Tag: "Medicaid"

Churn, Churn, Churn: Measuring the Cost of Fragmented Coverage

F1Low-income Americans face bewildering bureaucratic requirements when they try to obtain welfare benefits. One of the challenges is that they have to frequently re-apply for benefits because the state needs to know whether their incomes are still low enough form them to remain eligible. This moving in and out of benefits is called churn, and Dottie Rosenbaum of the left-wing Center for Budget and Policy Priorities has written an interesting paper discussing the challenges in measuring and understanding it:

States renew Medicaid and CHIP eligibility once a year, as federal rules require, and federal rules have changed to require a minimum eligibility period of 12 months for child care. Many states still review SNAP eligibility every six months……

States are allowed to recertify eligibility of elderly and disabled households for SNAP every 24 months.

There is trade-off here: If people have too much hassle re-applying for fragmented benefits they might not get them and that will cost taxpayers more down the road. On the other hand, welfare that depends on income demands some burden of re-certifying eligibility on the recipient.

NCPA recently published an analysis of the bewildering array of federally funded safety-net programs, and recommended that state, local, and civic agencies be able to apply for block grants that consolidate funding from multiple programs. This would also reduce the challenge of churn, as applicants would be able to re-certify eligibility at one agency.

The GOP’s Proposed Budgets’ Effect on Medicare and Medicaid

Today’s appalling vote in favor of a so-called Medicare doc fix that will increase the deficit by $141 billion makes it hard to take the House and Senate budget resolutions seriously. Nevertheless, they have a lot of positive reform in them. Sean Parnell of the Heartland Institute interviewed me for the Heartland Institute’s podcast.

The interview happened a few days ago, before we knew that almost all House Republicans were about to vote to endorse Obamacare’s vision of controlling Medicare by federalizing the practice of medicine. Nevertheless, if the Republicans ever re-gather their bearings. maybe they will move their budget forward.

Hear the entire podcast here.

Congressional Budget Resolutions Shoot for the Sky; Miss Low-Hanging Fruit

The House Budget Committee and the Senate Budget Committee have passed budget resolutions that shoot for the sky with respect to health reform. Their proposals recommit the Republican majorities to patient-centered health reform and show a path forward for the next president. However, they do not harvest some low-hanging fruit offered by President Obama. Failure to do so might doom patient-centered health reform to the forever future.

Galluping Away with the Uninsured

GallupGallup has released a teaser for its quarterly update of health-insurance coverage. Although the polling firm released only one datum (that the rate of uninsured fell to 12.3 percent in the first quarter from 12.9 percent in the fourth quarter of 2014) this was enough for President Obama to send forth a victory tweet.

Not so fast: As the press release itself notes, a large proportion of the newly “insured” are not actually insured, but on Medicaid. Medicaid is a welfare program. Consider the question: “Do you have health insurance coverage?” It is as if people receiving cash welfare payments answered the question, “Do you have a job?” in the affirmative.

More Reasons Why Doctors Do Not Participate in Medicaid

doctor-xray-2This blog has many entries discussing how few doctors participate in Medicaid, the joint state-federal healthcare program for low-income people that ObamaCare expands. One reason is that fees are too low to induce doctors to participate. But even if doctors are willing to accept low fees, they find that Medicaid is the worst payer in their practices:

  • Medicaid programs have the highest number of days to collect payment (days accounts receivable): All payer average = 26 days; Medicaid average = 44 days.
  • Medicaid programs have the highest denial rate: All Payer average = 6.8%; Medicaid average = 18.5%.
  • Medicaid programs have the lowest transparency in electronic explanation of payment and adjudication of claims (electronic remittance advice): All Payer average = 95%, Medicaid average = 89.4%.

Hits and Misses

Scale with tape measure bowThe post-2008 recession is associated with increasing obesity in rich nations.

The actual waiting time for an appointment at Phoenix VA hospital was 115 days – 91 days longer than falsely reported.

Samsung’s new watch has medical sensors that scan below the skin and read data deep inside veins.

Stanford University doctors are using iPhones to photograph the inside of the eye.

Federal grants to states for health care increased 34 percent, 2008-2014. Grants for everything else dropped.

No kidding! States that accepted ObamaCare’s Medicaid expansion face unanticipated health expenses.

Headlines I Wish I Hadn’t Seen

Window Sill with HandsThousands of 2-year old and 3-year old toddlers are medicated for ADHD.

If you lied about your earnings when you applied for ObamaCare, you can be fined $250,000.

If a family of four raises its income from $35,300 to $47,100, ObamaCare hikes its taxes 13 percent.

Zeke Emanuel thinks ObamaCare needs a Czar.

Medicaid fails preventive health: Patients arrive at hospital in worse shape, suffer more complications, and stay longer than privately insured.

Hits and Misses

Ambulance at Emergency EntranceEmergency department visits for traumatic brain injury increased 29.1 percent, 2006-2010.

“Buying health insurance across state lines”: The most popular Republican talking point is uncompetitive, unconstitutional, and unnecessary.

Early ObamaCare 2015 premium notices have double digit hikes.

Medicaid expansion creates poverty by punishing work.

Price transparency: Three major insurers to publish provider prices online in 2015.

Study: Surgeries take 25 percent less time in ambulatory surgery centers than hospitals.

Will ObamaCare Prove More Costly Than Medicare and Medicaid?

One consistent argument in favor of expanding government-run health care in the U.S. goes like this: “We’re the richest country in the developed world, so we should be able to provide universal health care like all the other developed countries.”

Well, we are a heck of a lot richer than we were in the 1930s or 1960s, when Social Security, Medicare, and Medicaid rolled out. Despite our significant increase in income, those three programs are bankrupting the nation. And ObamaCare wreaks more fiscal havoc at a significantly faster rate than any of those programs.

With two simple charts, Charles Blahous of the Mercatus Center shows how much more expensive ObamaCare will be than Social Security, Medicare, or Medicaid — just five years after Congress enacted them.

In one chart, Blahous illustrates that the federal deficit will be about 5.5 percent of GDP five years after ObamaCare’s enactment — versus only 3 percent five years after Social Security’s enactment and less than one percent five years after Medicare’s and Medicaid’s enactment.

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Source: Mercatus Center.

Headlines I Wish I Hadn’t Seen

Why thretirement-crackede disabled on Medicaid can’t afford to retire. Here’s how Chile solved that problem.

ObamaCare pushes doctors and hospitals to consolidate; then the FTC and the DOJ claim they’ve violated anti-trust law.

30 percent fewer “young invincibles” enrolled in ObamaCare than expected; administration gets two Pinocchios.

More than 1,100 IRS employees who owe back taxes received more than $1 million in bonuses and more than 10,000 hours in time-off awards.