect January 1 and how the crisis could have been prevented through honest, open government.

Rep. Waxman Requests GAO Investigation Into Multi-Billion Dollar Medicare Windfall for Drug Industry

In a letter, Rep. Waxman asks GAO to investigate new evidence that the Republican-designed program will likely result in a multi-billion dollar windfall for drug manufacturers, at the expense of U.S. taxpayers.

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