CMA Health Policy Blog

The “R” in COBRA: It’s Time to Use It Again

February 24, 2010 at 11:17 pm vgdc Leave a comment

Everyone knows about COBRA.  It’s the law that allows people who lose employer-sponsored health insurance to purchase the insurance they previously had.  Because COBRA prevents some people from being uninsured, Congress even set aside money in the Stimulus Package passed in 2009 to help some people who lost their job buy their COBRA coverage.

But not everyone knows that the “R” in COBRA stands for Reconciliation.  The COBRA health care continuation provisions were enacted as part of the Consolidated Budget Reconciliation Act of 1985.  In other words, this important health care protection came into being through the budgetary process that is now being discussed as a mechanism for enacting meaningful health insurance reform.

Some people argue that reconciliation can’t be used for health insurance reform; that reconciliation can only be used to “reconcile” income and spending with the income and spending levels established in the President’s annual budget. But Congress has often used budget reconciliation as a vehicle for making changes to existing policy; COBRA is not the only health bill that was enacted through this process.

Budget reconciliation has been used to establish protections for nursing home residents; extend insurance coverage to workers and dependents who lose employer-sponsored coverage; create a health insurance program for children; expand the role of private insurance offerings in Medicare; and change Medicaid eligibility. Given these precedents, budget reconciliation can be used to create health care reform that will:

• Expand health insurance to 31 million Americans;
• Make insurance more affordable for everyone, including closing the Part D donut hole for Medicare beneficiaries;
• Protect against discriminatory practices by insurers;
• Reduce fraud and waste; and,
• From a budgetary perspective, reduce the deficit by $100 billion over the next 10 years.

Congress will need to consider its next steps to enacting meaningful health insurance reform after the White House bipartisan meeting on health care on February 25.  It’s time for Congress to remember the “R” in COBRA continuation insurance stands for “reconciliation,” and to use the same reconciliation process to extend health insurance protections to all Americans.

Entry filed under: Health Care Reform.