Category: Medicaid

Republican Medicaid Reform Would Save $110 Billion to $150 Billion in 5 Years

Arguably more important than repealing and replacing Obamacare, a longstanding Republican proposal to change how Congress finances Medicaid would reduce the burden on taxpayers by $110 billion to $150 billion over five years, according to a new analysis by consultants at Avalere.

Currently, state spending on Medicaid is out of control because Medicaid’s traditional funding formula incentivizes the political class to overspend. For every dollar a state politician spends on Medicaid, the federal government pitches in at least one dollar via the Federal Medical Assistance Percentage (FMAP). This actually rewards states for making more residents dependent on Medicaid.

Feb 08, 2017 | 8 comments | by John R. Graham

Medicaid Expansion Also Expands ER Use

A new report in the New England Journal of Medicine found that Medicaid expansion in Oregon actually increased use of the emergency room (ER) by people newly covered by Medicaid. Policy experts had expected ER use to fall as people gained coverage and could have a usual source of care, such as a primary care physician. Within the first 15 months after gaining coverage, ER use spiked by about 40%, and remained high for subsequent years. It did not appear the people using the emergency room were necessarily substituting ER visits for primary care physicians (PCP) visits. Rather, PCP visits and ER visits appeared to be complementary.

Mercatus senior research fellow Brian Blase covers the implications in much more detail at Forbes. Blase points out that the value of Medicaid benefits is less than the cost, enrollees are misusing their benefits (ER visits when primary care would suffice). ER overuse makes it harder for those truly in need of emergency care to be seen in a timely manner. It is also arguably why the cost of Medicaid expansion is far above initial projections.

Oct 21, 2016 | 6 comments | by Devon Herrick

Arkansas’ “Private” Medicaid Expansion Improved Access to Care (At A Very High Price)

Arkansas has a love-hate relationship with Obamacare. The previous (Democratic) governor, Mike Beebe, made a deal to accept Obamacare’s Medicaid expansion but with an interesting twist. Obamacare significantly increased the number of Americans who could become dependent on Medicaid by increasing the income cut-off for eligibility. Many governors rejected the federal funds offered to expand this welfare dependency.

Governor Beebe took the money, but instead of using it to expand Medicaid for the newly eligible, he used it to subsidize beneficiaries’ purchase of private plans in Obamacare’s health insurance exchange. His successor, Republican Asa Hutchinson, and the Republican-majority legislature, decided to continue the program.

According to new research published by the University of Pennsylvania, this “private option” yielded dramatically improved access to care. In a “secret shopper” survey, callers identifying themselves as dependents on traditional Medicaid were able to make appointments with primary-care physicians in 55.5 percent of attempts. Medicaid dependents enrolled in exchange plans got appointments 83.2 percent of the time.

Aug 08, 2016 | 36 comments | by John R. Graham

Taxpayer Subsidized Coverage Rising

According to a new report by the Congressional Budget office health coverage paid for by U.S. taxpayers is expect to rise over the next 10 years.

Families with employer coverage are expected to decline by 2% from 2016 through 2026. Unsubsidized individual medical coverage is not expected to change. Traditional Medicaid and SCHIP — those eligible for Medicaid prior to the Affordable Care Act (ACA) — is expected to decline slightly, while the uninsured is expected to increase slightly. All told, traditional Medicaid will fall by 1 million people while the uninsured will rise by 1 million people. The disabled with Medicare coverage is also not expected to change.

Where all the growth in health coverage will occur is subsidized plans. Individuals with subsidized coverage through the federal and state exchanges are expected to increase by 40%, while those newly eligible for Medicaid due to the ACA will increase by 36%.

Mar 30, 2016 | 11 comments | by Devon Herrick

Increasing Medicaid Dependency Does Not Reduce “Uncompensated” Care

Robert Laszewski is a leading health insurance expert whom I often cite favorably. However, in a recent article praising Ohio governor John Kasich he has made an unforced error. Governor Kasich is one of only three Republican governors who took federal Obamacare money to expand Medicaid dependency. According to Mr. Laszewski:

On Medicaid, the Kasich administration helped 650,000 people whose uncovered health-care costs were being shifted onto and burdening employers and individuals struggling to pay their already-high health insurance costs. The administration enrolled them into a new Ohio Medicaid system that made 38 different reforms over five years. In 2015 alone, it saved Ohio taxpayers $1.9 billion compared with the original state-budget target. It held the program’s per capita cost growth below 3 percent while cutting the state’s uninsured rate in half.

The idea that people who cannot pay their hospitals bills are the major problem in driving American health costs is evidence-free. According to a September 2014 report promoting Obamacare’s benefits, Obamacare’s reduced so-called “uncompensated care” by $5.7 billion in 2014. Health spending in 2014 was $3 trillion, so $5.7 billion is less than one fifth of one percent of national health spending!

Feb 18, 2016 | 3 comments | by John R. Graham

Gov. Kasich: Tax Cutting Medicaid Expander?

Ohio Governor Kasich likes to portray himself as a Budget Hawk. Yet, Ohio’s state budget increased by nearly one-third since Kasich took office (just over $50 billion to nearly $70 billion)! Kasich’s assertion that he is a fiscal conservative only works if you ignore boosting Medicaid, which will soon account for more than half of Ohio’s general budget. By contrast, spending on education is about half that amount. Medicaid spending will increase by nearly $5 billion from 2015 to 2017 alone.

Kasich is proud of his record cutting income taxes. While some taxes fell under Kasich, others rose. However, the tax burden on Ohio will likely climb as the feds begin to ratchet down Medicaid matching funds in 2017. As the graph below illustrates, expanding Medicaid under the assumption that the federal government will continue to pay much of the bill is a dangerous game for Ohio taxpayers.

OhioBudget

Nov 10, 2015 | 1 comment | by Devon Herrick

Improper Payments Up 18 Percent, Mostly Medicare & Medicaid

The Government Accountability Office (GAO) has just reported that “improper payments” (that is fraud and abuse) are up to $124. 7 billion in 2014 from $105.8 billion in 2013. Most of this is Medicare and Medicaid:

The almost $19 billion increase was primarily due to the Medicare, Medicaid, and Earned Income Tax Credit programs, which account for over 75 percent of the government-wide improper payment estimate. Federal spending in Medicare and Medicaid is expected to significantly increase, so it is critical that actions are taken to reduce improper payments in these programs.

Oct 06, 2015 | 2 comments | by John R. Graham

42 Percent of Immigrant Households Used Medicaid in 2012, Vs. 23 Percent of Native-Born

The Center for Immigration Studies’ latest report concludes that 42 percent of immigrant households, both legal and illegal, used Medicaid in 2012. Only 23 percent of households headed by a native-born American used Medicaid.

Sep 02, 2015 | 1 comment | by John R. Graham

Only 20 – 40 Cents of Each Medicaid Dollar Benefits Recipients

(A version of this column was published by Inside Sources on July 29, 2015, and syndicated to other media.)

Medicaid is the largest means-tested welfare program in the United States. Jointly funded by state and federal governments, its spending grows relentlessly whether the economy is adding or shedding jobs. Its ostensible purpose is to ensure access to medical care for households without enough income to pay for it. Yet new research suggests that only 20-40 cents of each Medicaid dollar improves recipients’ welfare. On the other hand, 90 cents of every dollar spent on the Earned Income Tax Credit (EITC) does so.

Jul 30, 2015 | 10 comments | by John R. Graham

Medicaid’s Poverty Trap Illustrated

The tragic story of a disabled woman trapped in poverty by the hodge-podge of ways the U.S. finances health care illustrates why we need to sweep the whole thing away and give everyone a universal, refundable tax credit:

Jul 28, 2015 | 11 comments | by John R. Graham

Category: Medicaid

Republican Medicaid Reform Would Save $110 Billion to $150 Billion in 5 Years

Medicaid Expansion Also Expands ER Use

Arkansas’ “Private” Medicaid Expansion Improved Access to Care (At A Very High Price)

Taxpayer Subsidized Coverage Rising

Increasing Medicaid Dependency Does Not Reduce “Uncompensated” Care

Gov. Kasich: Tax Cutting Medicaid Expander?

Improper Payments Up 18 Percent, Mostly Medicare & Medicaid

42 Percent of Immigrant Households Used Medicaid in 2012, Vs. 23 Percent of Native-Born

Only 20 – 40 Cents of Each Medicaid Dollar Benefits Recipients

Medicaid’s Poverty Trap Illustrated

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Category: Medicaid

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