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March 30, 2004 The Honorable Don Nickles The Honorable Kent Conrad Chairman Ranking Member United States Senate United States Senate Washington, DC 20510 Washington, DC 20510 The Honorable Jim Nussle The Honorable John Spratt Chairman Ranking Member United States House of Representatives United States House of Representatives Washington, DC 20515 Washington, DC 20515 Dear Budget Conferees: The undersigned organizations strongly oppose any Medicaid cuts included in the fiscal year 2005 budget resolution, especially any reconciliation instructions that require the Energy and Commerce Committee or the Finance Committee to cut entitlement spending. Such cuts would harm the more than 51 million Americans who rely on Medicaid for their health care lifeline, and reduce reimbursement to critical health care providers. Medicaid provides health insurance to America s most vulnerable seniors, children, pregnant women, working families, and people with disabilities. Seniors receive prescription drug coverage and long-term care services through Medicaid. Children obtain vital screening and prevention services under Medicaid. Nearly one in ten American women and one-third of all poor women rely on the Medicaid program for their health care. Medicaid also provides the crucial services such as long term supports and services and therapy that people with disabilities need. The states are already facing a major loss in federal Medicaid funds when the temporary increase in the Federal Medical Assistance Percentage expires on June 30 th. The states are also facing unexpected new costs in helping to implement the new Medicare prescription drug law. To add any budget cuts on top of these existing strains will create enormous hardship for states and threaten the health security of the Americans who rely on Medicaid for their essential health care services. These cuts would occur as states are beginning to recover from the most severe budget crisis since World War II. States need more, not less, federal Medicaid funding to sustain their current Medicaid programs and avoid greater cutbacks that add to the ranks of the uninsured and further shifting costs to health care providers. We urge the Conference Committee to protect Medicaid in the fiscal year 2005 budget and to adhere to the bipartisan principle established in the Senate that does not require the Energy and Commerce or Finance Committees to produce budgetary savings that will lead to cuts in the Medicaid program. cc: Budget Conferees

Sincerely, Advancing Independence Advocates for Children and Youth, Inc. AIDS Action AIDS Alliance for Children, Youth & Families AIDS Treatment Data Network Alexander Graham Bell Association for the Deaf and Hard of Hearing Alliance for Children and Families Alliance for Retired Americans Alzheimer s Association Ambulatory Pediatric Association American Academy of Child and Adolescent Psychiatry American Academy of HIV Medicine American Academy of Pediatric Dentistry American Academy of Pediatrics American Association for Geriatric Psychiatry American Association for Marriage and Family Therapy American Association of Homes and Services for the Aging American Association of People with Disabilities American Association on Mental Retardation American Cancer Society American College of Obstetricians & Gynecologists American Congress of Community Support and Employment Services American Congress of Rehabilitation Medicine American Council of the Blind American Counseling Association American Dental Association American Dental Education Association American Dental Hygienists' Association American Diabetes Association American Federation of State, County and Municipal Employees American Federation of Teachers American Foundation for the Blind American Friends Service Committee American Geriatrics Society American Health Care Association American Medical Rehabilitation Providers Association American Music Therapy Association American Network of Community Options and Resources (ANCOR) American Nurses Association American Occupational Therapy Association American Pediatric Society American Physical Therapy Association American Psychological Association American Public Health Association American Social Health Association American Society of Transplant Surgeons American Therapeutic Recreation Association

Americans for Democratic Action Association for Gerontology and Human Development at Historically Black Colleges and Universities Association for Health Center Affiliated Health Plans Association for the Advancement of Psychology Association of Academic Physiatrists Association of Asian Pacific Community Health Organizations Association of Community Organizations for Reform Now (ACORN) Association of Maternal and Child Health Programs Association of Medical School Pediatric Department Chairs Association of University Centers on Disabilities (AUCD) Bazelon Center for Mental Health Law Brain Injury Association of America Call to Renewal Catholic Health Association of the United States Center for Medicare Advocacy, Inc. Center on Disability and Health Central Conference of American Rabbis CHAMP, Community HIV/AIDS Mobilization Project Child Welfare League of America Children & Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) Children s Defense Fund Children s Dental Health Project Children s Diagnostic & Treatment Center, Inc. Children s Foundation Church Women United Coalition on Human Needs Community Advocates for Developmentally Disabled (CADD) Community Healthcare Network Concerned Citizens for the Mentally Retarded Congressional Black Caucus Foundation Council for Exceptional Children Council for Health and Human Service Ministries Council of Women s and Infants Specialty Hospitals Depression and Bipolar Support Alliance Disability Service Providers of America Easter Seals Eating Disorders Coalition for Research, Policy & Action Epilepsy Foundation Evangelical Lutheran Church in America Families USA Family Voices Federation of Families for Children's Mental Health Gay Men s Health Crisis, Inc. Generations United Gray Panthers Helen Keller National Center HIV Medicine Association I Am Your Child

IDEA Infant and Toddler Coordinator Association Institute for Reproductive Health Access International Association of Psychosocial Rehabilitative Services International Union, UAW Jewish Council for Public Affairs Jewish Federation of Metropolitan Chicago Last Acts Partnership Legal Action Center Lutheran Network for Justice Advocacy Lutheran Services in America March of Dimes Medicaid Matters New York NAADAC - The Association for Addiction Professionals National Academy of Elder Law Attorneys National Adult Day Services Association National Advocacy Center of the Sisters of the Good Shepherd National Alliance for the Mentally Ill National Alliance of State and Territorial AIDS Directors National Association for Home Care & Hospice National Association for Retired Federal Employees (NARFE) National Association for the Advancement of Colored People National Association for the Advancement of Orthotics and Prosthetics National Association of Area Agencies on Aging (N4A) National Association of Community Health Centers National Association of Councils on Developmental Disabilities National Association of County Behavioral Health Directors (NACBHD) National Association of Mental Health Planning and Advisory Councils National Association of People with AIDS (NAPWA-US) National Association of Professional Geriatric Care Managers National Association of Protection and Advocacy Systems National Association of Public Hospitals and Health Systems National Association of School Psychologists National Association of Social Workers National Association of State Long Term Care Ombudsman Programs National Association of State Mental Health Program Directors National Association of State Units on Aging National Association of Urban Hospitals National Center for Assisted Living National Citizens' Coalition for Nursing Home Reform National Coalition for Asian Pacific American Community Development National Coalition of STD Directors (NCSD) National Coalition on Deaf-Blindness National Committee to Preserve Social Security and Medicare National Council for Community Behavioral Health Care National Council of Jewish Women National Council of La Raza National Council on Independent Living National Council on the Aging National Down Syndrome Congress

National Education Association National Family Planning and Reproductive Health Association National Fragile X Foundation National Health Council National Health Law Program National Immigration Law Center National Indian Council on Aging National Medical Association National Mental Health Association National Minority AIDS Council National MS Society National Organization on Disability National Partnership for Women and Families National Psoriasis Foundation National Rehabilitation Association National Respite Coalition National Spinal Cord Injury Association National Women s Law Center NETWORK, A National Catholic Social Justice Lobby Older Women's League Paralyzed Veterans of America Parent Project Muscular Dystrophy Parents & Associates Advocate Council Pediatrix Medical Group Physicians for Social Responsibility (PSR) Planned Parenthood Federation of America Presbyterian Church (U.S.A.) Washington Office Project Inform Rehabilitation Engineering and Assistive Technology Society of North America School Social Work Association of America Service Employees International Union (SEIU) Sjogren's Syndrome Foundation Society for Adolescent Medicine (SAM) Society for Pediatric Research Spina Bifida Association of America State Associations of Addiction Services The Arc of the United States The Gerontological Society of America UJA-Federation of Jewish Philanthropies Union for Reform Judaism Unitarian Universalist Association of Congregations United Cerebral Palsy United Church of Christ Justice and Witness Ministries United Jewish Communities United Methodist Church, General Board of Church and Society United Spinal Association USAction Visiting Nurses Association of America Voice of the Retarded

Voices for America's Children Volunteers of America Welfare Law Center Women of Reform Judaism World Institute on Disability