111th Congress and President Obama Burn the Midnight Oil
On March 9, The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) issued the following update on healthcare policy and reform and its potential impact on the O&P profession:
President Obama and the 111th Congress have been among the most activist in recent memory. This year, they have enacted a reauthorization and expansion of the State Children’s Health Insurance Program (SCHIP) and a massive $787 billion stimulus package designed to increase the number of jobs by 3.5 million, including almost $200 billion on healthcare spending. The remaining spending bills that fund the federal government for the remainder of fiscal year 2009 are poised to be debated by the Senate now that the House has passed the bill, and the federal budget blueprint calls for the creation of a $620 billion reserve fund to support the cost of national healthcare and entitlement reform.
Depending on personal politics, these developments can be seen either as the government taking bold action to address unprecedented national challenges or as a huge and unnecessary shift of debt to the next generation. Whatever is said in this regard, it is clear the new President will “own” these policies for years to come and the future of his presidency depends on how they ultimately succeed or fail. Inevitably, there will be threats and opportunities in these policies for O&P providers and patients.
President Obama’s FY 2010 Budget: Health Care and Entitlement Reform
This week, President Obama announced a blueprint of his federal budget for FY 2010 and beyond, a bold document that takes on healthcare reform through the creation of a $610 billion reserve fund. Contributions to this fund would come from tax increases primarily on wealthy Americans and reforms to entitlement programs such as Medicare. Assuming the Congress adopts the concept of a reserve fund, this creates a huge threat to all providers including O&P professionals, as Congress will be looking for ways to save federal dollars for years to come in the Medicare program.
With Medicaid largely being held harmless, the cuts will fall hardest on institution-based providers such as hospitals and nursing homes. A variety of very significant and controversial reforms were listed in the budget documents. The O&P community will have to remain vigilant to ensure that poor policy decisions are not made that impact O&P patient care for the sake of budget savings. On the other hand, the O&P field needs to be proactive about Medicare reform and not simply be in the position of rejecting any proposal for change that comes our way. NAAOP is closely monitoring developments on Capitol Hill and responding quickly when opportunities and threats arise.
It is clear that policymakers are serious about enacting healthcare and entitlement reform this year. Following the withdrawal of Health and Human Services (HHS) Secretary Designate Daschle, the momentum on healthcare reform slowed considerably, but the President’s Joint Address to Congress this week made it clear that he views healthcare and entitlement reform as a necessary component of furthering economic security. The momentum created as a result is palpable in Washington.
NAAOP is working alongside other O&P organizations to enact two major pieces of legislation that impact the O&P field, the federal O&P parity law, which impacts private insurance and employer-provided coverage or O&P care, and Medicare legislation to link provider/supplier qualifications with levels of complexity of O&P care. Both of these bills are soon to be introduced in the 111th Congress.
Wrap-Up of FY 2009 Spending Bills
On February 25, the House passed by a vote of 245 to 178 a $410 billion FY 2009 omnibus spending bill, finishing up the work left over from the past Congress. The agencies covered by the bill, including the Department of HHS, the Department of Labor, and the Department of Education, are currently being funded at 2008 levels under a continuing resolution, which expired on March 6. The Senate is expected to take up the bill toward the end of next week.
The belated FY 2009 spending plan provides about $152 billion to Labor, HHS, and Education programs, nearly a $6 billion increase over 2008. When entitlement spending such as Medicare and Medicaid is included, the total reaches $625 billion for the entire fiscal year, which is approximately $25 billion more than last year. The omnibus package provides HHS with a 4 percent overall increase. It is difficult to identify specific aspects of this budget that directly impact the O&P profession, but many programs that the O&P community values, such as research programs at the National Institutes of Health (NIH) and National Institute on Disability and Rehabilitation Research (NIDRR) will benefit from a settled budget for the remainder of the fiscal year.
Economic Stimulus Package
The increased funding under the Labor, HHS, and Education appropriations bill comes on the heels of President Obama’s signing of a $787 billion economic stimulus package designed to bring the economy out of the current recession. That package also includes significant boosts for healthcare programs including nearly $90 billion in Medicaid funding for the states and $10 billion in additional funding for medical research at the NIH. The O&P research program at the National Center for Medical Rehabilitation Research (NCMRR) will presumably receive its fair share of those increased funds.
SCHIP Reauthorization and Expansion
The SCHIP reauthorization and expansion was the first health bill signed into law by President Obama. The bill expanded the children’s health insurance program by more than $32 billion over five years and is expected to cover millions of currently uninsured children. To the extent that these children require orthotic and prosthetic care, this is welcome relief for providers faced with the difficult situation where a pediatric patient needs O&P services and is without insurance of any kind. SCHIP is designed to cover children whose parents do not quite qualify for Medicaid but whose incomes levels do not allow them to purchase private insurance coverage. Reauthorization and expansion of this program is being viewed as a “down payment” on national healthcare reform.
For more information, visit www.naaop.org