FixHealthCarePolicy

Side Effects: Cost Of Medicaid Expansion Going Nowhere But Up

In passing Obamacare, Congress has put the states in quite a pickle. To sharply expand health coverage, Obamacare flung wide the gates of Medicaid eligibility. It envisions a massive expansion of the federal-state health program that, historically, delivers low-quality care to low-income Americans.

Not a smart move.

States were already struggling to meet their share of Medicaid program costs—even though Medicaid payments to providers often don’t even cover the cost of care. And, due to the inadequate reimbursement rates, more and more doctors were already refusing to accept new Medicaid patients.

How fiscally shaky is Medicaid today? Well, last year Congress used the stimulus bill to give states $87 billion to help them cover rising Medicaid costs. And that doesn’t seem to be enough.

A recent letter from House Democrats encourages their colleagues to give states another $24 billion to help them cover Medicaid costs for another six months. “Without this funding,” the letter says, “our states will be forced to make severe cuts to Medicaid providers and benefits, and the ensuing budget shortfall would have grave consequences for school funding and other essential state programs.” (more…)

Tags: deficit, federal-state program, low-quality care, Medicaid Expansion, ObamaCare, Side Effects

Obamacare: A Hard Pill to Swallow for Physicians

The negative effects of Obamacare will impact every American. However, it is those who are the very backbone of the United States’ high-quality health care system who will be most severely affected: physicians. In a recent paper, Heritage’s health policy expert Robert Moffit, Ph.D., details the changes American doctors can expect to see in the way they practice medicine as a result of the recently-passed law.

Moffit outlines the following as being most detrimental to the practice of medicine:

Medicaid Expansion and Payment. As it is, doctors receive heavily reduced pay for treating Medicare patients, and reimbursement for Medicaid is even lower. In many areas, doctors who accept Medicaid do so at their own loss, as reimbursement rates do not even cover the expense of seeing the patient. Writes Moffit, “Medicare payment

has resulted in sporadic access problems for Medicare patients, and the lower Medicaid payments have already contributed to serious access problems for low-income persons and worsened hospital emergency room overcrowding.” By adding an estimated 18 million people to this system, Obamacare will aggravate these existing dilemmas.

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Tags: Medicaid Expansion, more bureacracy, ObamaCare, physicians, sustainable growth formula

The Long War of Repealing Obamacare

In the depressing aftermath of Congress’s passage of the Democratic health-care legislation, there has been an understandable temptation among conservatives to think that all their effort over the last year to derail what was coming down the tracks may have been for naught. After all, the bill did pass. The president and his allies got their signing ceremony and their victory lap, as well as a barrage of premature but predictable pronouncements from the national media that we are now witnessing a historic moment of irreversible liberal progress.

And there’s no use sugarcoating what has happened. It’s a debacle from every possible vantage point. The Democrats have created another massive entitlement program while expanding federal power and reach in a manner not seen since the heyday of Franklin D. Roosevelt. If allowed to stand, the new health-care law will tether America’s middle class to the federal government in ways that will fundamentally alter — and not for the better — the relationship between citizens and the state. The result will be worse health care, distorted politics, less medical innovation and economic vitality, and depleted wealth.

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Tags: $1.2 trillion cost, conservative opposition, doctor-patient relationship, massive entitlement program, Medicaid Expansion, Medicare cuts, ObamaCare, Public Opinion, public option, repeal

A Guide to the Senate Vote-O-Rama: Part Two

The Senate’s health care bill became law earlier this week, but the fight against a government overhaul of our nation’s health system continued in the Senate. Senators voted on many amendments to the reconciliation bill passed by the House as a “fix” to the massive Senate health bill, H.R. 3590.

This process proved extremely important, since it underscored some very key policy issues that have surfaced in the national debate. Forget what lawmakers say; look instead on how they act. Votes on key issues tell a big story. Consider the following policy issues:

Medicaid For Congressmen: CBO and other experts estimate that more than 30 million Americans will secure health care coverage under the recently enacted health care legislation. But there is one little problem: Roughly half of those will be covered, not under private health insurance, but under Medicaid, a poorly performing welfare program that indisputably delivers low quality care. Even though Medicaid is a mess, Congress voted to extend Medicaid coverage to 16 million more Americans by 2019. If Congress thinks Medicaid is the right option to cover millions of their fellow citizens, then House and Senate members should not mind enrolling in it themselves.

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Tags: Amendments, entitlement growth, Federal Employees Health Benefits Program, government overhaul, House "fix", Medicaid Expansion, senate health care bill

Reconciliation Bill Increases ObamaCare Medicaid Costs for Twenty Eight States

The U.S. Senate is currently debating H.R. 4872, which amends the Obamacare bill passed by the House Sunday evening and signed into law by the President on Tuesday. This second piece of legislation is advertised as necessary to “fix” problems with the basic Obamacare legislation — such as by deleting the notorious “Cornhusker Kickback” and by altering the timing and scope of the new penalty tax on “high-cost” health insurance plans.

However, other parts of H.R. 4872 actually make the original bill worse — for example, the provision that would increase the separate, new premium tax on commercial health insurance coverage and the one that expands the new tax on medical devices.

Yet another provision would change the federal Medicaid funding formula such that Obamacare will cost taxpayers in 28 states and the District of Columbia even more money. That means that 56 senators will have yet another opportunity to once more vote against the interests of their constituents back home by approving H.R. 4872. (more…)

Tags: Cornhusker Kickback, high-cost insurance plans, Medicaid Expansion, ObamaCare, state deficits

White House Health Care Rhetoric About to Meet Reality

At the signing of the Senate health bill today, President Barack Obama said: “In a few moments, when I sign this bill, all of the overheated rhetoric over reform will finally confront the reality of reform.” Let’s review some of the “overheated rhetoric” that is about to get tested by reality.

Over the past months, the President and Congress have promised: that premiums would drop by $2500 per family; that if you like what you’ve got, you can keep it; that it would bend the cost curve down; that it would decrease the federal deficit. The fact of the matter is, none of these things will become reality once the bill is implemented—these claims are nothing but the rhetoric attached to an unpopular piece of legislation in the hopes of creating support that has yet to materialize.

The truth about the bill is already becoming evident as effected parties become vocal with their concerns. Some highlights just from today’s headlines include: (more…)

Tags: bend the cost curve, higher health premiums, Medicaid Expansion, ObamaCare, ObamaCare promises, rising federal deficits, Senate Health Bill, Sunday vote

A First Look At The House Health Care Fix: More Bad News

In their feverish effort to enact the Senate health bill, the House leadership recently released their 153 page bill to fix the underlying 2,409 page Senate legislation through the budget reconciliation process. As a matter of health policy, there is little that is substantively different between the Senate bill and this “fix it” bill. A closer look at the fine print shows that the latest version would only make the massive and unpopular Senate health bill even worse.

Based on a preliminary review of the key provisions, taxpayers should be aware of the following features of the legislation.

More Spending

– The House reconciliation bill increases taxpayer subsidies and lowers cost sharing for individuals receiving a federal subsidy to buy health coverage. This change adds to the overall cost of the bill, while depending on unproven savings and tax hikes to pay for it.

– Instead of removing special deals, the bill extends additional federal funding to all states for Medicaid. This “fix” is supposed to replace the scandalous requirement that federal taxpayers fund the Nebraska Medicaid expansion. In both case, however, the burden is back on the backs of federal taxpayers. (more…)

Tags: Cadillac tax, federal bureaucracy, House reconciliation bill, individual mandate penalty, job killer, Medicaid Expansion, Medicare cuts, Medicare investment income tax, more spending, Senate Health Bill, taxpayer-funded abortions

The Senate Health Bill: Ordinary Americans Have Been Warned

As the House of Representatives prepares for a final round of debate on the health care legislation, ordinary Americans must grasp the huge impact on the future of the country. House Speaker Nancy Pelosi is pulling out all the stops to get the 216 votes needed to pass the Senate health bill, H.R. 3590 (PDF). The Speaker is also promising to fix the Senate bill’s many objectionable components later through the budget reconciliation process, parliamentary rules normally used to reconcile tax and spending provisions with the annual congressional budget resolution.

Meanwhile, the House leadership is also reportedly pursuing the controversial “Slaughter Rule,” in which the entire Senate bill be “deemed” to have passed the House without an “up or down” vote on the Senate language.

Regardless of whatever procedural shenanigans the House leadership tries to play, the end result would be enactment of the Senate health bill as the law of the land. That’s the end game. Period. (more…)

Tags: additional insurance costs, Congressional Budget Office, deem, Medicaid Expansion, reconciliation, Senate Health Bill, Slaugher Rule

Health Coverage for All Americans? Not Under the Senate Health Bill

As Congressional leaders continue to search for ways to pass the Senate health bill in the House later this week, Americans continue to be subjected to dubious rhetoric surrounding the bill’s provisions. The Senate bill’s supporters claim that their legislation must be made law, no matter the cost, in order to achieve universal coverage in the United States. However, even if the Senate bill does pass, this will not be the case. Despite the fact that the proposed legislation is exorbitantly expensive, it would still fail to achieve universal health coverage.

According to the Congressional Budget Office (CBO), by 2019, the legislation would cost (PDF) $196 billion annually and still leave 24 million Americans uninsured.

The fact that 24 million people remain would uninsured with enactment of the Senate health bill is remarkable. Under current law, there would be 55 million uninsured Americans in 2019. That means that over 43 percent of the projected uninsured would be unaffected by the legislation, continuing to go without coverage ten years from now. Yet according to research by Heritage expert James Capretta, the bill would cost well over $1 trillion over the next ten years. Capretta shows that the true ten year cost of the plan is more likely to be close to $1.2 trillion, but even this estimate significantly underestimates the true long term cost of the plan. Capretta further points out that this estimate includes ten years of new revenues, but only 6 or 7 years of new spending, skewing the Congressional Budget Office’s ten-year cost analysis to make the bill appear less expensive than it really is. He says that a true ten year estimate would put the price tag closer to $2.3 trillion. (more…)

Tags: $1 trillion, Congressional Budget Office, Medicaid Expansion, Senate Health Bill

Think Medicaid Expansion is a Good Idea? Think Again.

Most everyone agrees that decreasing the number of the uninsured is an important goal of health care legislation. What is not agreed upon is the best way to achieve that goal. Obama’s health care plan depends on expanding the number of Americans enrolled in Medicaid – the government-run program for the poor and disabled. The Congressional Budget Office (CBO) estimates the Senate bill would account for about 50 percent of the reduction in the uninsured population at a cost of $395 billion over 10 years.

New research by Heritage’s health fellow Brian Blase presents evidence suggesting that Medicaid expansion would be both costly and do little to improve the health of the uninsured. Blase examines the “TennCare” program, a Tennessee public program enacted in 1994 that dramatically increased the expansion of Medicaid to Tennessee’s uninsured population. The TennCare program quickly added over half a million individuals to Medicaid, enrolling one-fourth of the entire state. And costs also skyrocketed. Per-capita Medicaid spending from 1994-2004 increased by 146 percent in Tennessee, which was over double the national average increase of 71 percent.

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Tags: CBO, Medicaid Expansion, ObamaCare, President's proposal, TennCare