The House of Representatives is expected to hold a vote Sunday on a final health reform package. This is likely to be the make or break test for the bill. As Paul Krugman said in a New York Times column (Why We Reform) Friday, “If House Democratic leaders find 216 votes, reform will almost immediately become the law of the land. If they don’t, reform may well be put off for many years — possibly a decade or more.”
Although the bill isn’t perfect, it’s a major victory for children and families because it delivers what families need: affordable, reliable health coverage that won’t disappear if they lose a job or get sick.
The Congressional Budget Office (CBO) estimates that the bill will reduce the number of uninsured Americans by 32 million by 2019. The nonpartisan CBO also calculates that the bill would reduce the federal deficit by $138 billion over the next 10 years.
The following are highlights of the portions of the bill relating to health care for children and families:
• Continues BadgerCare Plus, which has successfully worked in partnership with Medicaid to cover 438,000 kids in Wisconsin.
• Makes coverage more affordable for middle class families by boosting their bargaining power through new health insurance purchasing pools (“exchanges”) and providing tax credits to those who need extra help buying insurance.
• Extends the Children’s Health Insurance Program (CHIP) through 2019, and includes funding for it through 2015.
• Increases Medicaid reimbursement rates for primary care up to Medicare levels during 2013 and 2014, with the federal government covering the full cost of those rate increases.
• Significantly expands coverage of parents and childless adults in most states by expanding Medicaid up to 133 percent of the poverty level. (In Wisconsin, this would have little or no affect for parent coverage, but would improve the benefits package for many adults in the Core Plan and would cover most of the people on the waiting – though not for several years.)
• Ends insurance companies’ discrimination based on pre-existing conditions. Starting right away, children who have insurance can’t be denied coverage for a pre-existing condition.
• Ensures that losing a job no longer means families also have to worry about becoming uninsured.
• Requires insurance companies to provide pediatrician-recommended care for children so they can grow and thrive.
• Allows parents to keep their college-age children (up to age 26) on their family health plans.
• Extends Medicaid coverage to all foster youth below the age of 25 who were formerly in foster care for a period of six months.
• Establishes an oral health prevention campaign, dental carries disease management, school based dental sealant programs and cooperative agreements to improve infrastructure and surveillance systems.
• Streamlines enrollment under Medicaid, CHIP and the Exchange.
• Establishes a grant program to support school-based health centers.
• Provides funding to states to develop and implement evidence-based Maternal, Infant and Early Childhood Visitation models.
• Establishes a Prevention and Public Health Investment Fund to fund and sustain prevention and public health programs.
An analysis released Friday by the Center on Budget and Policy Priorities does a nice job of summarizing the broad implications of the bill, including the insurance market place reforms, the expanded coverage, requirements for individuals and employers, and the cost-control measures.
In an upcoming blog, we’ll take a look at the improved fiscal assistance for states like Wisconsin that already cover parents and/or childless adults.
