Showing posts with label Medicaid. Show all posts
Showing posts with label Medicaid. Show all posts

Wednesday, March 27, 2013

ObamaCare's Plan to Insure 30 Million More People Leads to 30 Million More People Being Insured

Here are a few of the headlines that caught my eye on the Yahoo! newsfeed this week:









The first article points out a glitch in the law that could affect two to four million people and whether or not they receive the proper tax credits to help pay for their insurance coverage. It's a legit hole that could easily be plugged if there was support in Congress to make government work better, rather than dismantle it.

The second article, however, seems to miss the overall point of the law. Let's face it, ObamaCare was a large bill, thousands of pages long, as Republicans were always eager to point out. Surely, you can pick out any one piece of the bill and say, this will hurt this business or that sector of the health care market. But when you take the bill in its entirety it's expected to be a net-good for almost everybody.

The bulk of the increase in claims costs will largely be passed on to the states who are implementing the expanded Medicaid coverage. And the Feds will be picking up 100% of those costs now and 90% in the future. The rest of the costs will effect those who get their insurance through the individual marketplace - self-employed people or very small businesses. Those who get insurance through their employer will not be affected by these changes.

With ObamaCare in general and on this issue specifically, my initial reaction usually is "compared to what?" If the baseline is millions of people have no health coverage and receive emergency room care for everything, then that currently is already driving up the costs of: health insurance, hospital reimbursements, tests and procedures, and the subsidies the government is providing for all of that. In the long term, after the initial increase in claims costs is absorbed, costs stabilize.

Focusing on something like increasing claims cost, which are due to more claims being filed because more people will have health coverage, while the costs of which are more than offset by reductions in costs elsewhere, misses the point. Covering more people is a feature of the law, not a bug. And if it was easy and inexpensive to extend coverage to the uninsured, it would have already been done years ago. The rise in claims costs was not unexpected and was already factored into the bill.

The key point here is that ObamaCare wasn't passed to ensure that the number of medical care claims were held steady. The main goals of ObamaCare were: 1)to help give thirty million-plus more people access to health coverage, 2)to end insurance company abuses by more tightly regulating the health insurance market, and 3)by doing those previous two things and by implementing hundreds more cost control mechanisms, to attempt to eventually bring down the growth in health care costs to a more manageable number going forward, so we can deal with our long-term debt problem. You can't accomplish those goals without some minor and somewhat major changes and reforms.

Update 03/28/13: Yahoo! News continues to troll ObamaCare.....

Friday, September 7, 2012

Did Clinton's Response to the Medicare Attacks Win the Election for Obama?

(CBSNews)

We still won't really know what kind of post-Convention bounce Obama will get until early next week. But one essential goal in this convention was for the Democrats to clear up any confusion over the Medicare issue. Since the 2010 Midterm elections the Republicans have hammered the Dems over the "cuts" to Medicare in the Affordable Care Act (ACA) and in the process drove up support among voters 50 and over. When your base is old white people, this issue was teed up for them.

Of course President Obama was never going to win a majority of voters in this demographic, but he had to close the gap that opened up 2 years ago. Let's face it, older white voters typically lean Republican anyway. And when you add the race factor, it was always going to be an uphill climb for Obama with these voters. They were preconditioned to believe the distortions about the "Medicare "cuts" with Obama, more so than they'd be with President Clinton for the same reason that a lot of older white women put both hands on their pocketbooks when they see a black guy walking down the street.

But much like Republicans always have a built-in edge with voters on matters of the military and foreign policy, Democrats have always enjoyed a historical "trust" edge with voters on health care, particularly Medicare. This is for good reason, since the Democrats created the Medicare beneficiary program and have defended it from Republican attempts at cuts and privatization for over 40 years.

Some voters may not remember, but President Clinton "cut" Medicare in the 1990's. In exchange for slight benefit cuts (i.e. higher premiums for seniors, most of which were directed at the more well-to-do seniors), Clinton reduced the rate of growth and plowed the savings back into the Medicare trust fund to extend the life of the program.

The ACA essentially did the same thing. It reduced the rate of growth and cut payments to providers and insurance companies, which was estimated to save $716B over 10 years. And then it used that money to close the Medicare prescription drug donut hole (created by a bill Paul Ryan voted for, by the way) and extend the life of the program. Providers and insurance companies agreed to the Medicare payment cuts in exchange for the millions of new customers they will now be getting as a result of what the ACA does to provide access to insurance for people who are under the Medicare eligibility age. You have to look at the ACA in its entirety and not just the Medicare portion to understand how it all works.

Anyway, Clinton explains it better here:
Now, there were two other attacks on the president in Tampa I think deserve an answer. First, both Governor Romney and Congressman Ryan attacked the president for allegedly “robbing Medicare” of $716 billion. That’s the same attack they leveled against the Congress in 2010, and they got a lot of votes on it. But it’s not true.

Look, here’s what really happened. You be the judge. Here’s what really happened. There were no cuts to benefits at all, none.

What the president did was to save money by taking the recommendations of a commission of professionals to cut unwarranted subsidies to providers and insurance companies that were not making people healthier and were not necessary to get the providers to provide the service.

(APPLAUSE)
And instead of raiding Medicare, he used the savings to close the donut hole in the Medicare drug program.
(APPLAUSE)
And -- you all got to listen carefully to this. This is really important -- and to add eight years to the life of the Medicare trust fund so it is solvent until 2024. So...
(APPLAUSE)
So President Obama and the Democrats didn’t weaken Medicare. They strengthened Medicare.
(APPLAUSE)
Now, when Congressman Ryan looked into that TV camera and attacked President Obama’s Medicare savings as, quote, “the biggest, coldest power play,” I didn’t know whether to laugh or cry...
(LAUGHTER)
... because that $716 billion is exactly to the dollar the same amount of Medicare savings that he has in his own budget!
(APPLAUSE)
You got to give one thing: It takes some brass to attack a guy for doing what you did.
(LAUGHTER) 
It’s important, because a lot of people believe this stuff. Now, at least on this issue, on this one issue, Governor Romney has been consistent. He...
(LAUGHTER)
He attacked President Obama, too, but he actually wants to repeal those savings and give the money back to the insurance company.
(BOOING)
He wants to go back to the old system, which means we’ll reopen the donut hole and force seniors to pay more for drugs, and we’ll reduce the life of the Medicare trust fund by eight full years.
(BOOING)
So if he’s elected, and if he does what he promised to do, Medicare will now go broke in 2016. Think about that. That means after all we won’t have to wait until their voucher program kicks in, in 2023, to see the end of Medicare as we know it. They’re going to do it to us sooner than we thought.
(APPLAUSE)
Now, folks, this is serious, because it gets worse. And you won’t be laughing when I finish telling you this. They also want to block grant Medicaid and cut it by a third over the coming 10 years. Of course, that’s going to really hurt a lot of poor kids.
But that’s not all. A lot of folks don’t know it, but nearly two-thirds of Medicaid is spent on nursing home care for Medicare seniors who are eligible for Medicaid.
(APPLAUSE)
It’s going to end Medicare as we know it. And a lot of that money is also spent to help people with disabilities, including...
(APPLAUSE)
... a lot of middle-class families whose kids have Down’s syndrome or autism or other severe conditions.
And, honestly, just think about it. If that happens, I don’t know what those families are going to do. So I know what I’m going to do: I’m going to do everything I can to see that it doesn’t happen. We can’t let it happen. We can’t.

And then he dropped the mic.

Not only did he set the facts straight on Medicare, he also reminded everyone that Medicaid isn't just a program for poor people (as noted by Alec MacGillis on Twitter), that seniors and people with disabilities depend on Medicaid too.


And the cuts Romney-Ryan want to make to that program would devastate many families.

Recall, even with a booming economy in 1996, Clinton only managed to get 49% of the vote. With Ross Perot running again, he was still able to win an easy re-election partially by convincing many seniors that Newt Gingrich, Bob Dole, and the Republicans in Congress would follow through on their long stated goals to "let Medicare wither on the vine and die." Voters trusted Clinton and Gore on Medicare even after the cuts because Dole was stuck defending a more radical plan. Most voters believed that Clinton really did want to strengthen Medicare because that is what Democrats have always done. And most voters believed that Republicans really wanted to dismantle the program because that's what they have always tried to do.

Sound familiar?

If the Obama campaign doesn't end up using snippets of Clinton's comments in campaign ads this fall, they are really missing out on a golden opportunity. With post-Presidential approval ratings hovering around 70%, Clinton is the closest thing we have in this divided country to a statesman who most people like and trust.

With a slow recovery and unpredictable job growth, Obama is going to need to emphasize Medicare, foreign policy, and tax code fairness, among other things, the next few months. And Clinton may have helped him enough with seniors in states like Florida and the swing states in the Rust Belt in November, to allow Obama to make the closing argument on protecting Medicare, Medicaid, and ultimately the ACA.