The Better Care Reconciliation Act

Although division is seen between the political parties of the Republicans and Democrats, points exist to where lawmakers agree on the reform of healthcare. Lawmakers do, however, have three major points they agree. These points are the banning of underwriting by private insurance companies, providing federal funding to assistance low income families with securing insurance, and by accessing Medicare’s funding to its full advantage to reduce patients billing (Times Topics, 2009). While lawmakers have managed to agree on some points, by drafting a complete healthcare reform that is ethical. This will call for Congress to agree on a bill that fits President Obama’s views, requiring substantial research and planning.

"Let there be no doubt. Health care reform cannot wait, it must not wait, and it will not wait another year," President Barack Obama proudly stated (New 1). As soon as President Obama was elected into the White House, he made it a mission to get a Health Care Bill passed. On March 21, 2010, Congress passed the first draft of the monumental Health Care Bill. This bill was passed so quickly that citizens of the United States never got a chance to fully understand the pros and cons of the bill. Congress was allowed to read the bill within a 72 hour time frame. When the bill was brought to the Congress's floor, representatives and senators had a full day to debate and vote in favor or against. Due to positive promotion of the Health Care Bill,

Medicaid is a social health care program that covers nearly 60 million Americans, including children, pregnant women, seniors, parents and individuals suffering with disabilities. Medicaid is the biggest source of funding for health related services and medical needs for the people with low income in the United States. This program is funded jointly by the state and federal level governments, but it is the state’s responsibility to manage this program. The Medicaid program is not a required program that states have to use, but all 50 states have implemented this program. With the introduction of the Affordable Care Act (ACA), and its passing in 2010, the ACA unveiled its plans to expand Medicaid eligibility to nearly all low-income adults as an addition to the other groups that fall into the Medicaid eligibility. The Medicaid program had “many gaps in coverage for adults” because it was only restricted to the low income individuals and other people with needs in their own specific category. In the past, the majority of the states who had adults that did not have children dependent on those parents were not eligible for Medicaid. These low income adults without dependent children would be without medical insurance assistance before the ACA was introduced. Medicaid is now available to all Americans under the age of 65 whose family income is at or below the federal poverty guideline of “133 percent or $14,484 for an individual and $29,726 for a family of four in 2011” (NSCL).

I agree that the House bill would be best for America. Providing a standard baseline for all states would make them equal. If each state had its own freedom to choose what they wanted than there would be an imbalance between states. With that being said I do believe that the state having a say in the care is extremely important. Each state has a great idea of what is needed and should express that. Health care leaders will be faced with the challenge of managing the decision that is made.

Medicaid, which is a separate federal funded insurance was intended to cover low-income, aged, blind, disabled individuals, parents, and their dependent children on welfare. However, the senior citizens are the population group most likely to be living in poverty, and only about half of these individuals have insurance coverage. The difference between 1965 and now, of course, is costs. Years ago spending more on health care in result covering more people were the whole point. The administration wants to broaden coverage, but cut spending.

Medicare and Medicaid assist 111 million individuals of which 10 million individuals are qualified for both programs. By 2025, that number will increase to 139 million individuals. Medicare beneficiaries receive $23,500 for a medium income and Medicaid beneficiaries receive $15,000 (Altman & Frist, 2015). Both programs combined comprise of “39% of national health spending, account for 23% of the federal budget, and generate 43% of hospital revenues” (Altman & Frist, 2015). These programs are predicted to increase by 3.7% each year. Since the two programs affect many individuals, any changes to the programs can shake election turn-out votes. The toughest health policy surrounding Medicare and Medicaid today is whether the programs should remain entitlements.

The topic that I choose to write my policy brief on is Republican Health Policy. The article that I have selected is “What Would A republican Win Mean for Health Policy?” by Gail R. Wilensky. This article is a current event because of the Presidential elections that are taking place at the moment. As individuals are following the elections, it is important to know the changes that can occur depending on who is elected as the next president of the United States.

The purpose of the bill is to reduce state Medicaid disproportionate share hospital (DSH) allotments annually from fiscal year (FY) 2014 through FY 2020. The reduction will occur “at the same time as the Marketplace and Medicaid provide increased coverage options that will reduce uncompensated care levels for hospitals. State Medicaid programs make DSH payments to qualifying hospitals that serve a large number of low-income individuals.”

The bill is 1000 pages long and addresses a great many pieces of the American health care puzzle. This is too much for most people to read and try to understand. So, most people are looking for some digest form of information on the bill.

This is forcing the doctors to no longer accept certain insurance companies such as medicaid because they aren’t being reimbursed for the services they’re providing to the consumers that are using medicaid. One doctor, Dr. Martha Boone in Atlanta, Georgia, said that she would have to see 20 patients an hour in order to make any reimbursement from medicaid. She said that medicaid paid none of their bills coming from her office for 18 months and when her office sent registered letters to Medicaid to see what the problem was they said it was a computer error and still didn’t reimburse her office (Heritage, 2010). Because most doctors don’t receive money from Medicaid, most of them don’t accept it. “Of the 93 internists affiliated with New York-Presbyterian Hospital, for example, only 37 accept Medicare, according to the hospital’s Web site.” (Connelly, 2009). This forces the Medicaid consumers to go to the emergency room when they need help since normal doctors rarely take their insurance. Dr. Lloyd Krieger says that the undoing of this healthcare bill is, “an urgent necessity.” because it is, “doing great damage even years before it’s individual mandates and other controls kick in.” (Krieger, 2011).

This May, the United States House of Representatives successfully passed the American Health Care Act. This passed by a slim margin of 217–213. The bill was then sent to the Senate for deliberation where it was highly criticized, especially by the Congressional Budget Office, for the number of citizens which it would negatively impact. Therefore, instead of amending the bill, the Senate decided to write its own version. The Senate GOP healthcare plan is titled as the Better Care Reconciliation Act. It is titled this way because reconciliation is the process which the Senate will be using in order to pass the legislation. This maneuver allows the Senate to bypass the filibuster process. This will lower the 60-vote majority requirement to pass

Leading up to the vote, McCain made it evident that he believed that the bill would work if created as part of a bipartisan effort. McCain saw the potential of the bill, but it was evident to him that it was being passed quickly and not meeting its full potential. In response to his veto McCain said, “I would consider supporting legislation… were it the product of extensive hearings, debate and amendment. But that has not been the case” (Wilkie). Although McCain was not opposed to the bill as a whole, he knew that the way it was devised was improper and that the American people deserved better. Even considering his personal disagreements with Obamacare, McCain was not willing to let that stay in the way of fighting for the best health care bill possible.

The proposed health care reform bill attempts to change issues of public policy and health care management for the poor and uninsured. Many leaders from the Democratic Party are actively engaging in policy-making to fix what Rep. Henry Waxman (D-California) calls a “‘dysfunctional’ health care system” (2009). Currently, the U.S. health care system denies people with pre-existing conditions from receiving care. Another problem with the system is that the health insurance that some employers offer may be so expensive that their employees cannot afford it. Any cuts in Medicaid may mean that physicians have fewer incentives to provide adequate care for the poor. These are some of the many problems that the Affordable Health Choices Act attempts to address. Fiscally conservative political and business groups oppose this measure because they believe that any changes in public policy and health care management might affect them negatively.

“We will pass reform that lowers cost, promotes choice, and provides coverage that every American can count on. And we will do it this year.” The preceding is a powerful statement from the newly elected President Barak Obama. One of the main aspects of both political campaigns was health care reform. The above quote shows passion and encouragement, but the quotes about health care do not end there. Georgian republican gubernatorial candidate and health care policy maker John Oxendine expressed: “Their proposal would virtually devastate the private healthcare sector in this country along with competition and patient choice, by replacing it with bureaucratic planning and government control. The result of this plan and its one trillion

National health care spending is a heated issue; however there is a single entity that all agree upon and that is there needs to be cut backs or the maintaining of current expenses. The current reform will help decrease the percentage of Americans who are without coverage. An vigilant observation on healthcare spending is needed, at the rate its going now thing don’t look too good financially for anyone when it comes to healthcare.