Medicaid And The Election

 Health Care, Politics, Wonkery  No Responses »
Sep 072012
 

It warms my wonkish heart to see the media give more attention to Medicaid as a campaign issue. Bill Clinton considered the topic important enough to include in his speech on Wednesday evening. The complexity of our publicly financed health care system doesn’t lend itself to concise explanations, but Democrats need to start pointing out that plenty of middle-class families rely on Medicaid to care for elderly and disabled relatives. And they need to point out how Republican plans to slash Medicaid spending would almost certainly shift more of the financial burden of providing such care to families. Obama’s DNC speech acknowledged this threat only in passing. Here’s hoping he follows Clinton’s lead and hits the issue hard during the debates.

Healthy Mouths, Healthy People

 Health Care, Wonkery  No Responses »
Aug 292012
 

The Times examines how the state Medicaid budget cuts of the last few years are restricting access to dental care for many low-income adults. The inability to obtain preventive care results in more emergency room visits for tooth pain and other dental issues, which E.R.s are ill-equipped to treat. Minnesota is among the states that have cut dental coverage for adults on Medicaid, but it has also begun licensing dental therapists, mid-level professionals who can perform many procedures that dentists traditionally perform. As you might imagine, dentists are not keen on the idea.

Medicaid coverage of dental services may seem like an easily pared optional service, but the importance of good oral health cannot be understated. Gum disease has been linked to diabetes and stroke. Poor dental health can also complicate efforts to obtain employment. Let’s hope states can eventually restore some of these services.

Paul Ryan, Destroyer Of Medicaid

 Health Care, Politics, Wonkery  No Responses »
Aug 172012
 

A Paul Ryan vice presidency could have dire consequences for the poor and people with disabilities. Ryan’s plans to transform Medicare into a voucher system have been well-documented, but his proposed Medicaid reductions would cut even deeper. Between eliminating the Medicaid expansion in the Affordable Care Act and transforming the remainder of Medicaid into a capped block grant, the Ryan budget would deny health care coverage to 30 million people.

Whether Congress would enact such harsh cuts is an open question. Medicaid beneficiaries don’t possess the same political clout as senior citizens, but some elected officials may still cringe at the prospect of reducing services to their most vulnerable constituents.

The need to reform Medicaid is clear and I expect that beneficiaries like me will have to accept some reductions (on top of the reductions in personal care reimbursement we’ve already witnessed). But we would prefer not to hand the reins of power over to two men who seem to regard entitlements as abstractions disconnected from the lives of real people.

No Death Panels Here

 Disability, Health Care  No Responses »
Aug 012012
 

Andrew Sullivan points us to a blog post written by a young pro-life mom who moved to Canada and discovered that universal health care is not so scary after all. But she makes some curious statements about people with disabilities:

With Universal coverage, a mother pregnant unexpectedly would still have health care for her pregnancy and birth even if she was unemployed, had to quit her job, or lost her job. If she was informed that she had a special needs baby on the way, she could rest assured knowing in Canada her child’s health care needs would be covered. Whether your child needs therapy, medicines, a caregiver, a wheelchair, or repeated surgeries, it would be covered by the health care system. Here, you never heard of parents joining the army just so their child’s “pre-existing” health care needs could be covered. In fact, when a special needs person becomes an adult in Canada, they are eligible for a personal care assistant covered by the government. We saw far more developmentally or physically disabled persons out and about in Canada, than I ever see here in the USA. They would be getting their groceries at the store, doing their business at the bank, and even working job, all with their personal care assistant alongside them, encouraging them and helping them when they needed it.

Why, she could be talking about me! Except my nurses just give me quizzical looks whenever I ask them to write my policy papers for me.

I’m not sure where the author lives now, but I’m fairly certain people with disabilities live in her general vicinity, buying groceries and working jobs. And many of us receive Medicaid, which has that same great socialist flavor as Canada’s health care system. That’s not to say that life on medicaid is plush, but I’m willing to bet our Canadian brethren have similar gripes about finding quality assistants and jumping through the hoops of the pre-authorization process.

What say you, Canadian gimps? Are you better off than Yanks like me?

Cost Cutting

 Health Care, Wonkery  No Responses »
Jul 242012
 

Talking Points Memo has a good analysis of how the recent Supreme Court decision upholding the Affordable Care Act will affect the federal budget. According to the Congressional Budget Office, the ACA will save an additional $84 billion at a cost of an additional 3 million people left without coverage as a result of some states refusing to participate in the Medicaid expansion. This estimate doesn’t include the cost to hospitals and other providers that will still be required to treat those unfortunate enough to be poor and living in states like Texas or Florida. And the cost of repeal is approximately $100 billion. That probably won’t give pause to the more rabid conservatives seeking the law’s annihilation, but it might be a complicating factor for a Romney administration.

The CBO estimate gives some substance to conjecture about the long-term consequences of the Court’s decision. The federal government and states will realize savings while millions of people who would have received coverage will now be forced to fend for themselves.

Ready, Set, Reform!

 Health Care  1 Response »
Jul 182012
 

The big news at my office this week is that Minnesota signed a contract with a technology vendor to build its insurance exchange, where people will be able to compare and select health coverage. Like a lot of other states, Minnesota will be hard-pressed to complete implementation by the end of next year, but I’m confident it will get done. But I’m taking a week’s vacation before my Outlook calendar is completely booked for the next few months.

That Didn’t Take Long

 Health Care, Wonkery  No Responses »
Jul 022012
 

Several Republican governors, including Wisconsin’s Scott Walker, are already vowing to refuse federal dollars for the now-optional Medicaid expansion. Jonathan Cohn predicts most conservative states will eventually opt into the expansion after getting an earful from hospital executives who want reimbursement for serving low-income individuals, but that it may take a few years to achieve full participation. If that’s true, millions of people could be denied access to health care simply because they happen to live in a state where Tea Party ideology holds sway. The whole point of the expansion was to bring some much-needed uniformity to Medicaid eligibility and benefits rules, particularly in regards to poor adults without children. The Court’s decision undermines that goal and gives conservative elected officials yet another opportunity to score points with their political base while delivering an unabashedly gleeful “Fuck you!” to their poorer citizens.

I do think the expansion will be universally adopted–perhaps more quickly than we realize–but not before it becomes another election-year wedge issue. And not before plenty of elected officials utter some pretty horrible things about Medicaid and the people it serves.

I Heart Chief Justice Roberts

 Health Care, Law  No Responses »
Jun 282012
 

My prediction about today’s Supreme Court decision was wildly off the mark, but I’m thrilled with the final result. We’re still trying to parse the Court’s ruling on the Medicaid expansion and what it means for Minnesota. The Court treats the expansion as an entirely new program that exists separately from Medicaid: Original Flavor. Frankly, it’s a weird result and the reasoning seems shaky at best. I don’t think any legal scholar can articulate how the Court will distinguish between a non-coercive expansion of an existing program and the creation of a new program that is independent of the parent program. But, whatever. Most, if not all, will likely participate in the expansion because of the big carrot the federal government is offering in the form of federal funding.

So, a busy summer lies ahead for me. And in a couple months, I can start worrying about the fall election. My professional life is a series of cliffhangers.

Beware The Spin Doctors

 Health Care, Wonkery  No Responses »
Jun 272012
 

Here’s one of the best quotes I’ve read regarding public opinion and health care reform:

The truth is that healthcare reform is a very confusing and highly technical topic. Americans may support a policy presented in one form, but not in another. Americans may approve of certain individual policies of Obamacare right now, but may not once a strenuous debate takes place. For many, Obamacare remains for the most part an abstraction, which they find hard to judge without having directly felt the effect of several key measures, such as the individual mandate.

Keep these words in mind as both political parties do their damnedest to spin tomorrow’s Supreme Court decision. Most Americans simply don’t spend much time thinking about this stuff and they really shouldn’t have to. They just know that the current health care system is increasingly broken and they want it fixed. Whatever happens tomorrow, those attitudes won’t change anytime soon.

Petitioning The Court

 Health Care, Law  No Responses »
Jun 192012
 

Dear Supremes,

Can you please just issue a ruling on health care reform already? I’m wasting far too much time reading opinion pieces speculating on how you might rule and what it will all mean for the election, the Democrats, the Republicans, the health care system, the country, and possibly even the fabric of reality itself. I should be enjoying my summer, not obsessing over the import of comments made by one of your brethren at some lecture. Seriously, just do what you’re gonna do so I can get my back to my typical evening routine: check e-mail, check social networks and RSS feeds, blog, scour Internet for new fishnet-themed erotica with a single-minded drive usually reserved for overcaffeinated grad students pulling an all-nighter in the library.

Sincerely,

Me

 Older Entries  Newer Entries