July 2009 Domestic Monthly Action

Using the Media to Push for Health Reform that Meets the Needs of Low-Income Americans

Take Action! Submit Op-Eds and Letters to the Editor to Push for Expanding Health Coverage and Access for Vulnerable Populations

  1. Refer to a recent article in the newspaper on health care reform.

  2. Inform readers that some in Congress are threatening to scale back coverage for America’s poorest individuals, just to meet arbitrary spending targets.

  3. Remind them that a modest expansion in Medicaid (cover everyone at or below 150 percent of the federal poverty line) would cover over one-third of those currently uninsured and expanding America’s community health center network would provide millions of people access to vital primary health care.

  4. Emphasize that providing preventive care and access to early treatment to more Americans will not only benefit those who had previously lacked coverage, it will help control costs for health care overall by reducing the need for more complicated procedures. Insuring the uninsured benefits everyone.

  5. State that health reform is worth the investment; this is a matter of life and death, not just dollars and cents. Scaling back coverage for millions of low-income Americans is immoral and a recipe for failure.

  6. Call on your members of Congress by name and urge them to strengthen and expand both the Medicaid program and America’s investment in community health centers.

Note: Brevity is key in letters; most newspapers have a 150–250 word limit for letters to the editor. You can read more about writing letters to the editor in RESULTS tips for writing a letter to the editor and find contact info for your local media in our Take Action Now pages. Be sure to send a published copy of your letter to your members of Congress and the RESULTS office.

This month, Congress is moving fast on health reform. To help us keep track, here is a grid on the process (last updated: July 15), and where RESULTS’ priorities stand:


RESULTS Position

Senate HELP Committee Affordable Health Choices Act

Senate Finance Committee (detailed legislation expected July 17)

House Tri-Committee America’s Affordable Health Choices Act

Strengthening and Expanding Medicaid

Expand Medicaid to include everyone at or below 150% of the federal poverty line (FPL). Provide for automatic increases in federal funding during economic downturns, i.e. counter-cyclical financing.

Assumes Medicaid expansion to everyone up to 150% FPL. Expansion paid for with 100% federal funding until FY 2015. No provisions on counter-cyclical financing (note: Medicaid expansion is under the jurisdiction of the Senate Finance Committee, so these are just assumptions made in the HELP bill).

Rumors are that Finance is looking at Medicaid coverage for children and pregnant women up to 133% and others at 100%. In May laid out possible options including Medicaid coverage for pregnant women, children, and parents up to 150% FPL. Childless adults below 115% FPL could get tax credits.

Expands Medicaid coverage for everyone up to 133% of the FLP. Provides 100% federal funding for the expansion.

Community Health Centers (CHCs)

Increase funding for CHCs to $8.3 billion per year, pursuant to the Access for All America Act (S.486 and H.R.1296).

Authorizes increasing CHC funding to $8.3 billion by 2015; increases investment in National Health Service Corps to train more health care service providers.

No mention of increasing investment in CHCs.

Authorizes increasing CHC funding by $6.4 billion by 2019 (over current levels); increases investment in National Health Service Corps to train more health care service providers.

National Health Care Program (Single Payer)

RESULTS has endorsed a National Health Program as our long-term goal for health reform (H.R.676 and S.703).

Does not include a national health care plan. Senator Sanders (I-VT) offered an amendment during HELP deliberations to support state single payer experiments that failed with three other senators supporting it.

Does not include a national health care plan.

Does not include a national health care plan. Representative Weiner (D-NY) will introduce a single payer amendment during Energy and Commerce Committee deliberations on July 16.

For more details, see the Kaiser Foundation Side-by-Side Comparison of bills.

There has been a great deal of attention on what kind of health care reform Congress will present to the American people. Above you can see what the relevant House and Senate Committees have proposed so far. The House proposal includes both a Medicaid expansion, an increase in community health center funding, as well as a public health insurance option to compete with private plans. The House Committees (Energy and Commerce, Education and Labor, Ways and Means) are currently holding hearings on the proposal and are expecting to mark up the bill beginning July 13.

The Senate Health, Education, Labor and Pensions (HELP) Committee, chaired by Senator Kennedy (D-MA) and led currently by Senator Dodd (D-CT), is continuing to mark up their Affordable Health Choices Act. The latest HELP Committee proposal is said to cover 97 percent of people at a cost of $611.4 billion dollars over ten years, according to the non-partisan Congressional Budget Office. Much of the overall savings and coverage expansion stem from including a public health insurance option and a mandate for employers of more than 25 people to provide insurance to employees.

Finally, the Senate Finance Committee has released policy options for health reform, but has not yet released its draft legislation, as of the date of this printing. Their draft is expected in early-mid-July and mark-up of that bill will being shortly thereafter. Whether their mark-up will be completed before the August recess is still uncertain.

Of growing concern for anti-poverty advocates is talk of Congress scaling back a Medicaid expansion and subsidies for low-income persons to buy private insurance simply to meet an arbitrary funding target. Sen. Max Baucus (D-MT), Chairman of the Senate Finance Committee, wants health reform to cost no more than $1 trillion over ten years, a number that has no budgetary significance other than being a round number. Keeping the goal of health reform in a cost frame, i.e. what is most affordable, will make it easier for negotiators to scale back the final product. But health reform is not just a financial issue, it is a moral one. It is a matter of life and death (18,000 people die in the U,S, each year due to lack of health coverage) and financial security for millions (every 30 seconds, someone files bankruptcy due to medical debt). Health reform is an investment in our present and our future. To scrimp now is simply a recipe for failure.

Reiterating RESULTS’ Health Reform Positions

Expand access through community Health Centers: Community health centers provide affordable and quality access to health care to millions of America’s most underserved individuals and families. Community health centers primarily serve lower income and minority communities; over 70 percent of patients have incomes below 100 percent of the poverty line and 91 percent below 200 percent of the poverty line. Around 19 million people per year are served by 1,100 community health centers, making them the nation’s largest primary care system. This number is increasing by the day due to the current financial crisis.

The Access for All America Act, S.486 and H.R.1296, would authorize $8.3 billion a year for the expansion of Qualified Health Centers from the current number of just over 1,000, to 4,800 centers across the United States. The bill also addresses the need for doctors and health service providers by increasing the National Health Service Corps budget to $1.2 billion a year. Sen. Bernie Sanders (I-VT), the original sponsor of S.486, states that these investments would allow CHCs to serve 30 million people by 2015.

Strengthen coverage through Medicaid: Medicaid covers 60 million low-income people, including 29.4 million children, 15.2 million adults, 8.2 million people with disabilities, and 6.1 million seniors. Medicaid is a logical building block for health care reform. Medicaid provides quality and affordable care at a fraction of the cost of private insurance (around 3 percent overhead, versus 20–25 percent for private plans).

To protect America’s most vulnerable individuals and families, Medicaid should be expanded to cover every person at or below 150 percent of the poverty line and provide for automatic funding increases to protect coverage during economic downturns.

National Health Program: RESULTS supports the National Health Care Act (H.R.676), and the American Health Security Act of 2009 (S.703), both which create a national health program, also known as a single-payer health care system. Unfortunately, due to a lack of support in Congress and the strong influence of special interest groups, single payer has not been given a fair hearing in the current health care reform debate. As the chart above shows, a single-payer model is not part of any of the health reform proposals currently being drafted in Congress.

RESULTS remains committed to a national health program as the long-term goal for health care in the U.S. While we are disappointed in its lack of attention in the current debate, RESULTS will continue to endorse this system as the fairest, most comprehensive, and most affordable system of health care. In the interim, we want to also make sure we help expanding health care for the poor in 2009, while still remaining true to our long-term vision. Our work in expanding community health centers and Medicaid will provide a baseline to create high quality and affordable care for all.

Our July National Conference Call will feature domestic and global partners on one call this month, celebrating breakthroughs and excitement from the International Conference and beyond. We will also feature a short update of our Health Care for All by 2010 campaign on the call, which starts at 2 pm ET this month. Please call in to (800) 474-8920 with your group by 1:57 pm ET.