Health and human services: Toward universal coverage

Available details of President Barack Obama’s proposed government spending for the 2010 budget year that begins on Oct. 1. A more extensive budget outline is expected in April. In most cases, the figures are for discretionary spending and do not include mandatory entitlement programs like Social Security. The percentage change is based on what Obama wants to spend next year compared with what he anticipates the government will spend in 2009 once Congress completes appropriations for this year. Agency: Health and Human Services 2010 proposal: $821.7 billion ($78.7 billion for discretionary spending, plus $453 billion for Medicare and $290 billion for Medicaid) Change from 2009 estimate: 7.5 percent increase Highlights: The government’s gargantuan health insurance programs for the elderly and poor would grow more slowly under Obama’s proposed health care budget. Obama wants to squeeze Medicaid and Medicare spending to help create a 10-year, $634 billion fund billed as a “down payment” on his goal of providing health insurance for all. He would use $316 billion in savings from those entitlement programs and predicts other savings by reducing the rate by which wealthier people can cut their taxes through certain deductions. Obama’s budget proposal acknowledges that “additional funding will be needed” for health coverage for all, but doesn’t say how much or where it would come from. Experts say achieving universal coverage could top $1 trillion over 10 years. The 2010 budget for Medicare, the health insurance program for people 65 and older, is proposed at $453 billion. That’s a 6.5 percent increase from 2009. Medicaid, which covers certain poor and disabled people, would be funded at $290 billion in 2010, up 12 percent from 2009. Some of the Medicare savings would come from scaling back payments to private insurance plans that serve older Americans, which many analysts believe to be inflated. Other proposals include charging upper-income beneficiaries a higher premium for Medicare’s prescription drug coverage, and increasing the amount of money drug manufacturers rebate to states for prescription drugs covered under Medicaid.