CONTENTS Page B. Medicare Part B: Supplementary Medical Insurance (Title XVIII) C. Child Health (Maternal and Child Health Services Block Grant; Med- E. Utilization and Quality Control Peer Review Program II. Programs Authorized Under the Public Health Service Act: A. Adolescent Family Life Demonstration Projects....... B. Agency for Health Care Policy and Research and National Center for F. Alcohol, Drug Abuse and Mental Health Administration G. Alcohol and Drug Abuse and Mental Health Services Block Grant K. Community and Migrant Health Centers.. L. Health Care for the Homeless ..... M. Health Maintenance Organizations [HMOs]. N. Health Professions Education P. Human Organ Procurement and Transplantation Q. Childhood Immunizations Grants and the National Vaccine Program... X. Population Research and Voluntary Family Planning. INTRODUCTION The main office of the majority staff of the Subcommittee on Health and the Environment is located at 2415 Rayburn House Office Building (225-4952). General inquiries regarding the work of the subcommittee should be directed to this office. The office of the minority staff is located at 564 House Annex No. 2 (226-3400). The staff director for the majority is Karen Nelson (225-0130). Members and staff should contact her with questions concerning health policy matters under consideration by the subcommittee, other relevant committees, or the Congress. Similar requests for information from the minority staff should be addressed to Margaret Durbin, minority chief counsel and staff director, 2322 Rayburn House Office Building (225-3641). MAJOR PROGRAMS WITHIN THE JURISDICTION OF THE SUBCOMMITTEE ON HEALTH AND THE ENVIRONMENT I. PROGRAMS AUTHORIZED UNDER THE SOCIAL SECURITY ACT A. MEDICAID (TITLE XIX) Brief Description: Medicaid is a Federal-State, means-tested entitlement program that pays for health care for certain poor people. States use Federal funds and their own dollars to purchase medical care services on behalf of eligible aged, blind, and disabled individuals and dependent children and their families. State participation in the Medicaid program is voluntary; all States, as well as the District of Columbia, American Samoa, Guam, Puerto Rico, the Northern Mariana Islands have elected to do so. (Arizona operates its program under a demonstration waiver granted by the Secretary of Health and Human Services). Federal matching payments are available to participating States for payments they make to providers on behalf of eligible persons, so long as the States operate State Medicaid Plans meeting certain minimum Federal requirements. Within these requirements, States enjoy considerable discretion with respect to eligibility, benefits, and reimbursement policy; accordingly, Medicaid programs vary significantly from jurisdiction to jurisdiction. Federal outlays for Medicaid in fiscal year 1991 are estimated by the Congressional Office to be $49.3 billion. These funds are derived from general revenues. State (and in some States, local) outlays are projected to be about $37.2 billion. In general, eligibility for Medicaid benefits is based upon (1) low income, (2) low resources, and (3) relationship to a welfare eligibility category (e.g., aged, blind, disabled, or member of a family where a parent is absent, incapacitated, or unemployed). In recent years, the Congress has begun to dissociate Medicaid from welfare categorical eligibility, while leaving in place income and resource tests. Nonetheless, restrictive eligibility standards mean that a majority of the poor do not qualify for Medicaid; according to the Congressional Research Service, only 41 percent of those with incomes below the Federal poverty level were covered by Medicaid in 1986. There are two principal Medicaid eligibility categories: the "categorically needy" and the "medically needy". The "categorically needy" include cash assistance recipients under the Aid to Families with Dependent Children [AFDC] program and the Supplemental Security Income [SSI] program. With respect to persons receiving SSI assistance (the aged, blind, or disabled), States may apply more |