Our Health Policy Matters

As Congress works through the challenge of changing Obamacare, how the federal government pays its share of Medicaid dollars will be part of the debate. At first, Medicaid was designed primarily to offer to people with chronic conditions the long-term care benefits that Medicare did not. It pays much of our nation’s nursing home bill.  It was later expanded to provide safety net insurance to low income families, especially for women and children. Medicaid is a federal/state partnership program. The states design their own programs within federally-established rules, and the federal government reimburses half (or more) of the state’s cost. The Affordable Care Act added a new wrinkle to the cost-sharing formula.  For those states that expanded the Medicaid program to serve even more people, including uninsured single adults, it offered 90+ percent reimbursement for the new populations.  To date, 32 states have expanded. What’s wrong with Medicaid? Medicaid costs...

As Congress works through the challenge of changing Obamacare, how the federal government pays its share of Medicaid dollars will be part of the debate. At first, Medicaid was designed primarily to offer to people with chronic conditions the long-term care benefits that Medicare did not. It pays much of our nation’s nursing home bill.  It was later expanded to provide safety net insurance to low income families, especially for women and children. Medicaid is a federal/state partnership program. The states design their own programs within federally-established rules, and the federal government reimburses half (or more) of the state’s cost. The Affordable Care Act added a new wrinkle to the cost-sharing formula.  For those states that expanded the Medicaid program to serve even more people, including uninsured single adults, it offered 90+ percent reimbursement for the new populations.  To date, 32 states have expanded. What’s wrong with Medicaid? Medicaid costs...

I have never been the biggest fan of the Affordable Care Act.  I believe that since the government is already paying over 70% of our nation’s health care bill and we’re paying another 12% out of pocket, this colossal effort to preserve the small share financed by privately-funded private insurance without bankrupting the nation may not have been worth the effort.  Medicare-for-all would have been a much better approach. But now that an emerging group of at-risk Democratic senators have joined the Republican chorus to delay the individual mandate , I want to offer an opposing view to theirs.  Obamacare has been compromised enough. Since it was enacted in 2010, Obamacare has undergone the following significant changes: The minimum medical loss ratio requirements were delayed in several states. The long-term care insurance program has been repealed. The prevention fund has been raided. The reductions in payments to providers have been put off. The...

I have never been the biggest fan of the Affordable Care Act.  I believe that since the government is already paying over 70% of our nation’s health care bill and we’re paying another 12% out of pocket, this colossal effort to preserve the small share financed by privately-funded private insurance without bankrupting the nation may not have been worth the effort.  Medicare-for-all would have been a much better approach. But now that an emerging group of at-risk Democratic senators have joined the Republican chorus to delay the individual mandate , I want to offer an opposing view to theirs.  Obamacare has been compromised enough. Since it was enacted in 2010, Obamacare has undergone the following significant changes: The minimum medical loss ratio requirements were delayed in several states. The long-term care insurance program has been repealed. The prevention fund has been raided. The reductions in payments to providers have been put off. The...

The House of Representatives voted to repeal the Affordable Care Act for the 40 th time last week.  It did this before balancing the budget, passing a jobs bill, reforming election laws, or anything else that might actually improve its standing in the eyes of the general public. So what began for some members of Congress as principled opposition to federal “overreach” has turned into a political punch line: “How many more votes will it take for the House of Representatives to repeal Obamacare?  It doesn’t matter, because the House doesn’t count anyway.” The very first column I wrote after the mid-term election in 2010 was entitled “ Six Reasons Why Health Reform Won’t be Repealed .”  In it, I argued that there were at least five substantive reasons why the Affordable Care Act would not be repealed in spite of the Republican House takeover.  These included the popularity of the expanded Medicare benefits, the benefits to early retirees, the benefits to...

The House of Representatives voted to repeal the Affordable Care Act for the 40 th time last week.  It did this before balancing the budget, passing a jobs bill, reforming election laws, or anything else that might actually improve its standing in the eyes of the general public. So what began for some members of Congress as principled opposition to federal “overreach” has turned into a political punch line: “How many more votes will it take for the House of Representatives to repeal Obamacare?  It doesn’t matter, because the House doesn’t count anyway.” The very first column I wrote after the mid-term election in 2010 was entitled “ Six Reasons Why Health Reform Won’t be Repealed .”  In it, I argued that there were at least five substantive reasons why the Affordable Care Act would not be repealed in spite of the Republican House takeover.  These included the popularity of the expanded Medicare benefits, the benefits to early retirees, the benefits to...