Bush decides that Congress doesn't matter anymore...

States Can Limit Emergency Access in Medicaid Cases

WASHINGTON, Jan. 16 — In a reversal, the Bush administration has ruled that managed care organizations can limit and restrict coverage of emergency services for poor people on Medicaid.

The new policy, disclosed in a recent letter to state Medicaid directors, appears to roll back standards established in a 1997 law and in rules issued by the Clinton administration in January 2001 and by the Bush administration itself in June 2002.

Under the 1997 law, states can require Medicaid recipients to enroll in health maintenance organizations or other types of managed care. But certain safeguards for patients were built into that law. Congress, for example, stipulated that managed care organizations had to provide coverage for Medicaid patients in any situation that a "prudent layperson" would regard as an emergency.

Now the Bush administration has decided that states can place certain limits on coverage of emergency services "to facilitate more appropriate use of preventive care and primary care," the letter said.

Administration officials said today that the new policy was consistent with President Bush's desire to give states greater flexibility in the operation of their Medicaid programs.

...

Senator Bob Graham, Democrat of Florida, a principal author of the 1997 law, said the new policy "would undermine access to essential emergency services for low-income Americans," including children, the elderly and the disabled.

Mr. Graham said he did not understand how the administration could, by a letter, make such profound changes in a policy established by statute.

Because he is George W. Bush, Bob, and because your fellow Democrats didn't do enough to convince the guy that he isn't god.