03.23.10
Crazy over health care
Now that health insurance reform has passed were all dead. Just kidding. Or as Kuff points out it’s The Freakout that we knew was coming.
A month ago, Jonathan Chait saw the gathering momentum for getting health care reform passed, and observed “The conservative freakout is going to be something to behold.” And indeed so far it has been. Katherine Haenschen and Bob Moser did a fine job documenting the many shameful things Texas’ Congressional Republicans said on Sunday during the health care vote. I’d say that history will eventually judge them, but I suppose that depends on whether or not the SBOE still has influence over the textbooks. Follow the links for the full effect; I’ll just quote Moser quoting South Carolina Rep. James Clyburn, the Democratic whip, on what this was all about:
“A lot of us have been saying for a long time that much of this is not about health care at all. And I think a lot of those people today demonstrated that this is not about health care… it is about trying to extend a basic fundamental right to people who are less powerful.”
I thought this from the Texas Tribune highlighted, although I’m no sure that was the intent, of what a good deal this bill is for Texas, The Price of Reform.
The federal government would foot the whole bill, estimated by the non-profit, non-partisan Center for Public Policy Priorities (CPPP) to be roughly $3.7 billion a year — until 2017, when Texas would start paying a 5 percent share, or about $185 million. That share would grow to 7 percent, or about $259 million, in 2019, and top out at 10 percent, or $370 million, in 2020, according to the CPPP’s estimate.
On paper, the measure looks like a great deal for the state: For every dollar Texas pays, it will get about nine federal dollars, to be funneled into health care coverage for roughly a sixth of Texas’ 6.1 million uninsured. But it’s still a serious strain on the state budget. In seven years, Texas will have to come up with hundreds of millions of dollars in new revenue to fund the Medicaid expansion. “If you have a Legislature with leadership that is dedicated to never creating any new state revenue, it’s a problem,” said Anne Dunkelberg, associate director of the CPPP.
Yes, you read that right. Once this is fully implemented our state will only have to pay 10% of the cost or $370 million in 2020. Considering our state’s budget right now, is $182 Billion for the current biennium, (and will likely be much more by 2010), that’s a really good deal to insure 6.1 million people.
There’s also a large discrepancy between the CBO estimate ($1.4 billion) and the state HHS estimate ($24 billion) of how much this will cost Texas.
Texas’ Republican leaders — Gov. Rick Perry, Lt. Gov. David Dewhurst and House Speaker Joe Straus — are relying on a state Health and Human Services estimate that shows the bill costing Texas a whopping $24.3 billion over 10 years. In the absence of tax increases, which Republican leaders oppose at all costs, they argue the health care bill could force the state to make cuts in education, public safety and road construction.
“The federal government has no right to co-opt state budgets in the manner that it has with Medicaid,” said Arlene Wohlgemuth, executive director of the Texas Public Policy Foundation. “…Legislators need to help the public understand how deeply we will need to cut public education, transportation, and public safety to pay for this unfunded federal Medicaid mandate.”
But Democratic lawmakers, such as Houston state Rep. Garnet Coleman, cite the non-partisan Congressional Budget Office’s estimate: a far lower $1.4 billion over the next decade. They call the Texas estimate inflated because it doesn’t take into account the anticipated economic impact of health care job creation — estimated at $3.25 for every federal Medicaid dollar spent here. The state’s figures also include the price of paying for kids who are already eligible but not yet enrolled in Medicaid — which Democrats say shouldn’t be considered a new cost — and the shifting of certain costs from local to state budgets that may not ever occur.
“All told, Texans and Texas state government stand the chance to benefit greatly from federal healthcare reform legislation,” Coleman said. “Texas will likely receive over $120 billion in federal dollars. … The legislation has the potential to create jobs and boost economic activity in our state while also ensuring the health and well-being of all its citizens.”
The CBO is a non-partisan referee while the HHS is probably lead by a Perry crony, so it’s not hard to see who’s more trustworthy on the estimates. Also as Coleman says, making health care more universal will certainly have many economic benefits.
State’s Attorney’s General, including Texas Attorney General Gregg Abbott, claims of unconstitutionality are nothing more than a campaign ploy - The Constitutionality of the current Health Care proposal and AG threatens suit over health-care overhaul.
The “freakout”, the disarray, and whose Waterloo this really was, is just more of the benefits of Democrats finally passing health reform.
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