National Healthcare Reform: 2009

Will 2009 see Congress enact healthcare reform legislation, and if not next year, when? What might such a law provide? And how would it address mental health care?

Consider the more fundamental question, what is “healthcare reform?” The phrase has no fixed meaning. Many use it to refer to a goal of providing basic health coverage to uninsured and underinsured Americans. Some apply it to any steps that would improve a health care system with multiple ills. And still others employ the phrase to describe comprehensive, far-reaching system changes including coverage, benefit design, access to needed specialty care, quality, affordability, and financing.

Skeptics find many reasons to question whether any kind of health reform is possible in the coming years. Many contend that the nation’s economic problems have overtaken our health-system ills, as well as Congress’ appetite and ability to tackle these two huge issues. Others say that our ballooning deficit and need for further emergency fiscal-stimulus spending have made it unaffordable.

We at Mental Health America see it differently. In our view, the country’s economic problems make health-reform even more urgent given their impact on people’s health and well-being and the alarming extent to which people can no longer afford needed care. Our ailing economy and growing health-care insecurity have become intertwined, and we cannot afford to address one to the exclusion of the other.

The legion of voices calling for major health reform has also grown vastly larger, and includes not only longtime proponents of reform but newer adherents ranging from influential business leaders to the director of the Congressional Budget Office.

Many speculate on whether the new president will spend scarce political capital to press Congress to enact a health reform bill. But key leaders are not waiting for a signal. Last month, Senator Max Baucus, Chairman of the Senate Finance Committee, released a paper, “Call to Action: Health Reform 2009,” outlining his view for the direction of health care reform in the upcoming Congress. Many aspects of the Finance Committee Chairman’s paper closely track President-elect Obama’s campaign proposal. We view the Chairman’s obvious interest in pursuing health care reform, and parallel work being pursued by Senator Kennedy’s staff on the Senate Health, Education, Labor and Pensions Committee, as very encouraging.

Several key elements of the Baucus proposal offer significant opportunies for integrating mental health into health reform, a message we are pressing on the Hill.

This kind of leadership from the chairman of the Finance Committee gives health-reform a powerful boost. But for this ambitious objective to take flight, rank and file members of Congress must come around to the view that healthcare reform should be high on Congress’ agenda in 2009. Given the many competing priorities likely to be pressed on a new Congress, we’ll be encouraging mental health advocates to call on their federal legislators to make meaningful health care reform a top priority in 2009.