Budget Bill Fails on Unemployment Benefits, But Will Renew Health Insurance Help for Low-Income People

As I’m sure you know, the budget deal we’ve been reading so much about didn’t fold in an extension of the Emergency Unemployment Compensation program. And it’s highly doubtful Senate Democrats will upset the apple cart by adding it as an amendment to the bill the House passed.

The omission will, at the very least, make for a tough January for 1.3 million jobless workers and their families, who’ve got rent and other bills to pay. More harms to millions more if Congress actually lets the program die — not a foregone conclusion.

On a cheerier note, the budget legislation the House passed did fold in, via an amendment, extensions of two programs that benefit low-income individuals and families. Both, in different ways, help ensure that they can continue to get affordable health care.

They weren’t familiar to me. Perhaps aren’t to some of you either. So here are brief summaries, plus a bit of policy perspective.

The Transitional Medical Assistance program allows some low-income families to get up to a year of Medicaid benefits when they’d otherwise lose them because their incomes boost them over their state’s eligibility threshold — typically just 61% of the federal poverty line, but far lower in about a dozen states.

TMA temporarily averts an unintended penalty to parents in the Temporary Assistance for Needy Families program who move from welfare to low-wage work — one of those so-called “cliffs” that works against a primary TANF goal.

Those whose income rises because they get a raise or an increase in hours can qualify, as can those who come to the end of a partial income disregard that some states and the District of Columbia provide so that earnings from work increase family income, rather than merely replace cash assistance.

The Affordable Care Act initially would have enabled the lowest earners to remain in Medicaid until they made enough to lift their families above 133% of the FPL — effectively 138%, for technical reasons.

Now that 25 states haven’t expanded their Medicaid programs — a choice the Supreme Court’s ACA ruling allows — TMA remains an important, though time-limited protection.

The program also affords some months of protection for very low-income parents when their child support payments rise — or for that matter, when the absent parent merely starts paying them. Here again, it’s diminishing a conflict between two government priorities.

The Qualifying Individuals program provides federal funding to states so that they can pay Medicare Part B premiums for seniors with incomes between 120% and 135% of the FPL. Younger people who receive SSDI (Social Security Disability Insurance) benefits also qualify.

The QI program is that last tier of premium assistance for low-income Medicare enrollees — unless, in some cases, they are disabled and working.

Part B, as you probably know, covers most of the costs of outpatient care, lab tests, “medically necessary” equipment like a walker or a blood sugar monitor and certain in-home, health-related services.

For most people, the Part B premium will cost slightly less than $1,260 in the upcoming year — a real bargain, but a strain on the budget of someone who’s total income may be about $13,790.*

No one in the Senate — except maybe a few of those “wacko birds” — will oppose the amendment that extends these programs, since it also includes the annual “doc fix,” i.e. a measure to forestall what, by this time, would be a 24.4% cut in Medicare reimbursements to physicians.

Senate Minority Leader Mitch McConnell reportedly objects to the whole budget deal, as do several other Republican Senators who are looking nervously — or hopefully — at their Tea Party constituents. But they can’t stop it from passing, even if they vote against it.

So two worthy programs will live for another year — both small, but important to those who benefit and to bipartisan interests in promoting work and controlling health care costs.

Not enough to make us stand up and cheer for a bill that could, in many ways, have been better — and not only because it leaves jobless workers in the lurch.

But if you look at Congressman Ryan’s latest budget plan, you can see that we could easily have been heading toward another government shutdown — and even greater pressures on programs that serve low-income people’s needs.

* This is 120% of the 2013 federal poverty line for a single person, rounded up.

One Response to Budget Bill Fails on Unemployment Benefits, But Will Renew Health Insurance Help for Low-Income People

  1. […] One — Transitional Medical Assistance — enables families to temporarily remain in Medicaid after they’ve moved from welfare to work. That move can happen when they’re by no means earning enough to afford other health insurance because state income eligibility thresholds for welfare, i.e., Temporary Assistance for Needy Families, are so low. […]

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