Reduce states’ Medicaid Disproportionate Share Hospital (DSH) allotments.
Increase spending caps for the territories.
Requires states to expand their Medicaid eligibility rules to cover those up to 133% of the federal poverty level. Over half of those newly insured via ObamaCare will be getting their new insurance coverage through Medicaid.
Myth
It’s not a government takeover.
See: President Obama’s weekly radio address from July 19, 2009
Fact
The new health law hands over to the federal government immense new powers, powers that will, over time, mean all important decisions about the organization and financing of American health care will need to meet the approval of federal agencies and bureaucrats.
Among the new federal powers created in the health law are the following:
The power to establish standardized insurance benefit packages from which all Americans must choose their coverage (see section XXXX). This means that everyone must conform with federal requirements regarding what is and is not covered by health insurance.
The power to include or exclude insurers from the marketplace based on any criteria the Secretary of HHS considers appropriate (see section XXXX). This means the federal government will have the power to pick winners and losers in the insurance marketplace.
The establishment of a new unelected and unaccountable Independent Payment Advisory Board with the power to unilaterally cut payment Medicare rates to providers of medical services (see section 3403).
Increase Medicaid payments for primary care services provided by primary care doctors for 2013 and 2014 with 100% federal funding.
Create new demonstration projects in Medicaid to pay bundled payments for episodes of care that include hospitalizations (effective January 1, 2012 through December 31, 2016); to make global capitated payments to safety net hospital systems (effective fiscal years 2010 through 2012); to allow pediatric medical providers organized as accountable care organizations to share in cost-savings (effective January 1, 2012 through December 31, 2016); and to provide Medicaid payments to institutions of mental disease for adult enrollees who require stabilization of an emergency condition (effective October 1, 2011 through December 31, 2015).
Prohibit federal payments to states for Medicaid services related to health care acquired conditions.
Create a new Medicaid state plan option to permit Medicaid enrollees with at least two chronic conditions, one condition and risk of developing another, or at least one serious and persistent mental health condition to designate a provider as a health home. Provide states taking up the option with 90% FMAP for two years for health home related services including care management, care coordination and health promotion.
Create the State Balancing Incentive Program in Medicaid to provide enhanced federal matching payments to increase non-institutionally based long-term care services.
Establish the Community First Choice Option in Medicaid to provide community-based attendant support services to certain people with disabilities.