Fix Health Care Policy

HHS Initiatives Fail to Offer States Meaningful Flexibility

Last week, the Department of Health and Human Services (HHS) announced new initiatives intended to provide states with increased flexibility to better manage their Medicaid programs. However, these initiatives do not seriously address states’ mounting Medicaid crises.

The first HHS initiative is to improve coordination of care for individuals enrolled in both Medicare and Medicaid, the so-called dual eligibles. Under Obamacare, 15 states will receive up to $1 million through a new bureaucracy focused on duals. While reform should address the problem of coordinating care for the duals, HHS’s approach will likely fail because it ignores the root of the problem. Currently, incentives to coordinate care between Medicare and Medicaid are lacking, since taxpayer funds (and not private-sector profits) are at stake for poor management. Cost-effective care would occur naturally if incentives were properly aligned. (Read the rest on The Foundry…)

Tags: cost-effective care, Medicaid, ObamaCare, repeal the law, state flexibility

Medicaid Flexibility Still Missing from Wyden-Brown

On Monday Politico ran a column by Sen. Ron Wyden (D-Ore.) taking issue with my critique of his proposal to accelerate the granting of waivers under Obamacare. Unfortunately, he missed a central point I was making about limitations on the waivers that could be granted.

Apparently the senator was offended by this paragraph, from my New England Journal of Medicine piece on his bill:

Even more problematic to proponents of state flexibility on both the left and the right is that states would not be able to fold other health programs into their waiver request. Liberal skeptics at the Physicians for a National Health Program, for instance, point out that provisions of Medicare, Medicaid, the State Children’s Health Insurance Program (SCHIP), Taft–Hartley plans, and other programs could not be waived, leaving large obstacles in the path of a potential single-payer system. And on the other hand, by leaving Medicaid intact, including the required expansion of the program under the ACA, Wyden–Brown does little to comfort conservatives who envision a privatized voucher approach. (Read the rest at The Foundry…)

Tags: ObamaCare, Politico, state flexibility, Wyden-Brown bill

House Hearing: Secretary Sebelius Talks Fiscal Responsibility and Obamacare

Yesterday, Secretary of Health and Human Services Kathleen Sebelius testified before the House Energy and Commerce Committee on the President’s fiscal year 2012 budget and implementation of Obamacare. The Secretary’s remarks highlighted the need for fiscal responsibility and health care reform that gives greater power to individuals and more flexibility to the states. Unfortunately, none of these goals can be achieved under Obamacare.

Sebelius told the committee, “We can’t build lasting prosperity on a mountain of debt. And we can’t win the future if we pass on massive debts to our children and grandchildren. We have a responsibility to the American people to live within our means so we can invest in the future.” (Read the rest at The Foundry…)

Tags: HHS Secretary Kathleen Sebelius, House Energy and Commerce Committee, ObamaCare, state flexibility

White House Still Failing to Fix Medicaid Crisis

Yesterday President Obama announced support for the “Empowering States to Innovate Act” authored by Senators Ron Wyden (D-OR) and Scott Brown (R-MA). The Wyden-Brown proposal would advance the enactment date of an Obamacare provision that allows states to pursue alternative routes to reform if they can meet the same targets as the President’s overhaul. Though touted by Secretary of Health and Human Services Kathleen Sebelius as “another crucial step in empowering states to lead,” the proposal would fail to deliver the level of flexibility states need to achieve successful health care reform.

Members on both sides of the aisle admit that states’ health care reform needs are vastly different and cannot be addressed by a one-size-fits-all approach like Obamacare, which imposes a pre-ordained federal version of reform on the states. A group of 29 Republican governors has written to the White House to demand greater flexibility to innovate, and even some governors on the left have quietly made the same appeal. But as Heritage expert Stuart Butler warns, Wyden-Brown won’t do the trick. (Read the rest at The Foundry…)

Tags: HHS Secretary Kathleen Sebelius, ObamaCare, one-size-fits-all, state flexibility, Wyden-Brown bill

Obama Offers Flexibility to Implement Single Payer Faster

Obamacare remains tremendously unpopular with the American people. According to the latest Kaiser Family Foundation poll, only 14 percent of Americans believe they have benefited from the law, compared to 17 percent who say the law has already harmed them. Only 28 percent of Americans believe Obamacare will help the nation’s economy, compared to 45 percent who believe it will make it worse. Overall, 48 percent of Americans oppose Obamacare while only 43 percent favor it. Some provisions, like the individual mandate, are particularly unpopular, with a full 67 percent of Americans favoring its repeal.

President Barack Obama knows all of this, which is why he told the visiting National Governors Association at the White House yesterday that he supports changing the date that states can begin applying for waivers from some Obamacare mandates from 2017 up to 2014. Specifically, the President endorsed legislation by Senators Ron Wyden (D–OR) and Scott Brown (R–MA), claiming: “It will give you flexibility more quickly while still guaranteeing the American people reform.” President Obama is at least half right here. Wyden–Brown would give states some flexibility—but only the flexibility to implement a government take over of health care faster. Heritage Foundation Center for Policy Innovation Director Stuart Butler explained in the New England Journal of Medicine:

One [problem] is that [Wyden-Brown] still locks the states into guaranteeing a generous and costly level of benefits. True, a state could propose alternative benefit requirements if they had the same actuarial value as those in the [health care bill]. But the requirements go well beyond basic coverage, and the HHS secretary is the one who defines “at least as comprehensive” benefits. … (Read the rest at The Foundry…)

Tags: mandated benefits, ObamaCare, President Barack Obama, state flexibility

Obama’s Phony Obamacare Flexibility Offer

Speaking to the National Governors Association at the White House today, President Barack Obama endorsed legislation by Sens. Ron Wyden (D-OR) and Scott Brown (R-MA) that would allow states to request waivers from some Obamacare mandates in 2014 instead of the existing 2017 date. President Obama claimed: “It will give you flexibility more quickly while still guaranteeing the American people reform.” Has President Obama even read the legislation? Because that is just plan false. Heritage Foundation Center for Policy Innovation Director Stuart Butler explained in the New England Journal of Medicine:

One [problem] is that it still locks the states into guaranteeing a generous and costly level of benefits. True, a state could propose alternative benefit requirements if they had the same actuarial value as those in the ACA. But the requirements go well beyond basic coverage, and the HHS secretary is the one who defines “at least as comprehensive” benefits. (Read the rest at The Foundry…)

Tags: HHS Secretary Kathleen Sebelius, Obamacare waivers, state flexibility, Wyden-Brown bill