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All of CLASS’s advocacy work, up until this point, has been focused on potential cuts to Medicaid. As you are most likely aware, 99% of our funding for programs and services comes from Medicaid.
The House of Representatives today approved a budget resolution that outlines trillions of dollars in proposed reductions to Medicaid, which are essential for CLASS participants' daily lives. This decision, following the Senate's earlier approval of a similar budget framework, brings Congress closer to creating legislation that could enact these significant cuts. This action jeopardizes healthcare for millions of people, including those supported by CLASS.
It is important to note that several attempts to create amendments ensuring that the $8.8 billion wouldn’t come from Medicaid failed.
Who is in Charge of Medicaid Oversight
In the U.S. House of Representatives, Medicaid is primarily under the jurisdiction of the House Energy and Commerce Committee. The House Budget Committee also plays a significant role in setting overall spending levels. In the Senate, the Senate Finance Committee has primary jurisdiction over Medicaid. These are responsible for legislation, oversight, and budget related to Medicaid.
In Pennsylvania, the oversight of Medicaid, known as Medical Assistance (MA), happens through several avenues:
1. Legislative Oversight:
● The primary legislative oversight in the Pennsylvania General Assembly occurs through the House Human Services Committee and the Senate Health and Human Services Committee
● These committees are responsible for reviewing legislation related to Medicaid, holding hearings, and examining the policies and administration of the program.
2. Executive Branch Oversight:
● The Pennsylvania Department of Human Services (DHS) is the state agency that administers the Medicaid program. Within DHS, the Office of Medical Assistance Programs (OMAP) has direct responsibility for the day-to-day operations, policies, and program integrity of Medicaid.
● Various bureaus within OMAP, such as the Bureau of Fee-For-Service Programs and the Bureau of Managed Care Operations, have specific oversight responsibilities.
● The Office of the Auditor General also provides independent oversight by conducting audits of state agencies, including DHS and its Medicaid program.
3. Advisory Committees:
● Medical Assistance Advisory Committee (MAAC) advises DHS on matters related to the Medical Assistance program. Its members include representatives of providers, consumers, and other stakeholders. The MAAC has several subcommittees that focus on specific areas.
● The Consumer Subcommittee of the MAAC specifically focuses on addressing inequities and improving healthcare access for Medicaid recipients, with members who are past or present beneficiaries or work with welfare rights organizations.
● HealthChoices Advisory Committee Meetings, sponsored by DHS and facilitated by the Pennsylvania Enrollment Assistance Program, provide a platform for HealthChoices (Pennsylvania's managed care program for Medicaid) members to give feedback on services and materials.
● Participant Advisory Committees are offered at various managed care organizations (MCO) within the HealthChoices program, like PA Health & Wellness. These MCOs have their own advisory committees where participants can share their thoughts and concerns.
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