Campaign for Better Health Care

Support the fight for Health Care Justice! Support CBHC!   The Herndon Alliance compiles a daily collection of news clips relating to health reform. They allow us to pass these along to you, keeping you up to date on the latest developments in the fight for health care justice.

 

 

May 26th, 2013

Some Very BIG / GOOD News for Obamacare

o   IF YOU READ NOTHING ELSE – READ THIS:  If this health plan is ‘socialism,’ we need more of itLos Angeles Times by David Lazarus

o   Some v ery good news for Obamacare Washington Post by Ezra Klein and Evan Soltas

o   California Will Be Spared the Obamacare Apocalypse No sticker shock here—just affordable insurance premiums The New Republic by JONATHAN COHN

o   Health reform plans, pricing released in Calif. Associated Press by Judy Lin

o   California Obamacare premiums: No ‘rate shock’ here Washington Post by Sarah Kliff

o   ObamaCare plans cheaper than expected in key rate filing The Hill by Sam Baker

o   California’s Health Insurance Exchange Sets Plans, Premiums; No ‘Rate Shock’ KQED by Lisa Aliferis

o   California Insurance Exchange Rates: Not Too High, Not Too Low Kaiser Health News by Sarah Varney

 

Give me your tired, your poor, Your huddled masses, yearning to breath free, The wretched refuse of your teeming shore,  Send these, the homeless, tempest tost to me, I lift my lamp beside the golden door: BUT YOU CAN’T GO TO A DOCTOR.

o   Immigrant healthcare bills stump House group Los Angeles Times by Lisa Mascaro -

o   Pelosi vows there will be no ObamaCare for illegal immigrants The Hill by Mike Lillis and Russell Berman

 

Contraception:

o   Implementing Health Reform: Contraception Coverage And The Liberty University Case Health Affairs by Timothy Jost

 

ObamaCare / Healthcare News:

o   Dems, W.H. talk small business ACA worries Politico Pro ($) by Paige Winfield Cunningham

o   Bachmann’s Absurd Claim Of A Vast IRS Health Database Of ‘Sensitive, Intimate’ Information Washington Post by Glenn Kessler

o   Obamacare a strong first step to improving health of San Diegans San Diego Union-Transcript by Richard S. Ledford, Gregory E. Knoll & Irma Cota

o   The fog of Obamacare Washington Post by Robert J. Samuelson

 

Medicaid:  “Weigh the Evidence and Do the Math”:

o   Report Shows Medicaid Expansion a Boon for Mississippi Economy, Small Businesses Small Business Majority

o   (ME) MEDICAID EXPANSION GETS INSTANT VETO IN MAINE - PULSE

o   UTAH: ALL MEDICAID OPTIONS INCREASE COST PULSE

o   (OK) St. John plans layoffs, cites rejection of Medicaid expansion by Gov. Mary Fallin Tulsa World by WAYNE GREENE & SHANNON MUCHMORE

o   (AZ) Cheering TMC crowd hears Brewer pitch wider AHCCCS Arizona Daily Star by Stephanie Innes

o   (OH) Bill in Ohio House revives Medicaid expansion Columbus Dispatch by Catherine Candisky

 

Where the Rubber Meets the Road: State Based Health Care News:

o   (KY) ‘Obamacare’ Ads to Begin Airing in Mitch McConnell’s Home State National Journal by Chris Frates

 

Some Very BIG / GOOD News for Obamacare

o   IF YOU READ NOTHING ELSE – READ THIS:  If this health plan is ‘socialism,’ we need more of itLos Angeles Times by David Lazarus – As Obamacare’s exchanges take shape in California, true, transparent, capitalistic competition will be seen among insurance firms, going toe to toe to win consumers. – So this is what socialism looks like: Private companies competing for people’s business in an open marketplace. Californians got their first glimpse Thursday of what insurers plan to charge for coverage to be offered next year to about 5 million state residents who don’t receive health insurance from employers. In southern Los Angeles County, for example, Health Net is charging $242 a month for one of its plans. Blue Shield is charging $287 and Kaiser Permanente $325 for the same coverage. For the first time, consumers are in a position to make an informed decision about health insurance. They can opt for the lowest-priced plan or they can factor in other considerations, such as personal convenience. Insurers, meanwhile, are going toe to toe to win customers, keeping prices as low as possible and stepping up quality of service. Amazingly, the sky hasn’t fallen and the world as we know it hasn’t come to an end. Critics of Obamacare have long warned of the dire consequences of reforming the U.S. healthcare system. The federal Affordable Care Act constitutes a government takeover of healthcare, they have said. We might as well be living in Cuba. In reality, what we’re seeing is some much-needed sunlight being cast upon a market that for too long has operated largely in the shadows, denying consumers the information they need to make choices about medical treatment. Private insurers will have to meet minimum standards for coverage when they begin open enrollment in October, allowing people to compare apples to apples for the first time when shopping for individual or family policies. Insurers also will have to post their prices in a clear and easily accessible fashion, introducing a long-absent element of competition to the market. “It will be a one-stop shop for selecting policies,” said Devon Herrick, a healthcare economist at the National Center for Policy Analysis. “That should make things a lot easier for people.” Comparison shopping for health insurance isn’t a revolutionary idea. You can already go to websites such as eHealthInsurance.com to sample what’s available. But that’s kind of like going to a department store to shop for shoes. There may be plenty of choices at a Macy’s or a Nordstrom, and prices may vary, but it’s hard to know which ones are best. Different pairs of shoes might offer different features, or different workmanship, or come from different parts of the world. The beauty of the insurance exchanges is that they’ll make all participating insurance plans equal. So when one plan is offered at a particular tier — Platinum, Gold, Silver or Bronze — for significantly less than another, you’ll know you’re getting a better deal, not sacrificing quality for price. And insurers, at last, will compete by offering the best coverage at the lowest price, rather than trying to sell you as little coverage as possible for the highest price, which is how the market is currently structured. “It’s a completely different way of doing things,” said Richard Curtis, president of the Institute for Health Policy Solutions. “Insurers will try to offer better choices instead of trying to avoid people when they get sick.” Princeton lecturer Heather Howard is helping bring insurance exchanges to fruition nationwide as director of the State Health Reform Assistance Network. She said examples already exist in Oregon and elsewhere of insurers lowering their rates to attract customers. “That’s the big story,” Howard said. “Competition works.” What a shocking idea: Transparency and competition can improve a marketplace. Perhaps what has conservatives in such a dither is that it took a strong regulatory push to achieve what the free market was unable to accomplish. As things stand, the United States now has about 50 million people who are uninsured, as well as average healthcare costs that are twice as high as in other developed countries. By any reasonable reckoning, that’s evidence of a dysfunctional healthcare system. But it’s not surprising that this has happened. Left to their own device, profit-seeking health insurers have every incentive to keep costs down by minimizing the amount of treatment they cover and maximizing how much policyholders pay in rates and deductibles. Consumers, meanwhile, have every incentive to avoid paying for insurance while they’re healthy and to instead wait until they need it. These self-interested goals are why the free market has failed healthcare — and why the government had to step in with remedies. Thus, coverage requirements for insurance exchanges. Thus, a requirement that most people pay for coverage or face a tax penalty. Thus, a requirement that insurers cover everyone, including those with preexisting medical conditions. “You need the whole package of reforms to make the whole thing work,” Curtis said. That’s not socialism. Or communism. Or totalitarianism. It’s good old-fashioned capitalism, with a little helping hand from Uncle Sam to overcome personal and corporate considerations. It’s also humanism — an acknowledgment that healthcare, unlike most other products and services, is a necessity that requires all of us to band together as a society. There is still much to be done. The exchanges remain a work in progress. Some rates undoubtedly will have to be tweaked before being offered to consumers. Insurance plans may need to be revisited by authorities to ensure equitable coverage. Opponents of change should brace themselves for bumps ahead. The healthcare system is too complex for any overhaul to go smoothly. But change, in this case at least, is good, and long overdue. Any healthcare system that excludes tens of millions of people, requiring them to fall back on costly and inefficient emergency services, is a system that brings nothing but shame on us all. On Thursday, California took a big step toward a more honorable way of doing things. We can be proud.

o   Some very good news for Obamacare Washington Post by Ezra Klein and Evan Soltas – Obamacare got some very good news on Thursday. In 2009, the Congressional Budget Office predicted that a medium-level “silver” plan — which covers 70 percent of a beneficiary’s expected health costs — on the California health exchange would cost $5,200 annually. More recently, a report from the consulting firm Milliman predicted it would carry a $450 monthly premium. Yesterday, we got the real numbers. And they’re lower than anyone thought…Imagine it’s the end of 2014. California now boasts a working, near-universal health-care system. Nothing perfect, but clearly a a success after the first year of implementation. Texas, meanwhile, is a bit of a mess. They didn’t allow the Medicaid expansion so the state’s poorest residents got nothing. They didn’t help with the exchanges, or the outreach, so there aren’t many choices, and premiums aren’t as low one might hope. Viewed in isolation, Texas’s problems would be deadly for the law. But viewed next to California, they might mainly be a problem for the political class in Texas, which has failed to implement a clearly workable law.

o   California Will Be Spared the Obamacare Apocalypse No sticker shock here—just affordable insurance premiums The New Republic by JONATHAN COHN - Predictions of an Obamacare apocalypse seem a little less credible today, thanks to California. On Thursday, officials in that state offered the first detailed glimpse of what consumers buying health benefits on their own can expect to pay next year. And from the looks of things, these consumers will be getting a pretty good deal. Based on the premiums that insurers have submitted for final regulatory approval, the majority of Californians buying coverage on the state’s new insurance exchange will be paying less—in many cases, far less—than they would pay for equivalent coverage today. And while a minority will still end up writing bigger premium checks than they do now, even they won’t be paying outrageous amounts. Meanwhile, all of these consumers will have access to the kind of comprehensive benefits that are frequently unavailable today, at any price, because of the way insurers try to avoid the old and the sick. …Obamacare critics have long warned, and Obamacare defenders have long feared, that insurers selling plans through the new exchanges would inevitably jack up premiums—if not to pad profits, than to adjust to the regulations that the new law imposes. Under Obamacare, insurers can no longer deny coverage or charge higher premiums to people with pre-existing medical conditions. In addition, the insurers must offer plans that include all “essential health benefits.” All else equal, those requirements should make insurance more expensive, since they require insurers to cover more sick people and pay for more kinds of services. If premiums get too high, that would scare away some consumers—in effect, causing a severe case of “sticker shock”—driving up the program’s overall costs and eventually destabilizing the whole system…. “It’s a big deal,” Anthony Wright, executive director of the consumer group Health Access, said in an interview. And while Wright was careful to warn that insurance would still remain too expensive or have insufficient benefits for many people, he said the bids showed that reform will benefit millions—and is a major step in the right direction. “The scare mongers were wrong.”

o   Health reform plans, pricing released in Calif. Associated Press by Judy Lin – Californians are finally getting to see what “Obamacare” means for them. President Barack Obama’s health care overhaul made a big leapThursday when California’s health insurance exchange announced the plans and the prices that will be offered to those buying individual coverage. Some of the state’s largest individual health insurers, including Anthem Blue Cross, Blue Shield, Kaiser Permanente and Health Net Inc., will be among 13 plans competing through the state’s new health exchange. The rollout in the nation’s most populous and diverse state is important because it demonstrates how the Affordable Care Act will work on a large scale, health policy experts said. “California really demonstrates that the concept of an exchange can work by really increasing head-to-head plan competition,” said Caroline Pearson, vice president of Avalere Health, a Washington, D.C., data analysis firm catering to the health care industry and government. “It brought a lot of carriers into the market. It brought the premiums down. It was sort of the best example of the market working.” Other states running their own insurance exchanges already have announced the plans they will offer. Oregon offers 16 plans, Colorado has 10 and Washington has nine. The White House welcomed California’s options as it tries to allay fears about potential rate shocks when the Affordable Care Act takes full effect next year. The rates offered in many plans turned out to be lower than previous estimates, state officials said. “Given that California, the largest insurance market in the nation, has robust competition and a wide range of affordable plans, that bodes very well for the marketplaces across the country,” Tara McGuinness, a senior White House communications adviser, said in an email.

o   California Obamacare premiums: No ‘rate shock’ here Washington Post by Sarah Kliff -  Health insurers will charge 25-year-olds between $142 and $190 per month for a bare-bones health plan in Los Angeles. A 40-year-old in San Francisco who wants a top-of-the-line plan would receive a bill between $451 and $525. Downgrade to a less robust option, and premiums fall as low as $221. These premium rates, released Thursday, help answer one of the biggest questions about Obamacare: How much health insurance will cost. They do so in California, the state with 7.1 million uninsured residents, more than any other place in the country. Multiple projections expected premiums to be relatively high. The Congressional Budget Office predicted back in November 2009 that a medium-cost plan on the health exchange – known as a “silver plan” – would have an annual premium of $5,200. A separate report from actuarial firm Milliman projected that, in California, the average silver plan would have a $450 monthly premium. Now we have California’s rates, and they appear to be significantly less expensive than what forecasters expected. On average, the most affordable “silver plan” – which covers 70 percent of the average subscriber’s medical costs – comes with a $276 monthly premium. For the 2.6 million Californians who will receive federal subsidies, the price is a good deal less expensive, the amount noted in green below. … Health premiums will be lower for the youngest Americans. Here’s how the costs work out for a 25-year-old purchasing the same health plan.

o   ObamaCare plans cheaper than expected in key rate filing The Hill by Sam Baker – New insurance policies under President Obama’s healthcare law will cost significantly less than expected in California. The state released rate filings Thursday for the policies that will be sold through the health law’s insurance exchange. Experts had been especially eager to see California’s rates, and it is the first large state to release price information for next year. The average plan will carry a monthly premium of $300, regulators said. Most people will receive a subsidy to help cover part of that cost, and cheaper options are also available. The Congressional Budget Office predicted in 2009 that premiums for a middle-of-the-road exchange plan would come to about $5,200 per year. Other states have seen their rates track relatively close to that figure, but California’s plans came in substantially lower — about $3,600 per year before subsidies

o   California’s Health Insurance Exchange Sets Plans, Premiums; No ‘Rate Shock’ KQED by Lisa Aliferis – The state’s health insurance exchange, Covered California, announced Thursday morning the plans and premiums that will be available to people statewide to millions of Californians. And what everyone wants to know is: how much will it cost. Experts had warned of “rate shock ,” that premiums might skyrocket for all kinds of reasons. That has not happened. Covered California says that individuals will pay an average premium of $321 per month for a “silver” plan. (More on silver plans below.) Many people will be eligible for subsidies to reduce that cost further.

o   California Insurance Exchange Rates: Not Too High, Not Too Low Kaiser Health News by Sarah Varney – In the first disclosure of individual health insurance premiums by the nation’s largest state, California announcedon Thursday a wide array of choices for the 5.3 million people expected to qualify to purchase coverage through its online marketplace established by the Affordable Care Act.  The premiums, which aimed at a “just right” Goldilocks range, surprised many consumer advocates and analysts who had been anticipating much higher prices

Give me your tired, your poor, Your huddled masses, yearning to breath free, The wretched refuse of your teeming shore,  Send these, the homeless, tempest tost to me, I lift my lamp beside the golden door: BUT YOU CAN’T GO TO A DOCTOR.

o   Immigrant healthcare bills stump House group Los Angeles Times by Lisa Mascaro -Differences over whether immigrants should be deported for failing to have health insurance or pay their healthcare bills have stalled a bipartisan group of House lawmakers, who blew past a self-imposed Thursday deadline as they pressed forward on a sweeping immigration overhaul. Negotiators emerged upbeat from a closed-door meeting in the Capitol and said they remained on track to produce a bill by June. That, in itself, was significant, after the group of eight was on the verge of breakup. “We were all positive that we can move forward,” said Rep. Raul Labrador of Idaho, a top Republican leading the bipartisan effort. House Republican leaders are increasingly concerned that momentum in the Senate, where a bipartisan immigration bill cleared a committee this week, will leave them on defense without their own proposal. Trying to avoid that outcome, House Speaker John A. Boehner (R-Ohio) publicly drew a line Thursday by saying his chamber would not accept the Senate legislation.

 

o   Pelosi vows there will be no ObamaCare for illegal immigrants The Hill by Mike Lillis and Russell Berman – House Minority Leader Nancy Pelosi (D-Calif.) vowed Thursday that taxpayers will not cover healthcare costs for illegal immigrants who gain a pathway to citizenship under immigration reform. “It is stated very clearly in the Affordable Care Act, [and] it is our position in the immigration bill: no access to subsidies in the Affordable Care Act. Secondly, no access to Medicaid; no cost to the taxpayer,” Pelosi told reporters in the Capitol. “That has always been the Democratic position.” Pelosi was pushing back against reports indicating that Democratic leaders have stalled the House immigration negotiations by resisting a draft provision that would prohibit illegal immigrants entering the “pathway to citizenship” from receiving taxpayer-subsidized healthcare benefits at any level of government. The ban would include the federal subsidies under ObamaCare.

Contraception:

o   Implementing Health Reform: Contraception Coverage And The Liberty University Case Health Affairs by Timothy Jost – The first few days of the week of May 20, 2013 were quiet on the regulatory front, with no new Affordable Care Act regulations or guidance (at least that I could find). HHS released power point slides from an earlier webinar that usefully describe the different kinds of assisters who will be available in the marketplaces (navigators, in-person assisters, certified application counselors, and agents and brokers). It also has apparently updated its navigator and assister frequently-asked-questions paper, although most of these FAQs were released earlier. In other news, however, the Fourth Circuit Federal Court of Appeals has released the recording of the May 17, 2013, oral argument in the case of Liberty University v. Jacob Lew. The Liberty University case aroused quite a stir in November of 2012, when the Supreme Court reversed its earlier decision to deny certiorari in the case, granted certiorari, vacated the earlier decision of the Fourth Circuit rejecting the plaintiff’s case, and remanded the case to the Fourth Circuit for further proceedings.

ObamaCare / Healthcare News:

o   Dems, W.H. talk small business ACA worries Politico Pro ($) by Paige Winfield Cunningham – Senate Democrats voiced concerns about small business, part time workers and the health law at a meeting with two key administration officials on Thursday. Several senators said that they conveyed to Small Business Administrator Karen Mills and White House health policy adviser Jeanne Lambrew the worries they are hearing from small businesses, including restaurants, about the requirement that employees working a 30 hour week be considered full time and must be covered. Senators also said that businesses may need more clarification about their responsibilities under the law. (Businesses with fewer than 50 employees are not required to cover their workers.)

o   Bachmann’s Absurd Claim Of A Vast IRS Health Database Of ‘Sensitive, Intimate’ Information Washington Post by Glenn Kessler – With the Internal Revenue Service in the news, Rep. Michele Bachmann (R-Minn.) has taken the opportunity to marry that scandal with her ongoing battle against the president’s health-care law, a.k.a. “Obamacare.” The picture she has sketched is pretty frightening — that the “most personal, sensitive, intimate, private health-care information is in the hands of the IRS” via a vast database. Indeed, even though our colleagues at PolitiFact and FactCheck.Org have beaten us to the punch on this language, the issues she has raised have generated enough buzz on the blogosphere that we believe we should weigh in as well. What is Bachmann talking about?.

o   Obamacare a strong first step to improving health of San Diegans San Diego Union-Transcript by Richard S. Ledford, Gregory E. Knoll & Irma Cota - Ledford is owner and president of Ledford Enterprises; Knoll, Esq, is executive director, Legal Aid Society of San Diego and Consumer Center for Health Education and Advocacy; Cota is executive director of North County Health Services. They are on the board of directors of San Diegans for Healthcare Coverage. - Very few policy issues have been debated as intensely or have been as misrepresented as the Affordable Care Act. This is largely because the ACA makes big changes to the status quo — making it an easy target for naysayers. More than 100 million Americans have already benefitted from Obamacare. But this fact and many others get obscured by pervasive myths perpetrated by pundits and media outlets, including the recent series of editorials published by the U-T. When President Obama took office, 51 million Americans were without health insurance, premiums had more than doubled in the preceding decade, and insurers could deny coverage to those who needed it most. In spite of increasing per capita health care costs, our health status as a nation has stagnated. If there were simple solutions, these problem would have been resolved long ago. While not perfect, the ACA is a strong first step towards addressing these very complex issues. Everyone who can afford coverage is expected to have coverage, there will be expanded Medi-Cal for the very poorest and tax credits to reduce premium costs for low to modest income individuals and families who do not have employer sponsored coverage. This represents welcome relief for more than half a million San Diegans. Moreover, the ACA invests in prevention strategies and services that have been demonstrated to reduce long-term health and social service costs. More than 6 million young adults now have coverage on their parents’ plans until age 26. Seniors have saved close to $500 million in prescription drugs costs. Since the passage of the ACA, healthcare costs have increased at the lowest level in more than 50 years. The ACA should be credited for the common sense requirement that insurers spend 80 to 85 percent of health premiums on healthcare as well as for allowing review of rate increases saving Californians an estimated $175 million thus far. Policies that emphasize the efficiency and quality of healthcare, rather than the quantity alone, are making a difference. Assertions that employers will drop coverage because of a potential penalty that is less than providing coverage over-simplifies a complex business decision. Approximately 96 percent of California employers with more than 50 employees offer coverage today without any inducement. Small employers with fewer than 50 employees have no mandates and no penalties; those with less than 25 have incentives through tax credits of up to 50 percent in 2014 for their contributions to premiums for employees. The ACA will reduce the cost of care over time — that was the promise and the projections by the nonpartisan Congressional Budget Office (CBO) — this is a long-term transition. Despite the analyses offered by the CBO, critics seem to have a crystal ball predicting doom and gloom about the affordability of the health coverage that will be offered through California’s Health Exchange in the very first year. Let’s be clear, rates may be higher next year because the ACA delivers broader health coverage so people can afford to go to the doctor and can access preventive and mental health services. Premiums may also be lower than expected. We can look to the Oregon experience for an indication of how the new market may work towards that goal. When Oregon published rates for the same standard benefit packages, the premium for a 40-year-old Portland area nonsmoker ranged between $169 and $422, depending on the insurer. Health plans began scrambling not to be the high cost outliers. This is what competition and transparency look like. Because of the ACA, for the first time, consumers will be able to compare standard benefit plans, premium by premium. The Affordable Care Act is the law. Opponents argue that few will enroll in new coverage; it will take time to educate and enroll so many and we must give it that time. An ongoing campaign to confuse and misinform our communities about “Obamacare” is a disservice to the public and certainly will not help that enrollment effort.

o   The fog of Obamacare Washington Post by Robert J. Samuelson – You’ve heard of the “fog of war.” Well, now we’ve got the fog of Obamacare. The controversial Affordable Care Act (ACA) has so many moving parts that it’s hard to know how its implementation is proceeding. In 2014, many uninsured are supposed to get coverage either through insurance exchanges, where they can buy subsidized policies if their incomes are less than four times the federal poverty line, or through an expanded Medicaid. The trouble is that 20 or more states may reject the Medicaid expansion, and the exchanges aren’t yet finished. Much is unknown. It’s not just that the ACA’s plumbing is still under construction. Millions of Americans are perplexed. … First, some companies now providing insurance are being hit with huge premium increases. Before Obamacare, said one PEO adviser, his clients typically received annual increases of 6 percent to 12 percent. “This year we’re seeing 30 percent rate hikes,” he said. The surge is blamed, rightly or wrongly, on the ACA’s requirement for more comprehensive coverage and on its formula for calculating premiums (aka “community rating”). Costlier insurance could cause some employers to drop it and others not to offer it. But modest increases in overall health spending could relieve pressure on premiums. Second, most companies haven’t made final decisions. Those who have go both ways. Another adviser described a 250-worker car dealership with good wages but no health insurance; it will provide coverage and cut wages to help pay costs. Another example involved a 60-worker manufacturing firm with wages of $12 to $15 an hour. It offered bare-bones policies with steep deductibles. Confronting higher premiums for expanded coverage, the owner will drop insurance. He found the ACA “too complex,” said this adviser. Wages will be increased somewhat. With subsidies, workers might do better in the exchanges. Third, many firms are revising their business models to minimize insurance costs. One favorite idea: Hold workers below the 30-hour weekly threshold requiring insurance. Many part-time employees who work more (say, 35 hours a week) will lose hours. One adviser discussed a movie-theater chain that will keep most staff below the threshold. Many restaurants and hotels may do likewise. Similarly, companies are striving to stay below the 50-employee ceiling that triggers the insurance mandate. Another adviser mentioned a client, an engineering firm with 48 workers, that had deliberately restrained expansion. All of this clouds Obamacare’s promise of universal coverage. The Supreme Court’s decision that states don’t have to join the Medicaid expansion will reduce the number who get coverage. What matters for small and medium-size firms is the gap between providing coverage and paying the tax penalties. The wider it gets, the more likely it is that firms won’t provide insurance. Some will also be deterred by the “hassle factor” of complying. The less private coverage, the more federal subsidies for exchanges will rise — and the greater the chances that individual workers will forsake insurance and pay the tax penalty.

Medicaid:  “Weigh the Evidence and Do the Math”:

o   Report Shows Medicaid Expansion a Boon for Mississippi Economy, Small Businesses Small Business Majority – Small business advocacy group releases report showing Mississippi small employers and state economy would benefit from Medicaid expansion —A report released today found expanding Medicaid in Mississippi would be good for the state and its small businesses, relieving some of the burden of their health insurance costs and stimulating the state’s economy….The report, released by small business advocacy organization Small Business Majority, found that if Mississippi expands its program and takes advantage of the federal funding available to cover the costs, it will support jobs and stimulate economic growth throughout the state while expanding health coverage for residents. “read the full report: HERE

o   (ME) MEDICAID EXPANSION GETS INSTANT VETO IN MAINE - As promised, Gov. Paul LePage yesterday vetoed a bill linking the state’s repayment of hospital debt to the Medicaid expansion. We just didn’t know he’d do it so fast. Within minutes of the Senate passing the bill, LePage vetoed the measure and laid out his own plan for paying back the $484 million owed to 39 Maine hospitals, the Bangor Daily News reported. LePage has insisted that the debt repayment and the Medicaid expansion remain separate, as his administration continues to negotiate with CMS on the expansion. The BDN story: http://bit.ly/ZgDk1c

o   UTAH: ALL MEDICAID OPTIONS INCREASE COST PULSE – The state yesterday released a long-awaited consultant’s report showing the Medicaid expansion would mean savings for Utah, but Gov. Gary Herbert’s administration stressed that Utah faces increased costs no matter what path it takes. “The bottom line is that each and every scenario comes with significant costs to the taxpayer,” said Department of Health Executive Director David Patton in a statement. “But there are benefits, both human and financial, and we must remain focused on finding the best way to deliver high quality, affordable health care to Utahns.” The report, from Public Consulting Group: http://politico.pro/11dwYtz. Utah’s statement: http://politico.pro/1984Kbw –The PCG analysis found the state would have to spend $260 million on the expansion in a 10-year window, but when all the savings from public assistance programs and new revenues are added up, the state would save $131 million to cover 123,600 adults. Hospitals would also save $814 million in uncompensated care costs. The expansion would generate $2.9 billion in statewide economic impact and create 4,160 jobs. The report also analyzed four other options, but didn’t offer recommendations.

o   (OK) St. John plans layoffs, cites rejection of Medicaid expansion by Gov. Mary Fallin Tulsa World by WAYNE GREENE & SHANNON MUCHMORE – Tulsa’s St. John Health System is “restructuring its workforce” because of changes in medical financing, including Gov. Mary Fallin’s decision not to allow Medicaid expansion in the state, according to a statement from the medical center Wednesday. A message from St. John President and CEO David Pynn to hospital employees specifies that “over the next three weeks, we will implement a plan to strategically restructure the workforce, resulting in position eliminations of approximately 2 to 3 percent of our associates by the end of June.” The system has about 7,000 employees. Officials declined to detail the restructuring plan.

o   (AZ) Cheering TMC crowd hears Brewer pitch wider AHCCCS Arizona Daily Star by Stephanie Innes – Gov. Jan Brewer led a lively “pep rally” for Medicaid expansion at Tucson Medical Center on Wednesdaymorning, drawing cheers, shouts of support and a standing ovation from about 250 local health-care executives, business leaders and other citizens. Without the expansion, about 60,000 Arizonans now enrolled in Medicaid will immediately lose health coverage at the end of 2013, including an estimated 5,000 cancer patients and 2,000 with serious mental illness, state officials say. And hospitals and insured Arizonans will end up shouldering the cost, Brewer said. She said the state will also lose out on millions of dollars in federal matching funds to cover health care. “We cannot let that happen,” the Republican governor said to loud applause. “And I know that we won’t.”The Arizona House of Representatives could consider the expansion as early as next week.

 

o   (OH) Bill in Ohio House revives Medicaid expansion Columbus Dispatch by Catherine Candisky – A key Republican lawmaker hopes her colleagues can still reach a consensus on expanding the state’s Medicaid program to tens of thousands of uninsured Ohioans. Rep. Barbara Sears, R-Sylvania, introduced legislation yesterday to provide coverage to an estimated 275,000 people with incomes under 138 percent of the federal poverty level. The cost would be paid entirely by the federal government for three years under the new health-care law. Sears said she hopes to win passage of the legislation by the end of June to give state Medicaid officials the six months they say they need to implement an expansion by Jan. 1. That’s when the federal aid becomes available, and it’s also when most Americans must have health coverage or face penalties.

 

Where the Rubber Meets the Road: State Based Health Care News:

 

o   (KY) ‘Obamacare’ Ads to Begin Airing in Mitch McConnell’s Home State National Journal by Chris Frates -  As part of the multimillion-dollar implementation of ‘Obamacare,’ the health exchange where Kentucky residents can shop for insurance will launch a media campaign next month, and the state’s senior Republican is none too pleased about it. “Kentuckians don’t want the government spending their hard-earned tax dollars on a PR campaign for a law most of them want to see repealed,” Senate Republican Leader Mitch McConnell said in a statement to National Journal. It’s a preview of the kind of rhetorical warfare that will only heat up as the Affordable Care Act comes online over the next 18 months and Republicans bash the law every step of the way. That will hold particularly true in the Senate, where McConnell is betting that running against Obamacare in 2014 can win him control of the chamber. But, for now, there’s little McConnell can do to stop it. The federal government approved $4.7 million this year and another $6.6 million next year for required branding, public education, and outreach around the exchange, explained Gwenda Bond of the state Cabinet for Health and Family Services. The campaign will include paid television, radio, and print advertisements. “We are doing a lot of television because (in Kentucky) … it’s still the best way to reach a mass audience,” Bond said. “We believe that widespread education is needed to ensure that Kentuckians understand how the exchange works and what it offers in advance of open enrollment this fall.”