HHS Awards $72M for Gains in Children's Health Coverage

HHS Secretary Kathleen Sebelius announced awards to nine states for expanding and simplifying health insurance for children on Thursday. The awards amounted to $72.6 million and were given to Alaska, Alabama, Illinois, Louisiana, Michigan, New Jersey, New Mexico, Oregon, and Washington. Wires and many local news outlets covered the story.

The Newark (NJ) Star Ledger (12/18, Livio) reports that Sebelius rewarded New Jersey "with a $4.2 million bonus for enrolling more than 50,000 children from poor and working poor families in state and federally-funded health insurance programs over the last year."

Gannett (12/18, Chebium) explains that the "bonuses were created as part of a bill renewing SCHIP, which President Barack Obama signed into law in February." New Jersey Department of Human Services commissioner Jennifer Velez said, "This award proves that, while there are many children still in need of healthcare coverage, New Jersey is making great headway."

Alabama's Birmingham Business Journal (12/18, DeButts) reports that "the Alabama Medicaid Agency has received a $39.1 million federal performance bonus for enrolling more low-income children in Medicaid during fiscal year 2009." Also reporting on Alabama, the AP (12/18) notes that "Alabama boosted enrollment among eligible uninsured children by 39 percent. That was the largest increase in the country."

Meanwhile, from Illinois, the AP (12/18) reports that Sebelius announced a $9.1 million bonus for boosting Medicaid enrollment by 115,000 children in 2009.

Advocate argues CHIP better than insurance exchanges. In an op-ed in the Detroit News (12/18), Jack Kresnak, president and CEO of advocacy group Michigan's Children, writes, "Although the House reform legislation has many strong provisions supporting children and families, it calls for the abolishment of the Children's Health Insurance Program (CHIP) in 2013." Afterwards, the program "would be replaced by a far more expensive new health-insurance exchange, largely driven by insurance companies. We cannot allow this to happen." Kresnak argues that CHIP "has been critical to filling the gap and providing coverage for the children of working poor" and "has sharply reduced the number of uninsured children." Moreover, "CHIP is significantly better for low-income families than any health reform proposal pending in Congress."

Media reports describe a significant number of hurdles facing the White House and Senate Democratic leaders as they push for passage of a healthcare bill by Christmas Eve. NBC Nightly News (12/17, lead story, 2:50, Williams) reported that "even friends of the President, those most loyal to him, fear that the healthcare reform bill he wanted so badly has been pecked to death, and picked apart, watered down, and in the end, will be something nobody really wants." The CBS Evening News (12/17, lead story, 3:00, Cordes) noted that "the President's refusal to go to bat for the public option has sparked an uproar among the liberal activists who went to bat for him. 'Kill the bill' is becoming a common refrain on some of the nation's most influential liberal websites. ... On the President's official Facebook page, Democrats let him have it."

The New York Times (12/18, A26, Stolberg) reports that President Obama "has cast himself as a cold-eyed pragmatist, willing to compromise in exchange for votes. Now ideology -- an uprising on the Democratic left -- is smacking the pragmatic president in the face." The Times adds that "the left's disenchantment with Mr. Obama on healthcare harks back to his decision, before he became president, not to try to" push for "a single-payer, government-run 'Medicare for all' system." A Politico (12/18, Allen) story refers to "a stunning reversal of fortune for...Obama," with "top progressives...attacking the health-reform plan moving through the Senate as...a sellout to corporate interests." Politico adds that "the attack from the left comes at a delicate juncture when a delay of more than a couple of days could sink any remaining chance that the Senate can pass it by Christmas."

Politico (12/18, Brown, Shiner) notes in a separate article that Majority Leader Harry Reid (D-NV) has "until Saturday to strike a 60-vote compromise if Democrats hope to meet a Christmas Eve deadline -- but the obstacles kept piling up Thursday," and "the net effect was the loss of any sense of inevitability surrounding the passage of healthcare legislation by the end of the year." Politico adds, "Reid still had no legislative text and no cost analysis to release. One of the final moderate holdouts, Sen. Ben Nelson (D-NE), rejected compromise language on abortion funding and said he's doubtful a bill can pass by Christmas," and "two powerful unions blasted the bill."

The Hill (12/18, Young, subscription required), however, reports that while "the country's two largest labor federations on Thursday issued strong criticisms of the measure," the Services Employees International Union "expressly urged Democrats to keep the process moving by passing the Senate bill." The AFL-CIO "did not go that far, but its exhortations that Congress not give up on healthcare reform are" also "predicated on the legislation surviving the Senate." The Los Angeles Times (12/18, Oliphant) notes that "the powerful AFL-CIO and the Service Employees International Union said they would push House members to stand up for their version of the legislation when the House and Senate bills are molded into a single measure." SEIU President Andrew Stern also "called on Obama to make his presence felt in the negotiations."

Kaiser Health News (12/17, Gold) reported that proposal to extend the COBRA subsidies, "which passed the House Wednesday night, is tacked onto both the House defense appropriations and jobs-creation bills and would give some unemployed Americans an extra six months of help paying for their COBRA coverage." Notably, the Senate "could act on the Defense bill as soon as Saturday." It would "extend the sign-up deadline until the end of February. The Jobs bill, which will likely work its way through Congress early next year, would extend it until the end of June 2010. Both would lengthen the nine-month subsidy to 15 months and would be retroactive for those who already timed out." Meanwhile, a separate bill, "proposed in November by Sen. Robert Casey (D-PA) and Sen. Sherrod Brown (D-OH) would increase the subsidy amount from 65 percent to 75 percent."

Senate passes cloture motion on bill containing COBRA subsidy extension. Roll Call (12/18, Stanton, subscription required) reports, "At least for now, Senate Majority Leader Harry Reid (D-NV) has managed to stay on schedule to pass healthcare legislation by Christmas after the Senate early Friday morning agreed to vote on the Defense spending bill and get it out of the way." The cloture vote on the spending bill, which includes the COBRA subsidies, passed on a 63-33 vote.

In the Wall Street Journal (12/18, subscription required) "Potomac Watch" column, Kimberley Strassel calls the Democratic health agenda a suicide pact, arguing that it would be better not to pass any bill than to pass the healthcare reform legislation as it is currently. She says that orchestrators of the healthcare reform legislation are not worried about the next election, but hope to set up an inescapable slide to a full government takeover of healthcare.

In the "Deals" column in the Washington Post (12/18), Allan Sloan writes that he has "doubts" that Washington can successfully "impose a stiff excise tax on what they call 'Cadillac Care' health plans to raise revenue and reduce health spending." The problem, he argues, is that legislators "define 'Cadillac' not by the benefits a plan delivers but by how much a plan costs. But as any insurance maven will tell you, costs depend more on the people being covered...and location...than on the level of benefits." Sloan concludes, "If we're going to have a tax on health benefits, let's make it simple, broadly based, and intellectually honest. And let's not confuse Chevys with Caddys."