Tuesday, June 11, 2013

Affordable Care Update

The Huffington Post reports refusing Medicaid Expansion could cost states billions of federal dollars.
The Rand Corp. analyzed 14 states with governors who oppose the Medicaid expansion. It found their actions will deprive 3.6 million people of health coverage under Obamacare, forgo $8.4 billion in federal funding, and cost them $1 billion for programs that partially compensate medical providers who care for the indigent, according to the report published in the journal "Health Affairs." 

The New York Times Economix blog suggests the Affordable Care Act could be a boon to enterpreneurship.

A Fiscal Times report offers the border between Kentucky and Indiana as an illustration of the "haves and have-nots" with Medicaid Expansion.
On a good day it only takes nine minutes to drive across the Ohio River between Clarksville, Ind., and Louisville, Ky.  But for hundreds of thousands of uninsured poor and disabled people who live throughout Indiana and Kentucky, that short span defines a boundary between winners and losers in the political battle over expanding Medicaid coverage as part of the Affordable Care Act.
For the record, I personally do not believe that Indiana should expand Traditional Medicaid, nor should it be forced to. I do believe that Indiana should work with the federal government, as they are right now, to reach a compromise solution that uses the best practices Indiana has developed while including important guarantees under the Affordable Care Act. This means, yes, there should be cost sharing, but there should be reasonable out of pocket limits, which apply on a sliding scale according to income. Yes, there should be an emphasis on preventive care, but the annual and lifetime dollar limits should be removed from the current HIP program if it becomes the basis for an expansion. The structure of the POWER account should be built upon, including the health incentive payments, as well as nonprofit and employer contributions contained in state law. Participants ought to understand that they must take responsibility for their individual health.

Mississippi offers a case in point, where a lack of cooperation could mean a massive loss of federal funds in a state that can hardly afford the hit. The state may be left with no enabling legislation that authorizes any part of the Medicaid program due to the partisan, bitter environment in the state legislature. It is possible the Governor may attempt to at least maintain the existing program with an executive order, but the legal authority to do so is unclear at best.

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