WASHINGTON, DC – Today, the Government Accountability Office (GAO) and Congressional Research Service (CRS) confirmed that the Centers for Medicare and Medicaid Services (CMS) exceeded its authority in issuing a proposal threatening the health coverage of thousands of low-income American kids through the State Children’s Health Insurance Program (SCHIP).
The directive required that 95 percent of all children below 200 percent of the federal poverty level have verifiable health insurance before additional children could receive care through SCHIP, posing a serious threat to those already on the program. In essence, the GAO and CRS found that CMS did not have the authority to impose these changes in a letter. This confirms the findings of a report released in March by First Focus which determined, among other findings, that the new regulations are contrary to current law.
According to GAO, “The August 17 letter from CMS to state health officials is a statement of general applicability and future effect designed to implement, interpret, or prescribe law or policy with regard to [CHIP]. Accordingly, it is a rule under the Congressional Review Act. Therefore, before it can take effect, it must be submitted to Congress and the Comptroller General.”
“This confirms what we’ve already known – that CMS’s attempts to derail the effectiveness of the SCHIP program are patently illegal,” said Bruce Lesley, president of First Focus. “Now, even the federal government has offered definitive proof that the directive by CMS was not legal, and it should be ignored by the states. Moreover, Congress can wait no longer to take immediate action to halt all of CMS’s attempts to usurp Congressional authority through the six other Medicaid regulations. It is unfortunate that CMS staff have gone as far as undermining current law to place at risk the healthcare of our nation’s children.”
In March, First Focus released a report on the impact of the regulatory actions on children with special health care needs, finding they would have a disproportionate impact on that vulnerable population. Congressman Dingell later pointed to that report as the evidence that the CMS’ new Medicaid Regulations would weaken health care for children.
Lesley added, “The legal opinions from the General Accounting Office and Congressional Research Service confirm what the legal analysis issued First Focus and authored by George Washington University professor Sara Rosenbaum, also said, that the CMS directive is not legal and should be immediately withdrawn. The directive has resulted in negative health consequences for children across the nation and is now costing taxpayers millions of dollars in legal costs that would be far better spent improving the health and well-being of children.”
Report:CMS Medicaid Regulations: Implications for Children with Special Health Care Needs