Uninsured get no relief in economic stimulus bill

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Uninsured get no relief in economic stimulus bill

By Todd Zwillich

WASHINGTON, Mar 08 (Reuters Health) - The US Congress completed work on an

economic stimulus package Friday, but only after nearly every healthcare

proposal was jettisoned for the sake of forging an agreement between

Republicans and Democrats.

Falling by the wayside was any kind of relief for scores of uninsured

Americans, as the Senate approved the scaled-back package 85-9 Friday

morning, less than a day after the House passed it 417-3. The lopsided votes

ended nearly 5 months of political wrangling fueled largely by disagreement

over how to assist millions of idled US workers left without health

insurance because of economic recession.

Included in the package, which President Bush has pledged to sign, are tax

breaks and incentives for businesses as well as extended unemployment

insurance payments for workers. Left out were a variety of healthcare

proposals that had kept the parties at odds for fear that they would alter

the dynamics of debate over how to extend health coverage to nearly 40

million uninsured Americans.

Republicans and Democrats each expressed disappointment that help for the

recently uninsured was sacrificed to pass the stimulus. More than 2.2

million American workers have lost health coverage as a result of the

economic downturn, according to recent figures from the consumer group

FamiliesUSA.

" We had a chance to move forward on an important bipartisan objective,

improving access and affordability of healthcare, " said Iowa Sen. E.

Grassley, the senior Republican member of the Finance Committee. To reach

agreement with Democratic leaders, he said, " we had to punt. "

Grassley and other congressional centrists had supported a proposal offering

individual tax credits that workers could use to buy private health

insurance. House Republicans stripped the measure from their bill to satisfy

Democratic leaders, who worried that it would create a voucher system that

would undermine the existing employer-based healthcare system.

President Bush endorsed the credits in his 2003 budget as a way to extend

health coverage to uninsured Americans.

House Republicans also removed a measure supported by Democrats that would

send more money to states struggling to maintain benefits in the face of

rising Medicaid costs and expanding numbers of uninsured.

Governors lobbied throughout the week to replace the increases, though

Senate Democratic leaders ultimately refused in order to avoid scuttling the

deal with GOP members opposed to expanding Medicaid, according to one

official at the National Governors' Association.

" This is, frankly, what we expected, " the official said.

Senate Majority Leader A. Daschle praised the final stimulus package

Friday. " I am disappointed, however, that this bill does not include help in

affording healthcare coverage for unemployed workers or aid that states so

badly need, " he said.

Daschle vowed to include the Medicaid increases in future legislation. " We

are going to pass it sometime soon, " he said in an interview.

Interest groups representing insurance companies, large manufacturers,

healthcare providers and consumers have engaged in the stimulus debate for

months. Groups were keen to see what example the final product would set for

coming debates over how to extend coverage to uninsured Americans.

But a miniscule health provision, a one-year extension on tax breaks for

limited and seldom-used medical savings accounts, was all that remained of

the healthcare proposals that had divided the parties.

" They came back to the economic side of the stimulus bill, so hopefully they

can come back to the health side, " said Ignagni, president of the

American Association of Health Plans, a managed care trade group.

" I don't at all consider it dead, " she said.

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