I just read an article by Joe Paduda about the harsh realities facing health care reform. As usual, Joe makes excellent points. Health care reform is not going to be easy, quick, or cheap. On a federal level, money is pretty tight right now, and the money that is available is being pulled in every direction by special interest groups, lobbyists, and lawmakers from across the country. Health care reform has long been an issue for state governments, even during the years since the Clintons tried to overhaul health care on a national level. But most states are now facing budget shortfalls and having to cut back on spending.
Here in Colorado – as in most states – we have a budget shortfall, and Governor Ritter is proposing $823 million in spending cuts. Prisons, higher education, property tax cuts for seniors, and even the tourism advertising budget are all on the chopping block. Ritter’s current proposal doesn’t include cuts to public health insurance programs like SCHIP or Medicaid, but we’ll have to see what happens as the year goes on. Since programs like Medicaid and SCHIP are funded by a combination of state dollars and federal matching funds, budget shortfalls at either level could have an impact on access to healthcare for low income families.
In addition, HB1355, which went into effect last month, means that the majority of small groups in Colorado are paying significantly higher premiums than they were last year. The obvious result is that fewer employers will be able to offer health insurance to their employees. Basic economics would predict that outcome even in good economic times, and the current recession will likely further increase the number of small businesses that are unable to offer health insurance benefits. And of course businesses big and small are cutting costs any way they can, often by reducing the size of their workforce. Since most Americans get their health insurance from their employer, layoffs mean not just the loss of a job, but the effective loss of health care access as well. Even if COBRA is an option, how is an unemployed person going to pay for it? For those who purchase their own individual health insurance, a job loss doesn’t automatically translate to lost health insurance, but again, it’s tough to pay health insurance premiums without an income.
Over the last couple years, I think that there has been tremendous optimism that the new administration and congress would be able to make some real progress in reducing the number of people who don’t have health insurance. As recently as last fall, the health insurance industry offered a proposal that would result in more coverage for more people. But everywhere I look these days – from unemployment numbers to my own IRA balance – the outlook seems pretty bleak. And I wonder how many of the optimistic ideas that were tossed about during last year’s presidential and congressional campaigns will have to be scrapped for the time being. Hopefully health care reform will continue to be a priority. Hopefully the people who don’t have health insurance (and all the people who are at risk of joining them) will not become a forgotten minority. But you can’t get blood from a stone, and it does come down to money.
I found Joe’s article in the Cavalcade of Risk, hosted last week by David Williams at Health Business Blog. Thanks for hosting, David, and for including the Colorado Health Insurance Insider article about health insurance covearge and infertility treatment.