The Senate Health Bill: Medicaid and CLASS Act Provisions

Dennis Smith / November 19, 2009

The 2074 page Reid Health Bill (H.R. 3590) generally follows the Senate Finance and HELP versions on Medicaid and in the creation of a new health care program, the Community Living Assistance Services and Supports (CLASS) Act.

Curiously, in the short term (2010-2013), the Reid bill helps fewer people gain coverage than the Senate Finance bill. The Congressional Budget Office (CBO) estimates 2 million will lose Medicaid/SCHIP coverage each year in this period compared to current law. But, by 2019, Medicaid/SCHIP enrollment will increase by 15 million, accounting for nearly half of all individuals who will gain coverage.

More Welfare. The Reid bill expands Medicaid eligibility for people below 133 percent of the Federal Poverty Level (FPL), significantly changing it to a pure income based federal entitlement. It also raises, then lowers, the federal matching rates for different populations and states. In a provision aimed at Louisiana, the Reid bill provides a special “disaster recovery” match rate for states that have had a major disaster declared (Section 2006). CBO estimates that state spending under the Medicaid provisions will still increase by $25 billion. (more…)