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Home > Advocacy > Medicaid > CWLA Talking Points on White House Medicaid Proposal


CWLA Talking Points on White House Medicaid Proposal

Reject the White House proposals to restrict the use of Medicaid to provide services to children in the child welfare system.
On August 5, U.S. Secretary of Health and Human Services Michael Leavitt sent a letter to the House and Senate with recommendations to change the federal Medicaid program. The recommendations were accompanied with draft legislation that, if implemented, would decrease federal spending for Medicaid by $10 billion.

These proposals would have a devastating effect on abused and neglected children in the child welfare system by restricting support and access to mental health care and other needed services.
The White House package of legislation includes limiting the use of Medicaid funded targeted case management (TCM) and rehabilitation services for children in foster care. The legislation would directly limit the definition of TCM and rehabilitation services and prohibit Medicaid reimbursement for such services if these services could be paid for by other federal or state funds, including the Title IV-E Foster Care and Adoption Assistance program.

These proposals shift the burden of protecting and caring for abused and neglected children to the states.
If Congress adopts these proposals, states will have an immediate fiscal crisis as they scramble to make up for the reduced federal support for these services.

The federal supports currently in place to support states' efforts to protect and care for abused and neglected children are inadequate. Improvements are necessary to ensure better outcomes for these children. Reforms should be based on good policy decisions and not solely on attempts to cut overall federal spending.
We call on the White House to work with Congress to develop and advance comprehensive child welfare financing reform that improves the existing federal-state partnership that finances child welfare. Capping and limiting access to federal funds does not address the needed improvements. The federal Child and Family Service Reviews point to the need for more staff; better training, supervision, and oversight of performance; and new investments to provide a broader range of services--all within a more flexible system. Reducing federal supports merely shifts the financial burden of caring for these children to the states and puts the well-being of children at risk.

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