“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.”
Nationally, over half of those newly insured by ObamaCare will be added to Medicaid. This government-run program reimburses doctors at such low rates, that many providers refuse to treat enrollees. “The Kentucky Hospital Association said in a report on Monday that Kentucky hospitals will lose $1.2 billion in revenues in the next 10 years because of health care reform. Because Kentucky has one of the lowest income levels in the nation, the majority of uninsured Kentuckians will be covered under Medicaid rather than private health insurance, leaving the state with 25 percent of its population on Medicaid, the report said. Medicaid is jointly financed by federal and state tax dollars.”
“Indiana’s Medicaid chief told lawmakers Thursday that the federal government has largely left states in the dark on implementing the federal health care overhaul because it hasn’t yet provided needed guidelines. Medicaid Director Pat Casanova told the Health Finance Commission that key parts of the overhaul take effect in 2014 — about 3 1/2 years away — but states will need several years to pass their own rules and implement the overhaul.”
“The Congressional Budget Office estimates that the PPACA will add 16 million new individuals to Medicaid. And that almost certainly means many, many more emergency room visits. ObamaCare was sold as a way to ease America’s health care burdens. Instead, it looks more and more like its legacy will be to increase the strain on a broken system.”
“Considering how dubious the public remains about Obamacare, there is every reason to believe the Republicans really did want an exchange with the candid, erudite Berwick. The recess appointment strongly suggests the White House simply did not want to have another fight over the contentious health-care issue.”
According to surveys, only about a third of Texas primary care doctors accept Medicaid patients, because the government-run insurance program sets very low doctor fees. Over half of the people who will become newly insured because of ObamaCare will be added to Medicaid, which means their insurance will likely not actually allow them access to medical care.
When he takes control of Medicare and Medicaid, Don Berwick will begin to implement his vision of a more centralized, government-run health care system. This viewpoint is at the heart of ObamaCare, with the aim of putting Washington in charge of all health care decision-making. “Such a command-and-control vision is widespread among America’s technocratic medical left, but it is also increasingly anachronistic amid today’s breakneck medical progress. There isn’t a single ‘ideal model’ in a world of treatments tailored to the genetic patterns of specific cancers, or for the artificial pancreas for individual diabetics, or other innovations that are increasingly common.”
One of the consequences of President Obama’s recess appointment of Dr. Berwick is that he will completely avoid any scrutiny of his views on government rationing of care, especially end-of-life care. “Grassley had asked for information pertaining to sources of funding for Berwick’s Institute for Healthcare Improvement; he had also asked whether ‘Berwick had ever received funding from, been a member of, consulted with or for, or been associated in any way with Compassion and Choices, formerly known as The Hemlock Society,’ which advocates for patients’ right to choose euthanasia.”