On June 30, 2008, President Bush signed the Iraq war supplemental appropriations bill into law. This legislation calls for a one-year delay in the implementation of six of seven recent regulations proposed by the Administration to cut Medicaid funding, including funding for mental health case management rehabilitative services.

The National Council and its members fought long and hard to preserve the Medicaid safety net and urged Senators and Members of Congress to protect funding for essential services.

Thank you to all those who contacted your elected representatives to urge them to vote to preserve Medicaid. Your calls and e-mails have made a difference!

In addition to the regulations affecting case management, the rehabilitative services option and school-based services, language in the Iraq war supplemental bill delays the following rules for one year:

•  A portion of the Proposed Rule on Provider Taxes
•  Proposed Rule on Graduate Medical Education
•  Final Rule on Public Provider Cost Limit Regulation
  

The Proposed Rule to clarify the outpatient clinic and hospital facility services definition is not included in the bill.

The House of Representatives passed the supplemental spending bill on June 19. The bill was split into two votes - one on the war funding, which passed by a vote of 268-155, and one on domestic items included in the bill, which passed by a vote of 416-12. To see how your Representative voted in the first vote, click here. To see how your Representative voted in the second vote, click here. The Senate approved the bill’s domestic items by a vote of 92-6 on June 26. To see how your Senators voted, click here. 

The National Council will continue to work with Congress and with the next administration to straighten out final details on these Medicaid regulations.

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About Medicaid for Community Mental Health Services

Millions of Americans with serious mental illnesses depend upon Medicaid for treatment and services that allow them to live safely and productively in our communities. Medicaid is the single largest source of funding for America's public mental health system. The National Council estimates that Medicaid rehabilitative services and Targeted Case Management combine to produce more than 50 percent of all federal funding for community-based services for people with mental illnesses and other disabilities.

Rehabilitative services are designed to assist in the recovery of children and adults with serious mental illness. These services, which help people with mental illness improve or maintain their functioning, are key to allowing people with mental illness reduce their dependence on inpatient services and emphasize clients' recovery. Behavioral healthcare providers tailor rehabilitative services to the individual needs of each client with the goal of helping them to eliminate or compensate for the barriers to independent life in the community that their mental illness creates.

In early 2008, Medicaid funding for case management and rehabilitative services faced serious cuts on account of seven Medicaid regulations proposed by the Bush Administration, including:

• Interim Final Rule on Case Management
• Proposed Rule on Clarification of Outpatient Clinic and Hospital Facility Services Definition and Upper Payment Limit
• A portion of the Proposed Rule on Provider Taxes
• Proposed Rule on Graduate Medical Education
• Final Rule on Public Provider Cost Limit Regulations

The cuts to Medicaid targeted those who need help the most: children, and the mentally and physically disabled. Eliminating preventative healthcare programs and assistance will have a devastating effect on the long-term healthcare of Medicaid patients. This would only lead to higher costs in the future, and put the health of millions at risk.

See the National Council's ad "Save adults and children disabled by mental illness" that urges members of Congress to stop Medicaid cuts. The ad ran in various Hill newspapers during May 2008.