“As soon as Air Force One touched down in Indiana on Friday, Gov. Mike Pence met President Barack Obama on the tarmac with a plea: Expand the state’s access to government-sponsored health insurance.
The catch: Pence wants to do it with a conservative twist.
At least, that’s how he’s selling his proposal. And his political future could hinge on whether the first-term Republican can convince conservatives that he’s not just rebranding Obamacare.
Pence has spent much of his first two years in office trying to strike a bargain on one of the health care law’s core components. Indiana will expand Medicaid coverage, Pence says, but only if it’s allowed to do it through a tweaked version called the “Healthy Indiana Plan,” which also requires users to make small payments into health savings accounts.”
“The big story in the Medicare world these days is the slowdown in program spending. Based on our comparison of CBO’s August 2010 and August 2014 baselines, Medicare spending this year will be about $1,200 lower1 per person than was expected in 2010, soon after passage of the Affordable Care Act (ACA), which included reductions in Medicare payments to plans and providers and introduced delivery system reforms that aimed to improve efficiency and reduce costs. By 2019, Medicare spending per person is projected to be more than $2,400 lower per person than was expected following passage of the ACA. Medicare spending projections in CBO’s August 2010 and subsequent baselines take into account the anticipated effects of the ACA, along with other factors that are expected to affect future Medicare spending. So it seems that the ACA may be having a bigger than expected effect, but something else may be going on here too.”
“Governors suggest in a new report that states consider easing restrictions on physician assistants to help deal with swelling Medicaid rolls. The National Governors Association says states should consider including PAs in the definition of “provider,” loosening so-called scope-of-practice laws to let physicians delegate more tasks to PAs, opening clinical training sites and encouraging PAs to work in primary care.
“To increase the use of the physician assistant workforce, states should review the laws and regulations affecting the profession and consider actions to increase the future supply of PAs,” an NGA release states.”
“Washington is full of ideas to overhaul Medicare. Some would increase the program’s eligibility age, others would charge higher-income beneficiaries more for their coverage. There’s movement to link payment to the quality — rather than the quantity — of care delivered.
Marge Ginsburg decided to ask ordinary Americans how they would change the federal entitlement program.”
“If you are looking for information on how Americans are engaging with the Affordable Care Act, the Census Bureau’s recently released latest annual estimates of health insurance coverage is probably not the place to look—at least for now.
The Census Bureau, which derives its information on healthcare from the Annual Social and Economic Supplement—the same survey where it asks how many toilets, computers, microwaves, etc., people have in their homes—does provide some useful insights.
It catalogues the demographic characteristics of the population based on participation in different types of health insurance coverage—government health care programs, private employer and individual plans, and the uninsured. It tells us young adults make up a disproportionate share of the uninsured and provides useful information on the relative availability of employer-sponsored coverage by industry and firm size.
But its hard numbers on enrollment and enrollment trends are not reliable for drawing “big picture” conclusions, especially regarding the ACA. Indeed, that unreliability is why this year the Census Bureau started using a new set of health coverage questions in the ASEC.”
“When it comes to claims about Medicare, some political talking points just never die.
In Iowa and Virginia, Republicans have accused Democrats of cutting Medicare to pay for Obamacare. In Florida, a Republican was slammed for ending the Medicare “guarantee.” Other Medicare-related attacks have been deployed in Arkansas and Kentucky Senate races. The point of all the attacks is to convince midterm voters that one side or the other won’t protect the program.
Take this one, used in a recent ad aired by the National Republican Senatorial Committee in the hotly contested Iowa Senate race between Democratic Rep. Bruce Braley and Republican state Sen. Joni Ernst:
“Bruce Braley voted to cut $700 billion from Medicare to support Obamacare,” the ad says. “That’s just not fair. We paid in. We paid for it. That should be there for us.””
“Some of Obamacare’s big supporters say the new law has already contributed to decreases in the rate of growth of health spending.
But a new report from the Center for Medicare and Medicaid Services Office of the Actuary says the rate slowed because of a slow economic recovery, increased cost-sharing for those enrolled in private plans and sequestration.
Indeed, the report does not even mention Obamacare when assessing the situation. “The recent period is marked by a four-year historically low rate of health spending growth, which is primarily attributable to the sluggish economic recovery and constrained state and local government budgets following the 2007-09 recession,” the report states.”
“RICHMOND — Gov. Terry McAuliffe (D), who vowed in June to defy the Republican-controlled legislature and expand healthcare to 400,000 uninsured Virginians, unveiled a much more modest plan Monday after being thwarted by federal rules and a last-minute change to state budget language.
McAuliffe outlined measures to provide health insurance to as many as 25,000 Virginians, just a fraction of those he had hoped to cover by expanding Medicaid under the Affordable Care Act.
The biggest change, covering 20,000 people with severe mental illness, will need funding approval from the General Assembly to continue past the current fiscal year. McAuliffe also offered proposals to improve care for people already in Medicaid and boost outreach efforts to those who qualify but are not enrolled.”
“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.”
“RICHMOND, Va. — Virginia Gov. Terry McAuliffe is set to unveil his plan to increase health care coverage for the state’s poor.
The Democratic governor will speak publicly Monday on his plans for health care expansion.
The governor unsuccessfully tried to persuade Republican lawmakers to expand Medicaid during this year’s legislative session. The impasse led to a protracted stalemate over the state budget that ended with a GOP victory.”