May 3, 2013
On Wednesday the New England Journal published the results from year two of the Oregon project, which “showed that Medicaid coverage generated no significant improvements in measured physical health outcomes” versus being uninsured. If Medicaid were a new drug, in other words, the FDA would reject it.
The Medicaid group used about 35% more health services, but they showed no clinical differences from the identical uninsured group across basic health measures like blood pressure, blood sugar and cholesterol levels that can be improved with the right treatment. The same was true comparing subgroups such as people with chronic diseases like diabetes. Health spending was higher among the Medicaid group, despite claims that using more preventative care and less emergency room will lower costs.
Yet liberals are proclaiming the results a great success and a reason to expand Medicaid under ObamaCare. They point to a side finding that Medicaid increased economic security and led to “a reduction in financial strain,” the share of personal income going to care. “Here Medicaid shined. It hugely reduced out of pocket spending,” noted Aaron Carroll of Indiana University and Austin Frakt of Boston University.
via Review & Outlook: The Oregon Trial – WSJ.com.
May 1, 2013
On April 11, the GOP-controlled Florida House of Representatives passed an innovative, consumer-driven replacement for Obamacare’s Medicaid expansion, one that could be a national template for free-market health reform. But Republicans in the state Senate rejected the House plan, electing instead to expand Medicaid, as Obamacare prescribes. Senate Republicans’ inexplicable decision makes it likely that free-market reform will fail in Florida, an outcome that could easily have been avoided.
via Florida Senate Republicans Vote to Expand Obamacare and Medicaid, Rejecting House’s Free-Market Alternative – Forbes.
May 1, 2013
Using figures compiled by Kaiser and our own research at the state level, the Goldwater Institute estimates that the federal tab for Medicaid expansion has been reduced by more than $424 billion in new federal spending over the next eight years thanks to the 18 states that have already opted out. If the 12 still-undecided states also decide to opt out, there will be an additional $185 billion in savings.
The more than $609 billion in total savings from these 30 states would represent over 50% of the expected federal spending on the Medicaid expansion. A drop in the bucket? That’s more than seven times the $85 billion in 2013 sequester cuts and more than half the projected federal deficit for this fiscal year.
via Christina Corieri: States Can Save Taxpayers $609 Billion – WSJ.com.
April 15, 2013
The thinkers at Advance Arkansas Institute have released a new paper entitled, “How Medicaid Expansion (and the “Private Option”) Will Lock Its Clients Into Poverty.” The paper examines, among other things, how the healthcare plan being pushed through the legislature will trap the poor:
via The Arkansas Project — The Legislature’s Plan to Lock Arkansans Into Poverty.
April 9, 2013
Ohio Reps. Ron Young (R-Leroy Twp.) and Andy Thompson (R-Marietta), and Missouri Sen. John Lamping (R-St. Louis County), have introduced legislation—we call it the Health Care Freedom Act 2.0—that would suspend the licenses of insurance carriers who accept federal subsidies through one of the Patient Protection and Affordable Care Act’s (PPACA) health insurance Exchanges. At first glance, that might seem to conflict with or otherwise be preempted by the PPACA. Neither is the case. Instead, the HCFA 2.0 would require the IRS to implement the PPACA as Congress intended.
via Ohio, Missouri Introduce the Health Care Freedom Act 2.0 | Cato Institute.
April 9, 2013
This study is the first to offer a detailed look at medical spending burden levels, defined as total family medical out-of-pocket spending as a proportion of income, for each state. It further investigates which states have greater shares of individuals with high burden levels and no Medicaid coverage, but would be Medicaid eligible under the 2014 rules of the Affordable Care Act should their state choose to participate in the expansion. This work suggests which states have the largest populations likely to benefit, in terms of lowering medical spending burden, from participating in the 2014 adult Medicaid expansions.
via Financial Burden of Medical Spending by State and the Implications of the 2014 Medicaid Expansions.
April 3, 2013
Arkansas has attracted national attention over the possibility that the Obama administration might agree to allow Arkansas to implement Obamacare’s Medicaid expansion by enrolling these newly Medicaid-eligible patients on the ACA exchanges. This has appealed to me and others, because the exchanges, for all of their imperfections, would be a substantial improvement to the broken Medicaid program in a market-oriented direction. However, we’ve learned in recent days that what the Obama administration is offering Arkansas is not, in fact, true exchange-based insurance, but rather a kind of private-sector window-dressing upon the Medicaid program. Unless HHS agrees to revise its stance and embrace true market-oriented reforms, the Arkansas legislature should oppose the Medicaid expansion in their state.
via Should Arkansas Take the Obamacare Medicaid Deal? Probably Not – Forbes.
April 1, 2013
A Good Friday memo from the U.S. Department of Health and Human Services, however, splashes cold water on that aspiration. It’s now clear that the Beebe-HHS deal applies a kind of private-sector window dressing on the dysfunctional Medicaid program, and it’s not obvious that the Arkansas legislature should go along.
via The Arkansas-Obamacare Medicaid Deal: Far Less Than It First Appeared – Forbes.
March 29, 2013
Tennessee wanted to pursue a plan like that of Arkansas, one where it would use the Medicaid expansion dollars to buy private insurance coverage. And while Arkansas received a preliminary go-ahead from HHS, Gov. Bill Haslam had a quite different experience: He says that Health and Human Services would not support his plan to expand Medicaid and, as a result, he will not move forward.
“As a result of the lack of clarity from HHS,” his office said in a late Wednesday statement, “the governor will not ask the General Assembly for approval to accept the Medicaid expansion federal funds as he continues to work for the flexibility needed to implement his plan.”
via Want to buy private coverage with Medicaid dollars? Good luck!.
March 22, 2013
“It could look like two or three different countries,” said Robert Blendon, a Harvard School of Public Health professor who studies public opinion on health care. “The political culture of a state is going to play an important role in getting millions of people to voluntarily sign up.”
Civic leadership — from governors, legislators, mayors and business and religious groups — is shaping up as a huge factor in the launch of Obama’s plan, particularly since the penalty for ignoring the law’s requirement to get coverage is as low as $95 the first year.
People-to-people contacts will be key, and the potential for patchwork results is real.
via Obama health law anniversary finds two Americas – Yahoo! News.