The politics and economics of healthcare -
in this Washington and that one
In a previous post, DJ asked the question:
What are the practical economic impacts of the Stupak amendment limiting coverage of abortions? There are some persuasive politics at play, but will this have a measurable “real world” impact on plans, providers or patients?
Let’s take a look. (more…)
Democrats are working hard this week to firmly establish the link between healthcare reform and the health of small business in America.
Tomorrow, Senator Patty Murray will attend a hearing on the rising costs small business owners face in of providing healthcare for their employees.
According to the release, “The hearing will also highlight how health care reform legislation will lower costs, provide employees with portable care, and ease the burden of providing care for small businesses.”
Also tomorrow, Health and Human Services Secretary Kathleen Sebelius and Small Business Administration Administrator Karen Mills will join “Small business owners from across the country for a briefing on the impact of health insurance reform on small business.”
Beginning at 9:45 (Washington state time), the briefing will be streamed live here. There will also be a simultaneous chat hosted during the event here.
Last week, Administrator Karen Mills of the Small Business Administration held a short conference call with media outlets to discuss how healthcare reform will affect small businesses in the Unites States. The only mention of healthcare came eight minutes into the call and was brief, but you can download and listen to that phone call here.
Last week, four Snohomish County representatives, Marko Liias (WA-21st), John McCoy (WA-38th), Mary Helen Roberts (WA-21st) and Mike Sells (WA-34st), wrote a letter of support for a public option in healthcare reform to Unites States Congressman Rick Larsen (2nd).
“We write to express our enthusiastic support for the inclusion of a strong public option in the health care reform bill presently being debated in the House. As state legislators, we would be remiss if we did not voice our opinions on the current debate,” the letter states. “A strong public option is a critical fallback for the many different groups that would be covered under the reform plan.”
They go on to say, “The implementation of a strong public option would create incentives for insurance companies to charge competitive rates and become more efficient. Lower prices and better efficiency would benefit everyone, including those that presently have health insurance. In addition, the competition created by a strong public option would incentivize insurance plans to focus more on primary care and preventative medicine, leading to improved health outcomes and better care.”
One of the significant criticisms of the Senate Finance healthcare reform bill is the tab. According to the nonpartisan Congressional Budget Office (CBO), the bill will cost $829 billion, increase federal spending on healthcare by $85 billion over the next decade, and reduce the federal deficit by $81 billion over the next decade.
There is a balancing act that takes place when dealing with 1/7 of the federal budget, which is what the United States spends on healthcare. By spending money in ways that will reduce costs in the long-term, the budget deficit can be reduced. This is especially true when considering the costs of healthcare are increasing faster than inflation based on the Consumer Price Index, and many of the reforms reign that in.
The CBO projects the new House bill, which will cost $1.055 trillion, will increase federal spending on healthcare by almost $600 billion while reducing the deficit by $104 billion over the next decade.
Breaking down some of these numbers can get more complicated. The Senate Finance bill will cost $829 billion, but reducing spending on Medicare and Medicaid and creating a 40% tax on expensive, employer-based health insurance plans combine to reduce the total cost by over $600 billion.
According to the Washington Post, “Other tax changes that serve to reduce tax breaks for health care would produce another $138 billion.” And that is how the CBO reaches the $85 billion projection.
The House bill does not include taxes on high-cost, employer-based plans, which means it increases federal spending on healthcare by seven times as much as the Senate Finance bill at $598 billion versus $85 billion.
A new poll done by UW researchers suggests 49% of likely voters statewide are opposed to Initiative 1033 and 40% support the initiative with 10% undecided.
Among those surveyed in the Washington Poll who had already sent in their ballots, 56% said they voted “No” and 44% said they voted “Yes.”
Assuming Secretary of State Sam Reed’s prediction of 51% turnout, about 22% of voters in King County have already voted, and about 28% of voters in Snohomish County have already voted.
The poll showed 57% of respondents voting to “Approve” Referendum 71 and only 38% voting to “Reject” it.
The poll was based on interviews with 724 registered voters statewide, with a margin of error of 3.6%. Respondents were asked about Initiative 1033 first in each interview, meaning any priming effect, while unlikely, would have affected Referendum 71 results and not Initiative 1033 results.
These results constitute great news for supporters of state subsidized healthcare plans like the Basic Health Plan, which currently provides reduced cost health insurance for 103,687 low-income Washingtonians and children. Though, according to Health Care Authority estimates, that number could be reduced to 67,000 in 2010 at a cost of $234.16 per life, per month.
Passage of Initiative 1033 would almost surely mean further cuts to state subsidized programs like the Basic Health Plan. It would also mean long-term increases in healthcare costs to Washington taxpayers because (1) uninsured Washingtonians will be forced to visit emergency rooms for their medical needs, which is far more expensive than clinical visits, and (2) insurers negotiate with hospitals for better rates per procedure, and uninsured people have to pay the “ticket” price for procedures (which often means a difference of thousands of dollars). Again, those bills for uninsured Washingtonians are paid for by Washington taxpayers.
This morning Senator Maria Cantwell delivered a statement before the Senate Finance Committee at the beginning of mark-ups for America’s Healthy Future Act of 2009, the healthcare reform package sponsored by Senator Max Baucus.
Thank you Mr. Chairman.
Now Mr. Chairman, I want to say that you have proved that you are truly a distance runner. This process has been like a marathon and you have kept on pace. I guess my only request is that the committee process will give the due kick to the system that we need to have at the end of this. Because I do think that we do need to make some changes and I appreciate your willingness to make those changes.
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State Senator Karen Keiser, chair of the Senate Health & Long-Term Care Committee, hosted a series of four healthcare town halls last month with Representative Eileen Cody. You can read about those here and here.
This afternoon Senator Keiser responded to last night’s healthcare address by President Barack Obama and the effects of healthcare reform on Washington State.
The health reform goals outlined in the President’s speech, ─slowing health care costs, covering the insured and providing families with more security and stability─ are goals we have worked for years to achieve at the state level. Those are Washington state values. It’s clear we have a strong federal partner to help us solve this critical issue.
The National Conference of State Legislatures (NCSL) supports the public health insurance option, while over 850 individual states legislators from all fifty states with the Progressive States Network have called for any federal reform bill to include a public health insurance option, strong affordability protections, and shared employer responsibility for health care costs.
More than 876,000 Washingtonians have no coverage and many others are underinsured. They are just one illness or accident away from financial ruin. We need reform now, not yelling and screaming. Going forward, we need to tone down the rhetoric and focus on the issue at hand ─fixing our broken health care system.
States will be responsible for implementing any plan Congress passes and the President signs, so we will have a lot of work to do during the 2010-2011 sessions.
We’ve been working on health reform for years in our state with good success. Having the backing and support of the federal government will help us reduce waste, fraud and abuse in the industry and provide our citizens with the coverage they need and deserve.
I was glad to see bogus claims such as death panels debunked. The President set a new tone with the speech. As chair of the Senate Health & Long-Term Care Committee, I hope that spirit of cooperation will be evident at upcoming health reform hearings in both chambers of the state legislature.
On August 31st, Congressman Brian Baird of Washington’s 3rd Congressional District, held a healthcare town hall at the Washington Center for the Performing Arts in Olympia, Washington.