The Wall Street Journal editorializes, "In sum, what we are really getting in this stimulus bill are several more steps in the gradual government takeover of the health care market" (Wall Street Journal, 1/29).
I say, Yeay!!! About time!
The issues that most seem to rankle the Republicans are the money for Medicaid and the extension of COBRA benefits. The way the $87 billion for Medicaid will be spent is not yet clear, however. The Senate and the House differ on how the aid would be calculated and distributed, and the differences are not insignificant. They pit rural against urban lawmakers and states with low unemployment against states with higher rates. But however it is calculated, states have been staggering under the costs of the Medicaid budget for years, and they have been slowly cutting and gutting these programs.
About half of Medicaid budgets go for nursing home care for the poorest of our elderly -- a fact that many do not know. Most people think Medicaid is a program for all of the poor, but they don't know that it's only for certain categories of the poor -- disabled, women with children and the elderly. If you are a young healthy man who is poor you are pretty much out of luck. Republicans love to rail against Medicaid, most likely because it helps a constituency that they do not associate as their own. It's about time that they get called on that, especially about the old people in nursing home part. What do you want to do with these folks, Republicans? Toss them into the street?
As for the COBRA extension in the stimulus bill, about $40 billion is being made available for low income workers who lose their jobs and thus their health insurance, allowing them to apply for Medicaid through 2010. Given the number of people who are losing jobs in this economy, this is a critical lifeline and one that could help workers stay healthy enough to look for job. The $40 billion would also help workers who lose their jobs and are 55 or older, to keep the COBRA coverage for which they are eligible until they get another job or reach 65, the age for which they are eligible for Medicare.
There would be some subsidies for COBRA as well, because the cost of COBRA coverage is at least 105% of the total cost of the employer and the employee's share of the monthly premium. Many workers cannot continue their coverage through COBRA because of the cost, so the subsidies will be important. Even more important is the way in which this extension of health benefits for the over 55 population increases access to coverage for a group of people who have had few if any other alternatives. Most have been ill at some point in their lives and thus are relatively uninsurable on the individual market. It would have been even better if they could have bought into Medicare at the age of 55 -- that would be a REAL extension of federal benefits. But even this COBRA extension will cause a lot of relief for workers who are just hanging on to their jobs by a thread because of the health coverage.
So if this is a federal takeover of health care, I say, "Bring it on!"
http://www.philly.com/...
http://www.nytimes.com/...