Category: Medicaid

Is ObamaCare’s Medicaid Expansion Constitutional?

This is actually a more interesting question than I originally thought. Here is Robert Book at the Apothecary:

The health reform law passed in March 2010 provides for a substantial expansion of the “must cover” population – essentially anyone from a family with income below 138% of the federal poverty line (an amount that varies based on family size). This is a major component of the health reform law: according to the Congressional Budget Office, half the uninsured who they project to become covered as a result of new law will obtain coverage because of the Medicaid expansion…

The constitutional issue, however, is what would happen if a state declined to pay for that portion of the Medicaid expansion not paid for by the federal government? Suppose, for example, a state decided to just forgo the expansion entirely, on the grounds that it could not afford to pay its share of the cost? In that case, the health reform law contains a built-in retaliation – the state would lose all federal Medicaid funding.

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Feb 03, 2012 | 6 comments | by

Who Gets Welfare?

Source: Census Bureau

The chart shows the percent of households receiving a benefit in each of the education categories. For example:

Over a third of households with heads whose formal education was limited to a high school diploma — the most common type of household — received at least one of these types of assistance in 2010. A majority of households with heads who stopped their schooling before graduating from high school received government assistance in 2010.

Total assistance was about $600 billion in 2010 and it went to almost one half the population.

Source: University of Chicago professor Casey Mulligan at The New York Times’ Economix blog.

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Feb 03, 2012 | 5 comments | by

Is Medicaid Cheaper and Better than Private Insurance?

The claim that Medicaid is better coverage than private insurance was all the rage a couple of weeks ago thanks to a press release from Southern Methodist University highlighting doctoral candidate and adjunct professor Manan Roy’s paper “How Well Does the U.S. Government Provide Health Insurance.”

Before you rush out to enroll yourself and your family in the cheaper, better, Medicaid system, it might be worth taking some time to evaluate whether the slender evidence in the paper supports such a sweeping conclusion.

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Jan 26, 2012 | 5 comments | by

Minnesota Medicaid Confronts EMTALA

States are finally realizing that the ObamaCare Medicaid expansion makes it difficult or impossible to control their Medicaid expenditures. They are responding to the challenge in a variety of ways, some of which will likely put people’s lives at risk. In Minnesota, officials are trying to control the cost of treating the illegal aliens on Minnesota’s Medicaid rolls by creating a list of medical services that are not considered emergency care. According to Minnesota Public Radio, these include doctor visits, home health care, treatment for certain chronic conditions, and prescriptions from outpatient pharmacies. As of January 9th, 200 of the 2,300 noncitizens notified that they would no longer be allowed to use Medicaid for nonemergency conditions had appealed the state’s decision.

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Jan 20, 2012 | 7 comments | by

Sentences I Wish I Hadn’t Seen

How should Medicare and Medicaid measure doctors, hospitals, dialysis centers and other health care providers it pays? There are 368 new ideas on the table this year, according to a list compiled by the Centers for Medicare & Medicaid Services. CMS estimates 60 will be adopted in 2012.

More at Kaiser Health News.

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Jan 13, 2012 | 4 comments | by

Reasons to Reform Medicaid

Senators Orrin Hatch (R-Utah) and Tom Coburn (R-Okla.) have produced ten. Here are my top four:

1.  In the State of Oregon, as many as one out of five individuals enrolled in Medicaid aren’t even eligible for the program.(Source: HHS Secretary Kathleen Sebelius letter to Senator John Cornyn. February 25, 2010.)

2.  You can own a half a million dollar luxury home and still qualify for Medicaid. (Source: The Social Security Act: Section 1917(f).)

3.  An entire consulting industry now teaches how to do financial planning around Medicaid’s long-term care offerings, and not surprisingly, taxpayers now finance 40 percent of long-term care services in America through Medicaid. (Sources: The Center for Long-Term Care Reform: Medicaid Planning Quotes and Kaiser Commission on Medicaid and the Uninsured: Medicaid and Long-Term Care Services and Supports. March 2011)

4.  Individuals with an income of $64,000 a year — nearly $15,000 higher than the median household income in the United States — can now qualify for Medicaid. (Sources: U.S. Census Bureau: Income, Poverty and Health Insurance Coverage in the United States: 2010. September 2011 and Associated Press: Millions of middle-class people could get Medicaid. June 2011)

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Nov 09, 2011 | 13 comments | by

The Tattered Social Safety Net

In Massachusetts:

The August study on Massachusetts’s safety net system showed rising patient volume after the state’s health reform. The number of patients receiving care from community health centers jumped 31 percent from 2005 to 2009, while safety net hospitals experienced a 9.2 percent increase in nonemergency ambulatory care visits from 2006 to 2009, researchers from George Washington and the University of Minnesota found.

Lessons for ObamaCare:

The ACA scales back funding for disproportionate share hospitals — a special designation for hospitals with significantly higher shares of impoverished patients — while Medicaid is expected to absorb 16 million more people after 2014.

“The assumption that near-universal coverage will eliminate the need for extra financial help for safety net institutions is false, and Massachusetts provides the proof,” the health policy consultant said.

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Oct 17, 2011 | 8 comments | by

Four in Ten Children are Born on Medicaid

So should we blame the moms? Bryan Caplan seems to say yes:

I’m not insisting on perfect foreknowledge, just common sense. If you insist on marriage prior to pregnancy, you screen out an awful lot of unreliable men. And there are many other excellent ways to filter out cads: Lengthen the courtship, prefer older men, wait for your man to get a steady job, avoid men with questionable family and friends, etc. Even if the marriage eventually ends in divorce, you’ve still greatly mitigated the financial harm to yourself, your kids, and taxpayers.

See his exchange with his critics at Econlog.

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Oct 11, 2011 | 4 comments | by

Health Care in Texas: The Rest of the Story

As Texas governor Rick Perry makes a splash in the Republican presidential primaries, one place where critics are looking for evidence of poor leadership is his record on health care, especially Medicaid and the uninsured. According to a recent article by Noam N. Levey in the Los Angeles Times, Texans’ access to health care is “withering” under Perry. As Levey notes, Texas has the highest rate of uninsured in the nation, over one quarter of the population. This is important, but not in the way Levey believes.

Avik Roy, of The Apothecary blog, has published a comparison of various health-related measurements in Texas and Massachusetts. Drawing upon a number of sources, Roy concludes that those who believe more government spending and regulation is good will condemn Texas’ record, but those who believe in individual choice and limited government will cheer it. But what other costs did Texans pay? Or, as Paul Krugman might frame the question: “How many children died in the street to pay for Rick Perry’s tax cuts for millionaires and billionaires?” The answer is “none.”

More importantly, Texans have decided that it’s better to create more jobs than more Medicaid dependents.

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Sep 23, 2011 | 5 comments | by

Quote of the Day

The cuts to the Medicaid program in the president’s proposal — which shifts the burden to states and ultimately onto the shoulders of seniors, people with disabilities, and low-income families who depend on the program as their lifeline — would be harmful.

Ron Pollack,
Executive Director,
Families USA

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Sep 21, 2011 | 4 comments | by
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