The Healthy Indiana Plan 2.0 is now just over a year old. It’s Indiana’s version of the expanded Medicaid program offered by the Affordable Care Act. But unlike traditional Medicaid, Indiana received waiver approval for an alternate system that incorporates personal responsibility and consumer-driven health care. Here’s the theory: if one is financially engaged, it encourages a sense of ownership, personal empowerment, and responsible utilization of medical services.
Every state except Alaska (and Alaska recently awarded a contract to a firm “to study and develop” a tax proposal) uses Medicaid provider taxes. Since provider taxes are essentially a kick-back, the providers who benefit the most are generally those serving a larger number of Medicaid enrollees. They receive higher Medicaid payments than they would have received in the absence of the tax.
The kick-back often involves extra payments, dubbed supplemental payments, to providers. These extra payments raise serious questions of political influence and cronyism. For example, in 2014 GAO identified two New York City hospitals—Coler Memorial and Coler Goldwater— that received $416 million in extra Medicaid payments in 2011 in addition to $70 million in regular Medicaid payments. These Medicaid payments were nearly five times what Medicare would have paid these hospitals for these services, which is supposed to be the legal limit on what Medicaid can pay.
Cancer patients insured by California’s health plan for low-income people are less likely to get recommended treatment and also have lower survival rates than patients with other types of insurance, according to a new study by University of California-Davis researchers.
While other studies have linked Medicaid insurance status to worse cancer outcomes, the UC-Davis study appears to be the first to examine the impact of various kinds of health insurance across more than one kind of cancer.
That even a slim majority of Republicans favor expansion is notable given the tone of debate on this issue on the campaign trail, where expansion has become like a third rail for GOP candidates. This is not to suggest that Republican candidates or governors who oppose Medicaid expansion in conservative states will be anxious to flip any time soon. But Medicaid may not be as unpopular with Republicans overall as the conventional wisdom suggests, and other issues may be more salient for Republican voters in primary and general elections across the country than opposition to Medicaid expansion.
Health insurance enrollment data for 2014 shows that the number of Americans with health insurance increased by 9.25 million during the year. However, the vast majority of the increase was the result of 8.99 million individuals being added to the Medicaid rolls. While enrollment in private individual-market plans increased by almost 4.79 million, most of that gain was offset by a reduction of 4.53 million in the number of people with employment-based group coverage. Thus, the net increase in private health insurance in 2014 was just 260,000 people.
Wake Forest University’s Health Law and Policy Program will be releasing a report: “Medicaid Reform Options for North Carolina | Bioethics at WFUMay 5, 2015
“Medicaid Reform Options for North Carolina
POSTED ON THURSDAY, APRIL 30, 2015, 11:16 AM | BACK TO NEWS & ANNOUNCEMENTS
Edwin Shoaf, Health Law and Policy Research Associate and Mark A. Hall, Professor of Law & Public Health, both of Wake Forest University’s School of Law released this report 4/30.
Gov. Rick Scott reverses course, now opposes Medicaid expansion – Sarasota News | Mysuncoast.com and ABC 7: MySuncoast HealthApril 6, 2015
Gov. Rick Scott is reversing course and says he no longer supports Medicaid expansion in a move that threatens to undo budget talks between the state House and Senate.
In a statement Monday, Scott expressed concern that the federal government might not make good on their promise to fund Medicaid for an additional 800,000 Floridians. The decision comes as Scott and the Legislature have been in intense negotiations with the federal government to extend more than $1 billion dollars in hospital grants. But the feds have said no and the disagreement has spilled over to Medicaid expansion.
Scott originally opposed expansion, but in an emotional speech two years ago he came out in support.