“DETROIT– A lawsuit has been filed on behalf of potentially thousands of immigrants who have been rejected for full Medicaid coverage in Michigan because of computer problems.
The lawsuit in Detroit federal court says the state has known about the problem for weeks but is moving too slowly to fix it. Attorneys are asking a judge to issue an injunction to get things moving.
The Center for Civil Justice in Flint says many immigrants are approved only for emergency services. The group says federal law typically grants full health coverage under Medicaid to low-income refugees and poor lawful permanent residents.”

“Americans living in rural areas will be a key target as states and nonprofit groups strategize how to enroll more people in health law insurance plans this fall.
Though millions of people signed up for private insurance or Medicaid in the first year of the Affordable Care Act, millions of others did not. Many live in rural areas where people “face more barriers,” said Laurie Martin, a RAND Corp. senior policy researcher. Brock Slabach, a senior vice president at the National Rural Health Association, said “the feds are particularly concerned about this.”
Distance is one problem: Residents have to travel farther to get face-to-face assistance from the so-called navigators and assisters hired to help consumers figure out the process. And Internet access is sometimes spotty, discouraging online enrollment.
But the most significant barriers may stem directly from state decisions about whether to expand Medicaid eligibility — more than 20 states chose not to — and whether to operate their own health exchanges. States that embraced those parts of the law generally had more federal resources as well as funds generated by their online marketplaces for outreach efforts to boost enrollment, including those aimed at consumers in less accessible areas, and more coverage options, through Medicaid, for which these consumers might be eligible.”

“Enrolling in Missouri’s Medicaid program has not been easy.
Many applicants have experienced a barrage of problems when trying to sign up for the program, including long delays until coverage kicks in, lost paperwork and a lack of one-on-one interaction with caseworkers. State officials have blamed a new computer system used to process Medicaid applications.
But there is another reason why some Missourians struggle to get help.
When Deborah Weaver, 28, had issues enrolling in the state’s Medicaid coverage for pregnant women, a switch from her Medicaid disability coverage, she was directed to use a toll-free number, 1-855-373-4636. When she called, Weaver endured long waits and received no guidance.
“I called them three or four times and each time it would take a minimum of 15 to 20 minutes to get through to a human being, only to be given the runaround,” Weaver said.
One time the wait dragged on for so long, Weaver ended the call, worried she was racking up too many minutes on her family’s cellphone plan.”

“NORTHPORT, Maine – By the time Laura Tasheiko discovered the lump in her left breast, it was larger than a grape. Tasheiko, 61, an artist who makes a living selling oil paintings of Maine’s snowy woods, lighthouses and rocky coastline, was terrified: She had no health insurance and little cash to spare.
Laura Tasheiko, 61, sits in her home in Northport, Maine (Photo by Joel Page for USA TODAY).
But that was nearly six years ago, and the state Medicaid program was generous then. Tasheiko was eligible because of her modest income, and MaineCare, as it is called, paid for all of her treatment, including the surgery, an $18,000 drug to treat nerve damage that made it impossible to hold a paintbrush, physical therapy and continuing checkups.
But while much of America saw an expansion of coverage this year, low-income Maine residents like Tasheiko lost benefits. On Jan. 1, just as the Affordable Care Act was being rolled out nationwide, MaineCare terminated her coverage, leaving her and thousands of others without insurance.
Maine Gov. Paul LePage’s decision to shrink Medicaid instead of expanding it was a radical departure from a decade-long effort to cover more people in this small rural state of farmers, lobstermen, craftsmen and other seasonal workers, which at least until recently, boasted one of the lowest rates of uninsured in the nation.”

“Republicans vying to wrest the Kentucky House from Democratic control for the first time in nearly a century promised Tuesday to try to repeal the state’s Medicaid expansion and rein in other parts of the federal health care overhaul.
House Republican leaders made stops in western Kentucky as part of a multi-day tour to promote their legislative agenda, called the “Handshake with Kentucky.” They said they would push for legislation prohibiting mandatory participation in a workplace union and for a revamped state tax code and creation of medical expert panels to review proposed medical malpractice claims before they could be pursued in court.
“If the people of Kentucky entrust us with the majority, we are committing to immediately begin debate with the intention of passing each of these pieces of legislation,” House GOP Floor Leader Jeff Hoover said.
State Democratic Party Chairman Dan Logsdon called them “warmed over” ideas repackaged to get Republicans to the polls.
“It’s not leadership,” he said. “It’s pandering to their base.”
Republicans have not had a majority in the Kentucky House since 1920. Democrats have been whittled to a 54-46 majority, putting the GOP within striking distance of consolidating power in the Kentucky General Assembly. Republicans have solid control of the state Senate.”

“Medicaid expansion is expanding profits for a bunch of hospitals.
A new analysis of major for-profit health systems found that hospitals in states that expanded Medicaid eligibility under Obamacare are seeing far fewer uninsured patients, a large rise in paying patients and more revenue as a consequence—which stands in stark contrast to hospitals in nonexpansion states.
For example, there was about a 47 percent decrease in the rate of admissions of uninsured or self-paying patients at the hospitals in expansion states in the first half of 2014. Yet, hospitals in nonexpansion states either saw a slight reduction in such admissions or no decreases at all, according to the PricewaterhouseCoopers Health Research Institute. ”

“Reduced costs for medical services and labor have trimmed the 10-year projected cost of Medicare and Medicaid by $89 billion, the Congressional Budget Office said Wednesday.
Medicare spending is projected to drop by $49 billion — or less than 1 percent — from 2015 and 2024, while Medicaid spending is expected to drop by $40 billion — or about 1 percent — over the next decade, CBO said in an update to its April forecast.
Despite the long-term projected drop, federal spending for major health care programs will jump this year by $67 billion — or about 9 percent — the agency estimated. The largest increase will be for Medicaid, which is projected to grow by $40 billion, or 15 percent. Most of this short-term increase is attributable to the Affordable Care Act, including its Medicaid expansion and the financial assistance to help people purchase health insurance.”

“Federal officials have reached an agreement with Pennsylvania Gov. Tom Corbett over his plan to use federal funds to pay for private health insurance coverage for up to 600,000 residents, the governor said on Thursday.
The deal highlights a growing number of Republican governors who are finding ways to accept money under President Barack Obama’s Affordable Care Act, despite political opposition that has so far prevented nearly half of U.S. states from moving forward with the Medicaid expansion plan.
Corbett sought a waiver in February to use those expansion funds to instead subsidize private health insurance for low-income residents.”

“Revenue at not-for-profit hospitals grew at an all-time low of 3.9% last year with sluggish gains in both inpatient and outpatient activity, according to a report on 2013 medians from Moody’s Investors Service.
In comparison, hospital revenue increased 5.1% in 2012 and historically has grown about 7% per year.
Moody’s pegged the increased popularity of high-deductible health plans for leading people to postpone care or seek out lower cost retail clinics. “Patients have more skin in the game,” said Jennifer Ewing, an analyst at Moody’s.
The volume decline also is coming amid a number of Medicare reimbursement cuts, including the ones known as sequestration triggered by the 2012 Budget Control Act and reductions in disproportionate-share hospital payments under the Patient Protection and Affordable Care Act. In addition, Medicare’s two-midnight rule has made it harder for hospitals to bill short stays as inpatient care, and commercial payers have offered lower payment rate increases.”

“Last Saturday, August 16, marked the 60th anniversary of the enactment of the Internal Revenue Code of 1954, which permanently established in federal law generous tax advantages for employer-paid health-insurance premiums. Those group health benefits are excluded from employees’ taxable wages and thereby are not subject to income and payroll taxes. This tax break has been praised as a pillar of our employer-based private health-insurance system, but its age is showing. A growing list of critics agrees that the tax exclusion needs to be changed. The key questions are when and how. We should expect a significant overhaul, but not a full retirement party, within the next five to ten years.
The simplified history of the tax exclusion for health care usually begins with a 1942 ruling by the War Labor Board that allowed employers to bypass wartime wage controls by providing fringe benefits to workers. In 1943, the Internal Revenue Service issued a special ruling that confirmed employees were not required to pay tax on the dollar value of group health-insurance premiums paid on their behalf by their corporate employers. Over the next decade, a number of IRS rulings and court decisions created additional uncertainty over the full scope of the tax exclusion. When Congress codified this area of tax policy in 1954, it provided many employers and unions with even stronger incentives to sponsor group health-insurance plans.”