Will Healthcare Reform Sneak In Through Budget?
Posted: Tuesday, February 02, 2010
by Yamileth Medina
VitalOne Health
President Barack Obama recently released his proposed budget for the 2011 fiscal year. As expected after his State of the Union speech, it includes increases in funding for job creation. However, the soaring budget deficit has become a significant concern among politicians, as well as the American people That is why many other federal programs are facing a spending freeze in the new budget. Meanwhile, healthcare reform is no longer his central domestic issue. Legislation is in a holding pattern, with Congress neither having the appetite for approving the already-passed Senate bill as is, nor the ability to get newly powerful Republicans on board.If the provision in the budget does none of those things, what is its impact on healthcare reform? For one thing, it also seeks to cover millions of Americans at risk for being uninsured. The difference is that it applies to those eligible to receive health insurance from an existing program, Medicaid. It provides medical, vision, and dental insurance to the poor and working-class, and is funded by both the national and state governments. As millions of Americans lose their jobs and see their COBRA health insurance benefits expire, an increasing number of them are turning to Medicaid. In fact, programs like Medicaid typically see their nationwide enrollments increase by one million per 1% increase in the unemployment rate.
The main problem with this is that individual states are also struggling with their own budgets. Unlike the federal government, states are not allowed to run budget deficits. That leaves them without funding to provide medical insurance for an increasingly needy population. The nation's 2011 budget would give $25.5 million to the states in order to support Medicaid, extending the funding from last year's stimulus package. Comprehensive healthcare reform bills in the House and Senate included funding extensions. With their passage looking like a foregone conclusion, states already accounted for the continued funding in their own budgets. The possibility of reform failing, when even more of their residents must do without individual health insurance, leaves state governments in a bind.
The budget only requires a simple majority, as opposed to a super-majority, in order to pass. (In other words, they will need just 51 votes, instead of 60, in the Senate.) Democrats will be able to pass this measure easily in both houses of Congress. Although the deficit is worrying, the purpose of the funding itself is relatively noncontroversial with state constituents. Some political analysts predict that this provision in the federal budget serves as a way of sneaking the medical insurance reform issue under the radar. A few conservatives may find themselves at a loss when justifying their simultaneous opposition to the rest of the healthcare reform proposals. Republicans, meanwhile, would insist that the Federal Medicaid Assistance Percentage (FMAP) is a tiny slice of what the full bill would do; for example, relaxed eligibility requirements would result in a 25% increase of those enrolled in Medicaid. This may actually be an example of the bipartisan compromise Obama is seeking, though many other issues will no doubt prevent the minority party from voting in favor of his budget.
(Image: Jeff Keen under CC 2.0) Yamileth Medina is an up and coming expert on individual health insurance and healthcare reform. She aims to help people realize that they can find quality medical insurance right now. Yamileth lives in Miami, FL.
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