For those just catching up, the idea I have come up with to fix health care is not by adding in the public option or instituting Medicare for 55+. Instead I have taken a much different approach, one that would be much easier to make a reality. What we should focus on is the FPL, the Federal Poverty Level that is the main indicator for how much help you will get through federal subsidies and determining eligibility for Medicaid.
Currently the FPL is based nationally, with exceptions made for Alaska and Hawaii. At first glance this might seem logical, but in reality different parts of America fact very different economic states. Someone in South Carolina living at 150% of the FPL can actually have a rather decent life. Take that same person and move them to New York City at the same wages and you will have a much different outcome – someone who may very well end up homeless.
This system has been serving America for decades and it is time to update it. Something I had missed in the past is that this could be happening under the Obama administration. This is an article from September 2009, with a big hat tip to Jon Perr:
Two academics who are vocal critics of the federal government’s antiquated system for measuring poverty have landed important jobs in the Obama Administration, though it’s unclear whether they can overcome the political inertia that has left the current system largely undisturbed for more than four decades.
The two Obama appointees — Rebecca Blank, former dean of the public policy school at the University of Michigan, and Georgetown Law professor Mark Greenberg — are part of a dedicated band of scholars who have argued for years that the Federal Poverty Guidelines are a badly warped yardstick for poverty because they are derived solely from food costs and don’t take account of a wide array of valuable benefits lower-income Americans get from federal and local governments.
A movement is already on in both chambers to revamp the system – one from Connecticut Senator Chris Dodd and another from Rep. Jim McDermott (D-WA-07):
In June, McDermott introduced a bill that would overhaul the poverty measure, sweeping in most of the government aid that is now excluded and factoring in clothing and shelter costs. Health care costs and expenses would still be left out because of a lack of consensus on how to value them.
Last month, Senator Chris Dodd (D-Conn.) submitted a similar bill in the Senate.
McDermott said he fears that disturbing the poverty line could create a huge political backlash.
“It’s not my intention to change every program in the federal government,” McDermott said. “I’m not in favor of creating chaos. What we are trying to do is reflect what the realities are today.”
So far, McDermott’s “Measuring American Poverty Act” has thirteen Democratic cosponsors and no support from Republicans, who seem to fear that it’s a Trojan horse to declare more Americans poor and therefore make them eligible for public assistance.
But given the new health care bill, we could easily start calculating health care costs into it, as we would have a greater caliper offered by the new legislation. Adjust the FPL based upon food, clothing, shelter and health care costs. Use that as the mechanism to increase Medicaid coverage to millions of Americans and subsidies to millions more. It would push us towards more universal health care, while revamping a 50 year old system that is now seriously flawed.
The best thing about this approach is that it’s the kind of legislation that reconciliation was made for. A lot of federal items are calculated through the FPL and that directly translates into budgetary items – the key requirement for a provision to be included in reconciliation. We wouldn’t be creating a new government program, something that would happen with the public option going through under reconciliation and facing the Byrd amendment as a possible hurdle. Also once this kicks in with the new health care the savings Americans will see becomes a very tangible item, making it much harder for Republicans to remove later or let expire.
I seriously hope that this idea can gain some traction in Congress. After Christmas I fully intend to write the only member of Congress I have that I know will listen – Sen. Sherrod Brown. I hope everyone does the same and try to push Congress to take this angle on. It will be a big win for American and progressives as a whole, and given the old news that President Obama already appointed people in who are very well aware of the flaws, it becomes something that can be a huge possibility.