A “new season” of health reform was endorsed by Senators, state leaders, and Hill staff on both sides of the aisle at the National Health Policy Conference here in DC. [Update: Webcasts are now available.] This morning Sen. Max Baucus (D-MT), who chairs the Senate Finance Committee, predicted “the season of incremental change is coming to an end.” While Baucus said “I don’t think this country is ready for a single-payer system,” he did say “everything is on the table…even if only for a nanosecond” when asked if Congress would consider raising the retirement eligibility age to help fund program expansions.

Yesterday afternoon, Sen. Ron Wyden (D-OR), who introduced his own reform proposal in December, spoke of “new emerging common ground” between Democrats and Republicans on health reform. He also noted the coming together of economists on reforming the tax code which “promotes inefficiency in health and is regressive to boot.”

States. In a standing-room only session yesterday morning, state leaders spoke of reform possibilities. Former Massachusetts state legislator John McDonough said, “We are in the early stages of a four to five year health reform wave. Do we have the danger of screwing it up? Oh yeah! We have to buck each other up. I look at the California plan, and frankly, my breath is taken away. What Kim [Belshe, California State Secretary of Health and Human Services] has done is give everyone something to be really angry about.”

Belshe noted one particular area of controversy in California’s plan to provide health coverage–what to do with undocumented immigrants. “The governor, to his credit, has stepped up and given voice to this. He has said, I believe all kids should be covered regardless of immigration status.”

The state leaders conceded that a federal role is critical in reform. “States are the laboratories of democracy,” said former Vermont state legislator Jim Leddy. “But it must be predicated on empowerment, not bankruptcy” as the states rely on federal funding to support programs and mandates.

Len Nichols, an economist with the New America Foundation, likened the state reform activity to “a shining city on a hill—a vision of what could be.” As someone who was at the heart of the last major health reform effort—President Clinton’s health plan—Nichols concluded the session saying “Governor Schwarzenegger has changed the conversation in this national city. He has reenergized this conversation. . . They are to be applauded. Holy cow, if Arnold can do this, why can’t we?”

SCHIP. But as New York Times reporter Robert Pear wrote this morning:

“The states appear to be on a collision course with the Bush administration, whose latest budget proposals create a huge potential obstacle to their efforts to expand coverage. While offering to work with states by waiving requirements of federal law, the Bush administration has balked at state initiatives that increase costs to the federal government.

State efforts have almost invariably begun with children, building on the Children’s Health Insurance Program (SCHIP), which is jointly financed by the federal and state governments. Many states are eager to expand eligibility for that program and some are going far beyond the income levels deemed appropriate by the White House. In his budget last week, President Bush said he wanted to return the program to its “original objective” of covering children with family incomes less than twice the poverty level.”

Sen. Baucus said SCHIP would be the Senate Finance Committee’s “first priority” this year. With a September 2007 expiration date and some states running out of program money even before the reauthorization deadline, the children’s insurance program is poised to be an early marker along the road of federal/state health reform policymaking. A major hurdle will be how the Congressional Budget Office “scores” the SCHIP program in the budget. The president’s budget currently proposes an increase in program spending of $5 billion over five years, but current program costs are already exceeding this amount. And further efforts to cover the 6 million uninsured children that are already eligible but not enrolled in the program will bring costs even higher. Yet under new “pay as you go” budget rules, any new funding for SCHIP must be accompanied with equal cuts to other programs.

This entry was posted on Tuesday, February 13th, 2007 at 1:54 pm and is filed under All Categories, Children, Coverage, Health Reform, Medicaid, Politics, States. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.