"Republicans Finally Admit Why They Hate Obamacare"
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Red states feel pressure to expand Medicaid. "Pressure is building on states to go along with the expansion of Medicaid benefits under the Affordable Care Act as new studies and financial reports from health care companies point out stark differences between states treating more poor Americans and those that aren’t....A report last week from The Robert Wood Johnson Foundation-funded Urban Institute said states that haven’t expanded will 'miss out' on more than $420 billion in federal dollars between now and 2022. In addition, the states that don’t expand are losing out on increased employment in the health care industry from newly insured patients who have help paying for services." Bruce Japsen in Forbes.
Another argument against the Medicaid expansion just got weaker. "We learned late last week that the decision by 24 states to reject Obamacare's Medicaid expansion comes as a startling cost....So how are states justifying their decisions to leave that much federal money on the table? One of their main arguments is that the federal government will eventually renege on its generous funding commitment to the Medicaid expansion. But based on the 49-year history of the Medicaid program, that claim doesn't hold up, according to Urban Institute researchers in a finding that hasn't received as much attention." Jason Millman in The Washington Post.
Many still signing up for Medicaid anyway in non-expansion states. "The reason is a phenomenon that health experts like to call the 'welcome mat effect' or the 'woodwork effect.'...Many people who were always eligible for the program have finally decided to sign up. There was no policy change that gave them new access to insurance, but new online marketplaces and all the public conversation around new insurance options encouraged them to apply and get benefits they were always eligible for. There are quite a lot of uninsured people in the country who fall into this category. A 2012 study in the journal Health Affairs estimated that, in some states, fewer than half of all eligible people were enrolled in their state’s programs." Margot Sanger-Katz in The New York Times.
ICYMI: 7.2 million have signed up for Medicaid or CHIP since Oct. 1, when Obamacare open enrollment began. David Morgan in Reuters.
Waiting (and waiting) for Medicaid in Tennessee. "Five other states — Idaho, New Jersey, Pennsylvania, Texas, and Wisconsin — also decided to send applicants for public health insurance programs for low-income people to the new federal website. Tennessee is the only one that shut down its own system at the same time. As of Jan. 1, a state bulletin announced, residents...were directed to apply online....Tennessee’s approach seems to have been driven in part by antipathy to Obamacare on the part of the Republican-led state legislature....Civil rights lawyers say the state’s reliance onhealthcare.gov has been disastrous for thousands of people, especially pregnant women and newborns." John Tozzi in Bloomberg Businessweek.
How Obamacare is trying to find ways to deliver better health care. "While the focus of the federal law is to expand access to medical care, it also established the Patient-Centered Outcomes Research Institute to fund...studies...to evaluate the benefits and harms of different treatment options to better inform health care decisions....Before there was...PCORI, 'there was a disconnect between how health care research was being conducted and what patients actually needed,' said Dr. Jerry Krishnan, a researcher at the University of Illinois....The law also provides $10 billion in funding to the Center for Medicare and Medicaid Innovation through 2019 to conduct similar comparative effectiveness research." Judy Peres in the Chicago Tribune.
Center for Medicare and Medicaid Innovation has its skeptics. "The law created the Center for Medicare and Medicaid Innovation to launch experiments in every state, changing the way doctors and hospitals are paid, building networks between caregivers and training them to intervene before chronic illness worsens....Supporters say CMMI promises to eventually save taxpayers far more than that $10 billion....Policy experts have long recommended such research....But information is limited even for programs whose results have been announced.... It’s early, officials say....There’s also the political risk of revealing investments that aren’t working. HHS officials concede that some projects will fail, but, Conway said, even those will produce good information — on what doesn’t work." Jay Hancock in Kaiser Health News/The Washington Post.
Wide variation in ACA premium changes next year, but modest rise on average. "Data compiled by...PricewaterhouseCoopers found modest changes in premiums for 27 states and the District of Columbia, with the increases mostly falling short of dire predictions for ObamaCare’s second year. The average national increase of 7.5 percent is 'well below the double-digit increases many feared,' HRI Managing Director Ceci Connolly wrote in an email. The highest proposed rate increase so far came in Nevada, where consumers with Time Insurance Co. might see their insurance premiums rise by 36 percent. Some consumers in Arizona, on the other hand, could see rates drop by 23 percent." Elise Viebeck in The Hill.
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