The Medicaid and CHIP Payment and Access Commission is increasing its effort to present offset options when it advises Congress on funding and policy changes to the federal healthcare programs serving low-income people and children.
MACPAC's executive director, Anne Schwartz, revealed that information during a House Energy and Commerce Committee hearing on Medicaid and the Children's Health Insurance Program funding.
At the hearing, Rep. Brett Guthrie (R-Ky.) noted that the Medicare Payment Advisory Commission, or MedPAC, advises Congress on Medicare spending regularly and presents offset ideas, while MACPAC does not when recommending changes to Medicaid or CHIP.
“If MACPAC wants us to be able to move forward with recommendations, why doesn't MACPAC mirror MedPac?” Guthrie asked.
The criticism mirrors what Republican E&C staff members told Modern Healthcare exclusively last week. They said that lawmakers feel the panel offers advice that often is too generic and not backed by data and therefore not practical. Democratic E&C staffers and lawmakers disagreed with the characterization, saying it was partisan politics.
Most of MACPAC's recommendations don't have a budget impact, making the need to present an offset unnecessary, Schwartz said in response to Guthrie's question.
However, the commission is working on some CHIP recommendations that will result in additional spending, and it is looking for saving options, Schwartz said.
She added that the group regularly works with Congressional Budget Office to assess its recommendations.
The scrutiny comes as Medicaid, the nation's largest insurer, is experiencing severe growing pains. The number of enrollees has jumped from about 50 million in 2010, the year the Affordable Care Act was signed into law, to more than 70 million today. Medicaid spending hit $495.8 billion in 2014, and is expected to grow to over $600 billion by 2020.