January 2009 Archives

What should SCHIP reauthorization look like?

Congress is moving fast to reauthorize the State Children's Health Insurance Program, which is set to expire at the end of March. Reauthorization bills have already passed both chambers of Congress.

Conservatives were quick to complain that the legislation fails to require coverage of the poorest kids before expanding up the income ladder. There also were questions raised about whether immediately covering legal immigrants who are not yet U.S. citizens would eventually lead to coverage of illegal aliens.

Sen. Charles Grassley of Iowa, the ranking Republican on the Finance Committee, objects that both bills ignore last year's agreement "to prevent the crowd out of private coverage, putting more pressure on the federal budget."

Both bills carry $32 billion price tags and would cover about 11 million kids. Both would allow states to lift a five-year coverage delay for legal immigrants and pregnant women. The House bill would place restrictions on physician-owned specialty hospitals.

What do you think are the major strengths or weaknesses of the SCHIP bills passed by the House and Senate?

-- Marilyn Werber Serafini, NationalJournal.com

15 responses: Rep. Eliot Engel, D-NY, Rich Umbdenstock, John C. Goodman, Sen. Max Baucus, D-Mont., Billy Tauzin, Nancy H. Nielsen, Marilyn Werber Serafini, Janet Trautwein, Leonard D. Schaeffer, Stuart Butler, Andy Stern, Karen Davis, Uwe Reinhardt, Raymond C. Scheppach, Ron Pollack

Barack Obama and key members of Congress say they want to jumpstart efforts on health information technology by including it in the stimulus package. The idea is to bypass budget rules that would make it harder to spend the money later. Obama has proposed investing $10 billion a year for five years to move toward standards-based electronic health care systems. Senate Finance Committee Chairman Max Baucus, D-Mont., said in December that he also favored including some HIT money in an economic stimulus bill, but that Obama's number might be a little high. What do you see as the pros or cons of including $10 billion a year for health information technology in the stimulus package? Are there any reasons to be cautious about moving forward with this initiative?

-- Marilyn Werber Serafini, NationalJournal.com

14 responses: Jack Lewin, Marilyn Werber Serafini, Rich Umbdenstock, James P. Gelfand, Raymond C. Scheppach, John Sheils, Andy Stern, Jason Rosenbaum, Marilyn Werber Serafini, C. Eugene Steuerle, Uwe Reinhardt, Karen Davis, John C. Goodman, Len Nichols

Would it really do much good to extend the length of COBRA health insurance coverage as part of an economic stimulus package? Would people really sign up? Does COBRA ever really work well?

As more people lose jobs, and therefore insurance, policy makers are considering extending the length of time that unemployed people can continue their old employer health plans. Unemployed workers would have to pick up the entire cost, however, which can get very expensive.

Policy makers also are considering temporarily expanding Medicaid coverage to people who wouldn't otherwise qualify, with the federal government picking up the tab.

Is lengthening COBRA a waste of time? FamiliesUSA released a study Friday finding that COBRA costs on average eat up most unemployment benefits. Is it better to stick with Medicaid, or are there dangerous precedents in expanding Medicaid's reach?

-- Marilyn Werber Serafini, NationalJournal.com

8 responses: Janet Trautwein, Andy Stern, Newt Gingrich, Raymond C. Scheppach, James P. Gelfand, Karen Davis, Uwe Reinhardt, Ron Pollack

What early health care victories should President-elect Obama and Congress seek before Washington works on broad health care reform legislation?

What health care measures should be included in an early economic stimulus package? Federal Medicaid help for cash-strapped states? Legislation to lower drug costs? Obama said in December that he wanted to include money for Medicaid and health care information technology in an economic stimulus bill.

-- Marilyn Werber Serafini, NationalJournal.com

11 responses: Jane L. Delgado, Newt Gingrich, Karen Ignagni, Sen. Max Baucus, D-Mont., Andy Stern, Rich Umbdenstock, Drew Altman, Billy Tauzin, Marilyn Werber Serafini, Karen Davis, Drew Altman