Senate Recovery and Reinvestment Act Sells Health Care Short

SOURCE: AP/Ric Feld

A nurse administers a vaccine. Funding eliminated from the Senate Recovery and Reinvestment Act would have provided training for and promoted jobs like this in health care.

By Peter Harbage, Judy Feder, Ellen-Marie Whelan | February 10, 2009

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A percentage-point increase in unemployment could raise the number of uninsured by 1.1 million. So if unemployment rates continue as economists predict—increasing from 4.6 percent in 2007 to 11.1 percent in 2010—more than 7 million people will likely lose their health insurance.

Yet the Senate American Recovery and Reinvestment Act shortchanges support for these American families who are losing their health benefits. The bill offers less than the House version for workers who are losing their jobs and may also back away from investments aimed at refocusing our health care system on promoting health and gaining better value for our dollars. Specifically, the bill:

Limits access to health insurance. The Senate bill excludes a House provision that would make Medicaid available to low-income and other unemployed workers. This provision has significant potential to secure affordable health care to people most in need and promote the jobs that deliver the care.

An amendment further weakened the Senate legislation by pulling back support for COBRA. COBRA enables workers who have lost their jobs to continue to purchase health insurance from their employers. The original Senate bill would have made COBRA more affordable by covering 65 percent of the unemployed worker’s premium, but the amendment reduced support to 50 percent. This change will deprive workers of approximately $1,800 in support for annual premiums.

Eliminates $5 billion in funding for prevention. The health care system is skewed toward high-cost treatment, and it invests too little in preventing costly disease. The Senate bill initially provided support to help move the health care system toward better health promotion with support for immunizations, screenings, and other preventive service. That support was eliminated by an amendment.

Reduces health information technology investment by $2 billion. The health care system is decades behind most American industry in implementing information technology that would minimize waste and promote quality service. Yet an amendment reducing Senate investment in health information technology effectively downgrades support for technology jobs and needed industry reform.

Reduces workforce training by $600 million. Assuring adequate numbers of primary care workers, nurses, and other health professionals is important to providing Americans with needed care. The Senate legislation, like the House bill, initially provided investments in workforce training to get more qualified workers into these positions, but an amendment eliminated this provision and missed an opportunity to expand and protect our health workforce.

More on the Recovery and Reinvestment Act:

Column: A Step Forward, a Stumble Back

Background brief: Recovery and Reinvestment 101

Interactive Maps: Recovery Beyond the Beltway

Infographic: The Stimulus: Four Reasons We Can't Afford Not to Have One

Interactive: Design Your Own Stimulus Package