Weekly Newsletter: February 25, 2008

Mental Health Parity Bill Headed for Floor

With the House scheduled to return from its President’s Day recess today, the period between now and the Easter recess may include action on a mental health bill (H.R. 1424) sponsored by Rep. Patrick Kennedy (D-RI). Among other provisions, the bill would impose a federal mandate that group health insurance plans offered by employers provide insurance coverage for a broad array of mental and substance abuse disorders, impose a federal scope of benefits for mental health coverage, and permit states to enact laws with more stringent consumer protections, potentially creating a patchwork of regulations to which large employers will be forced to comply.

Some conservatives may have strong concerns about both the principle behind the legislation—a costly federal mandate that will raise the health insurance premiums and increase the number of uninsured Americans—as well as the way in which the expansive House language would mandate coverage for “mental disorders” such as caffeine addiction and jet leg. The RSC will be monitoring this legislation as it makes its way to the House floor, and will be weighing in during the process to express conservatives’ concerns.

SCHIP Hearing Scheduled

Tomorrow the Health Subcommittee of the House Energy and Commerce Committee has scheduled a hearing around the State Children’s Health Insurance Program (SCHIP). This hearing will center around the guidance letter the Centers for Medicare and Medicaid Services (CMS) issued in August 2007 requiring states to take steps that ensure that SCHIP funds are targeted toward low-income children before states spend money to expand coverage to wealthier populations.

Most conservatives support enrollment and funding of the SCHIP program for the populations for whom the SCHIP program was created. That is why in December the House passed, by a 411—3 vote, legislation reauthorizing and extending the SCHIP program through March 2009. That legislation included an additional $800 million in funding for states to ensure that all currently eligible children will continue to have access to state-based SCHIP coverage. However, many conservatives also express strong reservations about further expansions of government-funded health insurance, particularly when those expansions would displace private insurance coverage held by wealthier families and children.

Interestingly enough, the Subcommittee hearing comes just over a week after full Committee Chairman John Dingell (D-MI) called the President’s Medicare trigger proposal “little more than a scare tactic.” With the size of America’s unfunded obligations rising by $2 trillion every year that Congress takes no action to reform entitlement spending, some conservatives might argue that the better way to help America’s children is to reform Medicare and Medicaid so that future generations will not be saddled with trillions of dollars of debt, not work to expand public programs for wealthier children.

Chairman Hensarling Op-Ed on Medicare Trigger Legislation

Last Friday, RSC Chairman Jeb Hensarling placed an op-ed article in The Washington Times discussing President Bush’s submissions to Congress regarding the state of Medicare—both the package of reimbursement adjustments proposed in the Fiscal Year 2009 budget, and the additional reforms proposed as part of the White House’s response to the “trigger” issued as a result of the Medicare trustees’ funding warning.

Chairman Hensarling’s article reflects the views of many conservatives that the “trigger” represents a critical opportunity to enact fundamental reform of the Medicare program that should ensure the program’s long-term sustainability and reduce its cost growth. In the coming months, RSC members will explore and advocate for market-based approaches intended to alleviate the fiscal crisis that will loom large in the absence of comprehensive entitlement reform.

Read the article here. To learn more about the Medicare trigger, read the RSC policy briefs on this issue.

Article of Note: “Lone Star Showdown”

With the Presidential primary campaign moving to the key states of Texas and Ohio, the Hudson Institute’s Betsy McCaughey examines the way in which the Democratic candidates’ proposals might affect the Lone Star State. Her op-ed piece in the Wall Street Journal posed questions to Sens. Hillary Rodham Clinton (D-NY) and Barack Obama (D-IL) that illustrated the logistical and philosophical objections many conservatives find with their health platforms:

  • Would illegal immigrants receive federal subsidies for health insurance?
  • How would a mandate for all individuals to have health insurance—or, in the case of Sen. Obama’s plan, requiring all parents to buy coverage for their children—be enforced?
  • How are guaranteed issue and community rating policies—which prohibit insurance carriers from varying premiums based on age or health status—fair to the younger workers who will pay more to subsidize older and less healthy—but presumably richer—individuals?
  • How are dozens of costly state benefit mandates consistent with “affordable” health insurance coverage?
  • Will promises that individuals will be able to keep coverage they like extend to persons with high-deductible health plans and/or Health Savings Accounts, or will they be forced to convert to more expensive coverage they may not want?
  • Is attempting to regulate the profits of insurance companies a wise role for government to be playing in health care—or in any industry, for that matter?McCaughey’s article uses examples derived from Texas, but the concerns she raises could be cited by conservatives in all states as they weigh the import of the proposals put forward by the Presidential contenders.

Read the article here: The Wall Street Journal: “Health Questions for the Candidates” (subscription required)