House Passes Sentate Health Bill

Last evening the House passed the Senate's health bill, H.R. 3590, the Patient Protection and Affordable Care Act. Over 38 states are now stating they are in process and will file suit regarding the procedures and processes, as well as substance and constitutionality issues once the bill is signed into law. This law, along with H.R. 4872, the Health Care and Education Affordability Reconciliation Act which follows, will greatly expand Medicaid. Unlike Medicare, Medicaid requires states to chip in a percentage of the costs as well as administer the program. As mentioned in the January 4th posting, 43 states are facing financial deficits. Not every state was fortunate enough to get the nearly $600 million each in supplemental Medicaid deals to which Vermont and Massachusetts were privy, let alone the cornhusker kickback that Nebraska did which covered the state's required Medicaid contributions in perpetuity. (This provision for Nebraska will supposedly be eliminated in the yet to be passed by the Senate reconciliation bill.)

Last Thursday, Arizona's new budget signed by the governor dropped coverage for childless adults and the child health insurance program (CHIP) instate, leaving 357,000 Arizonans without coverage. The governor stated the "budget is a vivid reflection of how the fiscal crisis affecting state governments is cutting deeply into healthcare."

Politicians may choose to ignore the will of the people and pass legislation, but ultimately someone must pay for it. Given the present economic crisis, tax revenues are falling for both state and federal governments. It seems Washington has forgotten the fiscal realities of those outside of the Beltway. If the checks and balances built into our Constitution do not cause this legislation to be rethought, the financial realities will.