Barton declines to serve on panel

Just days after Health and Human Services (HHS) Secretary Mike Leavitt announced the members of the Bush administration’s Medicaid reform commission, House Energy and Commerce Committee Chairman Joe Barton (R-Texas) became the latest member of Congress — and first Republican — to decline  formally to participate in the panel’s work.

“Given the already diverse makeup of the commission, Chairman Barton has declined to name an additional member,” his spokesman Kevin Schweers said via e-mail yesterday. Barton instead will focus his energies on developing legislation in the committee to fulfill the fiscal year 2006 congressional budget resolution’s requirement that the panel identify $14.7 billion in savings from entitlement programs. The commission is tasked with finding $10 billion from Medicaid.

Barton is the latest in a string of key policymakers to back away from the commission. Although Schweers wrote that Barton plans to “work with the commission,” his choice to distance himself from a panel handpicked by Leavitt casts further doubt on how much of a role the panel will play in shaping the ongoing debate about the future of Medicaid

The House Energy and Commerce and the Senate Finance committees already have begun their own efforts to craft a Medicaid reform strategy, and the nation’s governors already have adopted their own menu of policy options, leaving open to question what will be the audience for the Medicaid commission report due Sept. 1.

Barton, House Speaker Dennis Hastert (R-Ill.), Senate Majority Leader Bill Frist (R-Tenn.), Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and their Democratic counterparts are all entitled to select one member of Congress each to serve as a nonvoting adviser to the Medicaid commission, as stipulated by the 2006 budget resolution. The Democrats quickly bowed out, maintaining that Medicaid spending should not be reduced by $10 billion as Congress weighs structural changes to the program.

The National Governors Association (NGA) also has backed away from the commission. The NGA said last month that it would not formally take part in the panel’s work, but Leavitt left spots on the commission’s roster open for two governors to join later.

Frist is still discussing the matter with other GOP senators and with the Republican leadership in the House, according to a spokesman. Frist already was rebuffed by Sen. Gordon Smith (R-Ore.), a leader in the effort to create a Medicaid commission, when Frist asked him to serve. Frist’s spokesman said the decision by the Democrats to boycott the panel complicated the GOP’s approach. Grassley has committed to naming a senator to the panel — after considering not doing so — but has not made any announcements. Hastert has not indicated what his intentions are, and aides to him and to Grassley did not return inquiries by press time.

Leavitt announced a Medicaid commission roster Friday. Former Tennessee Gov. Don Sundquist (R) will be chairman, and former Maine Gov. Angus King (I) will be vice chairman. The panel includes a number of current Bush administration appointees as voting members along with the two ex-governors, including HHS Assistant Secretary for Planning and Evaluation Michael O’Grady, Department of Education Deputy Assistant Secretary Troy Justesen and Kay Coles James, former director of the Office of Personnel Management.

Among the 13 voting members named to the commission, an HHS spokeswoman identified two as Democrats, former West Virginia Medicaid administrator Nancy Atkins and Melanie Bella of the Center for Health Care Strategies.

The budget resolution did not specify the partisan composition of the panel, but the original concept of the panel as devised by Smith and Sen. Jeff Bingaman (D-N.M.) was to be a bipartisan panel with a membership jointly selected by the administration and each party in Congress. Instead, Leavitt was granted nearly complete leeway in choosing members. HHS solicited for nominations to the panel, receiving about 200, but Leavitt went beyond that pool for some members, the spokeswoman said.

Nevertheless, the heavily Republican tilt to the commission’s membership could amplify criticisms from Democrats that the panel is illegitimate and will serve only to reinforce the White House’s well-known Medicaid reform principles.

Senate Finance Committee ranking member Max Baucus (Mont.), one of the Democrats who passed on naming an adviser to the panel, issued a disapproving statement about its membership on Friday. “I remain concerned about the lack of balance and independence of this commission. To be credible, this commission should have balanced representation of all viewpoints and operate independently of the administration. It is still not clear that this commission will meet this standard,” said Baucus. Families USA Executive Director Ron Pollack continued his drumbeat of criticism: “The new Medicaid commission appointed by Secretary Leavitt today is a sham that deserves — and will receive — no credibility,” said Pollack.

Leavitt’s choice of Sundquist as chairman also is likely to elicit backlash from the left. Sundquist’s term as governor coincided with the near-collapse of his state’s Medicaid program, Tenn-Care. Established in the 1990s under Sundquist’s Democratic predecessor, Tenn-Care began as a statewide HMO for all Medicaid beneficiaries. Tenn Care was considered a revolutionary approach to serving low-income people but has confronted considerable financial problems in recent years and been forced to cut benefits and to exclude people from its rolls.