WASHINGTON--The House and Senate budget committees approved separate budgets last week that call for cuts to various benefit programs--including Medicaid.

The Senate Budget Committee's resolution for fiscal year 2006 calls for trimming some $14 billion from projected Medicaid spending over the next five years. Meanwhile, the House plan calls for Medicaid and State Children's Health Insurance Program cuts of $15.1 billion, but, according to some experts, those cuts could ultimately be as high as $20 billion.

The congressional budget plans, to be put to floor votes this week, follow President Bush's proposal earlier this year for sharp cuts--$60 billion over 10 years--to federal Medicaid funding to help reduce the nation's growing deficit. At the same time, states are proposing their own cuts to the program, leaving HME state associations with their hands full.

During the last several months, for example, the Michigan Home Health Association (MHHA)--with membership that includes HME, home health agencies and private-duty nursing--has been working with state Medicaid to re-examine a proposed 50-percent oxygen concentrator reimbursement cut.

Meanwhile, the Pennsylvania Association of Medical Suppliers (PAMS) has organized a grassroots campaign against the state's proposed budget that has a $5,000-per-year cap on DME for adults.

And since October of last year, Mississippi Medicaid--a program that has come dangerously close to bankruptcy in recent weeks--has been slowly withdrawing coverage for many DME codes, including adult rehab products such as cushions and reclining wheelchairs.

"Our state legislature is just not educated as to how this equipment keeps people out of the hospital," said Danyelle Carroll, owner of Mobility Medical and president of the Mississippi Association of Medical Equipment Suppliers (MAMES), which has been communicating with state policymakers about "how cost-effective home care really is."

In Missouri, the Midwest Association of Medical Equipment Services (MAMES) and other advocacy groups have been protesting Gov. Matthew Blunt's proposed Medicaid cuts for most adult DME. And last week, the state's House backed a plan to restore some $242 million of the governor's proposed cuts, including $82 million for services such as hospice care, ambulance rides and wheelchair funding, according to reports.

The new plan hasn't come without intense debate, however. To pay for it, lawmakers had to trim almost $24 million for the state's MC+ for Kids program, which provides health care for families who don't have health insurance but do not meet the financial requirements for Medicaid.

Opposing the plan, state Rep. Margaret Donnelly, D-St. Louis, told the Associated Press that lawmakers "should not be balancing the budget on the backs of the poor, disabled and particularly not on the backs of children."