The HHS Budget and What it Says about Reform

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At a news briefing today, Health and Human Services Secretary Kathleen Sebelius talked about funding for her agency contained within President Obama’s proposed 2011 budget. She talked about more money for community health centers, information technology, and drug and cancer research, among other priorities. But toward the end of the news conference, the AP’s Ricardo Alonso-Zaldivar asked Sebelius to clarify what was obvious already – that the 2011 HHS budget doesn’t make any real headway toward solving the country’s health care crisis. The President’s budget “in no way replicates the efforts in the health reform legislation to reach out to the 30 some million Americans who have no health insurance at all and those who are woefully underinsured,” said Sebelius. “This budget – absent health reform – will still leave a major gap.” Without major reform of some kind, the cost curve will continue to go up unabated, millions will continue to go without insurance and, Sebelius pointed out, insurance companies will still deny coverage too often.

The point here is not that the HHS budget doesn’t do what massive health reform legislation was supposed to do. If that was as easy as a few budget items, things would certainly have been a lot easier for Democrats. The point is that Sebelius seemed eager to stress the continuing need for reform – a message that’s coming directly from the Administration. There is no shortage of skeptics who think this is Democratic bluster meant to distract from the lack of any progress since Scott Brown’s victory in Massachusetts. As Karen just noted, the GOP already has a procedural strategy for how to block Democratic attempts to pass health care reform via reconciliation. And what are we to discern from Peter Orszag’s blog post introducing the 2011 budget? Health care reform was touted as “the key to our long-term fiscal future,” but it was not mentioned until the second to the last paragraph of Orszag’s post – hardly prominent placement for what was until recently the President’s signature domestic priority.

I’d be remiss, however, if I didn’t highlight one major way and several small ways that the proposed 2011 Obama budget echoes Democratic health reform efforts. First, there’s about $25 billion to extend increased federal funding for Medicaid that’s called for in the stimulus bill. As Karen and I pointed out, states were terrified of new Medicaid burdens they would face under reform. Even without it, though, they can’t afford their programs. The $25 billion will help. There is also money in the HHS budget for comparative effectiveness research, health information technology, preventive care, and more primary care providers, efforts that would be heavily funded by the Democratic health care reform bills.