Gingrey legislation will prevent Medicaid, SCHIP abuse

U.S. Congressman Phil Gingrey, M.D. (R-GA) introduced H.R. 5691, legislation to eliminate the potential for individuals to fraud programs such as Medicaid and SCHIP, so that these programs can instead be used to benefit those truly in need. The Medicaid and SCHIP Abuse Prevention Act of 2008 will help ensure that these programs continue to be made available for the most vulnerable and needy in this country.

“SCHIP and Medicaid were originally designed to be safety-net programs for those most in need in our society,” said Gingrey. “However, these assistance programs for low-income Americans are now being hijacked, and their funds misused. By exploiting inadvertent loopholes in the statute, some states are allowing people to disregard significant portions of their income in order to appear poor on paper, even though their actual income is much higher.”

For example, there is a state whose statutory upper limit for SCHIP is 200% of the Federal Poverty Level, which is $42,400. However, by using income disregards, this state allows people to enroll in SCHIP with incomes up to $74,200 per year, which is 350% of the FPL. Yet, nearly 25% of this state’s children – whose families make under 200% of the FPL – are uninsured, leading many to argue that by focusing on higher income families, the state is ignoring the very people it should be helping the most.

Disregarding whole blocks of income – a practice already being employed by as many as thirteen states – for the sole purpose of making an individual eligible for a government entitlement program is an egregious practice that manipulates the very intent of these programs. In order to ensure these programs serve children and individuals who ACTUALLY qualify as “low-income,” the Medicaid and SCHIP Abuse Prevention Act of 2008 will institute a gross income cap of 250% for SCHIP and Medicaid eligibility. This legislation will limit any income disregards to a maximum of $250 per month or $3000 per year.

“Placing a firm eligibility cap on SCHIP and Medicaid is the best way to ensure that federal taxpayer dollars are spent on those most in need, and will not be diverted to people who already have the ability to purchase their own health insurance plan without taxpayer-funded assistance,” continued Gingrey.

Introducing the Medicaid and SCHIP Abuse Prevention along with Congressman Gingrey are original co-sponsors, Rep. Feeney (R-FL), Rep. Walden (R-OR), Rep. Herger (R-CA), Rep. Bartlett (R-MD), Rep. Kingston (R-GA), Rep. Broun (R-GA), Rep. Miller (R-FL), Rep. Wilson (R-SC), Rep. Price of Georgia (R-GA), Rep. Westmoreland (R-GA), and Rep. Deal (R-GA).