Monday, September 21, 2009

Health Reform Takes Senate Stage

The Senate Finance Committee will be wrestling with health reform this week. NY Times reports 564 amendments have been filed for the committee to consider. For most transportation interests, the leading issue in this debate is what will happen with Medicaid. In both House and Senate, the pressure's on for expanding Medicaid to all persons living at 133 percent of federal poverty lines, which would include many of the "working poor." As a side note, NPR recently reported on federal employees who can't afford their part of the premiums for feds' health benefits (note: listen to the 5-minute story, or download the transcript, as the NPR web story doesn't go that far). Governors are very worried that this expansion will create crises in states' budgets, although House and Senate bills currently hold states harmless. For transportation providers, it's less clear what that sort of Medicaid expansion would mean, as most of the new enrollees are, as mentioned, working people who can't currently afford health coverage, and thus more likely than current Medicaid enrollees to have existing transportation resources; on the other hand, they are likely to have dependents who may need access, so it's kind of hard to predict what would happen on the streets. Also in the House and Senate bills, there may be language that would - for the first time - add transportation as a specifically covered benefit within Medicaid (remember that, despite the billions of dollars now spent every year on Medicaid transport, it's done because a couple of federal courts said so, not on account of any statutory authorization). For more information on this possible change to Medicaid law - admittedly with a certain bias - see the CTAA web site.

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