Morning Briefing
Summaries of health policy coverage from major news organizations
Parsing Policies: Choose Politicians Who Want To Keep Coverage For Pre-Existing Conditions
USA Today: Don't Deny Insurance To Sick People, Find Other Ways To Reduce Costs
It's hard to think of a law that's been more controversial in the last decade than the Affordable Care Act, also known as Obamacare. Yet as the country continues to endure bitter division over the ACA, one provision remains extraordinarily popular: the requirement that insurers cover those who are sick. Even in the thick of the Obamacare debates a decade ago, 80 percent of Americans agreed the federal government should require insurance companies to offer coverage to everyone, regardless of their pre-existing illnesses and conditions. As Americans prepare to vote in a midterm election where polls show health care is a top issue, they will need to decide whether they want to choose candidates who would permit discriminating against sick people and support undoing the progress we've made on one of the few policy issues where the country has managed to find consensus. (Arthur Tim Garson, 7/12)
Lexington Herald: Managed-Care Firms Strangle Ky. Medicaid
More than half of all Medicaid beneficiaries nationally receive most or all of their care from managed-care organizations that contract with state Medicaid programs to deliver comprehensive services. Kentucky leads the way, providing some of highest profits to MCOs. This is suffocating the health-care system. Kentucky HEALTH, the state’s Medicaid reform, clearly decreases access to health-care services to Medicaid beneficiaries. This would have included new requirements for co-pays and work. Currently blocked by federal courts, the plan not only shifts more costs upon the population health-care providers serve, but also ensures greater profit to MCOs. (Larry Suess, 7/11)
The Topeka Capital-Journal: Stop Posturing About Medicaid Work Requirements
Last week, a Kentucky court blocked the state’s proposal to impose Medicaid work requirements, citing they “never adequately considered whether Kentucky HEALTH (the state’s Medicaid program) would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid.” Yet Gov. Colyer, who was stripped by the Legislature this past session of the ability to implement work requirements without legislative approval, still stands in favor of pursuing work requirements in Kansas even though it will lead to another expensive legal battle the state isn’t likely to win. It’s another example of shortsighted policy-making that satisfies political talking points but fails to meet the needs of Kansans and ends up costing the state more in a multitude of ways. (7/11)
Apalachicola Times: Medicaid Expansion Is Saving Lives
Louisiana expanded its Medicaid program just over two years ago. In that time, the number of people who were able to obtain health insurance has ballooned. When Gov. John Be Edwards approved the expansion, about 25 percent of the people in Louisiana lacked basic medical coverage. Since that time, the number is down to around 10 percent. That is a huge difference in numbers, of course, but the real difference is measured in the lives the expansion will be able to save. Consider these numbers, which tell just part of the story: 400 women on Medicaid have been diagnosed with breast cancer and begun treatment; 8,000 have had precancerous colon polyps removed; and 57,000 people are receiving mental-health care. Those are staggering figures that are making a real impact on the quality of people’s lives – and likely saving a good number of lives themselves. (7/11)
New England Journal of Medicine: Medicaid’s Path To Value-Based Reform
Prominent Medicare value-based payment models are influencing the ways in which clinicians deliver care. CMS and states have also started transforming reimbursement and care for Medicaid beneficiaries, but sustained success may be harder to achieve than in Medicare. (Joshua Liao, Benjamin D. Sommers and Amol S. Navathe, 7/12)
The Hill: AHA Medicare Appeals Reform Recommendations Miss The Mark
Last week, the American Hospital Association (AHA) filed a brief with the federal court in response to U.S. District Judge James Boasberg’s request for ideas to address the current Medicare appeals backlog. Instead of making substantive administrative recommendations to improve the Medicare appeals process, the AHA makes suggestions that are not only redundant based on existing Centers for Medicare and Medicaid Services (CMS) rules. It also clearly demonstrate that the AHA is more interested in sidelining the Recovery Audit Contractor (RAC) program than fixing the Medicare appeals backlog. (Kristin Walter, 7/11)
