Our Health Policy Matters

The reasons that 25 states chose not to participate in creating a new health exchange aren’t exactly the ones they’ve been claiming – that Obamacare is too complicated, too anti-consumer, or too politically unpopular.  The truth is that they have never done a very good job of protecting the health and well-being of their people – especially their children – and they were not ready to start now. Now that all fifty states have decided whether or not they will at least participate in running their own health insurance exchanges as allowed by the Affordable Care Act (you can see the updated information about what each state decided on my state rankings page ), a clear picture is emerging of what distinguished the states choosing to participate from those refusing to do so. On the whole, when compared to one another, the 25 states that have chosen to participate in running their exchanges (17 by themselves, 8 in partnership with the federal government)do a much better jo...

The reasons that 25 states chose not to participate in creating a new health exchange aren’t exactly the ones they’ve been claiming – that Obamacare is too complicated, too anti-consumer, or too politically unpopular.  The truth is that they have never done a very good job of protecting the health and well-being of their people – especially their children – and they were not ready to start now. Now that all fifty states have decided whether or not they will at least participate in running their own health insurance exchanges as allowed by the Affordable Care Act (you can see the updated information about what each state decided on my state rankings page ), a clear picture is emerging of what distinguished the states choosing to participate from those refusing to do so. On the whole, when compared to one another, the 25 states that have chosen to participate in running their exchanges (17 by themselves, 8 in partnership with the federal government)do a much better jo...

All over the country, governors are finally beginning to propose new mental health services funding in the aftermath of last year’s mass shootings in Aurora and Sandy Hook. Notes: OH funding is from existing OHT appropriation. CT funding is bond money, some of which may be used by non-MHSA providers. There will be a long road back to policy sanity.  We have to dig ourselves out of the mess caused by $4.6 billion in state mental health cuts over the last few years.  But these governors give us hope that the funding-cut nightmare over which many of them have presided may be finally coming to an end.  In recent weeks, both Republicans and Democrats have announced new community behavioral health funding initiatives, typically ranging between $5 million and $20 million.   But support for community mental health services is not universal.  In states with the worst track records in funding mental health services, their governors continue to be sa...

All over the country, governors are finally beginning to propose new mental health services funding in the aftermath of last year’s mass shootings in Aurora and Sandy Hook. Notes: OH funding is from existing OHT appropriation. CT funding is bond money, some of which may be used by non-MHSA providers. There will be a long road back to policy sanity.  We have to dig ourselves out of the mess caused by $4.6 billion in state mental health cuts over the last few years.  But these governors give us hope that the funding-cut nightmare over which many of them have presided may be finally coming to an end.  In recent weeks, both Republicans and Democrats have announced new community behavioral health funding initiatives, typically ranging between $5 million and $20 million.   But support for community mental health services is not universal.  In states with the worst track records in funding mental health services, their governors continue to be sa...

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...

We have made some big mental health policy mistakes in my lifetime.  And my son Tim is among the millions of our sons and daughters who have paid for them. This is because he happens to be among the 6% of sons and daughters with serious mental illness. We fail to see mental illnesses as often preventable and always treatable diseases.  And although half of us will be diagnosed with one during our lifetime and mental illnesses cost as much to treat as cancers, we more readily send people with mental illness to jails and prisons than we do to hospitals and health centers.  Meanwhile, we underfund mental health care, special education, and social services systems. I explain what this has meant for my son in an essay just published by Health Affairs , the nation’s leading health policy journal.  How I Helped Create a Flawed Mental Health System That’s Failed Millions – And My Son covers over twenty years of Tim’s life in Connecticut, Texas, and Calif...

We have made some big mental health policy mistakes in my lifetime.  And my son Tim is among the millions of our sons and daughters who have paid for them. This is because he happens to be among the 6% of sons and daughters with serious mental illness. We fail to see mental illnesses as often preventable and always treatable diseases.  And although half of us will be diagnosed with one during our lifetime and mental illnesses cost as much to treat as cancers, we more readily send people with mental illness to jails and prisons than we do to hospitals and health centers.  Meanwhile, we underfund mental health care, special education, and social services systems. I explain what this has meant for my son in an essay just published by Health Affairs , the nation’s leading health policy journal.  How I Helped Create a Flawed Mental Health System That’s Failed Millions – And My Son covers over twenty years of Tim’s life in Connecticut, Texas, and Calif...

President Reagan gave his first speech on the AIDS epidemic almost twenty-five years ago on May 31, 1987.  This was after 36,058 Americans had been diagnosed with AIDS, 20,849 had died, and over a quarter of a million had been infected with HIV. For years, he had been criticized for ignoring and underfunding the worst public health crisis of the late 20 th century.   So he began his speech with a joke: “A charity committee approaches the wealthiest man in town for a contribution.  ‘Our book shows that you haven’t contributed any money this year,’ they tell him.  ‘Does your book also show that I have an infirm mother and a disabled brother?’ he replies.  ‘Why no,’ they say, ‘we didn’t know that.’ ‘Well, I don’t give them any money.  Why should I give any to you?’” The bad joke was an inadvertent punctuation mark on a presidency too fondly remembered by both republicans and democrats today. On matters of health, Reagan took us ...