January 5, 2005

The Honorable George W. Bush
President of the United States
The White House
Washington, D.C.  20500

Dear President Bush:

On behalf of over 3 million volunteers and 1,400 staff of the March of Dimes Foundation, I am writing to express our strong commitment to working with your Administration to secure the role of Medicaid in the health care safety net for low income children, infants, and women of childbearing age (especially those who are pregnant).

Medicaid and the State Children's Health Insurance Program (SCHIP) are central to March of Dimes mission to improve the health of women and children.  As you know, Medicaid is the largest source of financing for health care services provided to women, infants and children in the United States.  Today, women of childbearing age (15 to 44) are the majority of adult Medicaid beneficiaries and 25 million children rely on the program for their health coverage.  In fact, the most recent estimates from the National Governors Association indicate that, in 2000, -- the latest available data -- Medicaid was the single most important source of reimbursement for maternity services, accounting for 1.4 million (37%) births in hospitals.  The program is equally important to the pediatric population, as it reimburses for an estimated 40% of hospitalizations involving children with birth defects and nearly half of hospital stays for infants born preterm or low birthweight.

The March of Dimes expects that restructuring of the Medicaid program will generate considerable debate as Congress considers avenues for deficit reduction in fiscal year 2006 and beyond.  Like you, we believe it is important to ensure that the Medicaid program reaches those in need and that States are making efficient and valuable use of federal dollars.  In particular, we feel it is essential to maintain the individual entitlement to coverage under Medicaid and to preserve the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefits for children.  Therefore, we will strongly oppose any attempt to abolish Medicaid’s individual coverage entitlement or to extinguish pediatric benefits provided through EPSDT.  We respectfully request that your fiscal year 2006 budget proposal not call for significant budget savings from Medicaid, as federal funding levels impact the ability of States to provide needed health services to the most vulnerable among us, including at risk children, infants, and women of childbearing age.

Thank you for your consideration of the March of Dimes’ views, and we look forward to working with your Administration to ensure the continuation of Medicaid’s important role in our nation’s health care system.

Sincerely,

Jennifer L. Howse
President, March of Dimes Foundation

cc:    The Honorable Joshua B. Bolten, Director
          Office of Management and Budget
          725 17th Street, N.W.
          Washington, DC  20503