Wednesday, February 24, 2010

Using Reconciliation For Health Care Is NOT Unprecedented At All

Despite the fact that the Republican Congress used the Senate procedure known as reconciliation (where only 51 votes are required to pass a bill and cloture is not required) numerous times to pass all sorts of legislation (i.e. Bush's tax cuts for millionaires for example), it is sort of par for the course for Republican talking heads to go to the media and say it would be "unprecedented" for the Democrats to pass health care legislation through this procedure. Like most things stated by Republican elected officials, this is not true.

NPR has published an article where they document the instances where reconciliation was used to pass health care related legislation. Here is some of what they reported:
For example, the law that lets people keep their employers' health insurance after they leave their jobs is called COBRA, not because it has anything to do with snakes, but because it was included as one fairly minor provision in a huge reconciliation bill, according to Sara Rosenbaum, who chairs the Department of Health Policy at George Washington University.

"The correct name is continuation benefits. And the only reason it's called COBRA is because it was contained in the Consolidated Omnibus Budget Reconciliation Act of 1985; and that is how we came up with the name COBRA," she says.

"In 1980, children who were living at less than half the poverty level in the United States could not get a Medicaid card in half the states if they had two parents at home," she says.

But via a series of budget reconciliation bills, beginning in 1984, Congress began expanding Medicaid coverage. In 1997, also in a budget reconciliation bill, it created the Children's Health Insurance Program, known as CHIP. Today, says Rosenbaum, who helped write many of the children's health provisions in those bills, Medicaid and CHIP together cover 1 in every 3 children in the United States.

"So literally we've changed everything about insurance coverage for children and families, and we've changed access to health care all across the United States all as a result of reconciliation," she says.

Among the other examples cited were adding a hospice benefit to Medicare in 1982, adding Medicare benefits for HMOs such as preventive cancer screenings, and changing the way Medicare pays doctors and hospitals. The article is summed up with the following...
In fact, over the past three decades, the number of major health financing measures that were NOT passed via budget reconciliation can be counted on one hand. And one of those — the 1988 Medicare Catastrophic Coverage Act — was repealed the following year after a backlash by seniors who were asked to underwrite the measure themselves. So using the process to try to pass a health overhaul bill might not be easy. But it won't be unprecedented.

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