For you wonks out there, Kaiser Health News has a fascinating Friday afternoon read for you.
In a piece titled “Bloggers See Own Reflections in Oregon Medicaid Study,” reporter Jordan Rau describes how this week’s news about Oregon’s Medicaid Experiment quickly became “a Rorschach test for how partisans and health policy wonks view the health care law.”
With no money for better food, no money for good shoes to go on walks, no rain gear, no walkman for listening to music as a distraction while walking, change is harder.
To quickly recap, in a New England Journal of Medicine study researchers analyzed how 10,000 people who won Medicaid coverage have fared since they gained insurance. The highlights were: no apparent affect on physical health; rates of depression 30 percent lower than those without coverage; catastrophic out-of-pocket medical expenses essentially eliminated.
In his piece, Rau publishes excerpts from seven blogs, each with a different take on the study’s highly nuanced results. But he closes with something I hadn’t seen elsewhere: a view of the experiment by someone who says he was one of the winners of the Medicaid coverage. Rau found the post on the blog Robert’s Stochastic thoughts.
Here’s the post in its entirety:
I am one of the winners in the Oregon lottery [winners could get Medicaid]. Going from no insurance to insurance is very confusing. When you have no money every health question starts with “would I rather live with this problem and have electricity, or treat this problem and keep my milk in a cooler for a month or so?” Stepping back into healthcare was like Continue reading
HHS Secretary Kathleen Sebelius, shown here speaking at a conference in Washington last week. (Chip Somodevilla/Getty Images)
The Obama Administration handed down a key rule Monday on its health care overhaul having to do with Medicaid, or Medi-Cal in California. States must expand to the federally mandated 138 percent of poverty in order to receive matching funds for those newly eligible for the program.
Because the Supreme Court ruling in June had struck down the requirement that states participate or lose existing match funds, some states thought there might be flexibility in the expansion. But the answer to that question is a clear “no” as Secretary of Health and Human Services Kathleen Sebelius explained in a letter to governors.
In a briefing last week, California’s Health and Human Services Secretary Diana Dooley indicated she was waiting for guidance from the feds about the Medicaid expansion and might not expand to the full 138 percent limit.
In an email, a spokesperson for the state’s department of health and human services said staff is currently evaluating the new information and declined to comment further at this time.
Consumer advocates said it was good to have the matter settled. “We thought that it was the case,” Anthony Wright, Executive Director of Health Access told me in a phone call, “but it’s good for the federal government to provide clarity and hopefully this allows the states to move forward with all deliberate speed.”
It’s expected that more than four million Californians will be newly eligible for Medi-Cal. Under the Affordable Care Act, the federal government will pay 100 percent of the cost of those new eligibles from 2014 to 2017. After that, the match will phase down to 90 percent by 2020.
By Mary Agnes Carey, Kaiser Health News
(Graphic: Kaiser Health News)
The so-called “fiscal cliff” is a package of automatic spending cuts and tax hikes set to kick in next month unless President Obama and Capitol Hill agree on a way to stop them.
Negotiations to avert the cuts are ongoing and both sides have exchanged offers. On one side, the president and congressional Democrats have said they will reduce spending on entitlements, including Medicare, if Republicans will agree to increase tax rates on the highest earners.
And on the other side, Republicans have agreed to more revenue — but by closing loopholes and eliminating some deductions. They oppose raising tax rates.
Here are answers to six questions about what could happen in health care before the end-of-year deadline.
Q: If no deal is struck, how would that affect Medicare patients as well as the hospitals and physicians and other providers who care for them? Continue reading
By Sarah Varney, Kaiser Health News
President Obama's health care overhaul largely survived court challenges. The presidential election poses another hurdle. (Mark Wilson: Getty)
If Caroline Cunningham wakes up in her Studio City home on Wednesday morning to a President-elect Mitt Romney, she knows the first thing she will do. “I have to rush and get back surgery,” she says.
Cunningham, a 62-year-old mental health therapist with spinal stenosis, has health insurance coverage through a temporary program established for people with pre-existing conditions under the Affordable Care Act. The pre-existing condition insurance plans, mandated in every state and subsidized by the federal government, offer coverage to those deemed uninsurable.
But the high risk pools, as they are known, have an expiration date. They are slated to shut down in January 2014 when, under the federal health law, people with pre-existing conditions can buy plans from private insurers through newly created insurance exchanges.
If Romney follows through with his pledge to dismantle President Barack Obama’s signature domestic legislation and Congress is unable to quickly enact a meaningful alternative, Cunningham worries she will, once again, be uninsured. “I called the Romney campaign and asked them what they’re going to do,” said Cunningham. “I hope they wouldn’t dump us.”
More than any other state, California has wagered heavily on the Affordable Care Act. It has moved quickly to erect an insurance exchange and establish the high risk pool. It has also put federal consumer protections into state law. Continue reading
By Julie Rovner, Kaiser Health News
Whatever the outcome on November 6th, officials in Washington will still have to deal with a looming “fiscal cliff” before the end of the year.
What’s coming is a perfect storm of expiring tax cuts, scheduled budget cuts, and various other spending changes scheduled to take place Jan. 1 unless Congress and President Obama (who, no matter what, will still be president until next Jan. 20) agree on a way to avert them.
As two of the largest spending items in the federal budget, the Medicare and Medicaid health programs are expected to play a role in how the deal gets done. Under the provisions of the law that created the budget deal Congress will attempt to undo, Medicare is subject to a two percent cut in provider payments, while Medicaid is exempt.
But two new studies and a proposed class action lawsuit settlement suggest a lot of dollar signs could change as lawmakers start to think about how to address the impending mess. Continue reading
By Sarah Varney, Kaiser Health News
It turns out Republicans and Democrats do have something they can agree on this election season – they’re worried about how to pay for long-term care when they or a family member can no longer live at home.
A new poll released Wednesday by The SCAN Foundation and the UCLA Center for Health Policy Research found that half of California voters say they’ll need long-term care for a close family member in the next few years, but won’t be able to afford it.
Anxiety over the cost of long-term care, like the price tag of a nursing home stay, is going up. The percentage of California voters who said they couldn’t afford more than three months of nursing home care increased to 73 percent from 66 percent in 2011, and 46 percent said they didn’t have the money to cover a single month in a nursing home, about $6,800 in California. For Latinos, the prospect of paying for long-term care is even more grim: nine in 10 Latino voters said they couldn’t afford more than three months of nursing home care and 86 percent couldn’t afford more than three months of part-time care at home. Continue reading
By Phil Galewitz, Kaiser Health News
Medi-Cal patients in California stand to lose a lot if Medicaid shrinks. (David McNew/Getty)
The future of the nation’s largest health insurance program — Medicaid — hangs in the balance of the Supreme Court’s decision on the 2010 health law.
The state-federal program which covers 60 million poor and disabled people would be greatly expanded under the health law, adding 17 million more people starting in 2014.
But if the entire law is struck down, states for the first time since 2009 would be free to tighten eligibility and make it more difficult for people to apply. The law had barred such changes.
And under another scenario — if the justices declare unconstitutional just the law’s expansion of Medicaid — the entire program enacted in 1965 as part of President Lyndon B. Johnson’s Great Society agenda could be threatened, health experts say. Twenty-six states had challenged the expansion, arguing it was “unduly coercive” because they would lose all of their federal Medicaid funding if they refused to expand the program. Continue reading