LTC Bullet:  The Medicaid Commission 

Thursday, May 26, 2005 

Washington, DC-- 

LTC Comment:  Specifications are out for the controversial, eagerly anticipated "Medicaid Commission" mandated by the 2006 budget resolution.  More after the ***news.*** 

*** LTC BLOG.  If you haven't checked out the Center for Long-Term Care Reform's new "LTC Blog," why not go there now: .  You'll find daily items of interest, our analysis of events and reports, and links to lots more valuable information here, there and everywhere on the web, including in our password-protected Members Only Zone for dues-paying supporters of the Center's mission:  universal access to top-quality long-term care for all Americans. ***

*** BOOTLEG copies of the National Governors Association's draft proposals for Medicaid and long-term care reform are creeping out.  We found ours in a flower pot at the Watergate complex.  Just kidding, they're everywhere finally.  But watch the LTC Blog and our LTC E-Alerts to Members for details and critical comments on that elusive document's contents. *** 

*** STEVE MOSES is midway through his first week of meeting and briefing key policy makers and legislators in DC.  His "behind the lines" LTC Embed reports provide frequent updates on the inner workings of public policy formation.  They're sent directly to Center members by email and summarized in the LTC Blog almost daily.  Steve says "This year presents a unique opportunity to save Medicaid for the truly needy and advance private LTC financing alternatives for everyone else.  Join us to fight for rational LTC policy." *** 



LTC Comment:  The Bush Administration and the House of Representatives wanted larger Medicaid cuts than the $10 billion (over five years) that appear in the 2006 budget resolution.  The Senate and many interest groups wanted less.  A compromise was reached premised on establishment of a "Medicaid Commission" to study the hidebound, anachronistic welfare program and propose money-saving improvements.  

Like everything else in beltway politics, the Medicaid Commission was embroiled in controversy immediately upon its legislative authorization.  The Administration wanted to control appointments to the commission.  Critics wanted appointment power in the hands of an independent organization such as the Institute for Medicine.  The Administration won. 

Following below is a summary of the Charter for the Medicaid Commission as released by Health and Human Services Secretary Michael Leavitt.  For more details, link to the federal register notice announcing "Establishment of the Medicaid Commission and Request for Nominations for Members" at

Secretary Leavitt introduced the Commission with these comments:  "For generations, Medicaid has served the health care needs of the truly needy in America, but today the program is no longer meeting its potential.  It is rigidly inflexible and inefficient, and  worst of all, it is not financially sustainable.  I look forward to working with this commission in an open and bipartisan manner to reform and modernize Medicaid."   

Long-term care, eligibility, benefit design and service delivery are key components of the Commission's mandate.  Let's hope the outcome is progress, savings, and improvements, not just delay and more stagnation.   

Information on how to nominate someone to serve on the Commission follows after this summary of the Commission's Charter: 


The Medicaid Commission . . . 

* Shall submit two reports to the Secretary and Congress on 9/1/05 and by 12/31/06.  

* The first report will provide recommendations on options to achieve $10 billion in Medicaid savings over five years.  The December '06 report will make longer term recommendations on the future of the program and specific performance goals. 

* The proposals developed by the Commission shall address six aspects of the program including long term care.  

* Composition will consist of three types of member groups:  Voting members, Non-Voting Members and Non-Voting Congressional Advisor Members.  Only voting members have authority to vote on the recommendations.  The Secretary shall designate a voting member to serve as Chair. 

    **  Voting members (Up to 15 members) 

          *** Former or current Governors. 

          *** Three representatives of public policy organizations involved in major health care policy issues for families, individuals with disabilities, low-income individuals, or the elderly. 

           *** Former or current State Medicaid Directors. 

           *** Individuals with expertise in health, finance, or administration. 

           *** Federal officials who administer programs that serve the Medicaid population. 

           *** The Secretary (or the Secretary's designee) and such other members as the Secretary may specify. 

           *** Ex Officio Members. 

    ** Non-Voting Advisor Members (Up to 15 members) 

           *** State and local government officials, consumer and provider representatives who have an inherent interest in the Medicaid program. 

     ** Non-Voting Congressional Advisor Members (8 members)  The following legislative leaders will make one Congressional selection each: 

           *** Senate Majority Leader
*** Senate Minority Leader
*** Chairman, Senate Finance Committee
*** Ranking Member, Senate Finance Committee
*** Speaker, House of Representatives
*** Minority Leader, House of Representatives
*** Chairman, House Committee on Energy and Commerce
*** Ranking Member, House Committee on Energy and Commerce 

* The Secretary is requesting nominations.  Nominations must include specific information detailed in below.  They are due June 3rd. 

* Subcommittees may be established.  

* Management and support services shall be provided by HHS.   

* Up to 6 meetings per year at the call of the Chair.  Meetings open to the public. 


Excerpt from CMS-2214-N announcing establishment of the Medicaid Commission and requesting nominations for members: 


            We are requesting nominations for membership as voting members or as non-voting members on the Medicaid Commission.  We will consider qualified individuals who are self-nominated or are nominated by organizations representing States, beneficiaries, and providers when we select these representatives.  The Secretary will appoint members to serve on the Commission from among those candidates that we determine have the technical expertise to meet specific agency needs in a manner to ensure an appropriate balance of membership. 

            Any interested person may nominate one or more qualified individuals for each of the categories listed [above].  Each nomination must include the following information: 

            1.  A letter of nomination that contains contact information for both the nominator and nominee (if not the same). 

            2.  A statement from the nominee that he or she is willing to serve on the Commission for its duration (that is, through January 31, 2007) and an explanation of the nominee's interest in serving on the Commission.  (For self-nominations, this information may be included in the nomination letter.) 

            3.  A curriculum vitae that indicates the nominee's educational and Medicaid experiences. 

            4.  Two letters of reference that support the nominee's qualifications for participation on the Commission.  (For nominations other than self-nominations, a nomination letter that includes information supporting the nominee's qualifications may be counted as one of the letters of reference.) 

            To ensure that a nomination is considered, we must receive all of the nomination information specified [above] June 3, 2005.  Nominations should be mailed to the address specified in the ADDRESSES section of this notice. . . . 

ADDRESSES:  Send nominations to:  Centers for Medicare and Medicaid Services, 7500 Security Boulevard, Baltimore Maryland 21244-1850, Policy Coordination and Planning Group, Mail stop S2-26-12, Attention:  Mary Beth Hance