3/4/2009
111 th Congress and President Obama Burn the Midnight Oil
President Obama and the 111th Congress have been among the most activist in recent memory. Thus far this year, they have enacted a reauthorization and expansion of the State Children’s Health Insurance Program (SCHIP) and a massive $787 billion stimulus package designed to increase the number of jobs by 3.5 million, including almost $200 billion on health care spending. The remaining spending bills that fund the federal government for the remainder of fiscal year 2009 are poised to be debated by the Senate now that the House has passed the bill and the federal budget blueprint calls for the creation of a $620 billion reserve fund to support the cost of national health care and entitlement reform.
Depending on personal politics, these developments can be seen as the government either taking bold action to address unprecedented national challenges or as a huge and unnecessary shift of debt to the next generation. Whatever is said in this regard, it is clear the new President will “own” these policies for years to come and the future of his Presidency depends on how they ultimately succeed or fail. Inevitably, there will be threats and opportunities in these policies for O&P providers and patients.
President’s FY 2010 Budget: Health Care and Entitlement Reform:
Just this week, the President announced a blueprint of his federal budget for FY 2010 and beyond, a bold document that takes on health care reform through the creation of a $610 billion reserve fund. Contributions to this fund would come from tax increases primarily on wealthy Americans and reforms to entitlement programs such as Medicare. Assuming the Congress adopts the concept of a reserve fund, this creates a huge threat to all providers including O&P professionals, as Congress will be looking for ways to save federal dollars for years to come in the Medicare program.With Medicaid largely being held harmless, the cuts will fall hardest on institution-based providers such as hospitals and nursing homes and a variety of very significant, and controversial reforms, were listed in the budget documents. The O&P community will have to remain vigilant to ensure that poor policy decisions are not made that impact O&P patient care for the sake of budget savings. On the other hand, the O&P field needs to be proactive about Medicare reform and not simply be in the position of rejecting any proposal for change that comes our way. NAAOP is closely monitoring developments on Capitol Hill and responding quickly when opportunities and threats arise.
It is clear that policymakers are serious about enacting health care and entitlement reform this year. Following the withdrawal of HHS Secretary Designate Daschle, the momentum on health care reform slowed considerably, but the President’s Joint Address to Congress this week made it clear that he views health care and entitlement reform as a necessary component of furthering economic security. The momentum created as a result is palpable in Washington.
In this connection, NAAOP is working alongside other O&P organizations to enact two major pieces of legislation that impact the O&P field, the federal O&P parity law, which impacts private insurance and employer provided coverage or O&P care, as well as Medicare legislation to link provider/supplier qualifications with levels of complexity of O&P care. Both of these bills are soon to be introduced in the 111th Congress.
Wrap-Up of FY 2009 Spending Bills:
On February 25th, the House passed by a vote of 245 to 178 a $410 billion FY 2009 omnibus spending bill, finishing up the work left over from the past Congress. The agencies covered by the bill, including the Department of Health and Human Services (HHS), the Department of Labor and the Department of Education, are currently being funded at 2008 levels under a continuing resolution that is set to expire in less than 10 days on March 6. The Senate is expected to take up the bill towards the end of next week.The belated FY 2009 spending plan provides about $152 billion to labor, health & human services and education programs, nearly a $6 billion increase over 2008. When entitlement spending such as Medicare and Medicaid is included, the total reaches $625 billion for the entire fiscal year, which is approximately $25 billion more than last year. The omnibus package provides HHS with a 4 percent overall increase. It is difficult to identify specific aspects of this budget that directly impact the O&P profession but many programs that the O&P community values, such as research programs at NIH and NIDRR will benefit from a settled budget for the remainder of the fiscal year.
