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The Hidden Cost of Inadequate Health Coverage

The fuss over ObamaCare produces confusion and obscures some important realities that deserve our attention. Much of the political debate creates a polarizing force like a centrifuge, splitting the pros and the cons into opposing camps that line up behind positional opinions about whether healthcare is a right or not. For those opposed to the taxpayer shouldering the financial burden of providing healthcare to those without insurance coverage, the less the taxpayers must fork out to subsidize the uninsured the better. All the while, there is an implied assumption on the part of the entitlement crowd that just providing insurance coverage for the uninsured is the end game. In my opinion, we are all laboring under serious misunderstandings of the reality of the healthcare system and the way the costs are absorbed by society. I was looking for some solid research about the cost of the uninsured, and I came across a powerful and highly useful study from way back in 2003 when the early debate about universal coverage was just beginning. The approach they took to analyzing the problem still has significant value today, and what it says helps shed light on the misunderstandings referenced above. In a preface to the third chapter of the book Hidden Cost, Value Lost*, there is this revealing assertion from their research: The health care services received by uninsured individuals that they do not pay for themselves are picked up or “absorbed” by a number of parties, including:... Read More

 

LA Care CEO Statement on the Graham-Cassidy Health Care Bill

L.A. Care is strongly opposed to the Graham-Cassidy health care bill, which is worse for L.A. Care members – and all of California – than the Repeal and Replace bill passed by the House in May and the bill that was defeated in the Senate in August. What is it?* The Graham-Cassidy bill is a last ditch effort by several Republican Senators that lumps Medicaid and the subsidies for the Exchange into block grants in 2020, leaving it to the states to decide how to allocate funding between Medicaid and the Exchange. It moves the funding formula for the block grants to a method that penalizes the states that expanded Medicaid, like California. Due to these changes, the Medicaid expansion population would be essentially eliminated by 2027. It also eliminates the mandate for individuals to have health insurance – a move that could destabilize the Exchange. This bill will fundamentally alter the federal/state partnership that has been in place since Medicaid’s inception since 1965. These changes will not only impact those who gained coverage through Medicaid expansion under the Affordable Care Act (ACA), but also for mothers, children, developmentally disabled and elderly in nursing homes – all who have limited incomes. According to a recent Avelere study, California would be the hardest hit under this proposal, with a reduction in federal funding between $50 billion to $78 billion by 2027.... Read More

 

Where to Now? True North Again

By Kevin Mowll, Executive Director of the RISE Association The failure of the Republicans to repeal, replace, or wreck ObamaCare is a wakeup call for everyone, not just Republicans. While the RISE Association steers away from purely political commentary, the lesson of this protracted political mess needs to be called out for the sake of putting our priorities straight around public policy regarding healthcare reform. In the attached Wall Street Journal article, which suggests that bipartisan solutions are the only remaining way forward, the author proffers hope that the blistering truth will be obvious to all the participants in the 7-year-long fracas around repeal and replace. The bloodied players may still brood in frustration that their political wills were not enough to win, but the author wonders if cooler heads will prevail. I, for one, am not so sanguine; yet I can only hope. https://www.wsj.com/articles/republicans-search-for-answers-can-they-find-any-across-the-aisle-1501259286 The lesson I take away from the many years of wrangling is that the ObamaCare political football games demonstrates that political wills are not the way forward. They lose sight of the True North issue at hand. Rather, the failures of both political parties in arriving at a bipartisan solution signals the fact that what is good for America is good healthcare policy, not political prowess over rivals. Governing from the fringe is not sustainable in a democracy. ... Read More

 

It’s not Obamacare anymore. It’s our national health-care system.

By Drew Altman and Larry Levitt July 29 Drew Altman is president and chief executive of the Henry J. Kaiser Family Foundation. Larry Levitt is senior vice president of the Kaiser Foundation. Republicans failed to repeal and replace the Affordable Care Act early Friday because of divisions within their own ranks, and because they tried not only to repeal and replace the ACA but also to cut and cap the Medicaid program, generating opposition from many red-state governors and their senators. But most of all, they failed because they built their various plans on the false claim — busted by the Congressional Budget Office — that they could maintain the same coverage levels as the ACA and lower premiums and deductibles, while at the same time slashing about a trillion dollars from Medicaid and ACA subsidies and softening the ACA’s consumer protection regulations. Had they succeeded, they would have won a big short-term victory with their base, which strongly supports repeal, but suffered the consequences in subsequent elections as the same voters lost coverage or were hit with higher premiums and deductibles. ... Read More

 

Getting It Right: True North in Healthcare Reform

The movement to repeal and replace "ObamaCare" created so much political noise that clear thinking has been hard to come by. The 2010 legislation that created the marketplace for individuals and small business (the Affordable Care Act or ACA), has almost evolved into a political Rorschach test. The more that politicized options and alternatives to repealing, replacing, or repairing it were discussed, the harder it was to put into focus the original problems the legislation was designed to address. Nevertheless, the rancorous divisions over what needs to happen to fix problems in the individual insurance market remain a distraction from the real issue at hand: the cost of healthcare weighing down the economy and what we need to do to fix it. With all the intense debates swirling around this topic, an impression emerges that “solving the ObamaCare issues” is something that must be accomplished as an isolated matter, discrete and independent of other problems. The heated debates concentrate on the mechanics and tactics required to solve the "uninsured problem", the "under-insured problem", and for some, the federal budget problems created by the subsidies for low-income enrollees in these plans. This single-issue mono-vision obscures a reality that must be addressed. This perspective completely misses the fact that something is going on that is far more corrosive to the wellbeing of all of us as consumers of health care, as taxpayers, and as a nation: something that overshadows the tug ‘o war over ObamaCare. The critical and overlooked issue is that health care expenditures in the U.S are at least twice as expensive as other nations, which consume so much of the national economy... Read More

 

Repealing Obamacare Isn't Top Priority for Americans

House Republicans plan to hold a vote today on the Trump administration's plan to repeal and replace Obamacare (ACA). Having apparently won the support of more senators, House Majority Leader Kevin McCarthy was confident they now had the 216 yes votes required to pass the bill, saying: "Do we have the votes? Yes. Will we pass it? Yes.” Although a win for the Republicans here would be seen a great triumph for President Trump - delivering on one of his campaign's main promises - recent figures from the Kaiser Family Foundation suggest that for the American public, repealing the ACA isn't actually such a high priority. When asked how they would rate a number of health care issues in terms of importance, the most pressing matter for respondents was revealed to be 'lowering the amount individuals pay'. As the infographic below shows, in comparison to the 63 percent of respondents in support of putting lower personal costs at the top of Trump's health care agenda, repealing Obamacare is seen as being far less important, with a total of 32 percent. This chart shows the health care issues the U.S. public think President Trump should prioritise.... Read More

 

ACA Marketplace Update

Filing extension may not be enough to keep insurers in individual market By Virgil Dickson | February 21, 2017 Modern Healthcare Article Health insurers are pleased the Trump administration wants to give them seven extra weeks to file rates for individual-market plans in 2018. But that move does little to settle their uncertainty about whether to offer plans at all. Their anxiety has been heightened by the Republican drive to repeal and replace the Affordable Care Act and by a pending House Republican lawsuit to block certain payments to insurers. Carriers say they need to know the rules of any new system before they can design plans and set rates.... Read More

 

What Do Voters for Trump and Who Have ACA Coverage Want?

Take a listen to this 5 minute video from a Kaiser Foundation focus group made up of people with ACA coverage who voted for Trump. It will sound awfully familiar to those providing qualified health plans in the marketplace, no matter which member voted for any particular candidate.... Read More

 

ObamaCare: How Will We Repeal and Replace It?

RISE presented a four-person expert panel that delivered a powerful, jam-packed 90-minute program on this hot topic. If you missed this one and have an interest in better understanding what is likely to happen, what is doable and what isn’t, then you should list to the recording of our webinar below. Lisa DiSalvo began with a thorough and compelling outline of proposals on policy currently under consideration, competing for favor in the jockeying process now underway in the new administration in Washington, D.C. Following her presentation was Richard Lieberman analyzing the political context and outlook for solving the challenge posed by the incoming administration that wishes to achieve many of the same goals as ObamaCare while spinning their own preferences into the recipe. ... Read More

 

Kaiser Health Tracking Poll: November 2016

Health Care in the 2016 Election Many factors were important to voters’ choices in the 2016 presidential election, with over two-thirds of voters stating that the direction the country is headed (82 percent), jobs and economy (75 percent), and health care (68 percent) were a “major factor” in their vote. Majorities also cite foreign policy (63 percent), terrorism (61 percent), immigration (58 percent), and candidates’ personal characteristics (56 percent for Clinton’s and 54 percent for Trump’s) as “major factors.” When voters are asked to select the “biggest factor” in their vote for president, the direction of the country (31 percent), Donald Trump’s personal characteristics (15 percent), jobs and the economy (15 percent), and Hillary Clinton’s personal characteristics (12 percent) rank above health care (8 percent).... Read More

 

Repeal the ACA? Not So Easy to Do

Here is an interactive article posted by the New York Times on December 3, 2016. It does a nice job of succintly telling the story with visual, interactive cards. It begins... Republicans plan to repeal much of the Affordable Care Act, sometimes referred to as Obamacare. But the law’s parts are interdependent, and removing some aspects while keeping others will be very difficult.... Read More

 

Former Head of CMS Berwick Says, 'Things Will Never Go Back'

Medscape Multispeciality Interview: Don Berwick, MD, a pediatrician by training, has been at the very center of US healthcare policymaking for many years. He served as president and CEO of the Institute for Healthcare Improvement (IHI) before heading the Centers for Medicare & Medicaid Services (CMS). Then he entered politics, running for governor of Massachusetts in 2014. In this Medscape interview, Dr Berwick discusses these roles and his take on a variety of pressing issues in healthcare. Medscape: What do you think you accomplished as CMS administrator?... Read More

 

What's Up with Healthcare?

Maybe healthcare is confusing and, for some, a mystery that befuddles. Sometimes it is hard to gain perspective. Yet in certain ways, these five reasons for optimism are ones that help to make it clearer and even worthwhile. Be sure to check Rosemarie's blogs from time to time. She is a frequent speaker at our HEA conferences and an expert on Health Insurance Exchanges. ... Read More

 

Open Enrollment: Election Results and What Really Matters

With the election results just one week old and the next open enrollment for health insurance exchanges only three days away, I took a look at whether these types of events have affected each other... Read More

 

The HIX Marketplace Soon Opens for Business Version 2.0

Rosemarie Day comments on what to expect as we get to the second open enrollment season for the Health Insurance Exchanges Marketplace. The expectations are that this season will be different from last year in significant ways,... Read More

 

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The Hidden Cost of Inadequate Health Coverage

The fuss over ObamaCare produces confusion and obscures some important realities that deserve our attention. Much of the political debate creates a polarizing force like a centrifuge, splitting the pros and the cons into opposing camps that line up behind positional opinions about whether healthcare is a right or not. For those opposed to the taxpayer shouldering the financial burden of providing healthcare to those without insurance coverage, the less the taxpayers must fork out to subsidize the uninsured the better. All the while, there is an implied assumption on the part of the entitlement crowd that just providing insurance coverage for the uninsured is the end game. In my opinion, we are all laboring under serious misunderstandings of the reality of the healthcare system and the way the costs are absorbed by society. I was looking for some solid research about the cost of the uninsured, and I came across a powerful and highly useful study from way back in 2003 when the early debate about universal coverage was just beginning. The approach they took to analyzing the problem still has significant value today, and what it says helps shed light on the misunderstandings referenced above. In a preface to the third chapter of the book Hidden Cost, Value Lost*, there is this revealing assertion from their research: The health care services received by uninsured individuals that they do not pay for themselves are picked up or “absorbed” by a number of parties, including:...
Read More

LA Care CEO Statement on the Graham-Cassidy Health Care Bill

L.A. Care is strongly opposed to the Graham-Cassidy health care bill, which is worse for L.A. Care members – and all of California – than the Repeal and Replace bill passed by the House in May and the bill that was defeated in the Senate in August. What is it?* The Graham-Cassidy bill is a last ditch effort by several Republican Senators that lumps Medicaid and the subsidies for the Exchange into block grants in 2020, leaving it to the states to decide how to allocate funding between Medicaid and the Exchange. It moves the funding formula for the block grants to a method that penalizes the states that expanded Medicaid, like California. Due to these changes, the Medicaid expansion population would be essentially eliminated by 2027. It also eliminates the mandate for individuals to have health insurance – a move that could destabilize the Exchange. This bill will fundamentally alter the federal/state partnership that has been in place since Medicaid’s inception since 1965. These changes will not only impact those who gained coverage through Medicaid expansion under the Affordable Care Act (ACA), but also for mothers, children, developmentally disabled and elderly in nursing homes – all who have limited incomes. According to a recent Avelere study, California would be the hardest hit under this proposal, with a reduction in federal funding between $50 billion to $78 billion by 2027....
Read More

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