Obama Supports Giving States More Flexibility in Reform Law
On Monday, President Obama told the National Governors Association that he supports legislation that would allow states to obtain waivers for provisions in the federal health reform law as early as 2014, three years before the overhaul currently permits, the Washington Post reports.
The bill (S 248) was introduced last year by Sens. Scott Brown (R-Mass.), Mary Landrieu (D-La.) and Ron Wyden (R-Ore.).
Obama said that states could obtain "innovation waivers" if they could prove to federal officials that they can still achieve the law's central goals, including:
- Making insurance benefits as affordable and comprehensive as the reform law;
- Covering the same number of residents as the federal overhaul; and
- Not increasing the federal deficit.
According to the Post, Obama's concession is an attempt to refocus the debate over the health reform law. With a majority of states challenging the overhaul in the courts and many states criticizing the law for providing too much federal oversight, Obama's concession now forces critics of the law to prove that their ideas on how to reform the U.S. health system could be successful.
Legislation Also Provides States With Medicaid Flexibility
The legislation also would give states the ability to work around Medicaid requirements in the reform law, which stipulate who must be covered and to what medical services they must have access (Goldstein/Balz, Washington Post, 3/1).
As most states deal with large budget deficits, many governors have taken issue with strict Medicaid regulations under the overhaul. They have called for the federal government to allow them more flexibility with the program to address escalating costs (California Healthline, 2/28).
Obama suggested that states create a bipartisan group to negotiate with HHS about Medicaid reform strategies. He said, "If you can come up with more ways to reduce Medicaid costs while producing quality care to those who need it, I will support those proposals."
A senior administration official later said that the White House hopes the group would focus on coordinating care, preventing hospital readmissions and keeping beneficiaries who wish to live on their own out of nursing homes (Pecquet, "Healthwatch," The Hill, 2/28).
Obama's message generally was well received, although many governors said they wanted to hear more specifics before endorsing the new plan.
Mississippi Gov. Haley Barbour (R) said, "The devil's in the details."
Meanwhile, Sen. Orrin Hatch (R-Utah) said moving up the timetable for waivers is a "gimmick," rather than a solution.
Kansas Gov. Sam Brownback (R) said the proposal would not change Republicans' opposition to the overhaul, which he said they would continue to fight in the courts.
Mike Leavitt, former HHS secretary and former governor of Utah, said Obama's endorsement of the proposal is "sort of a hollow victory" for GOP-led states. He said that Obama essentially is telling states, "We'll give you permission to ask for permission sooner rather than later." Leavitt added, "What Republicans are saying is that we don't want to have to ask for permission at all, because we can't afford to build the system that you've laid out for us" (Washington Post, 3/1).
Prospects for Legislation, Waivers
The legislation's chances of passage "appear dim," the New York Times reports.
House Republican leaders on Monday said they are committed to repealing the overhaul and not just changing it. Further, even if the bill became law, states would have difficulty proving they could meet the requirements for the federal waiver, according to the Times (Stolberg/Sack, New York Times, 2/28).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.