Tag Archives: Medicaid access

Colorado Health Benefits Exchange: poor access & narrow provider network?

At Forbes, Scott Gottlieb, MD provides a warning for Coloradans who will to buy health coverage through the Colorado Health Benefits Exchange (“Connect for Care Colorado”):

There’s an astute article in today’s edition of the Wall Street Journal by veteran healthcare reporter Anna Mathews. It outlines the scope of health plans that will be offered on the new exchanges taking shape this fall. And why Obamacare is looking more and more like Medicaid.

Mathews notes that hospitals are giving up discounts to the new exchange-based health plans. In turn, the hospitals plan to make up these discounts through the narrow networks of providers that consumers will be able to choose from. The bet that these hospitals are making is that they can offset the discounts by getting more volume. …

[Wi]th fewer out-of-pocket costs, consumers will also have far less skin in the game. In turn, they will have less incentive to constrain their demand for services.

That constraint will instead be applied by the providers themselves, through the limitations that they place on access. Not by outright denying care, but by funneling patients into overworked networks that make it much harder to actually get appointments and schedule needed services. This is exactly how rising demand is managed under Medicaid. It’s one more reason why Obamacare coverage is likely to resemble Medicaid over time.

More: The New Obamacare Insurance Is Looking More Like Medicaid – Forbes.

See also: Survey: Medicaid-Level Rates Could Cripple Health Insurance Exchanges.

 

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How Colorado’s Medicaid expansion harms patients

Linda Gorman of the Independence Institute writes:

Medicaid expansion would limit access to care for the significant fraction of the currently uninsured who would otherwise be eligible for federal premium subsidies under ObamaCare. It raises costs for state taxpayers, increases costs for people who are hospitalized, and prevents state insurers from collecting millions of dollars in federal subsidy money.

Read more: How Colorado’s Medicaid expansion harms patients | Complete Colorado – Page Two.

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Filed under Colorado health care, Medicaid/Medicare/SCHIP

Twelve Reasons Colorado should say no to Medicaid expansion

Avik Roy & Grace-Marie Turner in National Review present 12 reasons Virginia, or any state (like Colorado), should not expand Medicaid:

  1. Virginia’s Medicaid spending will explode
  2. Medicaid harms the poor.
  3. Medicaid’s access problems will get worse as more doctors drop out.
  4. Claims about job creation are exaggerated.
  5. Claims about coverage expansion are exaggerated.
  6. Medicaid raises premiums for those with private insurance.
  7. Medicaid’s undercompensated care is a bigger problem than providing uncompensated care for the uninsured.
  8. Expanding Medicaid will expose [states] to immense amounts of fraud and waste.
  9. [States] will be exposed to higher Medicaid costs when Washington recalculates its matching payments.
  10. By rejecting the Medicaid expansion, Virginia encourages other states to do the same, reducing waste of taxpayer dollars.
  11. Medicaid will worsen the cycle of dependence and harm the economy.
  12. Exchanges will provide better health outcomes, far less fraud, and fiscal certainty.

Read details on each: Twelve Reasons to Say No – National Review Online.

For more on Medicaid expansion, see posts on .

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Filed under Colorado health care, Medicaid/Medicare/SCHIP

Colorado Medicaid Expansion: Remember that health coverage is not health care

On December 30, Michael Booth of the Denver Post writes:

Free money now, untold costs later.

That’s the dilemma facing Gov. John Hickenlooper, state officials and legislators in 2013 as they contemplate one of the biggest questions in Colorado’s health future: Should we jump into the historic expansion of Medicaid that is a key element of health-care reform?

Read more: Will Colorado go all-out to broaden Medicaid pool?

Health economist John C. Goodman summarizes the poor medical outcomes on people enrolled in Medicaid, compared to those with commercial insurance or the uninsured. He notes:

[Austin] Frakt points to some studies finding that Medicaid makes a positive difference over being uninsured.[15] But the results would probably have been just as good or better if we spent the money giving free care to vulnerable populations. Moreover, even with their Medicaid cards, enrollees turn to emergency rooms for their care twice as often as the privately insured and the uninsured.[16]

Read Goodman’s whole post: How Bad Is Care under Medicaid?

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Filed under Colorado health care

Krugman Flunks Health Econ 101

John C. Goodman writes:

It’s painful to read Paul Krugman when he writes about health care. Makes you wonder how he ever won the Nobel Prize. Previously, he made the absurd claim that in repealing health reform Mitt Romney would allow “tens of thousands” of people to die. In his latest venture into the field, about which he knows embarrassingly little, he has this to say …

Read more: Krugman Flunks Health Econ 101 | John Goodman’s Health Policy Blog | NCPA.org.

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Should Colorado expand Medicaid per ObamaCare? No.

At Forbes, Grace-Marie Turner gives Colorado officials reason not to expand Medicaid:

One of the most tragic failings of ObamaCare is that it will make it harder for many of the most vulnerable citizens – patients with no option but Medicaid – to get care.

Medicaid is cumbersome, complex, and wasteful – already the worst health care program in the country. But rather than making changes to improve or modernize this program designed to finance care for the poor, the Obama administration is trying to convince states to add at least 16 million more people to Medicaid, including families making more than $30,000 a year. …

Studies consistently show that Medicaid patients have the worst health outcomes of any group in America, worse than those with private insurance and, in some cases, worse than those with no insurance. …

Despite these many problems, many states are tempted and are seriously considering whether to accept the generous 100 percent federal matching money ObamaCare initially offers if they expand eligibility for Medicaid up to 138 percent of poverty (more than $32,000 for a family of four).

But states should be warned:  It’s likely a loss leader.  There are no assurances that Washington would be able to keep its promise to continue the generous funding.

There already is evidence that could be the administration’s plan. …

There is a better way:  Allow people on Medicaid the option of private insurance so they can get coverage through private competing plans. Florida has a successful model underway. These plans could provide much better access to physicians, coordinate care for patients with multiple health problems, and allow patients to be seen in doctors’ offices rather than in expensive hospital emergency rooms.Patients would have the dignity of private coverage, and safety-net hospitals will be able to keep their doors open so they can continue their mission of caring for the poorest and neediest in our society.

via The Real Tragedy Of ObamaCare Has Yet To Be Felt By The Poor – Forbes.

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Study: Nearly A Third Of Doctors Won’t See New Medicaid Patients

From Kaiser Health News:

If you’re on Medicaid and looking for a new doctor, your chances are excellent of finding one … in Wyoming.

In New Jersey, not so much.

About 69 percent of doctors nationally accept new Medicaid patients, but the rate varies widely across the country, according to a study published Monday in the journal Health Affairs. …

For years, some states have struggled to attract doctors to treat patients enrolled in the state-federal health insurance program for the poor, largely because of their low pay. …

Doctors also cite administrative hassles and delays in getting paid as reasons why they don’t accept Medicaid patients, according to the Center for Studying Health System Change, a Washington nonprofit.

Read more: Study: Nearly A Third Of Doctors Won’t See New Medicaid Patients – Kaiser Health News.

The figure for Colorado: 66.1% of office-based physicians are accepting new Medicaid patients. That’s close to the national average.

 

 

via NCPA

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Colorado should let Medicaid recipients supplement Medicaid payments with their own money

Here’s a state-level Medicaid reform that the Colorado Legislature and the Colorado Center for Health Care Policy & Financing should implement:*  Let Medicaid recipients supplement Medicaid payments with their own money. Why? John C. Goodman explains:

Take a look at the table below. It compares the prices charged by MinuteClinic to the rates Medicaid pays in Dallas. In general, Medicaid pays less than half. That’s why MinuteClinics usually don’t accept Medicaid. If low-income families were allowed to add from $30 to $50 of their own money to the Medicaid rate, however, in one fell swoop we could make high-quality, very accessible primary care available to millions of people.

Read the whole post: What Food Stamps Can Teach Us about Health Care.

*I’m not sure if this would require asking the federal government for a waiver.

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ObamaCare: Dr. Orwell Will See You Now

At PJ Media, Paul Hsieh, MD writes:

The Obama administration can’t fix the actual substance of their health plan. Hence, their strategy is to obfuscate its problems with deceptive language and hope that voters don’t catch on. If you value your lives, don’t be fooled by their health care Newspeak. Otherwise, you may soon be getting your medical care from Dr. Orwell.

Read the whole post: PJ Media » Dr. Orwell Will See You Now.

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Filed under Policy - National

Medicaid’s Cruel Status Quo: It’s a Medicaid Ghetto

Avik Roy writes:

Last week, the editors of the New York Times called the House Republican budget “cruel” because it seeks to reform Medicaid, our nation’s government-run health insurance program for the poor. But, in fact, it’s the Times that is showing cruel indifference to Medicaid’s inhumane status quo, a status quo that will deteriorate further under President Obama’s health care law. …

The New York Times calls [Republican Medicaid reform proposals] “cruel.” But by ignoring the past success of welfare reform, and ignoring the serious problems with today’s Medicaid program, it’s the Times that is seeking to trap sixty million Americans in a government-run health care ghetto.

Read the whole article: Medicaid’s Cruel Status Quo | Fox News.

See also Linda Gorman’s Colorado issue paper: Medicaid Block Grants and Medicaid Performance.

via FIRM

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