Medicaid
kkrisberg | September 25, 2017In yet another attempt to repeal and replace the Affordable Care Act, much of the GOP justification boils down to one argument: that the ACA isn’t working. Never mind that we don’t really know what constitutes a “working” health care system for Republicans.
For a while, Republicans said the ACA wasn’t working because some U.S. counties didn’t have an insurer. Today, no county is without an insurer. Then there’s the argument that ACA premiums are too high. However, the research shows that while premiums have gone up, the rise in premiums has been slower under the ACA than it was before the ACA…
lborkowski | September 24, 2017Many of us were cheered by Senator John McCain’s announcement of his opposition to the horrible Graham-Cassidy bill that would gut Medicaid and wreck the individual insurance market. But Senate Republicans could still pass this bill, and will keep trying until the clock runs out at midnight September 30th.
Last week I explained why the bill is so damaging to public health, and Kim Krisberg rounded up opposition statements from major organizations that work on healthcare. Two items that have come out since then are also worth considering.
Senate Republicans are rushing to vote before the…
kkrisberg | September 20, 2017Senate Republicans are again trying to ram through an Affordable Care Act replacement that threatens the health and well-being of millions of Americans. It’s shameful. But don’t take my word for it. Let’s look at what people who actually work in health care are saying about the Graham-Cassidy-Heller-Johnson bill.
In this interview, Sen. Bill Cassidy insists that his bill would protect people with pre-existing conditions. Blue Cross Blue Shield Association disagrees. (Cassidy also says in that same interview that his bill would work through the Children’s Health Insurance Program (CHIP), which…
lborkowski | September 17, 2017Republican Senators have proposed one more bill to repeal the ACA. The Graham-Cassidy (or Cassidy-Graham) proposal would dramatically shrink the pool of federal money going to healthcare and revise how it’s distributed to states, in a way that is especially damaging to states that accepted the ACA’s Medicaid expansion. They hope to pass this destructive bill before the end of September, due to the upcoming expiration of reconciliation rules that let them pass a healthcare-related bill with votes from 50 Senators and Vice President Mike Pence.
Like Republican bills from earlier in the year,…
kkrisberg | September 15, 2017Earlier this week, members of the Senate Finance Committee announced an agreement to extend funding for the Children’s Health Insurance Program. The announcement had been anxiously awaited by families and advocates across the nation, as the program’s federal funding expires in about two weeks. The agreement is good news, but coverage for CHIP’s 8.9 million children isn’t safe just yet.
According to reports, the agreement would extend CHIP’s funding for five years — a win for advocates worried that lawmakers might propose another two-year extension as it did in 2015. The agreement would also…
kkrisberg | August 30, 2017The idea that the Affordable Care Act is a job killer is one of those regularly debunked talking points that won’t disappear. So, here’s yet more evidence that the ACA has had very little impact on the labor market.
In a new study from the National Bureau of Economic Research, a team of Stanford University economists found that even though different regions experienced varying labor market effects likely related to the ACA, the overall impact to jobs numbers was insignificant. In particular, researchers wrote: “Our findings indicate that the average labor supply effects of the ACA were close…
lborkowski | July 31, 2017Like millions of others, I was hugely relieved to get the news early Friday morning that three Republican Senators had joined 48 of their Democratic and Independent colleagues to vote down the third Republican proposal to take healthcare away from millions of people. Now’s a good time to think about how we got here and what comes next.
The Affordable Care Act
For much of 2009, Democratic members of Congress spent months negotiating with Republican colleagues and one another on the legislation that would eventually become the Patient Protect and Affordable Care Act. Over many hours of debate…
lborkowski | July 16, 2017Remember in the bad old days before the Affordable Care Act, when those who bought individual plans on the private market faced unpleasant surprises – like finding at out very inopportune times that their plans didn’t cover hospitalization or maternity care, or that they’d reached a lifetime limit and their insurer wouldn’t pay for any more care at all? When dysfunctional insurance markets meant individual coverage was effectively impossible to purchase for all but the healthiest or wealthiest? If Senate Majority Leader Mitch McConnell has his way, we’ll be going back to those hated…
lborkowski | July 10, 2017While much public attention is (appropriately) focused on the Senate bill that would shred the Medicaid program, House Freedom Caucus members are pushing a proposal to shred other parts of the social safety net: welfare, or Temporary Assistance for Needy Families (TANF), and food stamps, or Supplemental Nutritional Assistance Program (SNAP). Both the Senate BCRA and the Freedom Caucus budget proposal aim to cut spending on these crucial assistance programs while granting large tax breaks that disproportionately benefit the wealthy.
Representative Jim Jordan (R-Ohio) has put forward a budget…
lborkowski | July 5, 2017The Congressional Budget Office’s initial score of the Senate’s “Better Care Reconciliation Act” calculated that 22 million people, 15 million of them Medicaid beneficiaries, would lose health insurance by 2026. For Medicaid recipients, though, the picture worsens steadily after that ten-year window, due to per-capita caps on how much the federal government would contribute. At the request of Senate Budget Committee Ranking Member Bernie Sanders and Finance Committee Ranking Member Ron Wyden, CBO has also estimated Medicaid spending for the post-2026 decade under current law vs the BCRA. They…
lborkowski | June 30, 2017Kim Krisberg has already ably described how the Senate’s “Better Care Reconciliation Act” would gut Medicaid while giving massive tax breaks to the wealthiest, so I want to emphasize a few key points that are worth bearing in mind.
The Congressional Budget Office score of the Senate bill finds that over the next 10 years, 22 million people would lose coverage (relative to keeping the current law), and 15 million of those people would be losing Medicaid. The worst of the Medicaid cuts would come after 2026, though, as the per-capita cap on the federal share of spending rises much more slowly…
kkrisberg | June 30, 2017In Cuyahoga County, Ohio, nearly 200 people have died from opioid-related overdoses in the first five months of this year. That means that this one U.S. county is on pace to lose more than 700 people to fatal overdoses by the end of 2017.
Terry Allan, health commissioner at the Cuyahoga County Board of Health, and colleagues across the county have spent years building and scaling up a multifaceted response to the opioid addiction and overdose epidemic that includes getting people into treatment, changing clinical prescribing habits, preventing deadly overdoses, and dealing with the often-…
kkrisberg | June 23, 2017The House and Senate health care bills are overflowing with proposals that will strip Americans of access to quality, affordable health care. But perhaps the cruelest part is what they do to children — the most vulnerable and powerless among us. Children can’t show up at the ballot box to protect their health and so it truly is up to the rest of us.
Right now, after decades of hard work, the U.S. has achieved near-universal insurance coverage of its littlest residents. About 95 percent of U.S. kids have health insurance. Unfortunately, the House and Senate proposals to replace the Affordable…
kkrisberg | June 22, 2017This is the harsh reality of the Senate health care bill: it provides tax cuts to the wealthiest Americans, while taking away access to timely medical care from the poorest, most vulnerable Americans. You’ve probably been hearing this point a lot about the GOP’s repeal-and-replace efforts, and it’s easy to relegate it to partisan hyperbole. But the sad truth is that, well, it’s the sad truth.
The Senate’s “draft” health care bill, released this morning, proposes sweeping changes to the Medicaid system, which now provides health coverage for 76 percent of poor children, 60 percent of children…
kkrisberg | June 13, 2017Last year’s emergency Zika funding is about to run out and there’s no new money in the pipeline. It’s emblematic of the kind of short-term, reactive policymaking that public health officials have been warning us about for years. Now, as we head into summer, public health again faces a dangerous, highly complex threat along with an enormous funding gap.
“The Zika threat will get worse,” said Claude Jacob, chief public health officer at the Cambridge Public Health Department in Massachusetts and president of the National Association of County & City Health Officials (NACCHO). “And the…
lborkowski | May 29, 2017In early May, House Republicans rushed to pass an amended version of the American Health Care Act (HR 1628) without waiting for the Congressional Budget Office to give them an estimate of how it would affect health insurance coverage nationwide. Now, CBO has released a score that shows just how destructive this legislation will be if it becomes law: It will increase the number of uninsured by 23 million over the next decade by slashing Medicaid, allowing the destabilization of the individual markets in areas where one-sixth of the US population resides, and putting individual policies out of…
lborkowski | May 8, 2017Last week, 217 Republican members of the House of Representatives passed a bill that, if it becomes law, will leave millions of people without health insurance. We don’t have a good grasp of how many millions will be harmed, because they were in too much of a hurry to wait for an estimate from the nonpartisan Congressional Budget Office — or, in some cases, to read the bill they were voting on. My guess is that most of those members know it’s a terrible bill that will harm many of their constituents, and they’re hoping the Senate will fix the mess they’ve made.
Like the original American…
kkrisberg | April 25, 2017More than 8 million U.S. children depend on the Children’s Health Insurance Program for access to timely medical care. The program is authorized through 2019, but its federal funding expires in September and it’s unclear what Congress will do.
That uncertainty stresses all the systems and families that depend on CHIP, but it may be especially risky for the 2 million chronically ill children who get care through the program, which was originally designed for families falling in the gap between market affordability and Medicaid eligibility. In a study published this month in Health Affairs,…
lborkowski | April 3, 2017In the 18 days between House Republicans’ introduction of the American Health Care Act and its withdrawal, women’s health was in the spotlight. With House Speaker Paul Ryan now stating that he’s going to try again on legislation to “replace” the Affordable Care Act, it’s worth looking at some of the ways the ACA has benefited women – and how actions from Congress and the Trump administration could affect women’s insurance coverage and access to care.
Women gained coverage under the ACA
The ACA’s biggest achievement was reducing the percentage of the population without health insurance. It did…
kkrisberg | March 25, 2017Yesterday, House Republicans failed to find enough votes to pass their Affordable Care Act replacement. It was a very good day for the millions of Americans projected to lose their coverage under the GOP plan. But let’s be clear: Obamacare is not safe.
In a last-ditch effort to round up more votes, House Speaker Paul Ryan, R-Wis., proposed an amendment that would have, beginning in 2018, allowed states to determine the kinds of essential health benefits required in insurance plans purchased with tax credits. Under Obama’s health care law, insurance plans sold via the federal health care…