The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Posts Tagged ‘Congress’

Health Care Reform Bills: Coming Soon to a Nation’s Capital Near You

Posted by Alan on November 12, 2008

President-elect Barack Obama won’t take the oath of office for more than two months, but the drive for health care reform is about to get under way. Senate Health, Education, Labor and Pensions Committee Chair Ted Kennedy has been working from his home, where he’s fighting brain cancer, seeking to pull together a consensus bill. Meanwhile, Senator Max Baucus, Chair of the Senate Finance Committee introduced his health care reform plan today.

Senator Baucus’ Finance Committee and Senator Kennedy’s Health, Education, Labor and Pensions Committee share jurisdiction over this issue. According to Politico, the staffs of the two committees have been meeting with stakeholders since the summer and the two committee chairs have been in contact. The details of Senator Kennedy’s plan have not yet been released.

Senator Baucus’ health care reform plan contains several elements that align with the reforms President-elect Obama called for during the campaign. These include the creation of government-run “exchanges” to allow Americans to shop for coverage from multiple carriers and a requirement that carriers accept all applicants regardless of pre-existing health problems. Significantly, Senator Baucus goes a step further and would require all Americans to purchase coverage “once affordable options are available.”

Requiring everyone to purchase coverage was a contentious issue during President-elect Obama’s hotly contested primary fight against Senator Hillary Clinton. She was for a mandate to buy; he opposed it. As has been previously noted, a requirement to sell insurance without a requirement to buy results in higher premiums. Senator Baucus apparently agrees noting that the uninsured incur medical costs that are then shifted to those with insurance. By bringing everyone into the system, Senator Baucus believes the average cost of insuring each American will be reduced. By including an alternative for those who cannot afford coverage he avoids one of the most vociferous objections to requiring consumers to buy coverage.

Senator Baucus’ health care reform plan would also allow those between the ages of 55-and-64 to purchase Medicare if they lack access to public insurance programs or a group health plan. According to the New York Times, four million people in this age group are currently uninsured. He would expand the State Children’s Health Insurance Program to include children in families at or below 250 percent of the federal poverty level ($44,000 for a family of three) and he would lift the ban preventing legal immigrants to enroll in SCHIP until they’ve been in the country for five years. Like President-elect Obama, Senator Baucus supports tax credits for small businesses that provide health insurance coverage and for individuals and families, below 400 percent of the federal poverty level, who purchase their own coverage.

We haven’t heard from the Republican side of the aisle on this issue yet, but it shouldn’t be long now. There proposals will likely be more market oriented and less far reaching.

The key question is whether lawmakers in Washington have the bandwidth to fashion a comprehensive health care plan while simultaneously dealing with a crashing economy, a host of international issues and energy policy. Personally I think they’ll make the time. Health care reform is too entwined with people’s sense of financial and is too much a part of the economy to be put off. As I’ve written before, if health care reform is positioned not as a cost item, but as in investment in the nation’s infrastructure, it becomes very compatible with other economic stimulus efforts.

On the other hand, it is interesting that Senator Baucus, the Chair of the Senate Finance Committee, has apparently left out the funding mechanism for his reform package. That in itself is a telling reminder of how difficult achieving meaningful reform in today’s economic climate will be. That it is difficult, however, does not mean it’s impossible.

Note: I haven’t been able to find

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Yes It’s the Economy, But It’s Health Care Reform, Too

Posted by Alan on October 25, 2008

In 1992, James Carville wrote down the key messages then Governor Bill Clinton’s campaign had to focus on in order to win.

  1. Change versus more of the same
  2. The economy, stupid
  3. Don’t forget health care

Throw in a cup of national security and you’ve got the same recipe for presidential success in 2008. Anyone listening to a speech by Senator John McCain or Senator Barack Obama will appreciate that their campaigns understand this reality. And given the recent credit crisis and financial maelstrom, the economy has become an even more central part of this election. In interpreting the public’s demand for change, however, the dominant position of economic issues should not hide the fact that voters want health care reform, too.

According to the October Kaiser Health Tracking Poll, no surprise here, the economy is overwhelmingly, the most dominant issue in this year’s campaign. 62 percent of the survey’s respondent’s listed the economy as “the single most important issue in [their] vote for president.” 13 percent of the respondents cited Iraq while 12 percent named health care.

Economic concerns emerged as the key issue long before the current financial crisis, however. In the December 2007 poll, Iraq was the top issue, with 30 percent of the respondents listing it as the most important issue. It was followed by the economy at 23 percent and health care at 21 percent.

In February 2008, the economy had moved into first place, having been named by 43 percent of respondents. The percentage name Iraq and health care as the most important issues remained constant at 29% and 21 percent, respectively.

By August 2008 49 percent of respondents were citing the economy as their top issue while Irag had dropped to 25 percent and health care to 16 percent. The Kaiser survey interviewed “likely voters” by phone between October 8th and October 13th, well after the economic crisis had set in, making the big change in the results understandable.

One might conclude from this that health care reform is moving off the public’s radar as a salient issue. That would be a mistake. The Kaiser survey shows that 75 percent of Democrats and 61 percent of independents believe “it is more important than ever to take on healthcare reform.” Even 42 percent of Republicans agreed with this statement. What it shows is that health care reform and economic security are intertwined and inseparabe. A key aspect of “fixing” the economy will involve “fixing” health care.

According to the Kaiser study, 35 percent of respondents themselves or a family member had put off getting health care they needed because of the economy. 31 percent said they skipped recommended medical tests or treatment and 27 percent said they didn’t fill a prescription. 28 percent of the respondents reported they had problems paying for health care and health insurance as a result of recent changes in the economy.

Restoring consumer confidence is a substantial part of recovering from economic set backs. So it is significant that half of the respondents (51 percent) said that “lower prices for health care and insurance would make a big difference in their family’s financial situation.” That’s more than the 45 percent who said a rebound in the stock market would make a big difference in their situation.

Senator Obama has cited health care reform as one of the top three issues he’ll address as president. There are numerous plans already circulating in Congress to jump start the reform process, including a bipartisan health care reform package backed by 12 Senators, six from each party. Senator Ted Kennedy, who is at home battling brain cancer, is talking with lobbyists, policy mavens and lawmakers from both parties to develop a framework for health care reform for the new president. Senator Kennedy intends to introduce his legislation as soon as the new Congress convenes.

So yes, the economy will be the dominant issue between now and election day. And it will dominate the president-elect’s wait to move into the White House and it will dominate his first months — perhaps his first term — in the oval office. The economy will dominate, but it won’t eliminate other issues. The American people expect health care reform to be among those other issues — and it will be.

What may surprise some is how quickly the health care reform effort will get underway. My guess is the new president will give a major address on the issue before inauguration day. Health care reform is simply too tied to the reality and perception of Americans’ economic security. It’s too important to Senator Kennedy. It’s too important to helping businesses recover and grow. The American people want the new president to address health care reform. And the new president will need to.

Posted in Health Care Reform, Healthcare Reform, Politics, Presidential Election | Tagged: , , , , , | 1 Comment »