By Pamela Gentry, Senior Political Analyst

Sept. 2, 2009 –  The task of getting a health care reform bill through Congress will be decided by lawmakers who hear from the people they represent – will they hear from you?

I’ve tried to keep the discussion about health care reform alive on my blog to keep my readers informed with the hope of stirring up debate and eliciting responses on what  “reform” should entail. 

But the responses have been very few.  Why?  I’m not sure, so I decided to take this opportunity to provide a little insight into where Black folks fit into the health care picture.   It may influence how you view the health care debate.

In 2004, when the economy was booming, 25 percent of African Americans were on Medicaid, a state and federally funded health care program for the poor.  That’s about 9 million people.  

By 2006, 44 percent of all African-American children were covered by Medicaid as well as 32 percent of their parents and 25 percent of senior citizens.

Now if we fast forward to 2009, we know unemployment has doubled in the Black community since 2004, more African Americans are uninsured and safety net providers like community health clinics aren’t able to meet the growing demand, some have even been faced with budget cuts.

And for those of us who are insured through our employer or have purchased insurance, we know our out-of-pocket costs and premiums have increased, in some cases as much as 17 percent.    

Every bill under consideration now expands the roll of Medicaid, allowing states to increase the number of people eligible. 

Black lawmakers have been pushing for health reform to address chronic diseases that disproportionally affect the African-American community.  The Joint Center Health Policy Institute addressed these same concerns in a report in 2006 when they looked at the Medicaid program.

The report said, “African-American adults are more likely to have chronic conditions such as diabetes, heart disease or hypertension.  African-American children are more likely to have asthma.” 

It added, “When African-American perspective is not integral to health policy decisions; health policymaking will fail to eliminate inequities and will also reinforce structural race-based disparities.”

That’s why this discussion is so important to the Black community and why I hope my readers will tune in to the debate.     

This issue is about you – be engage.

President Obama

By Pamela Gentry, Senior Political Analyst

Aug. 10, 2009 – President Obama arrived in Mexico Sunday to begin a three-way summit with North American leaders from neighboring Canada and Mexico. But before leaving the U.S. the president warned Americans not to believe “rumors” being circulated about health care reform.

“Let me start by dispelling the outlandish rumors that reform will promote euthanasia, or cut Medicaid, or bring about a government takeover of health care. That’s simply not true,” Obama said in his weekly address.

Members of the Senate will join House members back home this week to answer questions and take the temperature of their constituents on the issue. Some town hall meetings have been met with protestors and there is some suspicion that these protests are being waged with the help of lobbyists hoping to defeat the bill.

It’s not a far-reaching assumption.  Most town hall meetings are for questions and answers – so the fact that people want to protest outside before even going inside is a bit curious.  What could be wrong with asking questions?  

Obama didn’t call out who was behind what he suggested were “organized efforts” to demonize the White House-backed health reform plans. He suggested that the efforts were originating in the capital.

The president also warned Americans of what to expect as efforts continue. “As we draw close to finalizing — and passing — real health insurance reform, the defenders of the status quo and political point-scorers in Washington are growing fiercer in their opposition.

“That is why it is important, especially now, as senators and representatives head home and meet with their constituents, for you, the American people, to have all the fact,” Obama said.

While Congress heads home, the commander-in-chief headed south of the boarder for meetings with Canadian Prime Minister Stephen Harper and Mexican President Felipe Calderon for talks on issues impacting the Americas. 

President Barack Obama and Mexican President Felipe Calderon

This is the president’s second trip to Mexico in four months; you may recall his last visit was during the worldwide outbreak of the H1N1 virus (swine flu).

Calderon and Obama held their first meeting on Sunday.  They discussed the swine flu, the request for aid to combat Mexican drug-trafficking and Mexico’s growing concerns regarding the ban on Mexican trucks north of the boarder.   

Trade  (NAFTA) will also be an issue when Harper joins the talks.  Canadian officials are concerned with the language in the stimulus bill that encouraged “Buy American” when spending from the $787 billion economic stimulus program.  Canadian companies fear this could send the wrong signal and shut Canadian companies out.  That alone could place stress on trade relations between the U.S. and Canada.

Obama and Congress have a busy week ahead.

By Pamela Gentry, Senior Political Analyst

March 3, 2009 – Monday’s appointment of Nancy Ann DeParle to serve as the White House lead on health care reform was particularly interesting to me.  You see, I once worked for DeParle back when she still hyphenated her name “Minn-De Parle.”

It only goes to show how small the Washington circle really can be.  I doubt DeParle remembers much about our almost two years together even though I reported directly to her. She was focused, and clearly on the fast track at Health and Human Services.

It’s no surprise she landed this post.

I recall when she came to the top spot as the administrator of the agency that runs the Medicare and Medicaid programs.  I was over the communications offices for the agency and she followed another highly-respected policy wonk, Bruce Vladeck.

There was always a distant rumor that she was eyeing the secretary post should then-Secretary Donna Schalala have made an early departure.  Of course Schalala stayed until the end of the Clinton Administration so that was never an issue.

DeParle’s landing this job is no surprise.  At age 29, she became Tennessee’s Commissioner of the Department of Human Services, one of the youngest folks to ever do so, and like others on the Obama team, she has the Clinton connections.

I remember her as a feisty and energetic colleague who juggled several balls in the air at one time.  She either liked you or she didn’t, and she sometimes had very little patience for the bureaucratic process.  It will be interesting to watch how she co-leads health care reform with Gov. Kathleen Sebelius and how persuasive she’ll be with Congress.

Sebelius, a two-term Democratic governor in a Republican state will most likely be the lead on congressional outreach, but DeParle will be called upon to do some arm-twisting in the health care industry and my guess is that will be her strong suit.

I’ll have to check in with her at 1600 Pennsylvania Avenue once she settles in: Long-time-no-see, Nancy Ann.

By Pamela Gentry, Senior Political Analyst

Feb. 26, 2009 – President Barack Obama outlined his first budget for the nation’s ailing economy, targeting cuts to wasteful spending on health care and raising taxes on the wealthy. The plan calls for spending $3.55 trillion in 2010 as well as adding $3.9 trillion in spending to the 2009 budget.

“Having inherited a trillion-dollar deficit that will take a long time for us to close, we need to focus on what we need to move the economy forward, not on what’s nice to have,” Obama said during his opening remarks.

So, how will the president’s budget impact you?

Obama’s proposed budget lays out a plan for overhauling one of the largest entitlement programs: Medicare. He isn’t looking to balance the budget this year, but he would allow the tax cuts from the Bush years to expire (on those making more than $250,000), and cut taxes for the middle class (those making less than $250.000).

That means the $400.00 (if you’re single) or the $800.00 (for couples) designated as the middle class tax cut in the stimulus package would become permanent. The budget also calls for expanding existing tax credits for college students and the child tax credit.

Black lawmakers met with the president Thursday afternoon at the White House and told reporters it was “a very open meeting.”  Rep. Barbara Lee, (D-Calif.) told reporters after the closed door meeting that they discussed “how we move forward.” 

“The president is a former member of the Congressional Black Caucus and we’ve been working with the president on our priorities and those for all Americans.”

But health care is the biggie.  The president is looking at getting huge savings from Medicare and Medicaid and getting an estimated 48 million uninsured folks insured.  In the president’s budget he would set aside $634 billion over the next 10 years to get the job done.

Obama told those gathered, “As we develop a full budget that will come out this spring, we’re going to go through our books page by page, line by line, to eliminate waste and inefficiency. This is a process that will take some time, but in the last 30 days alone, we have already identified $2 trillion in deficit reductions that will help us cut our deficit in half by the end of my first term.”

The rest of the money would come from cuts in Medicare across the board.  Insurance plans, hospitals, nursing homes and drug companies would face cuts because all health care contracting would be open for competitive bidding.  Something these programs don’t do now.  If Congress allows this, it could result in substantial savings and drive some costs down.

This strategy won’t sit well with his Republican critics and fiscally conservative Democrats.  They may agree with his plan to pay for health care with savings rather than adding it to the budget woes, but they may not come on board with what they consider tax hikes.

Now we’ll have to see what Congress does with the president’s budget.