Annals of Long Term Care

Healthcare reform took center stage in Washington last month, with President Obama convening a White House “healthcare summit” and proposing a budget that would set aside $634 billion over ten years as a “down payment” on comprehensive reform that covers the uninsured and reins in healthcare spending.

The previous month, the President signed into law both a $787 billion economic stimulus proposal that included significant funding for healthcare, and legislation expanding the State Children’s Health Insurance Program (SCHIP). The legislation provides an additional $32.8 billion for SCHIP, funded through an increase in the federal tobacco tax, that will enable the program to boost the number of children it covers from 7 to 11 million.

President Obama also nominated a new Secretary of the Department of Health and Human Services (DHHS) and named a “health reform czar” and chief of the Health Resources and Services Administration (HRSA).

Opening the March healthcare summit, President Obama warned “special interests” that they wouldn’t succeed in blocking needed reform as they had in the past. He also indicated that he would be flexible and open to reform proposals that differed from those he set forth while a candidate.

“During the campaign, I put forward a plan for healthcare reform,” he told those gathered for the conference. “I thought it was an excellent plan. But I don't presume that it was a perfect plan or that it was the best possible plan.”

The more than 150 participants in the half-day healthcare summit included members of Congress, healthcare professionals, and leaders of business groups, insurance companies, hospitals, labor unions, and consumer organizations, with a wide variety of viewpoints.

Several senior Republican senators attending the summit warned the President that many in their party would strongly oppose any effort to cover the uninsured by creating a public health insurance program that would compete with private programs. A public plan, they and other critics argue, would drive private plans out of the market. Though Mr. Obama proposed creating a public health insurance plan while campaigning, he indicated during the summit that he would consider alternative strategies that didn’t include a public plan.

While campaigning, Mr. Obama also proposed mandating coverage for children, but he stopped short of calling for mandated coverage for adults as well. A number of speakers at the summit—including both Democratic and Republican lawmakers, business leaders, and the president of the Blue Cross and Blue Shield Association—called for mandated coverage for all.

Neither during the summit nor while proposing his budget did President Obama lay out a detailed reform plan indicating who would be covered and how. Instead, he called on Congress to deliver a healthcare reform plan—this year.

A number of lawmakers, including Sen. Max Baucus (D-MT), are at work on healthcare reform proposals. Sen. Baucus told reporters in mid-March, when this issue of Annals of Long-Term Care went to press, that he planned to introduce a bipartisan reform bill with Sen. Charles E. Grassley (R-IA) that would include both “public and private solutions.” While Sen. Baucus supports universal coverage, he does not advocate a single-payer health system.

“Enacting comprehensive healthcare reform…is my top priority,” Sen. Baucus said, adding that he wanted to “make sure it passes this year” and is phased in over the next two or three years.

The $634 billion reserve fund that Mr. Obama's budget would establish would cover roughly half of what it's expected to cost to accomplish the President's goals of ensuring that all Americans have healthcare coverage and improving care quality and cost-effectiveness.

While President Obama’s budget plan doesn’t spell out how to accomplish healthcare reform, it does include assumptions and proposals that would shape and reshape care.