Annals of Long Term Care

There were more questions than answers about the extent and pace of healthcare reform and potential changes to Medicare as President-Elect Barack Obama’s inauguration neared and this issue of Annals of Long-Term Care went to press in mid-January.

Overhauling Medicare and Social Security will be a “central” part of his administration’s effort to contain federal spending, Mr. Obama told the press shortly before his January 20 inauguration. The president-elect didn’t offer details, however, but promised to have more to say about the matter when unveiling his budget plan in February.

Congress is expected to press for more information. As initial confirmation hearings for Department of Health and Human Services (DHHS) Secretary-designee Tom Daschle got underway January 7, the The New York Times predicted that the former Senate Majority Leader would get the nod. But it noted that Mr. Daschle still faced a hearing before the Senate Finance Committee, “where he (would likely) face tougher questions about Medicare, Medicaid and other entitlement programs.”

Detailed information about other healthcare reform plans were also hard to come by as employment and additional economic indicators worsened. During his initial hearing, Mr. Daschle noted that the growing number of Americans losing their jobs—and with them, their health insurance—made healthcare reform increasingly urgent. He didn’t, however, indicate how quickly the new administration would move to institute reforms or how far reaching they would be.

On the campaign trail, Mr. Obama promised widespread healthcare reform, including efforts to insure the 45 million Americans who lack health insurance. Disputing those who have argued that the nation cannot afford the kind of large-scale spending needed to expand health coverage, Mr. Obama has contended that healthcare reform will help stimulate the economy. However, growing economic concerns may prompt the incoming president to delay some promised reforms and adopt a more “piecemeal,” gradual, approach to delivering on his promises, including those to expand coverage, The New York Times speculated.

The expansion of the State Children’s Health Insurance Program (SCHIP) may be the first step in such a gradual approach. With strong support from the president-elect, the House voted January 15 to expand SCHIP. The Senate Finance Committee approved a similar measure the following day. After the House vote, Rep. Frank Pallone (D-NY) described the legislation as “a down payment on Mr. Obama’s promise to make health insurance available to all Americans,” The New York Times reported. The House bill allocates $32.3 billion over four-and-a-half years to continue coverage for the 7 million children currently enrolled in SCHIP and extend coverage to another 4 million children.

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AARP and Coalition Including AGS Put Healthcare Reform at Top of List for 111th Congress; Survey Finds Americans See Reform as Top Priority

Healthcare reform topped the list of priorities for the 111th Congress that AARP unveiled in early January. AARP and its “Divided We Fail” coalition—which includes the American Geriatrics Society, the Business Roundtable, the Service Employees International Union (SEIU), National Federation of Independent Business (NFIB), and a wide range of other organizations—are influential advocates for healthcare reform. Such reform, AARP and the coalition argue, is central to reining in healthcare spending and addressing fiscal problems facing Medicare.

In a recent nationwide Kaiser Family Foundation/Harvard School of Public Health survey of more than 1600 Americans, 43% of respondents agreed that healthcare reform should be one of Washington’s top priorities. Healthcare reform ranked third, behind “improving the economy,” which 73% of respondents identified as a top priority, and “fighting terrorism,” which 48% said should be a leading priority.