With little notice and no public hearings, House Democrats would create a temporary new entitlement allowing workers getting unemployment checks to qualify for Medicaid, the health program for low-income people. Spouses and children could also receive benefits, no matter how much money the family had.
In addition, the stimulus package would offer a hefty subsidy to help laid-off workers retain the same health plans they had from their former employers.
Altogether, the economic recovery bill would speed $127 billion over the next two and a half years to individuals and states for health care alone, a fact that has Republicans fuming that the stimulus package is a back door to universal health coverage.
Medicaid is normally for low-income people, and for decades it has been financed jointly by the federal government and the states, with the federal share averaging 57 percent of costs.
The economic stimulus bill prevents states from enforcing a means test, saying, “No income or resources test shall be applied with respect to any category of individuals” who become eligible for Medicaid because they are receiving unemployment benefits. The federal government would pay 100 percent of the costs for people enrolled under this option through December 2010.
Republicans said this proposal would take a big step toward federalizing Medicaid. For their part, Democrats said the changes took a major step toward their goal of coverage for all Americans.
At the same time, the legislation would provide a huge measure of fiscal relief to state Medicaid programs, at a time when state revenues are declining and the number of Medicaid recipients is rising because of the recession.
The bill would also offer a lifeline to workers who have lost health insurance along with their jobs. In theory, such workers and their families can keep their group health benefits for 18 months under a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1986, known as Cobra. But laid-off workers are often required to pay 102 percent of the full premium, including the employer’s share, so the cost now can be prohibitive.
Under the bill, the federal government would pay 65 percent of the premiums for a year. That subsidy would almost surely increase the number of laid-off workers choosing to continue coverage.
Thirty-five percent is still a lot, especially if someone recently laid off was used to their employer picking up most of the bill, but it's a hell of a lot better than one-hundred and two percent, and at least gives people a realistic chance of maintaining their health care for (maybe?) long enough to get through this downtime (provided of course they can find employment that permits them even that.)