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

Rep. Waxman Holds Briefing on Medicare Drug Benefit

Rep. Waxman hosts a briefing to examine how the new Medicare drug benefit is working. Medicare beneficiaries, doctors, and pharmacists, as well as state health officials, testify about their experiences with the benefit's implementation.

HHS Misleading Claim on Medicare Drug Plan Enrollment

Today, the Bush Administration released information on enrollment in the new Medicare prescription drug program. In a letter to Administrator McClellan, Rep. Waxman asks several serious questions about the extent to which the program is functioning as planned.

New Reports Find Major Flaws in Medicare Drug Card Program

Two new GAO reports released by Rep. Waxman show that the Bush Administration failed in implementing and enforcing virtually every aspect of the Medicare drug card program, calling into question the ability of the Administration to oversee the vastly more complicated Medicare drug benefit.

New Medicare Drug Plans Fail to Provide Meaningful Drug Discounts

A new report by Rep. Waxman shows that the drug prices offered by ten leading Medicare drug plans are over 80% higher than federally negotiated prices and over 60% higher than Canadian prices. The Medicare drug plan prices are even higher than the prices available from Drugstore.com and Costco stores.

Lax Oversight of Medicaid Drug Pricing Costs Millions

Rep. Waxman releases a new GAO study that shows that the federal agency responsible for Medicaid has failed to ensure that the program get the "best possible" prices from prescription drug manufacturers, as required under law.

Republican "Modernization" Act Behind Record Increase in Medicare Premiums

An analysis by the minority staffs of the House Government Reform, Ways and Means, Energy and Commerce, and Budget Committees finds that the 2003 Medicare Modernization Act is responsible for more than half of the record increase in Medicare premiums that seniors will pay in 2005.

CMS Urged to Reconsider Citizenship Records Requirement

Rep. Waxman, Sen. Kennedy, Sen. Bingaman, and Rep. Solis urge the Centers for Medicare and Medicaid Services to reconsider a proposal that would require hospitals seeking reimbursement to maintain records on the citizenship of patients who are undocumented immigrants.

HHS IG Summary Fails to Answer Critical Questions

Reps. Waxman, Dingell, Rangel, Stark and Sherrod Brown ask that the acting IG and staff investigators meet with them to discuss the scope, focus, and results of their investigation into the withholding of the Medicare cost estimates.

Failure to Investigate Withholding of Medicare Cost Estimates Is Dereliction of Constitutional Duties

In a letter to Senate Majority Leader Frist and Speaker Hastert, Senate Democratic Leader Daschle, House Democratic Leader Pelosi, Rep. Waxman, and ten other congressional leaders call the failure to investigate the Administration’s withholding of Medicare cost estimates from Congress a gross abdication of Congress’ constitutional oversight responsibility. In a letter to the President, the members ask the President to provide complete answers to straightforward questions on his role in the matter.

Members File Suit To Force Administration To Release Medicare Cost Estimates

All 19 members of the Government Reform Committee minority file suit against the Secretary of Health and Human Services to compel the Administration to release cost estimates prepared by the HHS Actuary during congressional consideration of Medicare reform legislation.

HHS Refuses to Release Medicare Cost Estimates

All 19 minority members of the Committee write Secretary Thompson to protest HHS's obstruction of their investigation into the withholding of the cost data. The members officially expand their Seven Member request to include the communications between HHS and congressional leadership.

Rep. Waxman Asks for Hearings on Medicare Cost Estimates, Threatens Suit over Documents

In a letter to Chairman Davis, Rep. Waxman requests a hearing on the allegations that the HHS Actuary was told he would be fired if he shared with Congress estimates on the true costs of the Medicare prescription drug proposal. In a letter to HHS Secretary Thompson, Rep. Waxman threatens legal action under the "Seven Member Rule" if the Secretary continues to refuse to release the cost estimates.

Members Demand Information on Medicare Cost Estimates

In response to reports that the true cost of the Medicare prescription drug legislation was concealed, 19 committee members demand the release of the cost estimates prepared by the Administration during congressional consideration of the legislation.

Drug Benefits CEO May Have Helped Write Medicare Law Provisions

Reps. Waxman and Sherrod Brown write HHS Secretary Thompson, OMB Director Bolten, and White House Counsel Alberto Gonzales about reports that a pharmaceutical benefits management company CEO may have helped write provisions of the recent Medicare law that govern the prescription drug card program.

Administration Asked to Release Medicare Cost Estimates

Ranking Members Waxman, Rangel, and Dingell ask HHS to release cost estimates prepared by the Administration during congressional consideration of the Medicare prescription drug legislation.

Administration's Changes Undermine Medical Privacy Rule

Six members write Health and Human Services Secretary Tommy Thompson with questions on the Administration's proposed changes to the medical privacy rule, including the creation of a broad loophole through which drug companies could access patient health records without patient permission.

HHS Letter: CDC to Guide Lead Screening Policy

In response to an April 17 letter from Rep. Waxman and other members, HHS Secretary Thompson has promised to be guided by the experts at CDC in determining policies for testing children for lead poisoning, rejecting an ill-advised proposal to end universal screening under Medicaid for lead poisoning.

New Mexico Youth Incarcerated Due to Lack of Treatment Services

Senator Jeff Bingaman, Rep. Tom Udall, and Rep. Waxman released a report revealing that hundreds of New Mexico youth suffering from mental health problems were incarcerated in juvenile detention centers because treatment spots were not available. The report finds that from January to December 2001, an estimated 718 youth were collectively incarcerated for 31.3 years even after being cleared to leave to obtain mental health services. Inadequate federal oversight of the state's Medicaid program is a key cause of this problem.

Preserving Financial Protections in Medicare

On March 4, Rep. Waxman, along with Rep. Sherrod Brown, Rep. Pete Stark, Rep. Ben Cardin, and Sen. Dick Durbin, wrote to Secretary Tommy Thompson with concerns about the growing number of "concierge" physician practices that are charging seniors annual membership fees. Secretary Thompson wrote back that these practices do not necessarily violate Medicare billing laws. On May 16, Rep. Waxman became an original co-sponsor of H.R. 4752, which would bar membership fees to Medicare patients.

Medicaid Managed Care Protections

On August 13, Rep. Waxman, along with Reps. John Dingell and Sherrod Brown, sent a letter to President Bush regarding the Administration´s attempts to undermine key measures to protect against managed care abuses. On August 2, President Bush publicly endorsed H.R. 2563, a patient rights bill that calls for the same patient protections for patients covered by Medicaid as for those with privately insurance. However, just two weeks later, on August 16, the Administration moved to delay and weaken patient rights in the Medicaid program. Rep. Waxman, along with Reps. John Dingell and Sherrod Brown, exposed this glaring contradiction in a letter to President Bush. Reps. Waxman, Dingell, and Brown prepared a comparison between H.R. 2563 and pending Medicaid patient protections.

Children's Access to Health Screening Services

At the request of Reps. Waxman and Dingell, the General Accounting Office (GAO) investigated the extent to which children in Medicaid are receiving important health screening and other preventive services. In July 2001, GAO reported that many children are not receiving the services required by law and that managed care plans participating in Medicaid do a poor job of providing data to states and the federal government about the provision of these required services.

Medicaid Drug Price Manipulation

At Rep. Waxman's request, the Inspector General of HHS and the Special Investigations Division have examined allegiations allegations that drug companies have circumvented the requirement that they provide the Medicaid program with rebates based on their “best” or lowest drug prices.

Children's Access to Lead Screening

At the request of Rep. Waxman, GAO investigated whether children in Medicaid receive necessary screening for lead poisoning. In February 1998, GAO found that most Medicaid children had never been screened, and that an estimated 352,000 children covered by Medicaid probably had lead poisoning that was undetected.

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