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FY2011 Federal Budget: Stepping Stones to Comprehensive Reform

02/01/10 | by Adam Dougherty [mail] | Categories: Cost Containment, White House, Covering the Uninsured

The President's budget proposal was released today, which includes a combination of spending increases/decreases, tax cuts for the lower and middle class, and allows some high-income tax cuts to expire. In all, the 2011 budget totals $3.8 trillion and would reduce deficits by $1.25 trillion over 10 years compared to current policies.

As for the health related provisions, the budget includes some notable increases in spending in order to help cash-strapped states preserve vital programs, improve infrastructure investments, and initiate other projects. These increases are a testament to the necessity for comprehensive health reform (and may actually substitute for some of the larger bills' anticipated spending) in order to provide security and stability for Americans who are paying more and more for less and less high quality health care. The budget also properly frames health reform as the only path to long-term deficit reduction, and actually assumes $150B in deficit reduction in anticipation of the pending health reform bill passing.

Below are the health-related highlights from a useful OMB Fact Sheet, and you can find an informative HHS budget overview here.

-$25.5 billion for an additional 6 months of Federal Medicaid assistance to help states maintain their Medicaid programs and ensure access to health care for millions of Americans. (CA could receive $2-3B of the total)

-$2.5 billion for health centers to provide affordable high quality primary and preventive care to underserved populations, including the uninsured. This will allow health centers to continue to provide care to the 2 million additional patients they served under Recovery Act and support approximately 25 new health center sites. In 2008, health centers provided direct health care services to 17 million people.

-$110 million for continuing efforts to strengthen health IT policy, coordination, and research activities.

-$286 million for research that compares the effectiveness of different medical options, building on the expansion of this research begun under Recovery Act.

-New Medicare demonstration projects that evaluate reforms to provide higher quality care at lower costs, improve beneficiary education and understanding of benefits offered, and better align provider payments with costs and outcomes.

-$169 million in the National Health Service Corps (NHSC) to place providers in medically underserved areas to improve access to needed health care services. Under the NHSC, primary health professionals such as physicians, nurse practitioners, and dentists serve in a medically underserved community in exchange for having a portion of their student loans paid off.

-Add 400 NHSC clinicians to the more than 8,100 who will provide essential primary and preventative care services in health care facilities across the country.

-$20 million to fund a new effort in up to 10 of the largest U.S. cities to reduce the rates of morbidity and disability due to chronic disease.

-$10 million to improve workforce capacity of state and local health departments.

-$10 million for the federal employee workplace wellness initiative.

-Increase enrollment in the Children’s Health Insurance Program by 7 percent (more than 500,000 children) from 2008 to 2011.

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In the wake of successful passage of the most comprehensive federal health legislation since Medicare, the focus now comes back to the states for effective implementation. California is in the midst of an unprecedented fiscal crisis, and many state health programs face an uncertain future. For California's uninsured population and safety net system, it is of the utmost importance to connect the dots between the state budget, program financing, the §1115 waiver, and public-private partnerships as a bridge to full federal reform implementation. This blog will allow our readers to be better informed on all issues regarding reform's incremental induction, in addition to the latest developments out of Sacramento and from around the state. Stay tuned for regular updates, and as always, your comments and questions are welcomed!

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