rssFinance Panel Moves to Create State-Based Public Plans
Thursday, October 01, 2009 at 4:40 pm
- 8 Comments
The Senate Finance Committee on Thursday approved legislation empowering states to create public insurance plans that would negotiate rates on behalf of some of their poorest residents.
The proposal, sponsored by Sen. Maria Cantwell (D-Wash.), would allow states to create “basic health plans” catering to those earning between 133 percent and 200 percent of poverty. The bill is designed to ease the budget squeeze on some states with generous Medicaid programs – states which would otherwise be forced to pay a portion of the Medicaid costs for the same people.
Importantly, the bill would also empower states to negotiate with physicians, hospitals and other providers in search of affordable care. “It is a public plan, but negotiated with the private sector,” Cantwell said.
The new plan would be optional, Cantwell emphasized, with states participating only at their own discretion. “The state is in the driver’s seat,” she said.
Republicans weren’t convinced. They blasted a stipulation that those qualifying for the new plan wouldn’t be eligible for federal subsidies to buy different insurance coverage on the state exchange. “There is no choice for people if a state decides to do this,” said Sen. Jon Kyl (R-Ariz.).
There were additional concerns. Kyl and Sen. John Cornyn (R-Texas) both worried that, by draining the exchange of a chunk of beneficiaries, the risk pool would shrink, thereby raising premiums on everyone else. “This seems to me to be moving in the wrong direction,” Cornyn said.
Supporters of the Cantwell proposal hope it will solve a dilemma facing states under the health reform proposal moving through the Finance Committee. That bill hikes minimum Medicaid eligibility to 133 percent of poverty, but also requires states to maintain their current eligibility levels even if they’re well above 133 percent. Some states are concerned that, with Medicaid enrollment rising amid the recession, the mandate to keep eligibility steady will break their already bursting budgets. The Cantwell amendment will shift a percentage of those states’ Medicaid populations into a separate plan funded with federal subsidies.
The Congressional Budget Office has yet to estimate the cost of Cantwell’s proposal — a situation prompting Republicans to claim that it shouldn’t get a vote.
Sen. Jim Bunning (R-Ky.) called on Baucus to rule the amendment out of order until the CBO score is known. Baucus refused. “This amendment is structured in a way to save money,” he said. “Therefore it is in order.”
“We don’t know that,” Bunning snapped.
The vote was 12 to 11. Sen. Blanche Lincoln (D-Ark.) was the only member to cross party lines, joining all Republicans in opposing the bill.
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Comment posted October 9, 2009 @ 4:02 am
WILL CANTWELL PROTECT THE POOREST?
“The Cantwell proposal is based on Washington's Basic Health Plan, which she said results in lower-cost, high-quality coverage, generally delivered through managed care, as the state uses its purchasing power in negotiations with insurers.”
http://seattletimes.nwsource.com/html/health/20…
With the exception that Cantwell's amendment applies only to person earning greater than 133% of the poverty level, and (in itself) ignores those less fortunate.
“The bill proposed by Mr. Baucus would expand Medicaid to all American citizens earning up to 133 percent of poverty. Ms. Cantwell’s plan effectively broadens it further.”
-New York Times, 10-01-09
In such a senatorial den inhabited by specious lounge-lizards like Senator Baucus, few would be surprised if the provisions for such dramatic and nation-wide expansions of (presently state-determined) medicaid eligibility standards (to all individuals with income below 133% of poverty level) bites the cutting-room floor in the sausage factory.
Where would *that* leave the “least among us”?
In Cantwell’s very own State of Washington (under it’s own Medicaid eligibility standards), individual persons (without children) are presently (and may well remain) completely *ineligible* for any kind of Medicaid assistance (excepting the mere handful of persons accepted into the already-cut and further budget-threatened GAU and GAX programs).
“… 'In our state we’re producing efficient health care,' Ms. Cantwell said. 'Better care at lower cost.' …”
-New York Times, 10-01-09
Such slick-sounding bites ring rather hollow in Cantwell’s own state to individuals with incomes less than 133% of the poverty level.
The (state-funded) Washington Basic Health Plan (BHP) is not (and may well not in the future) be an option for such unfortunate members of society, as Governor Gregoire herself specifically requested (and got from the state legislature) an approximately 40% cut in the BHP’s budget in the Spring of 2009:
http://seattletimes.nwsource.com/html/localnews…
With well less than 10% of the state’s uninsured citizens currently able to be enrolled in the BHP, now the Governor rumbles about possible upcoming gubernatorial requests of the state legislature to eliminate the program entirely, stating:
“Do we devastate the Basic Health Plan? Do we completely gut it? We are almost to the point where we have as many people covered as we do on the waiting list.” (-Gregoire, 09-29-09):
http://www.theolympian.com/thepoliticsblog/stor…
With Senator Baucus’ integrity and credibility long ago sold off, will (if Medicaid eligibility policy remains unchanged in the federal legislative process) Senator Cantwell turn her back on the very *poorest* individuals in her own State?
Such a “sweet spot” for *all but* the poorest individuals in Cantwell’s own state would be a saccharine coated dose of strychnine for the “least among us”, and moral leprosy itself.
Does Cantwell have such a moral spine (to protect the “least among us” as a core and necessary imperative) – or does she just “play one” on TV?
Please, if you would, Senator Cantwell, clarify your position to the public on this matter, forthwith.
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