Almost All Legislative Advances In Health Care Passed Via Reconciliation
In spite of Republicans claiming that it’s practically unheard of for a heath care bill to pass via the reconciliation process, almost all progress in health care legislatively has been achieved that way. Yet Senator Jon Kyl of Arizona says, it “was never designed for a large, comprehensive piece of legislation such as health care, as you all know. It’s a budget exercise, and that’s why some refer to it as the ‘nuclear option.'” Sen. Orrin Hatch of Utah says, “The use of expedited reconciliation process to push through more dramatic changes to a health care bill of such size, scope and magnitude is unprecedented.”
But health care and reconciliation actually have a lengthy history. “In fact, the way in which virtually all of health reform, with very, very limited exceptions, has happened over the past 30 years has been the reconciliation process,” says Sara Rosenbaum, who chairs the Department of Health Policy at George Washington University.
COBRA, the plan that allows workers to have health care after they lose their jobs, was passed via reconciliation.
“The correct name is continuation benefits. And the only reason it’s called COBRA is because it was contained in the Consolidated Omnibus Budget Reconciliation Act of 1985; and that is how we came up with the name COBRA,” she says.
The CHIP program for children was created using reconciliation.
“In 1980, children who were living at less than half the poverty level in the United States could not get a Medicaid card in half the states if they had two parents at home,” she says.
But via a series of budget reconciliation bills, beginning in 1984, Congress began expanding Medicaid coverage. In 1997, also in a budget reconciliation bill, it created the Children’s Health Insurance Program, known as CHIP.
A host of other programs have been enacted this way.
“Going back even close to 30 years, if you start say in 1982, the reconciliation bill that year added the hospice benefit, which is very important to people at the end of life,” says Tricia Neuman, vice president and director of the Medicare Policy Project for the Kaiser Family Foundation.
Over the years, budget reconciliation bills added Medicare benefits for HMOs, for preventive care like cancer screenings; added protections for patients in nursing homes; and changed the way Medicare pays doctors and other health professionals.
Only a handful of policies were enacted by not using the reconciliation process. So don’t let Republicans tell you that doing it this way is unheard of.Click here for reuse options!
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