We have expressed our disappointment in Gov. Gary Herbert (R-UT) for his decision to pursue expanding Obamacare in Utah. Herbert has spent months negotiating an Obamacare expansion plan with the federal government, despite the lack of legal authority to commit the state to any “deal” he strikes with the Obama administration. His drive to expand is seemingly out of character, as he has been solid in the past expressing concerns about the insidious federal strings that come with Obamacare.
Any plan Gov. Pat McCrory’s administration presents for expanding Medicaid would have a tough time getting through the state legislature.
A key House member said Tuesday it would probably be premature to consider expanding Medicaid next year with the future of the federal health care law uncertain.
The Republican-controlled Congress is expected to make changes to the Affordable Care Act, under which states had the option to make more people eligible for the government health insurance program. The U.S. Supreme Court will hear a case about who is eligible for tax credits under the law.
Rep. Nelson Dollar, a Cary Republican and a legislator who works extensively on Medicaid policies, said state should wait “until we see what fully develops” in Congress and with the court case. The state then “would have a better idea of what the lay of the land is,” he said.
Underlying the hospitals’ financial problems, Mr. Shields said, is a systemic dilemma shown in a graph he has been displaying to policy makers and business leaders. It highlights the gap between Truman’s cost of caring for people without insurance and government funding the hospital gets to cover it—nearly $30 million in fiscal 2014, according to Truman. One of his slides notes that Truman currently has just one day of cash on hand. The gap is “not sustainable over time,” Mr. Shields said.
The health law could exacerbate the problem. Under the measure, federal payments to hospitals like Truman that provide a lot of unpaid care are supposed to be cut substantially, though Congress delayed the timing until 2017. Truman projects its reduction could amount to $22 million in 2017, growing to $34 million in 2018.
Enrollment in Medicaid is surging as a result of the Affordable Care Act, but the Obama administration and state officials have done little to ensure that new beneficiaries have access to doctors after they get their Medicaid cards, federal investigators say in a new report.
The report, to be issued this week by the inspector general at the Department of Health and Human Services, says state standards for access to care vary widely and are rarely enforced. As a result, it says, Medicaid patients often find that they must wait for months or travel long distances to see a doctor.
Arkansas Private Option’s Latest Boondoggle: “Health Independence Accounts” Increase Dependence and Increase CostsAugust 12, 2014
Like so many of the promises ObamaCare expansion advocates have made, however, this promise turned out to be false.Not only did the Private Option lack any kind of meaningful “skin in the game” requirements, it actually reduced cost-sharing to below what Medicaid allows.It’s these cost-sharing provisions, which have enrollees pay a portion of their own health care costs, which can incentivize enrollees to be more responsible health care consumers. Yet more than 80 percent of Private Option enrollees currently have no cost sharing whatsoever.
this first tranche of data is highly revealing. Drew and I present the numbers and analyze them in more detail in our new report, but here are three key takeaways from the data for the six-month period of October 1, 2013, through March 31, 2014:
- Net enrollment in the individual-coverage market grew by 2,236,942 individuals, while net enrollment in employer group coverage declined by 1,716,540 individuals.
- The decline in employer-sponsored coverage offset 77 percent of the gain in individual-market coverage, for a net increase in private-market coverage of only 520,000 individuals during the period.
- Medicaid and CHIP enrollment reports from the Centers for Medicare and Medicaid Services CMS show that enrollment in those programs increased by about 5 million individuals during the same six-month period, with 87 percent of those gains occurring in the 26 states plus the District of Columbia that elected to adopt Obamacare’s expansion of Medicaid to able-bodied adults.
Arkansas’s Alternative to Medicaid Expansion Raises Important Questions about How HHS Will Implement New ACA Waiver Authority in 2017July 21, 2014
This essay presents Arkansas’s alternative to Medicaid expansion as a case study motivating John McDonough’s assessment of the recommendations states may want to make to the Department of Health and Human Services regarding the implementation of statewide Patient Protection and Affordable Care Act–alternative waivers scheduled to begin in 2017. Arkansas’s private option uses federal funds to purchase marketplace silver level qualified health plans for low-income, low-risk participants, while “medically frail” adults are covered through Medicaid. By improving the size and risk profile of Arkansas’s health insurance marketplace, the private option will also encourage entry of and competition among private carriers. If it succeeds in keeping insurance premiums below the level they would otherwise be in the marketplace, Arkansas’s private option could reduce subsidy costs for the federal government. Under the broadened scope of section 1332 waivers, states will be able to capture such savings and use them to support innovation across both Medicaid-funded and Treasury-subsidized programs and populations.Freely available online through the Journal of Health Politics, Policy and Law open access option.