Our Health Policy Matters

Health and mental health policy stories dominated 2012.  From how the Affordable Care Act framed the health policy debate at the start of the year to how the Sandy Hook tragedy framed the mental health and public health debate at year’s end, 2012 will go down in history as the most significant year in health policy since the 1960s. Here are summaries of a few of the biggest news stories. The Supreme Court Decision on the Affordable Care Act.   Nothing quite compares to the drama of the day in June when the Supreme Court ruled the Affordable Care Act to be constitutional .  Few people guessed right in advance that the decision would come down to finding the “individual mandate” to be constitutional because it is a tax, but mandatory Medicaid expansion unconstitutional because it tied future federal funding for the existing state Medicaid programs to the Medicaid expansion. People on both sides of the debate came away wanting more, and states reluctant to acce...

Health and mental health policy stories dominated 2012.  From how the Affordable Care Act framed the health policy debate at the start of the year to how the Sandy Hook tragedy framed the mental health and public health debate at year’s end, 2012 will go down in history as the most significant year in health policy since the 1960s. Here are summaries of a few of the biggest news stories. The Supreme Court Decision on the Affordable Care Act.   Nothing quite compares to the drama of the day in June when the Supreme Court ruled the Affordable Care Act to be constitutional .  Few people guessed right in advance that the decision would come down to finding the “individual mandate” to be constitutional because it is a tax, but mandatory Medicaid expansion unconstitutional because it tied future federal funding for the existing state Medicaid programs to the Medicaid expansion. People on both sides of the debate came away wanting more, and states reluctant to acce...

The entire world is in mourning over the senseless and horrifying massacre of innocent children and adults in Sandy Hook, Connecticut.  This hit so close to home for me, about forty miles from where I grew up.  So many of my former legislative colleagues are among those trying to help the state through it.  I can’t even pretend to imagine what this must be like for the families of Sandy Hook.  On the first day of the tragedy, too many politicians trotted out their tired old line that “today is not the day to have the debate” about gun control.  Thank God their tone-deaf voices were silenced by the outcry of reasonable people. Connecticut Congressman John Larson (D-1) said that “Congress should be prepared to vote on requiring background checks for all gun sales, closing the terrorist watch list loopholes, and banning assault weapons and high capacity clips. Those measures don’t solve all our problems, but they’re a start.” Senator J...

The entire world is in mourning over the senseless and horrifying massacre of innocent children and adults in Sandy Hook, Connecticut.  This hit so close to home for me, about forty miles from where I grew up.  So many of my former legislative colleagues are among those trying to help the state through it.  I can’t even pretend to imagine what this must be like for the families of Sandy Hook.  On the first day of the tragedy, too many politicians trotted out their tired old line that “today is not the day to have the debate” about gun control.  Thank God their tone-deaf voices were silenced by the outcry of reasonable people. Connecticut Congressman John Larson (D-1) said that “Congress should be prepared to vote on requiring background checks for all gun sales, closing the terrorist watch list loopholes, and banning assault weapons and high capacity clips. Those measures don’t solve all our problems, but they’re a start.” Senator J...

There’s a new disease this year along with the winter flu.  It is called Secession Fever.  Secession Fever has reached epidemic stage across the south.  As of Monday, there were more than 25,000 cases in each of eight southern states – North Carolina, South Carolina, Georgia, Florida, Alabama, Tennessee, Louisiana, and Texas.  A ninth, Arkansas, had over 23,500.  Collectively, these states had almost 402,000 cases, and the number was still growing. Secession Fever is a self-reportable disease.  People who have it signed a petition on the White House website .  Secession Fever is characterized by the irrational belief that the federal government does more harm than good, and that states would be better off if they seceded from the Union. So what if these nine states did secede and form a new Southern Confederacy?  Would their citizens be better off?  Some data from the Kaiser Family Foundation and the Central Intelligence Agen...

There’s a new disease this year along with the winter flu.  It is called Secession Fever.  Secession Fever has reached epidemic stage across the south.  As of Monday, there were more than 25,000 cases in each of eight southern states – North Carolina, South Carolina, Georgia, Florida, Alabama, Tennessee, Louisiana, and Texas.  A ninth, Arkansas, had over 23,500.  Collectively, these states had almost 402,000 cases, and the number was still growing. Secession Fever is a self-reportable disease.  People who have it signed a petition on the White House website .  Secession Fever is characterized by the irrational belief that the federal government does more harm than good, and that states would be better off if they seceded from the Union. So what if these nine states did secede and form a new Southern Confederacy?  Would their citizens be better off?  Some data from the Kaiser Family Foundation and the Central Intelligence Agen...

There’s a simple way to calculate just how much a state will save in the long term by expanding the Medicaid program under the Affordable Care Act.  Just multiply whatever it says it will cost by 9. That’s because the federal government will contribute at least $9 worth of match for every dollar a state spends on Medicaid expansion. By now, we’ve all heard just how big some of the match numbers will be.  Based just on the estimates provided by the state itself in its January 2012 Supreme Court brief , Florida, for example, would gain at least $3.2 billion annually. But Florida’s Governor has openly fought the expansion until recent weeks, and has yet to say whether or not he will support it in any form.  He’s not the only one.  A weekend article in the Washington Post reported that as many as thirteen states may be leaning against the expansion, versus 17 plus the District of Columbia that are pursuing it. According to the analysis on which t...

There’s a simple way to calculate just how much a state will save in the long term by expanding the Medicaid program under the Affordable Care Act.  Just multiply whatever it says it will cost by 9. That’s because the federal government will contribute at least $9 worth of match for every dollar a state spends on Medicaid expansion. By now, we’ve all heard just how big some of the match numbers will be.  Based just on the estimates provided by the state itself in its January 2012 Supreme Court brief , Florida, for example, would gain at least $3.2 billion annually. But Florida’s Governor has openly fought the expansion until recent weeks, and has yet to say whether or not he will support it in any form.  He’s not the only one.  A weekend article in the Washington Post reported that as many as thirteen states may be leaning against the expansion, versus 17 plus the District of Columbia that are pursuing it. According to the analysis on which t...

As the December 14 th and February 14 th dates draw near for states to say whether they will create Affordable Care Act health insurance exchanges and what they will look like, the world seems upside down. Traditional “states’ rights” advocates such as South Carolina, Georgia, Alabama, Louisiana, and Texas all say they will let the federal government set up their exchange.  Historically “strong federal government” allies like Connecticut, Massachusetts, California, New York, and the District of Columbia are setting up their own exchanges. In all, sixteen states so far have said they want the federal government to set up their exchange, while eighteen states and the District of Columbia have decided to run their own .  The rest are either undecided or looking to partner with the federal government.  No states are considering a multi-state exchange – so much for “selling insurance across state lines.” The states that are deferring to the federal government...

As the December 14 th and February 14 th dates draw near for states to say whether they will create Affordable Care Act health insurance exchanges and what they will look like, the world seems upside down. Traditional “states’ rights” advocates such as South Carolina, Georgia, Alabama, Louisiana, and Texas all say they will let the federal government set up their exchange.  Historically “strong federal government” allies like Connecticut, Massachusetts, California, New York, and the District of Columbia are setting up their own exchanges. In all, sixteen states so far have said they want the federal government to set up their exchange, while eighteen states and the District of Columbia have decided to run their own .  The rest are either undecided or looking to partner with the federal government.  No states are considering a multi-state exchange – so much for “selling insurance across state lines.” The states that are deferring to the federal government...

A person who was unhappy with the outcome of the election suggested that the voters gave President Obama a “Mulligan” on election day – a second chance to do things right.  That’s one way to look at it. But if you belief that, then you also have to say the same thing about the divided Congress – it, too, was being given at least one more chance to get things right. That means agreeing to the surprisingly little compromise on which the future of Medicare will depend. It’s hard to understand how two sides looking at the same reality and sharing the same goals could be so far apart in coming to an agreement about what to do.  Nowhere is this more evident than in the Medicare program debate. Both sides acknowledge that Medicare is as popular as any entitlement, is as well run as any health insurance program, and addresses a need that is only going to grow in the coming years. They also agree on certain facts.  The first is that Medicare hasn’t yet cont...

A person who was unhappy with the outcome of the election suggested that the voters gave President Obama a “Mulligan” on election day – a second chance to do things right.  That’s one way to look at it. But if you belief that, then you also have to say the same thing about the divided Congress – it, too, was being given at least one more chance to get things right. That means agreeing to the surprisingly little compromise on which the future of Medicare will depend. It’s hard to understand how two sides looking at the same reality and sharing the same goals could be so far apart in coming to an agreement about what to do.  Nowhere is this more evident than in the Medicare program debate. Both sides acknowledge that Medicare is as popular as any entitlement, is as well run as any health insurance program, and addresses a need that is only going to grow in the coming years. They also agree on certain facts.  The first is that Medicare hasn’t yet cont...

It took Super Storm Sandy to remind us how much we need our government. And how rarely we see government leaders truly cooperate. Cooperation has been a dirty word in politics for close to two decades.  But in responding to the crisis caused by Sandy, President Obama and Governor Christie showed us that political adversaries are at their best when they work together to meet our needs. It took an environmental holocaust for this to happen.  But as the pictures of destruction in state after state circulated throughout the media, no one talked about privatizing FEMA.  No one complained that the government was spending too many taxpayer dollars rescuing people from death.  It was a fine way for the President to end his first term in office – one that may ultimately have won him his re-election.  And also won him a new opportunity to collaborate with the states. In the storm’s aftermath, we understand that one of the prices of having the freedom t...