Tag Archives: SCHIP

Why Obamacare’s Medicaid Expansion Will Reduce Health Care Access

In the Atlantic, Avik Roy writes:

Chapin White of the Center for Studying Health System Change has published an important new paper in Health Services Research, a journal of health economics, which suggests that a critical part of the Affordable Care Act–its expansion of Medicaid coverage to 16 million more Americans–may actually reduce those individuals’ access to health care. …

Believe it or not, physicians even do better caring for the uninsured than they do caring for Medicaid patients. Two MIT economists, Jonathan Gruber and David Rodriguez, have found that three-quarters of physicians receive lower fees for serving Medicaid patients than they do for the uninsured, because many people without health insurance are still able to pay out-of-pocket for routine health expenses.

How?  Medicaid notoriously underpays doctors, so Medicaid patients have trouble accessing them. When Medicaid eligibility expands, many newly eligible people drop “private” health plans to enroll.

Read the whole post: Why Obamacare’s Medicaid Expansion Will Reduce Health Care Access – The Atlantic.

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Filed under coverage isn't care, Medicaid/Medicare/SCHIP

Hickenlooper’s veto of SB 11-213 insults low-income parents

The Boulder Daily Camera published my article criticizing Governor’s veto of Senate Bill 11-213. Here are the first and last paragraphs:

“Let them drink beer, while you pay.”  This is how Colorado taxpayers should interpret Governor Hickenlooper’s recent veto of Senate Bill 213.  For some families, SB 213 would have increased the Child Health Plan Plus (CHP+) enrollment fee to $20 per month. This is what the lowest income U.S. households spend on alcohol.

CHP+ officials will soon propose changes to CHP+ fees and possibly co-payments, which are also extremely low. Maintaining current fees would not only be an injustice to taxpayers, but also an insult to eligible parents. The fees imply that parents value enjoying life’s amenities more than their own children’s health.

Read the whole article in the Boulder Daily Camera.

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Filed under Colorado health care, Medicaid/Medicare/SCHIP

Gov. Hickenlooper wrong to veto Colorado SB11-213

The Denver Post published my letter to the editor criticizing Governor Hickenlooper’s veto of Senate Bill 11-213:

Re: “Hick’s reason for veto makes sense,” June 2 editorial.

Gov. John Hickenlooper was wrong to veto Senate Bill 213, which would have increased Child Health Plan Plus premiums for families earning more than twice the federal poverty level. Enrolling one child costs just $25 per year. A Post editorial asked if it was unfair for SB 213 to raise the fee to $20 per month. It’s fair. According to the latest Consumer Expenditure Survey, the poorest U.S. households spend on average more than $150 per month on alcohol, tobacco, sweets and entertainment.

What’s unfair is that Colorado compels taxpayers to fund a program that allows eligible parents to value satisfying bodily appetites more than their children’s health.

This was a very short version of my longer article on the subject, which describes how programs like CHP+ crowds out private insurance. That is, parents stop buying it and sign up for the tax-funded product.  Read more:

Colorado Child Health Plan: Parents should value children’s health more than sweets and booze, Health Policy Solutions, May 17; Denver Daily News, May 20.

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Filed under Colorado health care

The immorality of government medicine vs. your right to your own life

The Association of American Physicians and Surgeons‘ summary of Yaron Brook’s talk:

To save American healthcare, not to mention to save the country itself, Advocates of freedom, free markets, and capitalism must take the moral high ground from the proponents of government-control, Dr. Yaron Brook tells patients and doctors on May 14, 2011 at a Doctors Town Hall.

Whether an idea works does not determines its success in the political system, but rather whether an idea is considered morally correct. Capitalism is proven to be effective but more importantly that that, it is the only ethically sound economic system. Free markets depend on voluntary cooperation between individuals not government force.

Dr. Brook is the Executive Director of the Ayn Rand Institute.

via YouTube – Yaron Brook, PhD – The immorality of government medicine.

More of Yaron Brook’s writings on health care.

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Filed under charity, morality

Colorado SB 11-213: Parents should value children’s health more than sweets & booze

Would you donate to a charity that allows parents well over the poverty line to pay just $25 per year for their child’s’ medical insurance? What if many recipients previously paid for such insurance themselves, and spend hundreds of dollars a year on booze, sweets and entertainment?  If you pay Colorado taxes, you’re forced to fund such a charity – the state-run “Child Health Plan Plus” (CHP+).  Senate Bill 11-213, which is awaiting the governor’s signature, would increase CHP+ enrollment fees for the wealthiest of eligible households, and rightly so.

Read the rest of this article at HealthPolicySolutions.org: Parents should value children’s health more than sweets and booze

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Filed under Colorado health care, Medicaid/Medicare/SCHIP

Colorado SB 11-213: Parents can afford higher child health plan fees

Colorado parents earning up to 250% of the Federal Poverty Level (FPL) are eligible for the tax-funded Child Health Plan Plus. Enrollment fees are $25 per year for one child, and $35 per year for two or more children. The Denver Post reports that  Senate Bill 11-213 would increase the enrollment fees for households with incomes between 205% & 250% of the FPL: $20/month for one child, $10/more for each additional child with a $50/month limit.

[History of votes on this bill; May 1 Denver Post article on its status]

Can parents in this income range afford this?  Data from the Bureau of Labor Statistics says yes.  As I’ve written before:

The 2009 [Bureau of Labor Statistics] Consumer Expenditure Survey data suggests that some Medicaid recipients and parents with kids in CHP+ can afford more. On average, the lowest income households, less than $5,000, spend almost $1,900 on sweets, alcohol, tobacco, and entertainment. (That’s $156 per month) Oddly, households with incomes between $5,000 and $10,000 spend less on these items – around $1,400 ($113/month).

More details: If you look at the BLS data, the average number of people in a “consumer unit,” i.e., household or family is 2, with on average half a person under 18.  Then look at the CHP+ eligibility rules for a family size of 2. The maximum income such a family can have is $3,065 per month, or about $37,000 per year.

Now look back to the BLS data, which splits households according to $10,000 income increments, and look at the spending habits for households with the bracket below $37,000 per year: $20,000 – $30,000 per year. Note that looking at spending of families in this income range underestimates the spending of higher-income CHP+ eligible families with income betweeen $30,000 and $37,000.

For this group ($20,000 – $30,000 per year.), the total spending on alcohol, tobacco, candy, and entertainment is $2,287 per year, or $191 per month.   Such households have, on average half a person under age 18, which means that about half do not have kids.  For sake of argument, say that the childless households account for, say, 3 times as much spending as those with kids.  Even in this case, the spending by households with kids is $95 per month.

(See my calculations here.)

Moreover, the Congressional Budget Office reports that 77% of children in families with incomes between two and three times the FPL have commercial (non-government) health plans.  For the lower-income bracket, between one times and twice the FPL, the rate is 50%.  The CBO report also concludes that the State Health Insurance Program (S-CHIP) crowds out private insurance:

for every 100 children who enroll as a result of SCHIP, there is a corresponding reduction in private coverage of between 25 and 50 children.

(Colorado’s “Child Health Plan Plus” is Colorado’s version of S-CHIP.)

A study co-authored by MIT economist (& past Obama Administration consultant) Jonathan Gruber estimates that SCHIP’s crowd out level is 60%. Or as Michael Cannon puts it, S-CHIP  covers “four uninsured Americans for the price of ten — a lousy deal even by government standards.”

So when people object to SB 11-213 by saying parents will drop enrollment, do they say what happens next?  Some buy insurance themselves. After all, according to the CBO, between 50% and 77% of people with incomes between 205% and 250% of the FPL already buy commercial health plans for their kids.

The enrollment fees of Senate Bill 11-218 are similar to New Hampshire’s “Healthy Kids” program, which charges monthly fee $32 for households between 185%-250% FPL). As I’ve noted before, the program’s co-pays are also higher, and more reasonable.

See also: The Citizens’ Budget by the Independence Institute, health care policy section (page 75 of pdf for CHP+).

Recent news: Last week the Denver Post reported that “Deal on Colorado children’s health care bill faces last-minute snag.”


Filed under Colorado health care

The Road To Socialized Medicine Is Paved With Pre-existing Conditions – The Objectivist – – Forbes

At Forbes.com Yaron Brook and Dan Watkins explain how government has taken over the medical care and insurance industry:

Washington’s control of medicine has grown slowly, evolving piecemeal over decades. Even before ObamaCare, half of all heath care spending was controlled by the government.

The general pattern of the expansion works like this: advocates point to some group in real or alleged dire need and declare that Washington has a duty to act; Washington eventually does. It started with the poor (Medicaid) and the elderly (Medicare). Then came the uninsured in need of emergency care (Emergency Medical Treatment and Active Labor Act). Then came middle-class parents (S-CHIP).

And ObamaCare? It was sold to us, in large part, as the indispensible means of addressing the plight of those with preexisting conditions.

Read the whole article: The Road To Socialized Medicine Is Paved With Pre-existing Conditions.

(Via Voices for Reason.)

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Filed under Medicaid/Medicare/SCHIP, Policy - National