Friday, February 6, 2009

Expanded Health Care Coverage: Blessing or Curse

Have you heard? Under the economic stimulus package, expaned health care coverage is on the way.  Question is, for how long? Is it hard to believe that 4 million children in the United States have no type of health coverage at all.  Well it brings me some comfort to know that at least half of 4 million children will receive coverage under the SCHIP (State Children Health Insurance Program). Under the two-year economic stimulus package released last week by House Democrats, recently laid-off workers could receive health coverage assistance through an $8.6 billion expansion in medicaid or $30 billion in federal COBRA subsidies. 

House leaders said that under the proposal, the federal government would pay in full all benefits and administrative costs for all unemployed medicaid beneficiaries through 2010.  My question is after 2010 when this coverage has run its course, what type of plan or program is to take place of this one?  The proposal would allow states to choose whether to extend medicaid coverage to unemployed residents, and it would allow states to determine who whould qualify for the program.  States would have the option of expanding medicaid benefits to people using or who have exhausted unemployment benefits, no matter what their income is; unemployed people who qualify for food stamps, which in many states are available to residents whose incomes are too high to qualify for medicaid and people who have been laid off and have incomes up to 200% of the federal poverty level who otherwise would not qualify for medicaid.  

We know most private practices and specialist in the health care profession would not even bother to look at a person that has medicaid.  Let's not even talk about charity care.  That's another blog writting in itself.  Getting back to the issue at hand, House leaders said that under the COBRA proposal, health insurance premiums would be subsidized.  Let's examine this closely shall we.  COBRA subsidize their health insurance premiums?  Are they SERIOUS!  Seven out of ten Americans are filing bankrupcy every year on account of high medical expenses.  The COBRA proposal is this, health insurance premiums would be subsidized up to 65% for one year for recently laid off workers.  According to legislative sources, the level of assistance could change depending on the results of congressional budget analyses.  I wonder if the folks on Capital Hill ever thought about what would happen after the funds run out and the aid of this expanded health care coverage program ended in 2010?

Conservative health care policy experts are critical of expanding an entitlement and are predicting that states would have a hard time shutting the spigot of help once the federal money stopped.  It's almost like putting a band aid on a bullet wound.   It will be like trying to rinse soap out of your eyes only to find out that there is no more running water.  "Nina Owcharenko, an analyst at the Heritage Foundation's Center for Health Policy Studies, said that states will feel mounting pressure to maintain the Medicaid expansion when the federal funds run out in two years otherwise, it's seen as kicking people off the program. If  that happens, where is the cushion to break the fall?