The March Continues

Grace-Marie Turner

With a major expansion of the State Children's Health Insurance Program in place and more than $150 billion in health spending authorized in the stimulus bill, the Obama administration already is well on its way to significantly increasing the role of government in our healthy sector.

President Obama is expected to take the next step in advancing his health reform agenda when he delivers his first State of the Union address on Tuesday.

As Mr. Obama said during the signing of the economic stimulus legislation, "we have done more in 30 days to advance the cause of health care reform than this country has done in an entire decade."

The march continues.

Details of his Tuesday address are sketchy, but I expect calls for further expansion for government health programs, including broader access to Medicaid and possibly Medicare, a mandate on employers to provide health insurance with subsidies for small busineses, creation of a new government health insurance program, and a significant increase in federal regulation of private health insurance.

The big question mark is whether the President will accede to the demands of Democratic leaders in Congress to call for a mandate that all individuals purchase health insurance. This is a political hot potato because the young people who energized the Obama presidential campaign would be hit hardest as they inevitably would be forced to pay more than their share for insurance to subsidize older, sicker Americans.

And who is going to lead this effort at HHS now that former Sen. Daschle is out? The capital was abuzz yesterday that the President might announce next week his choice for HHS secretary, with Kansas Gov. Kathleen Sebelius the
leading contender.

Governors bring important expertise to HHS because they have experience in dealing with Medicaid, in trying to reduce the number of people without health insurance (Kansas has a lower uninsured rate at 12.7% than the national average), and in trying to make health care and coverage more affordable - all goals of the Obama administration. Gov. Sebelius also is a promoter of health information technology and is a cheerleader in encouraging Kansans to adopt healthy lifestyles.

But Gov. Sebelius or whoever is nominated will have to hit the ground running to start spending the $150 billion in new health care funds authorized in the stimulus law, including $87 billion for Medicaid, $24.7 billion to subsidize COBRA health insurance, $19.2 billion for health information technology, $10 billion for the National Institutes of Health, and $1.1 billion on comparative effectiveness research.

With a $2-trillion budget deficit expected this year and new efforts in Congress to get back to fiscal responsibility (imagine that!), it is going to be a huge challenge to push an even more ambitious health reform agenda. Further, leaders at both ends of Pennsylvania Avenue had said they want bipartisan support for major health reform effort.

There may indeed be common ground to be found, but it will require a true bipartisan effort that has not been evident in Washington so far this year. It requires more than asking the other side to support legislation that already has been drafted or inserting pet projects in a bill to gain a few Republican votes.

Grace-Marie Turner is President of the Galen Institute
Copyright 2009. All Rights Reserved.

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