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Life Health > Health Insurance

Settling Scores Can Be Dangerous

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Congress returns to work Sept. 4 with a huge unfinished agenda on its plate, with many members on both sides of the aisle feeling a sense of urgency that one of the first things they should do is extend the State Children’s Health Insurance Plan, a highly successful program that expires at the end of the current federal fiscal year, Sept. 30.

But at the same time, the uncertainty over what is going to happen with the program is also a microcosm of all that has gone wrong with official Washington.

For example, Sen. Charles Grassley, R-Iowa, and Sen. Orrin Hatch, R-Utah, are dedicated supporters of President Bush. But, despite the president’s heavy criticism of efforts in the Senate to expand SCHIP, they both worked hard to help craft the bipartisan bill hammered out in the Senate Finance Committee that constitutes the Senate position on the extension issue.

And they also played a key role in pushing the current Senate bill, which calls for a $35 billion increase in the program over 5 years, through that chamber with a 68-31 vote, a vote designed to send a message to the president that extension of the program has veto-proof support in the Senate.

The president’s position is based on the theory is that the G.O.P can win in 2008 by embellishing voters’ perception of Republicans as the party of fiscal conservatism.

Conservatives in Congress are supporting the president in this latest form of Swift-boating despite the fact that discretionary federal spending has soared 59% since the Republicans took control of both the White House and Congress in 2001.

Yet, despite the fact that President Bush remains comfortable with his position and has shown an ability to consistently stymie the Democrats’ agenda, liberals in the House have come up with comparable legislation that stands little chance of becoming law–but has a strong chance of delaying a final solution for perhaps many months.

In a phrase, the Democrats’ effort, dubbed the CHAMP Act for Children’s Health and Medicare Protection Act, risks creating the perception of House Democrats as a bunch of politically na?ve chumps.

The House bill accomplishes this, first of all, by doubling current expenditures for the SCHIP program to $50 billion over 5 years.

It does so in part by phasing out over 4 years the estimated 12% greater government spending for those enrolled in the Medicare Advantage program, which is provided by private health insurers.

This program was created in the 2003 Medicare Modernization Act.

Democrats are seeking to reduce this program because Republicans rightly regard this as their signature act of the last 6 years.

And, they are right, especially from the perspective of the Iraq War, the handling of Katrina, the clumsy effort to thwart Democratic get-out-the-vote efforts by firing U.S. attorneys more cognizant of the law than Republican electoral needs, and the unfolding subprime loan fiasco.

And the Medicare Modernization Act, which created the prescription drug program under Medicare Part D and revitalized what is now known as the Medicare Advantage program, has been successful because of the ability of the health insurance industry to accomplish a goal from a standing start over a short period that is comparable to the job being done by the Centers for Medicare and Medicare Services.

Yet, House Democrats supported the cutback in the MA program despite the fact that both Republicans and the health insurance industry can rightly point to the MMA as an achievement.

Moreover, the MA program has broad support in Congress, especially among members of Congress serving rural areas in Western states who have disproportionate representation in the Senate.

Even Democrats in far western states, like Oregon and Washington, support the program because it has resulted in upgraded medical care in rural areas.

There is some legitimacy to the fact that the MA program is a little more expensive. But the fact is that the Democrats who wrote the CHUMP Act also imposed onerous enrollment, financial and reporting mandates on insurers as well as greater oversight on their marketing practices.

The reasons for this are clear: Democrats are seeking to take advantage of voter discontent with the cost and restrictions of private health insurance plans in order to settle accounts with the insurers for their refusal to support the Democrats’ universal health proposal in 1994 and to undermine Republicans for their unwillingness to engage Democrats in the writing of the MMA in 2003.

It is clear that Republicans used the “Harry and Louise” ads fashioned by the health insurance industry to gain control of Congress in 1994, leaving Democrats on the sidelines, especially in the House, for more than a decade.

And, Republicans were clearly heavy-handed in their handling of the MMA in 2003.

But settling accounts is a dangerous business, especially when it puts your current political aspirations in question, and has the potential to affect the health of children and the elderly. Isn’t it time to move on?


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