Viewpoints: 'Tug of War' over Medicaid expansion; Bill Keller debunks 5 'Obamacare' myths

Jul 17 2012

The New York Times: The New Tug of War Over Medicaid
The new health care law's individual mandate -; the provision pushing people to buy insurance, and upheld last month by the Supreme Court -; has garnered huge attention. But about half the planned expansion of insurance coverage under the new law comes from another source entirely: growth of the Medicaid program. Yet Medicaid has never been especially popular, and when its expanded role becomes more widely understood, it is likely to become less popular still (Tyler Cowen, 7/14).

Arizona Republic: Will Governor See Human Face Of Health Care?
Like all of the nation's governors, (Ariz. Gov. Jan) Brewer must decide if she will expand the state's Medicaid program as part of the Affordable Care Act, which she derisively calls "Obamacare." The expansion would allow an additional 325,000 low-income Arizonans into the program during the first year and be paid for almost entirely by the federal government. … Maybe the governor hasn't met any of these individuals. Politicians in a heated debate don't always see sick people as living, breathing human beings, but as statistics (E.J. Montini, 7/14).

Denver Post: Should Colorado Opt Out Of The Medicaid Expansion As Outlined In The Affordable Health Care Act? No
Colorado needs to maintain, if not improve, our investment in Medicaid. As an important, reliable, and creative source of coverage for poor and working class families alike, strengthening Medicaid will yield exponential dividends to the health, well-being, and economic prosperity of Coloradans (Shepard Nevel, 7/15).

Denver Post: Should Colorado Opt Out Of The Medicaid Expansion As Outlined In The Affordable Health Care Act? Yes
The decision by the Supreme Court to strike down the federal mandate in President Obama's health care law coercing states to grow their Medicaid rolls was an important win for states still struggling under the weight of an unstable economy. We believe Gov. John Hickenlooper should pass on the now-optional expansion, resist the enticement of new federal dollars, and instead pursue a Colorado solution that seeks to address the immediate challenge of reducing existing Medicaid costs without adding future liabilities (Earl Wright, 7/15).

Houston Chronicle: Grandstanding Over Medicaid Is Unhealthy
Expanding Medicaid statewide, and paying for clinic visits long before a patient is hauled away in an ambulance, is both the cheapest option and the best for keeping Texans healthy. If we say no thanks to the federal matching money, as Gov. Perry plans, Texans will continue to pay for federal health-care reform; we just won't get any of the benefits. Our tax dollars will foot other states' bills. And without the federal matching funds, it's hard to see how our cash-strapped state government could begin to fix our broken system (7/13).

The Dallas Morning News: Texas Physician-Legislators: Limiting Obamacare Is Right For Texas
The unprecedented expansion of Medicaid proposed under the Affordable Care Act will not fundamentally improve patient access to care and, as a greater number of physicians withdraw from the system entirely, will only make it more difficult for these individuals to seek the medical help they need…. The best solution to ensure the long-term viability of our state's ailing Medicaid program is to seek a federal block grant that would allocate funding to the state directly, thereby providing Texas with the freedom to design its own Medicaid system without burdensome federal regulations and one-size-fits-all mandates (State Sen. Bob Deuell and State Reps. Charles Schwertner, Mark Shelton and John Zerwas, 7/15).

iWatch News:  Why Insurers Want ObamaCare's Medicaid Business
Don't be fooled by Republican governors like Florida's Rick Scott and Texas' Rick Perry, who are saying they'll opt out of the Medicaid expansion now that the Supreme Court says that's allowable. When the Feds start doling out billions in 2014 to bring an additional 16 million Americans into the Medicaid program, they'll be on board. Trust me (Wendell Potter, 7/16)

The New York Times: Five Obamacare Myths
On the subject of the Affordable Care Act -; Obamacare, to reclaim the name critics have made into a slur -; a number of fallacies seem to be congealing into accepted wisdom. Much of this is the result of unrelenting Republican propaganda and right-wing punditry, but it has gone largely unchallenged by gun-shy Democrats. The result is that voters are confronted with slogans and side issues -; "It's a tax!" "No, it's a penalty!" -; rather than a reality-based discussion. Let's unpack a few of the most persistent myths (Bill Keller, 7/15).

MinnPost:  Individuals Have A Moral Duty To Buy Health Insurance, Three Bioethicists Say
In a provocative commentary published this week in the Journal of the American Medical Association (JAMA), three bioethicists argue that the individual mandate of the Affordable Care Act (ACA) -; the requirement that everybody who can afford it must purchase health insurance -; is morally appropriate.  In fact, argue NIH Clinical Center bioethicists Tina Rulli and David Wendler and University of Pennsylvania bioethicist Dr. Ezekiel Emanuel, it is the moral duty of individuals to reduce certain burdens they pose on others, including the financial burden of asking others to pick up the cost of their emergency medical care (Susan Perry, 7/13).

Richmond Times-Dispatch: Shifting The Burden
Under the law, Virginia must have a special insurance "exchange," a sort of clearinghouse where people and businesses can shop for policies much as Travelocity lets them shop for travel arrangements. Virginia can set up its own exchange -; at a cost of millions of dollars, and then only on Washington's terms. Or it can let Washington create an exchange for the commonwealth. A number of Republican governors -; such as Louisiana's Bobby Jindal and Texas' Rick Perry -; have opted not to shoulder Washington's burden. Virginia could do the same. And doing so would achieve more than saving the state considerable expense. It also could help hasten the repeal of the law. Here's how (7/16).

Richmond Times-Dispatch: McDonnell's Resistance Is Measured, Not Massive
Even when he's sticking his thumb in someone's eye, Gov. Bob McDonnell tries to be a gentleman about it. He's insisting that Virginia do nothing, at least until November, on carrying out health care reforms won by President Barack Obama and upheld by the U.S. Supreme Court. McDonnell's position may be bad policy -; even fellow Republican suggest as much. He's gambling that it's better politics (Jeff Schapiro, 7/15).

Boston Globe: State Health Care Bill Should Focus On Areas Of Broad Agreement
The long effort to develop an effective cost-containment law for the Massachusetts health care system has entered a worrisome phase. With just two weeks left in the Legislature's formal session, a conference committee is reportedly making little headway on resolving critical differences and arriving at compromise legislation. ... Lawmaking is seldom neat or orderly. Yet because of how important the health care sector is to the Massachusetts economy, this law must be wisely crafted (7/16).

Boston Globe: The Health Reform We Still Need
Now that the Supreme Court has upheld the Affordable Care Act, the law's ultimate success or failure may be judged on whether we can afford it. A look at the Massachusetts experience with health care reform illustrates the point. The law, which was used as a template for federal reforms, shows us that expanding coverage can be achieved through a government mandate (98 percent of the state's citizens are insured), but controlling costs is far more difficult (Kenneth E. Thorpe and Thomas P. Trimarco, 7/14).

San Francisco Chronicle: S.F. Mental Health Project A Good Start
A succession of different mayors has tried different solutions to help the mentally ill and improve the quality of life on the streets for the public -- and each has been defeated by the complexity of the issue and the thorniness of the politics.  That's why the Department of Public Health's Community Independence Pilot Project is so important. Slowly and quietly, it's creating progress on this tough issue. Now the city has to find a way to successfully scale it up -- and to keep pushing for tougher strategies that could work, like the state's controversial Laura's Law (7/16).

Milwaukee Journal Sentinel: Primary Care Docs A Good Source On Reform Law
The ACA is far from perfect, but by extending coverage to an estimated 93% of all legal U.S. residents, it is a major step forward in providing affordable coverage to nearly all Americans. It is the first U.S. law to attempt comprehensive reform touching nearly every aspect of our health system. The law addresses far more than coverage, including health system quality and efficiency, prevention and wellness, the health care work force, fraud and abuse, long-term care, biopharmaceuticals, elder abuse and neglect, and many other issues (Richard E. Rieselbach, Patrick L. Remington, Patrick E. McBride and John G. Frohna, 7/14).

Sacramento Bee: Discussion Of Health Care Should Focus On Lowering Prices
The price of health care, therefore, must go down or policymakers will take more radical steps than the Affordable Care Act to address this issue. It is time, therefore, for everyone, Republican and Democrat, industry and advocates, to rededicate themselves to the cause of controlling rising health care costs within the framework of the federal health care law. Every moment spent talking about going backward is a moment wasted (Micah Weinberg, 7/15).

The New York Times: D Is For Dazed
Why would anyone in her right mind spend July 4 -; and then July 5 and July 6 -; trying to make sense out of Medicare Part D, the drug plan added six years ago to an otherwise user-friendly health care system widely beloved by the 65-and-over set? My 65th birthday is approaching, and with it the deadlines for enrolling in Medicare. As a retiree, I must switch my primary health coverage to its new role as secondary provider to the government program. I'd been writing about the elderly for years, had cared for my mother through the last four years of her life, was Dear Abby on this subject to my friends on a daily basis. I thought I had it all down cold (Jane Brody, 7/14).

The New York Times: Distributing, Then Confiscating, Condoms
I met her at 2 a.m. on a cold and windy morning in Washington, when she ran over to the outreach van to get a warm cup of coffee. Volunteers were offering condoms and health information to sex workers. She took only two condoms, and I urged her to take more. She told me that although she was worried about H.I.V., she was more afraid of the police. A month earlier, she had been harassed by officers for carrying several condoms. They told her to throw them out. She thought if they picked her up with more than a couple of condoms again, she might be taken to jail on prostitution charges (Megan McLemore, 7/15).