In his first 30 days in office, President Obama used the stimulus package and the reauthorization of the State Children’s Health Insurance Program (SCHIP), both already enacted into law, to lay the groundwork for what may be a major overhaul of America’s health care system.
To ensure that CA’s voice is heard as this debate continues, we are in a series of ongoing meetings with staff members from a number of congressional committees and offices as they consider major health care reform legislation in the coming months. We also will be meeting with the Department of Health and Human Services as the plan evolves.
The stimulus bill
The American Recovery and Reinvestment Tax Act, also known as the Stimulus Bill, was signed by Obama in Denver on February 17. This new law will fund record investments in education, energy research and infrastructure, and it includes a $400 tax break for most individuals and $800 for married couples. The bill also expands food stamps and child nutrition programs, as well as increases unemployment benefits.
On health care, the president said, “we have done more in 30 days to advance the cause of health care reform than this country has done in an entire decade.”
In addition to expanding eligibility for Medicaid and providing increased federal matching payments to states, the new law also:
- Includes roughly $19 billion for health information technology infrastructure and Medicare and Medicaid incentives to encourage the electronic exchange of patient health information amongst providers;
- Provides a 65 percent federal subsidy for health insurance under COBRA for up to nine months for workers who have been involuntarily terminated, as well as their families;
- Extends Medicaid coverage for up to four months for families in transition from welfare to the work force; and
- Provides $500 million for community health centers to provide care to uninsured and under served rural and urban populations.
SCHIP reauthorization
On February 4, Obama signed a four-and-a-half-year reauthorization of SCHIP that expands individual insurance coverage for children. Before the Senate passed the reauthorization, CA wrote a letter of support to Sens. Max Baucus and Charles Grassley, the chairman and ranking member of the Senate Finance Committee.
The new law:
- Expands the program by $32.8 billion (in addition to the $30 billion baseline spending) by increasing the tobacco tax by about $1 per pack;
- Expands SCHIP to families with incomes up to 300 percent of the federal poverty level;
- Allows states to drop the five-year waiting period for covering legal immigrant children and allows them to cover pregnant women; and
- Removes barriers in order to allow better coordination and partnership with existing employer-provided health insurance.
On the same day, the president also rescinded a directive that states must enroll
95 percent of children from families with incomes below 200 percent of the federal poverty level before expanding coverage to those above 250 percent, opening up coverage to a larger population.
Health care reform legislation
Even before the budget proposal, key staff members along with members of Congress and several committees, including the Senate Finance Committee, told CA that they are in the first stages of writing health care reform legislation.
In a broad outline of his “Call to Action,” the probable starting point for this legislation, Senate Finance Committee Chairman Max Baucus, D-Mont., outlined the basics of reform legislation that includes an individual mandate for purchasing health insurance.
The plan would create a nationwide insurance pool called the Health Insurance Exchange. Those who already have health coverage could keep what they have, but for those who need insurance, the Exchange would be a marketplace in which they could compare and purchase the plan of their choice regardless of pre-existing conditions. Premium subsidies would be available to qualifying families and small businesses.
While the Exchange was being created, the plan would make health care coverage immediately available to Americans ages 55 to 64 through a Medicare buy-in. Programs to encourage wellness programs and preventive care are also included.
Amongst other things, this redefined health care system would encourage providers in different settings to collaborate and provide patient-centered care that would enhance quality and save money through improved health information technology. Hill staff members tell CA they hope to have a proposal together by this summer.
CA's proposal
In mid-January, CA hosted a community health care discussion at the Lake Region Hospital in Fergus Falls, Minn. A cross-section of community leaders, locally elected officials and a representative from Rep. Peterson’s office all attended. CA founder and chairman Milt Smedsrud gave the opening remarks and CA president Wayne Nelson led the discussion.
Everyone agreed that health care costs are too high and there needs to be improved access to health care for all Americans. As a result of that meeting, and more than 30 years of participation in the health care debate, CA has created a white paper that is now being distributed in Washington, D.C., and to others involved in health care. It says:
- All Americans should be required to have health insurance that provides a minimum of benefits;
- All Americans should have equal tax treatments for their health insurance premiums;
- All Americans below certain income thresholds should be eligible for
refundable tax credits to help them purchase insurance;
- All Americans should be eligible for lifestyle tax credits based on measurable improvements to their health, education and well-being; and
- All Americans should have better access to price and quality information, allowing them to make more informed health care decisions.
CA will continue to carry the message to Congress that, through comprehensive reform and the collaborative efforts of the private market, we can assure that everyone is afforded quality health care through a strong private health insurance market coupled with enhancements to present government programs.
Read CA’s white paper Quality, Accessible, Affordable Health Care for All Americans.
Risk-pool funding
The Omnibus Appropriations bill for fiscal year 2009 that the Congress just passed includes $75 million for state high-risk insurance pools, an increase of $26 million from last year.
Health care continues to take the spotlight, and CA will be there in Washington, D.C., advocating for you. We need your input on current issues! Let your voice be heard — take our survey.
