Admin Costs Outpace Health Spending In Ga.’s Medicaid Work Program: GAO
Georgia’s Pathways to Coverage is the nation’s only Medicaid work requirement program and has been touted by congressional Republicans as a model for the nation. As of April, the Georgia program has spent $54.2 million on administrative costs since 2021, compared to $26.1 million spent on health care costs.
ProPublica, The Current:
Georgia’s Medicaid Work Requirement Program Spent Twice As Much On Administrative Costs As On Health Care, GAO Says
Most of the tax dollars used to launch and implement the nation’s only Medicaid work requirement program have gone toward paying administrative costs rather than covering health care for Georgians, according to a new report by the Government Accountability Office, the nonpartisan agency that monitors federal programs and spending. The government report examined administrative expenses for Georgia Pathways to Coverage, the state’s experiment with work requirements. It follows previous reporting by The Current and ProPublica showing that the program has cost federal and state taxpayers more than $86.9 million while enrolling a tiny fraction of those eligible for free health care. (Coker, 9/24)
More on the high cost of health care —
The New York Times:
Why Obamacare Bills May Double Next Year
Earlier this month, Julie Morringello, an artist in rural Maine, received a notice that her health care premiums could nearly double next year. She now pays $460 a month for her Obamacare plan, but that amount is contingent on government subsidies that the Republican-controlled Congress may not extend. (Abelson and Sanger-Katz, 9/24)
Modern Healthcare:
Providence, Adventist Health Layoffs Tied To Tax Law
Providers and insurers are cutting staff or eliminating unfilled positions due to forthcoming funding cuts stemming from the tax law. The law, H.R. 1, is expected to cost the industry $1.1 trillion and leave 10 million people uninsured, according to the Congressional Budget Office. Among other likely challenges, health systems are forecasting less reimbursement for Medicare and Medicaid services, while insurers anticipate rising claims costs. (DeSilva, 9/24)
Modern Healthcare:
How Community Health Worker Programs Can Boost Hospital ROI
Health systems are growing investments in community health workers, but they face questions about how to make these programs financially sustainable. Community health workers are gearing up for the impact of federal healthcare funding cuts, and health systems hope they can help patients avoid losing insurance coverage with expiring enhanced subsidies and the new tax law, among other areas. But setting up these kinds of programs — and finding stable funding for them — can be tricky, even if community health workers ultimately help avoid unnecessary costs. (Hudson, 9/24)
KFF Health News:
As Trump Punts On Medical Debt, Battle Over Patient Protections Moves To States
With the Trump administration scaling back federal efforts to protect Americans from medical bills they can’t pay, advocates for patients and consumers have shifted their work to contain the nation’s medical debt problem to state Capitols. Despite progress in some mostly blue states this year, however, recent setbacks in more conservative legislatures underscore the persistent challenges in strengthening patient protections. (Levey and Houghton and Zionts, 9/25)
KFF Health News:
Big Loopholes In Hospital Charity Care Programs Mean Patients Still Get Stuck With The Tab
Quinn Cochran-Zipp went to the emergency room three times with severe abdominal pain before doctors figured out she had early-stage cancer in the germ cells of her right ovary. After emergency surgery four years ago, the Greeley, Colorado, lab technician is cancer-free. The two hospitals that treated Cochran-Zipp at the time determined that she qualified for 100% financial assistance, since her income as a college student was extremely low. Not having to worry about the roughly $100,000 in bills she racked up for her care was an enormous relief, she said. (Andrews, 9/25)
KFF Health News:
AI Will Soon Have A Say In Approving Or Denying Medicare Treatments
Taking a page from the private insurance industry’s playbook, the Trump administration will launch a program next year to find out how much money an artificial intelligence algorithm could save the federal government by denying care to Medicare patients. The pilot program, designed to weed out wasteful, “low-value” services, amounts to a federal expansion of an unpopular process called prior authorization, which requires patients or someone on their medical team to seek insurance approval before proceeding with certain procedures, tests, and prescriptions. (Sausser and Tahir, 9/25)
