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house Bill H.R. 3253

Should Medicaid Provisions to Protect Vulnerable Populations & Enable Community-Based Care Be Extended?

Argument in favor

This bill’s proposed reforms would collectively strengthen Medicaid by making it more responsive to beneficiaries’ needs, protecting vulnerable Medicaid beneficiary populations and their spouses and ensuring that Medicaid drug prices are reasonable.

Kodiwodi's Opinion
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06/18/2019
As a Gerontologist and Specialist in Aging I fully support HR 3253.
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Rebekah 's Opinion
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06/18/2019
Yes. Then extend it to cover ALL Americans. We need Medicare For All now! It would cover all medical, dental, pharmacy, vision, mental health, and long term care. Employers and the public would save billions compared to our current system and the 40K Americans who die every year for lack of care would have a chance to be productive.
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Cherie65's Opinion
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06/18/2019
Although I am a fiscal conservative, I do believe we must provide for our vulnerable elderly and disabled Americans. This bill wouldn't be as necessary if we cared for our own. Unfortunately, that doesn't happen for everyone. Since so many people have abdicated their responsibility, the "state" is becoming our caretakers by proxy. Scary.
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Argument opposed

This bill combines too many disparate Medicaid reforms & extensions, not all of which are urgent. For example, the MFP demonstration has already been extended through September 30, 2021 — there’s no need for a preemptive extension so far in advance of its expiration.

KAG-2020's Opinion
···
06/18/2019
👉Medicaid needs to be completely reworked to rid abuse of the system- and save taxpayer dollars. Rising Costs are not sustainable at present- especially for illegals to use US taxpayer healthcare.
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Vanessa's Opinion
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06/18/2019
I can barely afford my own middle class health care; now I’m expected to have my taxes go to take care of the health care for undocumented migrants, which is what this bill is really all about.
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Mark's Opinion
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06/18/2019
Stop the theft of working family hard earned money
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bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
  • The house Passed June 18th, 2019
    Roll Call Vote 371 Yea / 46 Nay

    Your Representative Voted

    Rep Harris
    Voted nay
      house Committees
      Committee on Energy and Commerce
    IntroducedJune 13th, 2019

Log in or create an account to see how your Reps voted!

What is House Bill H.R. 3253?

This bill — the Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019 — would extend a number of provisions within the Medicaid program that serve to make the program more effective. A breakdown of the extensions can be found below.

Money Follows the Program Rebalancing Demonstration (MFP)

This bill would extend the Money Follows the Person Rebalancing Demonstration (MFP), which helps states rebalance their Medicaid long-term care systems by transitioning people with chronic conditions and disabilities into community-based care, through FY 2024. It’d also extend research and evaluation requirements for MFP through FY 2024 and clarify the process by which states apply for the MFP by requiring each state to include a description of their planned use of MFP funds and program evaluation plans in their applications.

Additionally, this bill would require a report to the president and Congress describing findings and conclusions on best practices for MFP implementation. Finally, it’d require a Medicaid and CHIP Payment and Access Commission (MACPAC) report to Congress on the Commission’s position on the Home and Community Based Services (HCBS) Final Rule published on January 16, 2014.

State Medicaid Fraud and Abuse Control Units’ Authority to Investigate and Prosecute Medicaid Patient Abuse and Neglect

This bill would clarify that state Medicaid fraud and abuse control units are authorized to investigate abuse and neglect of Medicaid patients in board and care facilities, as well as patients receiving Medicaid-funded care in noninstitutional settings.

Protection for Medicaid Recipients Against Spousal Impoverishment

This bill would extend spousal impoverishment protections for seniors who receive long-term care in their homes or community settings through March 31, 2024.

Community Mental Health Services Demonstration Program

This bill would extend the Community Mental Health Services Demonstration Program through December 21, 2021 and require a report to Congress recommending whether the program should be continued, expanded, modified or terminated by June 30, 2021.

Inappropriately Low Rebates Under Medicaid Drug Rebate Program

This bill would prohibit drug manufacturers from blending the average manufacturer price of branded drugs and their authorized generics for the purposes of determining Medicaid rebates. It’d also eliminate drug manufacturers from being defined as drug wholesalers.

Medicaid Improvement Fund

Finally, this bill would appropriate $45.5 million for the Medicaid Improvement Fund.

Impact

Medicaid beneficiaries; state health systems; states; Medicaid; state Medicaid fraud and abuse control units; drug manufacturers; drug prices; Money Follows the Program Rebalancing Demonstration (MFP); Medicaid spousal impoverishment protection; Community Mental Health Services Demonstration Program; inappropriately low rebates under the Medicaid drug rebate program; and the Medicaid Improvement Fund.

Cost of House Bill H.R. 3253

A CBO cost estimate is unavailable.

More Information

In-DepthSponsoring Rep. Debbie Dingell (D-MI) originally introduced two bills — the Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources and Care (EMPOWER Care) Act, which extends the MFP program through 2024 and the Protecting Married Seniors from Impoverishment Act, which permanently extends spousal impoverishment protections for Medicaid beneficiaries receiving long-term care in a home or community care setting — which are included in this bill. When she introduced those bills, Rep. Dingell said in a press release:

“The long-term care system in this country is broken. Seniors, families, and caregivers are often desperate, stressed, and don’t know where to turn. The Money Follows the Person program and spousal impoverishment protections have shown they can create better outcomes for people receiving long-term care in the home or in the community. These proposals have strong bipartisan support and I hope the House passes them quickly.”

The Partnership for Medicaid Home-Based Care expressed its support for extending the MFP demonstration in February 2019, upon Rep. Dingell’s introduction of the EMPOWER Care Act. Its Chairman, David J. Totaro, said:

“This important legislation will ensure that individuals who could be helped by MFP to live in their homes and communities will not be forced into an institution instead, and it’s for that reason that we will be proud to advocate for its passage.”

The National Council on Aging’s Vice President for Public Policy and Advocacy, Howard Bedlin, noted that MFP and spousal impoverishment programs are “essential” for older adults and those with disabilities who want to live at home:

“For older adults and people with disabilities wanting to live at home with dignity and independence, federal Medicaid programs like Money Follows the Person and spousal impoverishment protections are essential. The Money Follows the Person program helps people move out of institutions and back home, while spousal protections keep older couples together, reducing unnecessary nursing home placement. Every community across this country has someone who would benefit from one of these important safeguards.”

Justice in Aging advocates making the spousal impoverishment protection permanent:

“Married seniors and adults with disabilities overwhelming want to live at home and age in place. Increasingly, federal and state Medicaid rules have prioritized home and community-based services (HCBS) which allow people to stay in their homes and in their communities. Congress recently helped these efforts by expanding a Medicaid eligibility rule, known as the spousal impoverishment protection, to individuals eligible for HCBS. The protection makes it possible for an individual who needs a nursing home level of care to qualify for Medicaid while allowing their spouse to retain a modest amount of income and resources. However, the expansion of the spousal impoverishment protection is set to expire on March 31, 2019 unless Congress acts. This means that individuals who qualified under the expanded protection may lose access to Medicaid and to their HCBS and may be left with no choice but to move into institutional long-term care, away from their spouses. Letting the spousal impoverishment protection expire will hurt families and force more people out of their homes and their communities. We urge Congress to make the expanded spousal impoverishment protection permanent so seniors and people with disabilities can age in place and with dignity.”

This bill has nine bipartisan cosponsors, including five Republicans and four Democrats.


Of NoteThe MFP demonstration has already been extended through September 30, 2021 through the enactment of the Medicaid Extenders Act of 2019.


Media:

Summary by Lorelei Yang

(Photo Credit: iStockphoto.com / courtneyk)

AKA

Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019

Official Title

To provide for certain extensions with respect to the Medicaid program under title XIX of the Social Security Act, and for other purposes.

    As a Gerontologist and Specialist in Aging I fully support HR 3253.
    Like (83)
    Follow
    Share
    👉Medicaid needs to be completely reworked to rid abuse of the system- and save taxpayer dollars. Rising Costs are not sustainable at present- especially for illegals to use US taxpayer healthcare.
    Like (43)
    Follow
    Share
    Yes. Then extend it to cover ALL Americans. We need Medicare For All now! It would cover all medical, dental, pharmacy, vision, mental health, and long term care. Employers and the public would save billions compared to our current system and the 40K Americans who die every year for lack of care would have a chance to be productive.
    Like (67)
    Follow
    Share
    Although I am a fiscal conservative, I do believe we must provide for our vulnerable elderly and disabled Americans. This bill wouldn't be as necessary if we cared for our own. Unfortunately, that doesn't happen for everyone. Since so many people have abdicated their responsibility, the "state" is becoming our caretakers by proxy. Scary.
    Like (52)
    Follow
    Share
    I can barely afford my own middle class health care; now I’m expected to have my taxes go to take care of the health care for undocumented migrants, which is what this bill is really all about.
    Like (33)
    Follow
    Share
    Stop the theft of working family hard earned money
    Like (27)
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    First, it is the right thing to do. Second, it will decrease hospital "write-off" costs for near terminal conditions that arise if people in need can not get care while conditions are treatable. Third, with reduced "write-offs", medical bills for everyone else should go down.
    Like (20)
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    We must care for our most vulnerable.
    Like (18)
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    Our ‘most vulnerable’ are not able-bodied or normally employable humans. They are a special category of Medicaid recipient. We take atrocious care of that segment of our population in need. Screeching at them to get off their lazy asses like I’ve read here numerous times, is hateful and ignorant.
    Like (15)
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    Yes, this needs to be done. The fact that this isn’t obvious just goes to show how American values has devolved. Doing the right thing for people in need should never be a question & should never require an explanation.
    Like (13)
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    The more the GOP takes away our medical care and ability to make ends meet (stupid GOP senate), the more vulnerable families will be -old people, children, women-you know, the underserved and without rights populations. So yes, please extend it.
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    This extension needs to be approved. As for the Community Mental Health Demonstration Project: why are you reinventing the wheel??? There was a extremely successful Community Mental Health system in place in the 1960’s and 1970’s until Ronnie Reagan, and every administration since, cut funding for it. The Learning Communities that were part of that program helped advance many highly successful ideas and programs for the mentally ill, programs that Medicaid needs to be in place to help pay for.
    Like (12)
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    No. When do individuals become responsible for themselves and not always dependent on the government?? They want the government to take care of them, but then they will complain it’s not enough. Newsflash: government assistance will never set you up in a mansion, buy you a luxury car, and endow you with lots of spending money with YOU doing nothing!! There is a catch!! You get to be beholden to them, a slave, and it doesn’t matter what color your skin is. Hard working people do so to help their families not so they can support the lazies who don’t want to do anything.
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    That is what Medicaid is supposed to do. Why would we stop doing something that makes things easier.
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    I’d gladly pay a bit more in taxes to help those in need!!!
    Like (12)
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    We shouldn’t even be asking this type of question
    Like (12)
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    Most people who benefit from Medicaid truly need these funds to pay for their healthcare or long term care in a facility. Our country does not do enough to provide for the elderly and infirm, and especially the mentally ill, so programs under Medicaid need to be strengthened.
    Like (11)
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    No, Medicare is doomed for failure.
    Like (10)
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    This bill has a lot of good intentions but the Devil is always in the details and this bill does not address the known abuses of the Medicaid program or to make it more financially viable. If anything, it makes it less financially stable. Reform the Medicaid and Medicare programs first before adding expansions. As any builder knows, no structure can stand without a solid foundation. Without fixing the foundational program, the entire program is doomed to collapse and failure and with just as many casualties.
    Like (10)
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    👎🏻👎🏻Empowering Beneficiaries, Ensuring Access, & Strengthening Accountability Act”👎🏻👎🏻 👍🏻👍🏻 I’m in opposition to the Dingell House Bill H.R. 3253 bill AKA the “Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019” which would extend a number of provisions within the Medicaid program that serve to make the program more effective.👍🏻👍🏻 This bill combines too many disparate Medicaid reforms & extensions, not all of which are urgent. For example, the MFP demonstration has already been extended through September 30, 2021 — there’s no need for a preemptive extension so far in advance of its expiration. This Bill is just another Democratic attempt in extending their desired medical programs to foster continued support of their agenda in dependency of their voter base. SneakyPete..... 6.18.19..... 👎🏻👎🏻HR.3253👎🏻👎🏻
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