Passing the Buck on Health Care
Editorial
The New York Times
February 12, 2007
President Bush’s new budget would extend the administration’s warped priorities deep into the realm of federally supported health care programs. The administration long ago sacrificed any meaningful domestic agenda to finance tax cuts for the wealthy and its reckless war in Iraq. The White House’s reckless determination to make the tax cuts permanent is now driving it to slash domestic spending in health and other vital programs.
Instead of trying to address the underlying problems of escalating health care costs, Mr. Bush’s strategy is to cut services or shift more of the bill to states, health care providers and individuals.
In the Medicare program, which covers health care for Americans aged 65 and over, the administration would find most of its savings by slowing the annual increase in reimbursements for services, forcing hospitals and other providers to absorb the burden. Given Medicare’s precarious financial straits, the package appears broadly acceptable.
The real outrage is that the administration has not proposed comparable reductions in the large overpayments — roughly 12 percent more per patient — made to private managed care plans that enroll Medicare beneficiaries. The budget would also phase out Medicare bad-debt payments, forcing hospitals to swallow beneficiaries’ unpaid bills.
The budget also looks to save money by eliminating inflation indexing so that as incomes rise, so would the number of people required to pay higher premiums. Although this is a sneaky way to raise premiums, it is hard to argue with the notion that better-off beneficiaries should pay more to help rescue a financially strained program.
What seems counterproductive is Mr. Bush’s plan to lower federal matching funds for Medicaid administration — forcing the states to find more of their own funds or sacrifice good management and oversight. More worrisome is his plan to cut back on state programs that insure the young.
The most shortsighted restrictions would come in the highly acclaimed State Children’s Health Insurance Program, which uses federal matching funds to provide coverage for low- and moderate-income children who are not quite poor enough to qualify for Medicaid. The program has been enormously successful in reducing the number of uninsured children. Yet now the administration wants to reduce its matching rate and limit enrollment to children in households earning no more than twice the federal poverty level. That would undercut programs in 16 states that have expanded coverage to children above that level.
Although the administration’s budget would grant the children’s program a small $5 billion increase spread over five years, that’s less than half, and possibly only a third, of the amount needed just to maintain current enrollments and participation rates. This is too high a price to pay for more tax cuts and Mr. Bush’s ill-managed presidency.
The New York Times
February 12, 2007
President Bush’s new budget would extend the administration’s warped priorities deep into the realm of federally supported health care programs. The administration long ago sacrificed any meaningful domestic agenda to finance tax cuts for the wealthy and its reckless war in Iraq. The White House’s reckless determination to make the tax cuts permanent is now driving it to slash domestic spending in health and other vital programs.
Instead of trying to address the underlying problems of escalating health care costs, Mr. Bush’s strategy is to cut services or shift more of the bill to states, health care providers and individuals.
In the Medicare program, which covers health care for Americans aged 65 and over, the administration would find most of its savings by slowing the annual increase in reimbursements for services, forcing hospitals and other providers to absorb the burden. Given Medicare’s precarious financial straits, the package appears broadly acceptable.
The real outrage is that the administration has not proposed comparable reductions in the large overpayments — roughly 12 percent more per patient — made to private managed care plans that enroll Medicare beneficiaries. The budget would also phase out Medicare bad-debt payments, forcing hospitals to swallow beneficiaries’ unpaid bills.
The budget also looks to save money by eliminating inflation indexing so that as incomes rise, so would the number of people required to pay higher premiums. Although this is a sneaky way to raise premiums, it is hard to argue with the notion that better-off beneficiaries should pay more to help rescue a financially strained program.
What seems counterproductive is Mr. Bush’s plan to lower federal matching funds for Medicaid administration — forcing the states to find more of their own funds or sacrifice good management and oversight. More worrisome is his plan to cut back on state programs that insure the young.
The most shortsighted restrictions would come in the highly acclaimed State Children’s Health Insurance Program, which uses federal matching funds to provide coverage for low- and moderate-income children who are not quite poor enough to qualify for Medicaid. The program has been enormously successful in reducing the number of uninsured children. Yet now the administration wants to reduce its matching rate and limit enrollment to children in households earning no more than twice the federal poverty level. That would undercut programs in 16 states that have expanded coverage to children above that level.
Although the administration’s budget would grant the children’s program a small $5 billion increase spread over five years, that’s less than half, and possibly only a third, of the amount needed just to maintain current enrollments and participation rates. This is too high a price to pay for more tax cuts and Mr. Bush’s ill-managed presidency.
posted by greenpagan at 7:38 PM
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