Stand Up For Health Care Blog

Give the gift of healthcare this holiday season

'Tis the season to be jolly! That may be how the song usually goes, but this year American families are singing a different tune.

As the economic recession deepens, companies around the country are closing their doors or cutting back by laying off employees and millions of Americans are losing their jobs, salaries, and health insurance.

According to the San Francisco Chronicle,

The unemployment rate has jumped from about 4.7 percent last December, when the recession began, to 6.7 percent today. Economists estimated in a Kaiser Family Foundation report that each 1 percent gain in the unemployment rate adds 1 million people to the Medicaid and State Children's Health Insurance Program.

This estimate means that about 2 million people have been added to these state-run programs, putting added strain on state governments that are already struggling to keep these programs alive.

In the spirit of the holidays, one gift that we can give to our fellow Americans in 2009 is access to the State Children's Health Insurance Programs (CHIP) and Medicaid. Unfortunately, without funding from the federal government, these crucial programs may endure budget cuts that result in millions of adults and children losing their health care coverage. During such tough economic times, when even more people are expected to lose their jobs and apply to these programs, we must ensure that CHIP and Medicaid are well-funded and can continue to provide high-quality health care to those in need.

By including funding for Medicaid and CHIP in the economic recovery package in the New Year, Congress can help states by sharing the financial burden of supporting these programs, while guaranteeing that those currently enrolled will not lose their coverage.

Please take a look at our E-card and let your friends know how important the gift of affordable health care is this holiday season and in 2009.

Have a safe, happy, and healthy holiday. We will be closed from December 24 through January 5, but we hope to see you in the New Year with a renewed hope for high-quality, affordable health care for all.

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A painful recession

As families crunch numbers to figure out how they're going to make ends meet during this recession, state governors are crunching numbers for their budgets next year and realizing that they are going to come up short.

Forty-three states expect to see budget shortfalls in the coming year. And, while the federal government can run a deficit, most state governments are required to keep a balanced budget. As a result, 18 states and DC have already cut or are proposing cuts to their Medicaid and CHIP programs. Cuts in state Medicaid and CHIP eligibility and services pose a real threat to the very families and individuals who most need the help.

At the National Governors Association meeting in Philadelphia last week, governors from both sides of the aisle pleaded with President-Elect Obama to include at least $40 billion for Medicaid in the economic recovery package that is expected to be signed shortly after Inauguration Day (January 20). The $40 billion would come in the form of a critically important federal match increase to the funds that states allocate to their Medicaid programs. As pointed out in a recent Washington Post article,

On average, the federal government pays 57 percent of Medicaid costs, and states cover the rest. That means for every $1 a state trims from its Medicaid budget, more than $2 is lost in health care services. Conversely, pumping money into Medicaid "has a double impact."

But increasing federal funding for Medicaid actually has an even greater than "double impact." That's because in addition to helping states pay for extra Medicaid costs, federal funding for Medicaid will also give state economies a jump start by generating new jobs, wages, and business activity. In other words, putting more federal money into the Medicaid program will help state economies move out of recession and back into the black.

Increasing the federal share of Medicaid has a proven record of fueling the economy. During the last economic decline in 2003, Congress made a similar move, and the Kaiser Commission found that the additional money "helped states to both balance their budgets and maintain eligibility." For analysis of how much the latest congressional proposal would help state economies, see Families USA's new report, A Painful Recession.

When the economy slows, more individuals and families enroll in Medicaid. With over a million people at risk of losing Medicaid or CHIP due to proposed cuts, states cannot afford to wait any longer for federal help. Including additional federal money for state Medicaid programs in the economic recovery plan will enable states to continue their programs without having to cut eligibility or services.  

And during such tough economic times, that's news that both families and state legislatures can feel good about. 

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America’s children uninsured this Thanksgiving

Although the Bush Administration proclaimed it would "leave no child behind" when it comes to education, 8.6 million American children are now being left behind because they lack health coverage. Last year's bipartisan legislation to reauthorize the State Children's Health Insurance Program (SCHIP), which would have expanded health coverage throughout the nation to approximately 4 million additional uninsured children, failed when President Bush vetoed it twice.

The result is that millions of American children - a majority of whom are from working families - remain uninsured, according to a new Families USA report, Left Behind: America's Uninsured Children, which finds:

  • One in nine children in America is uninsured.
  • Uninsured children come from working families. The vast majority of uninsured children-88.2 percent-come from families where at least one parent works.
  • The five states with the largest number of uninsured children are Texas, California, Florida, New York, and Georgia. Together, the uninsured children in these five states account for nearly half of all uninsured children in the country (48.3 percent).

Why did so many children remain uninsured? Rising premiums and stagnant wages prevented many families from being able to afford employer-based coverage. But that's assuming they could even keep their jobs. The unemployment rate jumped in 2007, forcing millions out of work and stripping them of employer-based coverage. As unemployment rose, more families qualified for public programs like Medicaid and SCHIP - actually causing the uninsured rate to fall because more people were absorbed into public programs. Together, Medicaid and SCHIP prevented half a million children from becoming uninsured. These programs offer an excellent safety net for low-income children, but they are in jeopardy. As the economy worsens, state budgets will tighten and these programs may end up on the chopping block. California is already considering putting a cap on enrollment.

For many families, the State Children's Health Insurance Program is a lifeline, allowing children to see a doctor and remain healthy. We are encouraged by signs that the incoming Obama Administration will work to cover more kids and provide them with the care they need by reauthorizing and expanding the State Children's Health Insurance Program, which expires at the end of March 2009.  According to Stateline.org:

So far, signs from the incoming administration and Congress are promising on SCHIP. Both House Speaker Nancy Pelosi and Obama's new chief of staff, Illinois U.S. Rep. Rahm Emanuel, have said SCHIP renewal will be one of the first issues the next Congress considers.

As Medicaid enrollment continues to climb, the federal government should also ease the resulting financial burden on states by temporarily increasing the federal share of Medicaid funding (called FMAP, the Federal Medicaid Assistance Percentage) as part of the economic recovery package. This will allow states to maintain their programs in these times of economic distress, instead of being forced to cut coverage for people who need it the most.

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Kids can’t wait

Trying to get your kids to wait patiently in line at the grocery store or sitting at the table is next to impossible. Have you tried making them wait for health coverage? Probably not, because that would make you feel fidgety and nervous.

California is considering a move that would do just that-put uninsured kids who qualify for the State Children's Health Insurance Program (CHIP) on a waiting list for health coverage. The Los Angeles Times reports:

State officials are considering capping enrollment in California's health insurance program for children of the working poor, as an influx of new clients overwhelms it.... As many as 162,750 children could end up on a waiting list within six months.

The economic crisis is taking a toll on working families, leaving more and more without jobs and without health insurance. The corresponding increase in demand for public programs like CHIP and Medicaid puts extra pressure on state budgets just when states can least afford it. Over half of state budgets are currently in the red, with worse news coming every day.

However, states should not balance the budget on the backs of children. States must protect the safety net, which is all the more valuable to working families during tough economic times.

States can't do it alone, though; they need greater support from the federal government (which currently picks up more than half the tab of the SCHIP program). Last year, President Bush vetoed the bill Congress passed to provide adequate funding to cover 4 million uninsured kids. Twice. Now the 111th Congress has the opportunity to complete this unfinished business and strengthen the safety net for uninsured kids. They can also helps kids by providing a temporary increase in federal funding for Medicaid, since half of all Medicaid enrollees are kids.    

Encourage your members of Congress to act swiftly and boldly. Kids can't wait. Nor should they have to.

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Daschle goes to HHS

In a sign that President-Elect Obama means business, former Senate Minority Leader Tom Daschle (D-SD) was selected to fill the top spot at the Department of Health and Human Services. This is good news. Very good news. "The appointment of Senator Daschle as Secretary of the Health and Human Services Department is the best news possible for those who want to achieve meaningful health care reform," said Families USA's Ron Pollack.

In addition to leading HHS, Daschle will also serve as the health "czar" - or White House point person who will report directly to the President.

As The New Republic's Jonathan Cohn points out:

This is a perfect role for Daschle. Although he was always been interested in health care, in the last few years he's become a true wonk on the subject, publishing a book called Critical: What We Can Do About the Health-Care Crisis. It urges precisely the sorts of reforms President-Elect Obama and his congressional allies are promoting right now.

Daschle's track-record as Senate Minority leader turned health wonk gives him incisive knowledge of both the political environment and the policy required to push legislation through Congress.

Speaking at Families USA's Health Action conference last year, Daschle said:

One of the biggest tactical mistakes we've made, the opponents of health reform have defined the debate. As a result, we've lived under a number of myths. Perhaps the biggest myth of all is that the US has the best health system in the world. So before the debate can begin, we need to all understand the same basic facts. We need to understand how we got here and where we need to go.

Incremental change in our system is no longer a viable option. Instead we need comprehensive reform. In growing numbers the American people are demanding that we do something. Our goal should be to build what current and retired members of Congress have today, and make that available for all Americans.

Daschle's commitment to health care, combined with his astute understanding of the political climate, gives us reason to believe that health care reform is not simply a campaign promise, but a likely reality in an Obama administration.

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A costly vote against kids

While kids are unable to enter the voting booth and cast ballots, they did prove to have some political power in this last election. If you recall, an expansion of the State Children's Health Insurance Program (SCHIP) passed Congress, but President Bush sided with tobacco companies and right-wing ideologues to veto the bill - twice. Looks like that vote haunted the members who stood by the President.

This, via Politico:

Here are the 10 Republicans who stuck with their leaders on SCHIP, voted against children's health care, and for that reason (among others), got swept aside:

Rep. Steve Chabot (Ohio)
Rep. Thelma Drake (Va.)
Rep. Tom Feeney (Fla.)
Rep. Robin Hayes (N.C.)
Rep. Ric Keller (Fla.)
Rep. Joseph Knollenberg (Mich.)
Rep. John R. Kuhl (N.Y.)
Rep. Marilyn Musgrave (Colo.)
Rep. Bill Sali (Idaho)
Rep. Tim Walberg (Mich.)

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A call to action

Today, Senator Max Baucus, chair of the Senate Finance Committee, revealed his long awaited white paper on health care reform. According to the Senator,

...the Call to Action has three equally important legs: (1) a policy that ensures meaningful coverage and care to all Americans; (2) an insistence that any such expansion be coupled with an emphasis on higher quality, greater value, and - over time - less costly care; and (3) an absolute commitment to weed out waste, eliminate overpayments, and design a sustainable financing system that works for taxpayers as well as for the nation's recipients and providers of health care.

Baucus's plan includes:

  • Creating a health insurance "exchange," where individuals and small businesses could compare and purchase plans - which would include a range of private plans and a public plan option.

  • An expansion of Medicaid and SCHIP.

  • The plan would allow people between 55 and 64 to "buy-in" to Medicare as a temporary transition provision until quality, affordable insurance options are available through the exchange.

  • Support for the employer based model where employers would be required to offer coverage to their employees, and small businesses would receive a tax credit if they comply.

Senator Baucus, along with Senator Kennedy, is expected to play a very important role, as Ezra Klein explains here, in the road to reform. Baucus chairs the Senate Finance Committee, which has broad jurisdiction, overseeing health care reform, Social Security, unemployment benefits, and taxes and trade. As chairman, it is up to Baucus to schedule markups, hearings, and votes - and ultimately serves as the gatekeeper for legislative action on, say, health care reform.

Having Baucus on board with such a comprehensive plan is certainly encouraging. To quote Families USA's own Ron Pollack:

"The white paper released today achieves a sound balance between public- and private-sector approaches, and it blends good policy with a sound view of what is achievable.

"There has never been a more auspicious opportunity to secure meaningful health care reform: The President-Elect has made it a top priority; key congressional committee chairs have made it their top priority; and the large and diverse health care interest groups are working cooperatively to find common ground.

"As a result, we have a unique opportunity to succeed this time in securing much-needed health care reform."

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Poised for reform

We heard encouraging words from Michael Myers, staff director for the Senate Health, Education, Labor, and Pensions (HELP) committee, chaired by Senator Ted Kennedy, at Families USA's post-election health care briefing:

"With the Obama victory, the question is no longer whether we'll pursue comprehensive healthcare reform, but when and in what form."

Determined to see health care reform come to fruition, Senator Kennedy has wasted no time in convening regular meetings with key stakeholders in the hopes of introducing comprehensive legislation in early January. In an op-ed in Sunday's Washington Post., Kennedy reiterated the urgency for reform:

"...despite the current economic downturn, we must forge ahead with this urgent priority. The system is broken. And it's no longer just patients demanding change. Businesses, doctors and even many insurance companies are demanding it as well."

The specifics of his reform proposal remain under wraps, according to Kennedy's office, but Myers suggested that it will look much like Obama's plan and the Senator will pursue a "single bill" strategy.

Senator Obama's proposal builds on our current system of health coverage, preserving what works and strengthening aspects of the system that need improvement. Under his plan, workers who are satisfied with their employer-based coverage would keep it. A new National Health Insurance Exchange would enable individuals and businesses to purchase health coverage that's as good as the coverage for members of Congress and other federal employees. His proposal requires that all children have insurance. It would also cap out-of-pocket expenses and regulate insurance companies so that they can no longer cherry-pick the young and healthy and deny coverage to people with pre-existing conditions.

Many observers are poised to see reform finally happen. Having learned a thing or two from the last reform efforts in 1993 led by President Clinton, and understanding that reform is not inevitable, many stakeholders (who don't always see eye-to-eye) are searching for common ground. In Congress, staff from three jurisdictional committees -- Finance, Budget, and Health, Education, Labor and Pensions (HELP) -- have met to form working groups to discuss coverage expansion, systems reform, and financing. In addition, Senator Baucus, chair of the Finance Committee, which must approve any legislation before it goes to the Senate floor, is also committed to reform:

"I made sure the finance committee spent this year learning and preparing for action on a comprehensive overhaul of the healthcare system, and I intend for us to move swiftly and decisively with legislation in early 2009."

We'll hear more from Baucus this week when he releases his white paper on health reform.

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A Transformative Election

The election we witnessed yesterday was not simply historic - it was truly transformative.

Just 43 years ago, Congress passed, and President Lyndon Johnson signed, the Voting Rights Act. For decades, since the end of Reconstruction, voting for many in the states of the old Confederacy was an act of unmatched heroism. To vote was to lose a job - even the laborious job of chopping and picking cotton for a meager $3 a day. To vote was to have your house shot into in the dark of night. To vote was to risk, and for too many to lose, one's life.

The Voting Rights Act was borne out of the heroism of many. Most visibly, it was catapulted onto the national agenda by the hundreds of brave souls, led by John Lewis in March of 1965, who crossed the Edmund Pettus Bridge leaving Selma, Alabama east on Route 80 to march towards Montgomery. As they crossed the bridge, they were brutally assaulted by police and highway patrolmen on horseback. They were beaten but not defeated.

Dr. Martin Luther King re-started the march soon thereafter. Thousands marched with him, sleeping in the fields at night. Singing their defiance of then-Governor George Wallace, they chanted:

            Wallace, you never can jail us all,

            Wallace, segregation's going to fall!

And they made it triumphantly to Montgomery. At night, after the final speeches were over near the State Capitol, Viola Liuzzo - a then-unknown civil rights activist who participated in the march - was murdered.

In the first election in Mississippi after the Voting Rights Act, a number of brave heroes decided to run for local office: sheriff, county board of education, mayor, county supervisor. They knew they wouldn't win, but they were undaunted.

I remember in the all-black town of Mound Bayou, Mississippi - in the heart of the Mississippi Delta, in the poorest part of our nation - black leaders assembled in houses before the elections, not knowing what violence they would face. Some had guns and other weapons to protect themselves and their families; others, more schooled and adherent to Dr. King's admonitions of non-violence, simply brought their bodies and heroic determination to vote for the first time.

Now, only four-plus decades later, we have witnessed an election that no one could realistically have dreamed about during those dark and difficult days. President-Elect Barack Obama's triumph - more profoundly, the triumph of our nation - is, in no small part, the victory of so many people who risked all they had to work for a better day.

For those of us fortunate to see, and participate in, this transformative election, our work must continue and start anew. This election is an opportunity - an opportunity to bring fairness and decency and dignity for those who have yet to share our nation's bounty. It is only the achievement of such justice that will enable us to realize Dr. King's dream: "Free at last, free at last, thank God almighty, we're free at last." 

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Vote like your health depends on it

The Partnership to Fight Chronic Disease has an important message for you: Vote like your health depends on it.



We couldn't agree more.

 

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