Stimulus Debate Indicates Return of ‘Health Care Wars’
The "deadlock" in Congress over the economic stimulus bill indicates that the "health care wars have returned with a vengeance," the New York Times reports in a news analysis. Although the "details of the dispute" over health provisions in the economic stimulus bill are "complicated and arcane" and only apply to a "small slice of the uninsured," the argument highlights the "basic fault lines" between the parties -- Republicans' "faith in the virtues of tax cuts and an unfettered private marketplace" versus the Democrats' "trust in the goverment as an instrument of social equity." (Toner, New York Times, 12/20). During debate over the economic stimulus bill, Democratic health coverage proposals have relied primarily on subsidies to help unemployed workers purchase health coverage through COBRA and funds to allow states to expand Medicaid coverage. COBRA, the 1986 Consolidated Omnibus Budget Reconciliation Act, allows unemployed workers to retain health coverage under their former employers' insurance plans by paying 102% of the premiums. Republicans have mainly supported expanding coverage through tax credits or block grants to the states. Stuart Butler, a health expert at the Heritage Foundation, said "[Liberals] don't want anything other than an increase in the government programs." Butler added that Democrats are "holding low-income people 'hostage to ideology.'" Meanwhile, Anita Dunn, a top aide to Senate Majority Leader Tom Daschle (D-S.D.), said, "The genuine sticking point is whether individuals are thrown out there to fend for themsleves with a tax credit, which our caucus by and large finds abhorrent."
The Times reports that health experts say "the debate will intensify" next year. According to the Times, the economic downturn will likely "heighten" Americans' "anxiety" over health coverage, while "substantial increases" in premiums will put "new strains" on companies and workers. In addition, governors from both parties are already cautioning that they need help "to deal with the growing demands on Medicaid." Ultimately, all of these factors combined could make the "politics of the issue ... as powerful as they were in the last recession," which led to the Clinton administration's efforts to create universal health coverage. That attempt "ended in legislative disaster and turned the problems of the uninsured into a political third rail for many lawmakers for many years." The Times concludes that the current debate is "rousing much of the passion of the last -- not an auspicious sign for producing actual legislation" (New York Times, 12/20).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.