Obama Administration Will Begin Distributing $15B in Federal Medicaid Funds to States

President Obama during a Monday meeting at the White House with the nation's governors said Medicaid funding from the economic stimulus package will begin arriving at the states on Wednesday, the Omaha World-Herald reports (Morton, Omaha World-Herald, 2/23). Obama added that the first two quarters of matching funds for 2009 are set up in special Treasury Department accounts, allowing the states to utilize the money almost immediately. "That means that by the time most of you get home, money will be waiting to help 20 million vulnerable Americans in your states keep their health coverage," Obama said (Youngman, The Hill, 2/23). Of the $15 billion, New York and California will receive the largest portions, at $2.07 billion and $1.99 billion, respectively.

Obama told the governors that he will "call them out" if he believes they are not spending the money properly, adding, "This is not a blank check. ... These funds are intended to go directly toward helping struggling Americans keep their health coverage, we want to make sure that's what's happening and we're going to work with you closely to make sure that this money is spent the way it's supposed to" (Condon, CongressDaily, 2/23). He also addressed governors who have said they will not accept portions of the stimulus money, warning them "against allowing political considerations to cloud a discussion of the stimulus program," the AP/Kansas City Star reports (Fouhy, AP/Kansas City Star, 2/23).

Community Health Centers
The $2 billion included in the stimulus for community health centers will allow the program to show its potential and play a larger role in U.S. health care reform efforts, experts testifying before a congressional panel said Monday, CQ HealthBeat reports. CHCs, created by federal law in 1965, provide services to about 16 million U.S. residents who are uninsured or live in medically underserved areas at about 6,300 facilities nationwide. Uninsured patients make up about 40% of those seen at CHCs, while low-income patients who qualify for Medicaid make up about 35%, according to the National Association of Community Health Centers.

Of the total funding, $1.5 billion will be directed to infrastructure and construction projects and $500 million will make up additional operating funds. Programs that "work in concert" with CHCs also would receive funding. The National Health Services Corps will receive $300 million and other federal programs intended to train primary care physicians will receive $200 million, CQ HealthBeat reports (Nylen, CQ HealthBeat, 2/23).

Comparative Effectiveness
The Los Angeles Times on Tuesday examined the debate surrounding funding for comparative-effectiveness research included in the stimulus bill. According to the Los Angeles Times, "The comparative-effectiveness issue was supposed to help lay the groundwork for the broader reform effort," however, it "became a lightning rod for conservative commentators who labeled it a step toward socialized medicine, a line of attack that has doomed every health overhaul effort since World War II." The Los Angeles Times reports that "the ferocity of the tussle ... provided a warning for those seeking to reshape the nation's health care system" (Levey, Los Angeles Times, 2/24).

Editorial
"[C]onservative ideologues" are expressing "particular vitriol" over a $1.1 billion provision in the stimulus package that is intended to increase comparative effectiveness research, which they "see ... as the slippery slope to rationing or Washington-mandated protocols for treatment," a Boston Globe editorial states. The editorial adds that the medical device and pharmaceutical industries "worry that studies on effectiveness will find that some of their prize -- and most profitable -- products are no better, or even worse, than cheaper alternatives."

However, it continues, "If this research can provide credible evidence of the superiority of one treatment over another, professional organizations, hospitals and insurers will have to take notice," and if that leads to "broad adoption of best practices, patients will get better faster -- and health care costs will decline," according to the Globe . The Globe continues that comparative-effectiveness research "isn't rationing -- it's rational" (Boston Globe, 2/24).

Letter to the Editor
"Well-intentioned people differ about the role of the federal government in health care, but who can argue about the need for transparency?" Betsy McCaughey, chair of the Committee To Reduce Infection Deaths and former lieutenant governor of New York, writes in a New York Times letter to the editor. McCaughey, responding to the mention of an opinion piece she wrote by a New York Times article, writes, "My article ... called the public's attention to numerous health provisions in the stimulus bill that had nothing to do with jump-starting the economy."

She added that these "changes will affect all of us, at the least by requiring that our treatments be recorded in a federally mandated electronic database and guiding the choices our doctors make." McCaughey continues, "Yet no hearings were held, no expert witnesses called, no opinions gathered from patient advocates, doctors' groups, the elderly or other stakeholders." McCaughey concludes that the health provisions in the bill "should be repealed and offered as a separate bill" because they were "too important to have been rushed through without considering consequences for privacy, patient care and medical innovation" (McCaughey, New York Times, 2/24).