[NYAPRS Enews] WT: Medicaid Expansion Hinders Health Reform Talks

[Matt Canuteson]

Medicaid Expansion Hinders Reform Talks

Washington Times Jennifer Haberkorn
<http://washingtontimes.com/staff/jennifer-haberkorn/>  & Ralph Z.
Hallow <http://washingtontimes.com/staff/ralph-z-hallow/>  

 

A proposed expansion of Medicaid, the health care program for
lower-income Americans, has emerged as one of the last sticking points
in the Senate Finance Committee's health care reform bill, with
governors and state legislatures around the country worried they're
going to get left with the tab. 

Proposals in the House and Senate would expand Medicaid eligibility to
133 percent of the federal poverty level, potentially putting millions
of new people on the public health program for the poor younger than 65.


As the Senate Finance Committee's "gang of six" tries to wrap up its
health care reform bill, it is also trying to determine how much of
those new costs should be paid by the states and how much by the federal
government. 

The gang of six - three Republicans and three Democrats - hopes to
finish negotiations this week. Committee Chairman Max Baucus, Montana
Democrat, said he is likely to issue a bill Tuesday or Wednesday, but
it's still unclear whether Republicans are going to sign on. Mr. Baucus
said he plans to continue to lobby Republican support, even after the
bill is released. 

Other points of dispute for the group include medical malpractice
reform; drafting a verification system to prevent illegal immigrants
from obtaining government insurance subsidies; and preventing federal
funding from going to abortions. 

President Obama's plan got a bit of good news Monday, as a new survey by
pollster John Zogby found a large consensus in the country on eight
major health care issues, although in some cases the majority favors
items not in the president's blueprint. And Mr. Obama's much-touted
speech last week to Congress helped his cause. 

According to a survey of 4,426 likely voters, 78.5 percent say they back
tort reform - tentatively embraced in Mr. Obama's speech, and 82.8
percent of voters think that allowing out-of-state health-insurance
purchases may lower premium costs. 

Mr. Zogby said the speech improved Mr. Obama's standing among skeptical
independents - though there is still plenty of work to do. 

"Obama's speech boosted his approval by nine percentage points with the
all-important independents - but not as much as needed," Mr. Zogby told
The Washington Times. "Even with this post-speech boost, 54 percent of
independents still disapprove of his job performance." 

The Medicaid expansion plan is designed to extend health care access to
more of the poor, a population that often doesn't get preventive care
and ends up getting treated for routine medical problems in hospital
emergency rooms. If the individual can't pay the hospital bill, those
costs get "shifted" by the hospital or doctor to patients who can pay. 

The proposal would extend Medicaid access to 133 percent of the federal
poverty line, which in 2009 would mean that individuals making less than
$14,404, or families of four making less than $29,327, would be
eligible. 

The National Governors Association (NGA) and the National Conference on
State Legislatures have cautioned that the states cannot afford to take
on new costs, particularly in a struggling economy. 

"Any increase in the mandatory minimum eligibility threshold will cost
states tens of billions of dollars per year," NGA Executive Director Ray
Scheppach told a House panel in June. 

States with spiking unemployment rates, such as Michigan, would be hit
hardest. 

Michigan Gov. Jennifer M. Granholm "recognizes there needs to be a
shared responsibility in health reform ... from both federal and state,"
her spokeswoman, Megan Brown said, "and we look forward to working with
the president to get health reform done this year." 

Other states, such as Rhode Island, would be barely impacted by the
change. There, adults with children are eligible until their incomes are
175 percent over the poverty rate, and children are eligible until their
parents' income reaches 225 percent of the poverty rate - well above the
proposed federal limit. 

The gang of six is expected to hold a conference call about the Medicaid
expansion proposal with a group of governors on Tuesday. 

Republicans in the gang of six - Sen. Michael B. Enzi of Wyoming, Sen.
Charles E. Grassley of Iowa and Sen. Olympia J. Snowe of Maine - have
voiced concern over saddling the cash-strapped states with additional
costs. 

"Sen. Enzi ... believes that approach to covering the uninsured fails on
all counts by creating a new, unfunded mandate for state governments,
and by putting folks who need health care the most into a federally
managed, waste-ridden program already desperately in need of reform,"
his spokesman said. 

Mr. Baucus has also expressed concern over the impact on state budgets.
He insisted Monday that the states would not be left with much to pay
for, but declined to reveal specifics of how to avoid the extra costs. 

"States, I think, are going to be pleasantly surprised because there are
going to be some additional costs, but much less than we originally
expected," he said. "The Medicaid costs with expansion are not going to
complicate near as much as we originally feared because of" other
programs, such as more generous drug rebates and changes to the state
Children's Health Insurance Program. 

The nonpartisan Congressional Budget Office found that the expansion, as
described in the House health care bill, would increase federal outlays
for Medicaid by $438 billion over a 10-year-period. Mr. Obama said again
Monday in a New York speech that he would not sign off on a bill that
isn't fully paid for, a stance shared by Senate Democrats. 

Under current law, Medicaid eligibility varies widely by state, with
some states providing access to the program at 175 percent of the
poverty rate and some offering little more than the federal
requirements. States administer the program but are reimbursed by the
federal government. 

http://washingtontimes.com/

 

 

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