“The new health care law specifically targets reimbursement for new drugs and devices as a way to save money in programs like Medicare and Medicaid. These savings, in turn, are used to pay for new health coverage for the uninsured. But the legislation doesn’t take down drug and medical device prices directly. Rather, it creates a series of new agencies, boards, and authorities that separately will be empowered to construct new rules to impact how medical products are priced, as well as to restrict their use by defining when and if products are covered by insurance.”
“As the details of this massive government-led health care overhaul begin to trickle out, let me be clear (to borrow the president’s go-to phrase): The medical system is about to be overwhelmed because there are no disincentives for overuse.”
“In his ruling, Vinson criticized Democrats for seeking to have it both ways when it comes to defending the mandate to buy insurance. During the legislative debate, Republicans chastised the proposal as a new tax on the middle class. Obama defended the payment as a penalty and not a tax, but the Justice Department has argued that legally, it’s a tax.”
“Government, at both the federal and the state levels, is no longer merely an umpire. It is not just setting rules and impartially enforcing them, government all too often is taking sides and picking winners and losers. Overall, Americans accept and expect government as a regulator, but in the world of health care, it is also a purchaser and competitor. There are countless examples in Medicare and Medicaid in which the federal government and states have re-written the rule book to favor a particular hospital or type of provider, or block competition. Special accommodations that were justified (or rationalized) in the past as ‘one-time deals’ or ‘transitional’ somehow become embedded parts of the program.”
“When a federal program is hemorrhaging taxpayer dollars and delivering poor results, policymakers should reform it. Fundamental Medicaid reform is desperately needed. Market-based principles should be introduced to re-align incentives of doctors and patients so that quality can increase and cost can decrease. Instead of addressing the many problems of Medicaid, Obamacare doubles down on the broken program and greatly adds to its rolls.”
Texas doctors will be unable to accept new Medicaid patients under scheduled reimbursement cuts. ObamaCare further squeezes these physicians with more across the board cuts, which will lead to access problems.
State budgets are already in the red, and ObamaCare saddles them with new costs for Medicaid expansions and to establish and implement new insurance exchanges.
“I note with special sadness that first and foremost amongst the bill’s consequences will be the probable demise of the Healthy Indiana Plan (HIP). This program is currently providing health insurance to 50,000 low-income Hoosiers. With its Health Savings Account-style personal accounts and numerous incentives for healthy lifestyle choices, it has been enormously popular and successful. Obamacare’s expansion of Medicaid, soon to cover one in every four citizens, will not only scoop up most of HIP’s participants, but will also cost the state between $3.1 and $3.9 billion over the next decade. It is hard to see how my successors as governor will be able to avoid a steep state tax increase to pay for it.”
The presidents of Texan medical schools are concerned about new costs from ObamaCare that will cause them to train fewer doctors. Teaching hospitals rely on Medicare and Medicaid patients, and they will be reimbursed less per patient by the government according to ObamaCare’s new payment schedules. Given that new insurance subsidies will drive up the demand for medical services, a restriction in supply could result in higher premium costs or rationing of care.
“Under Obamacare, Medicare and Medicaid can be expected to add 35-40 million enrollees in the next ten years, with cost projections amounting to a 35 percent increase of the current state burden of $190 billion. States will face massive cost-sharing increases, with a disproportionate increase in the Mountain States.”