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Millions more could join Medicaid as Republican governors cave in
NEW YORK (CNNMoney) Despite their initial, vehement protests, a growing number of Republican governors are giving their blessing to expanding Medicaid in their states. That opens the door for millions of poor Americans to enroll in government health care coverage, beginning in 2014.
Florida Governor Rick Scott on Wednesday became the latest to warm up to the expansion, which broadens coverage to adults with incomes below 138% of the poverty line. Medicaid rules vary from state to state, but many states (including Florida) do not currently cover most childless, non-disabled and non-elderly adults.
Scott, a former health care executive, follows his GOP peers in Ohio, Michigan, Arizona, New Mexico, Nevada and North Dakota in accepting a reform they once strongly opposed.
The Supreme Court ruled last year that states can opt out of broadening Medicaid coverage, striking down one of the provisions of the Affordable Care Act. Some 15 states have chosen to participate so far, with another 10 leaning towards expansion, according to the Center on Budget and Policy Priorities, a liberal group.
Though many Republican governors say their state can't afford the cost of expansion, the political resolve of some has crumbled over the past two months in the face of heavy pressure from hospital associations, medical groups, local governments and others. Providers -- particularly hospitals, where many uninsured folks go for care -- say their costs of treating those without coverage would fall under the expansion.
"Medicaid expansion is a very good deal that's hard to pass up," said January Angeles, a senior policy analyst at the center. "In a lot of these states, a lot of stakeholders have done a good job making the business case."
Most states will have to shell out very little at first -- in the early years. The federal government will pick up 100% of the cost for the first three years, and then gradually reduce its subsidy to 90% by 2020.
Over the next decade, expanding Medicaid is expected to cost states only another $8 billion, or 0.3% more, that they would have otherwise spent, according to an Urban Institute estimate. Some 14.3 million citizens would be newly eligible if every state enrolled.
Various interest groups have put a full-court press on governors and lawmakers, said Ed Haislmaier, a senior research fellow at the conservative Heritage Foundation, which opposes broadening Medicaid.
"They want to get their hands on that money," he said.
The financial argument helped sway Scott, who still has to convince a Republican-led legislature to sign on. Some 1.3 million adult Floridians would become eligible for Medicaid under the expansion.
"While the federal government is committed to paying 100% of the cost of new people in Medicaid, I cannot, in good conscience, deny the uninsured access to care," he said Wednesday when announcing his decision to participate for three years.
Now that Scott is on board, Texas remains the last big holdout.
Texas has the highest share of uninsured in the nation, at nearly a quarter of residents. Some 1.75 million adults would be newly eligible if the Lone Star State joins in. It stands to gain $25.3 billion in federal funds over four years to insure poor adults, while spending $1.3 billion, according to the Center for Public Policy Priorities, an advocacy group for low-income Texans.
On Thursday morning, representatives from counties, hospitals, insurers and other groups discussed coordinating their message to Governor Rick Perry and lawmakers in Austin.
"We are making the case that people are already paying for that care in a fragmented and inefficient manner," said John Hawkins, senior vice president of government relations for the Texas Hospital Association. "We have to tell the story of how the expansion is financed."
Hospitals, for instance, already provide $5 billion a year in uncompensated care. That shortfall gets made up by raising premiums for private patients and levying property or sales taxes on residents in special "hospital districts."
"It's a hidden tax," Hawkins said. Federal funds could cover a significant portion of that.
So far, though, Perry is not convinced.
"The governor's position has not changed," said his spokeswoman, Lucy Nashed. "It would be irresponsible to add more Texans and dump more taxpayer dollars into an unsustainable system that is broken and already consumes a quarter of our budget."
SOURCE: http://money.cnn.com/2013/02/22/news/economy/medicaid/
Florida Governor Rick Scott on Wednesday became the latest to warm up to the expansion, which broadens coverage to adults with incomes below 138% of the poverty line. Medicaid rules vary from state to state, but many states (including Florida) do not currently cover most childless, non-disabled and non-elderly adults.
Scott, a former health care executive, follows his GOP peers in Ohio, Michigan, Arizona, New Mexico, Nevada and North Dakota in accepting a reform they once strongly opposed.
The Supreme Court ruled last year that states can opt out of broadening Medicaid coverage, striking down one of the provisions of the Affordable Care Act. Some 15 states have chosen to participate so far, with another 10 leaning towards expansion, according to the Center on Budget and Policy Priorities, a liberal group.
Though many Republican governors say their state can't afford the cost of expansion, the political resolve of some has crumbled over the past two months in the face of heavy pressure from hospital associations, medical groups, local governments and others. Providers -- particularly hospitals, where many uninsured folks go for care -- say their costs of treating those without coverage would fall under the expansion.
"Medicaid expansion is a very good deal that's hard to pass up," said January Angeles, a senior policy analyst at the center. "In a lot of these states, a lot of stakeholders have done a good job making the business case."
Most states will have to shell out very little at first -- in the early years. The federal government will pick up 100% of the cost for the first three years, and then gradually reduce its subsidy to 90% by 2020.
Over the next decade, expanding Medicaid is expected to cost states only another $8 billion, or 0.3% more, that they would have otherwise spent, according to an Urban Institute estimate. Some 14.3 million citizens would be newly eligible if every state enrolled.
Various interest groups have put a full-court press on governors and lawmakers, said Ed Haislmaier, a senior research fellow at the conservative Heritage Foundation, which opposes broadening Medicaid.
"They want to get their hands on that money," he said.
The financial argument helped sway Scott, who still has to convince a Republican-led legislature to sign on. Some 1.3 million adult Floridians would become eligible for Medicaid under the expansion.
"While the federal government is committed to paying 100% of the cost of new people in Medicaid, I cannot, in good conscience, deny the uninsured access to care," he said Wednesday when announcing his decision to participate for three years.
Now that Scott is on board, Texas remains the last big holdout.
Texas has the highest share of uninsured in the nation, at nearly a quarter of residents. Some 1.75 million adults would be newly eligible if the Lone Star State joins in. It stands to gain $25.3 billion in federal funds over four years to insure poor adults, while spending $1.3 billion, according to the Center for Public Policy Priorities, an advocacy group for low-income Texans.
On Thursday morning, representatives from counties, hospitals, insurers and other groups discussed coordinating their message to Governor Rick Perry and lawmakers in Austin.
"We are making the case that people are already paying for that care in a fragmented and inefficient manner," said John Hawkins, senior vice president of government relations for the Texas Hospital Association. "We have to tell the story of how the expansion is financed."
Hospitals, for instance, already provide $5 billion a year in uncompensated care. That shortfall gets made up by raising premiums for private patients and levying property or sales taxes on residents in special "hospital districts."
"It's a hidden tax," Hawkins said. Federal funds could cover a significant portion of that.
So far, though, Perry is not convinced.
"The governor's position has not changed," said his spokeswoman, Lucy Nashed. "It would be irresponsible to add more Texans and dump more taxpayer dollars into an unsustainable system that is broken and already consumes a quarter of our budget."
SOURCE: http://money.cnn.com/2013/02/22/news/economy/medicaid/
Yes it does make one angry doesnt it? And I agree. Altho I am a supporter of the ACA I do not think its a cure all and this is only one of the reasons why. As long as healthcare is a for profit deal this will continue to go on. When one has insurance there is a deal between the carrier and the provider to provide a certain fee for certain services that is able to happen because of the pools that people are in. Hopefully that in and of itself will improve things but I agree something needs to be done to reign in this kind of robbery. The documentary was very eye opening. I knew things were bad but this is ridiculous and needs stopped, among other things as well. Seems no one wants to take it on tho.
I have had the pleasure of disputing some medical care costs after a surgery. Looking at the itemized bill was a joke. I started to notice that some things were double charged. I questioned those charges and got them waived, but I have to tell you. It didn't really help that much in the end.
That's one of the things I mentioned when the health care debate first started, back in 2008/2009 and is the main thing that made me angry about the whole thing.
At that time, it was more about bringing down the COST of the care so people could afford it....... hence "Affordable Care"; then suddenly the focus switched from bringing down the cost of the care to making sure everyone has insurance........ you're completely right -- who cares that one of those little pill cups is $7, when it's not coming from their own pocket...... why do you think insurance premiums are so high? We pay outrageous premiums so health insurance can pay for $7 pill cups...... of course, that's one of the main problems with our health care system. Prices are through the roof and there doesn't seem to be any effort being made to bring them down....... just make sure everyone has coverage.
Bring the cost of CARE down, more people could pay for it and coverage wouldn't be such an issue. Since the focus is now all about coverage, they need to change the name from Affordable Care Act to Expensive Insurance Act.
At that time, it was more about bringing down the COST of the care so people could afford it....... hence "Affordable Care"; then suddenly the focus switched from bringing down the cost of the care to making sure everyone has insurance........ you're completely right -- who cares that one of those little pill cups is $7, when it's not coming from their own pocket...... why do you think insurance premiums are so high? We pay outrageous premiums so health insurance can pay for $7 pill cups...... of course, that's one of the main problems with our health care system. Prices are through the roof and there doesn't seem to be any effort being made to bring them down....... just make sure everyone has coverage.
Bring the cost of CARE down, more people could pay for it and coverage wouldn't be such an issue. Since the focus is now all about coverage, they need to change the name from Affordable Care Act to Expensive Insurance Act.
I watched a program on CNN about the cost of healthcare in the form of bills. Just one of those little cups they bring your meds in is 7 big dollars each. Might that be part of the problem with healthcare in this country? Ever hear of that song, Money Money?
I dont see how people think it can be anymore expensive to actually have the multitudes covered than to put up with this kind of fraud over and over and over. Funny tho. I dont hear anyone complaining of that. Might it be because its NOT coming out of their pockets directly? Its a little easier if its someone else paying for it? I think they otta have a tax on everyone and healthcare for everyone paid for by everyone. Its called universal healthcare.
I dont see how people think it can be anymore expensive to actually have the multitudes covered than to put up with this kind of fraud over and over and over. Funny tho. I dont hear anyone complaining of that. Might it be because its NOT coming out of their pockets directly? Its a little easier if its someone else paying for it? I think they otta have a tax on everyone and healthcare for everyone paid for by everyone. Its called universal healthcare.
The Texas Hospital Association represents the people who actually have to deal with the finances of patient care. If they say the ACA makes sense, it makes all the original opposition to it look like foot dragging and political posturing. Too bad Perry still thinks he has a shot at the White House.
I understand the "humanitarian" effort. I think it would be great if everyone in this country were afforded the same kind of health care that everyone in Dc, including the President gets.
There are a couple of problems and one being the funding. On the surface to some, it seems almost a sure deal that the funding will be there one way or the other. (I don't see it that way.) There have been discussions about people continuing to raise the cost of said health care by taking their kids to the doctor for every head ache, fever, and sniffles. (That jams things up anyhow.) There have been discussions about prioritizing ones health needs. A heart attack comes before a cold. (I get that and it seems rational, but there is grey area in the making by prioritizing.) I've seen just about all of the stuff being talked about when it comes to funding and I am not sure it is doable.
Secondly is putting ones health in the hands of the individual. I know a lot of stubborn people who will not get the care they need, even when they have insurance. I know this is anecdotal, but a guy who used to work for me (we provide good health insurance for our full time staff) walked away from this job to take a job that paid less. His reasoning is because it is something that he wanted to do more.
Now, just recently this guy gets an absessed tooth. The infection grows until this guy is miserable. Sick and in pain, he now tries to go get help. He finally finds someone that will treat him and this doctor said, "why did you wait so long?" This guys answer was, "no insurance". He walked away from a better paying job with insurance to a part time job that paid 60% of what we did and no insurance. Furthermore, he waited until he was just about on his last leg to get assistance.
Doesn't a person like this have some responsibility to take care of his own health? What is it that makes one feel that "I can wait this out"? Personally, I don't understand that and I have not had insurance. Maybe I am in touch more with my health than this guy, but I took my sick butt to the doctors when I was sick in order to avoid the situation he was in.
Now this guys situation is dire. The treatment is going to cost way more than it would hve if he addressed it earlier.
This guy could have done better on so many fronts and he is concerned about what it is going to cost him? Where was that concern when he knew earlier when he knew he was sick and wasn't going to get better? This guy is an a-hole and an idiot.
There are a couple of problems and one being the funding. On the surface to some, it seems almost a sure deal that the funding will be there one way or the other. (I don't see it that way.) There have been discussions about people continuing to raise the cost of said health care by taking their kids to the doctor for every head ache, fever, and sniffles. (That jams things up anyhow.) There have been discussions about prioritizing ones health needs. A heart attack comes before a cold. (I get that and it seems rational, but there is grey area in the making by prioritizing.) I've seen just about all of the stuff being talked about when it comes to funding and I am not sure it is doable.
Secondly is putting ones health in the hands of the individual. I know a lot of stubborn people who will not get the care they need, even when they have insurance. I know this is anecdotal, but a guy who used to work for me (we provide good health insurance for our full time staff) walked away from this job to take a job that paid less. His reasoning is because it is something that he wanted to do more.
Now, just recently this guy gets an absessed tooth. The infection grows until this guy is miserable. Sick and in pain, he now tries to go get help. He finally finds someone that will treat him and this doctor said, "why did you wait so long?" This guys answer was, "no insurance". He walked away from a better paying job with insurance to a part time job that paid 60% of what we did and no insurance. Furthermore, he waited until he was just about on his last leg to get assistance.
Doesn't a person like this have some responsibility to take care of his own health? What is it that makes one feel that "I can wait this out"? Personally, I don't understand that and I have not had insurance. Maybe I am in touch more with my health than this guy, but I took my sick butt to the doctors when I was sick in order to avoid the situation he was in.
Now this guys situation is dire. The treatment is going to cost way more than it would hve if he addressed it earlier.
This guy could have done better on so many fronts and he is concerned about what it is going to cost him? Where was that concern when he knew earlier when he knew he was sick and wasn't going to get better? This guy is an a-hole and an idiot.
"Obamacare/ACA will fail. It's not sustainable, financially."
You will eat those words El....
You will eat those words El....
"...most people believe that other people deserve a fair chance to have some..."
If by "most people" you're referring to Democrats, then you're right.
Democrats believe in being humanitarians, and I applaud them for that. Republicans look a little deeper, and think about the IMPACT of that humanitarianism. Doesn't mean that we're wishing ill on anyone, and that we don't "care" about our fellow humans, it just means we think about 'where the $$$ comes from to pay for it'. Democrats pay for things by picking $$$ of the money-tree, and raising taxes on the rich, and increasing the corporate tax-rate.
If the cost of the humanitarian effort, negatively impacts your general populous, then take a better look at it, and take a different approach.
Obamacare/ACA will fail. It's not sustainable, financially.
If by "most people" you're referring to Democrats, then you're right.
Democrats believe in being humanitarians, and I applaud them for that. Republicans look a little deeper, and think about the IMPACT of that humanitarianism. Doesn't mean that we're wishing ill on anyone, and that we don't "care" about our fellow humans, it just means we think about 'where the $$$ comes from to pay for it'. Democrats pay for things by picking $$$ of the money-tree, and raising taxes on the rich, and increasing the corporate tax-rate.
If the cost of the humanitarian effort, negatively impacts your general populous, then take a better look at it, and take a different approach.
Obamacare/ACA will fail. It's not sustainable, financially.
It's called "health care" and most people believe that other people deserve a fair chance to have some. It's called Humanitarian. I hope you stay employed and healthy until the day you die.
Time and time again, the federal govt's health department has shown that it has no desire to improve the life-span of anyone.
The way they tax, is the same way.
2 years ago, the geniuses in DC eliminated tax deductions for OTC-type medications, including a few that had been converted from prescription to OTC.
It also stopped tax deductions for healthclub memberships and other programs designed to maintain and improve health.
You don't gain voters by making them stay healthy.
You gain voters by keeping them alive after they've made choices that are not healthy.
It's called "Health Care" not "Wellness Assurance" or "Sickness Prevention."
The way they tax, is the same way.
2 years ago, the geniuses in DC eliminated tax deductions for OTC-type medications, including a few that had been converted from prescription to OTC.
It also stopped tax deductions for healthclub memberships and other programs designed to maintain and improve health.
You don't gain voters by making them stay healthy.
You gain voters by keeping them alive after they've made choices that are not healthy.
It's called "Health Care" not "Wellness Assurance" or "Sickness Prevention."
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