CQ WEEKLY
– VANTAGE POINT
Jan. 25, 2009 – 2:12 p.m.
Within Stimulus Bill, Democrats Move to Expand Medicaid
By Rebecca Adams, CQ Staff
Democrats and President Obama are moving on so many fronts to change policies of the Bush administration that Republicans might not even notice them all right away, let alone be able to stop them. Last week, while social conservatives focused on Democratic legislation to expand health insurance for poor children — and on Obama’s repeal of a rule that kept some international family planning groups from even discussing abortion — House Democrats included language in their economic stimulus bill that would expand the Medicaid program and allow its use for family planning services.
Republicans have spent the better part of the past decade shrinking the Medicaid program, which states complain has gotten too expensive; states pay, on average, 43 percent of the cost. Under current law, if a state wants to use Medicaid money for family planning, it must obtain a waiver from the Department of Health and Human Services. So far, 26 states have; under the Democratic provision, none would need to.
Those in favor of the change say it would actually save the government money because birth control is a lot less expensive than prenatal care, childbirth and the subsequent medical bills of a young child. The Congressional Budget Office found that the federal government could save $160 million over a decade if it covered family planning services for women in low-income families.
Officials from Planned Parenthood, which operates nearly 880 clinics, say a recent study found that nearly half of American pregnancies are unplanned. The rate among low-income women is about four times greater than among higher-income women. Women who are not planning to get pregnant are less likely to get prenatal care, which can result in medical problems for mother and child.
But the provision in the stimulus bill “will irritate a lot of conservatives,” said John Hart, the spokesman for Tom Coburn , an Oklahoma Republican and one of the most conservative members of the Senate. (That he’s also an obstetrician gives him added heft in the anti-abortion movement.)
“It appears,” Hart says, “to be ideological overreach to use a package that should be about stimulating economic growth to expand family planning. It’s not the type of side debate that Democrats should encourage on a package that will already be controversial.” The provision is not in the Senate draft version of the stimulus.
Most of the attention though has been on Obama’s removal of a global “gag rule” that denied federal funds to family planning groups that discuss abortion options with women in other countries. Conservatives also were defending a controversial regulation Bush’s administration issued on his last full day in office that doctors who don’t support abortion or contraception would not have to provide or tell patients about those options.
Comments
Medicaid has paid for family planning since 1972. The Clinton-era waivers allowed those who were too rich to qualify for Medicaid to receive taxpayer-funded contraception. These sections of the stimulus would allow pretty much everybody to qualify for free contraception, including free sterilizations, free fertility treatments, free Viagra, etc. To qualify, you'd just need to have reached puberty (except for the sterilizations, where you need to be 18).
The article is accurate and the comment is not. Individual states would not have to go through the cumbersome process of negotiating a waiver to provide Medicaid-paid contraceptive coverage to participants BEFORE they have children or are pregnant. However, the states still would determine eligibility and covered services. These programs have been proven to save taxpayer dollars, to improve maternal and child health, and the link to family ability to achieve economic goals - complete educations - participate in the workforce - are quite clear.
Sen. Coburn is wrong in his assessment that including the Medicaid waiver expansion would do nothing to stimulate the economy. Several of the 27 states that currently have waivers have reported that the extra funds have resulted in the creation of new positions to serve more people. In this economic downturn, it's vitally important that those who need access to health care the most get it. This provision of the economic recovery package is smart legislation and must be included in the final bill.
I hope medicaid is expanded,I was recovering from an injury and now the job market is kaputz,only me getting healthy again will enable me to get back where I was before. I spent most of my savings on medical the rest on silly things like house payments and food.I need to get healed and do not have any more money,I was a productive worker/tax payer all my life (am 53)I need medical treatment and hopefully this enhanced bill will allow me to again be a productive tax paying American. To contraception expert,When you say "these sections" of the stimulus package,where did you get a copy? Did you actually see a copy? I think you made that up,rush or hannity told ya lie and being the good programmed pub repeated it as though it was real.The part about you just need to have reached puberty was the giveaway.I heard myself the blathering and CONJECTURE about this also,I just happen to know fact from fiction and I think you want us to believe you saw this package with "these sections" was that how it was headlined? when it came to the family planning section did it really say "THESE SECTIONS".I watch fox and listen to all the extremist as well as normal media,there is much of the news you are missing.You do know that when pinned down rush is classified as an entertainer,his words. Do you ever wonder why an opposing view is NOT allowed? In a debate any of these people would get smoked,thats why you never hear them in one,except that time rush had to take back what he said about canadian doctors coming to america for health treatment,he knew moments in he was smoked and said sorry he got bad info from his aides,sounds like cheney huh.
THE PRO-LIFE MOVEMENT IS REPSONSIBLE FOR MOST ABORTIONS IN AMERICA. I'm not Pro-Choice, I'm Pro Contraception. Since half of all pregnancies in America are unplanned, a major expansion of contraception use would eliminate most unplanned pregnancies and abortions. However, this is NEVER acceptable to the conservatives. You would think that a choice between funding sex education and contraception use would be a lesser evil than more unplanned pregnancies and abortions. However, the reverse is actually true for Conservatives. They see abortion as the lesser evil, because they have consistently opposed more comprehensive sex education in public schools and Medicaid funding for contraception. They more upset by (and obsessed with) other people's sex lives, than the abortion. Hypocrites.
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