Viewpoints: 'Big risks' of buying private insurance with Medicaid dollars; One month of sequestration

Apr 2 2013

The New York Times: Using Medicaid Dollars For Private Insurance 
The Obama administration and Republican officials in several states are exploring ways to redirect federal money intended to expand Medicaid, the main public insurance program for the poor, and use it instead to buy private health insurance for Medicaid recipients. The approach could have important benefits for beneficiaries and for the future of health care reform. But the idea also carries big risks. Federal officials will need to enforce strict conditions before agreeing to any redirection of Medicaid dollars that were originally intended to enlarge the Medicaid rolls (3/31).

Forbes: The Arkansas-Obamacare Medicaid Deal: Far Less Than It First Appeared 
When Arkansas Gov. Mike Beebe (D.) first announced that he had reached a deal with the Obama administration to use the Affordable Care Act's private insurance exchanges to expand coverage to poor Arkansans, it seemed like an important, and potentially transformative, development. ... A Good Friday memo from the U.S. Department of Health and Human Services, however, splashes cold water on that aspiration. It's now clear that the Beebe-HHS deal applies a kind of private-sector window dressing on the dysfunctional Medicaid program, and it's not obvious that the Arkansas legislature should go along (Avik Roy, 4/1).

USA Today: 'Sequester' Still Looks Stupid, As Planned: Our View 
Congress and the White House exempted some programs when they finalized the original deal, and the spending bill they agreed to last month to keep the government open to Sept. 30 spared some vital functions -; food inspections, for example. But not enough. Nor does the sequester seriously address the major spending driver: health care costs. The best outcome would be for the sort of anger that forced Congress and the White House to re-open the government in 1996 to push Congress and the White House back to the table on a realistic budget deal this year. The outlines of that deal have been obvious for too long: Trim entitlement programs such as Medicare and Social Security, overhaul the hopelessly inefficient and corrupt tax code to bring in more money, and cut defense and domestic programs with a scalpel instead of an ax (3/31). 

USA Today: 'Sequester' Needed To Rein In Spending: Another View 
Let's get real on the "sequester." One month in, not much has changed. Nor is it likely to. Rather than devastating the federal government, the sequester is necessary to rein in the unbridled growth of federal spending. The sequester is certainly flawed. It's a blunt instrument leaving the biggest spending drivers, entitlements, virtually untouched (Alison Fraser, 3/31). 

The Wall Street Journal: The Liberal Medicare Advantage Revolt 
A big political story this year is likely to be Democrats turning on their White House minders as the harmful and unpopular parts of the Affordable Care Act ramp up. On the heels of the recent 79-20 Senate uprising against the 2.3% medical device tax, now comes the surge of Democrats pleading on behalf of Medicare Advantage. Liberals have claimed for years to hate this program, but by now Advantage provides private insurance coverage to more than one of four seniors. And those seniors like it (3/29).

The Chicago Tribune: Scrubbing Medicaid 
In January, Illinois launched an effort to scrub ineligible people from the state's Medicaid rolls. ... The initial results of this audit are ... astonishing: Of the first 20,500 recipients screened by an outside contractor, the auditors recommend that 13,709 be removed from the rolls. Yes, that's two-thirds of the first group screened, flagged as ineligible to receive their current Medicaid benefits. How so? In some cases, the recipients make too much money to qualify. In other cases, they don't live in Illinois (3/31).

The New York Times: The Campaign to Outlaw Abortion
Anti-abortion groups have been trying to re-impose restrictions on abortion rights for 40 years, but the Legislature and governor of North Dakota have taken this attack on women's reproductive health and freedom to a shocking new low ... The clear message is the need for a stepped-up effort to hold state officials electorally accountable for policies that harm women in states where right-wing Republicans control the machinery of government (3/29).

The Seattle Times: State Senate Health Care Committee Should Vote On Abortion Measure
After the Senate Health Care Committee hearing on the Reproductive Parity Act Monday, members should vote for it before a key deadline Wednesday. State lawmakers do not need to complicate this issue. House Bill 1044 would maintain insurance coverage for women seeking abortions after federal health reforms take effect (3/31).

Los Angeles Times: The Starbucks Syndrome In Healthcare
Medicare statistics, for example, reveal that Los Angeles leads the nation in the amount of medical services provided during the last six months of a person's life. Healthy seniors here are also big consumers of healthcare, getting about 65% more MRI studies and utilizing ambulances three times as often as seniors elsewhere. Commercial insurance data point to similar patterns in the healthcare of the younger population in Southern California. What explains such avid use of medical services. ... Part of the problem is that Angelenos approach healthcare as they do other kinds of consumption. They expect their CT scans, when they want them, in much the same way they expect their decaf caramel extra hot low-fat macchiatos. (Daniel J. Stone, 3/31).

Los Angeles Times: Bump In The Road For Healthcare Law
One figure in a new report neatly summarizes the potential pitfalls for Obamacare: 30.1%. That's how much premiums could rise next year, on average, for the roughly 1.3 million moderate- and upper-income Californians who buy individual health insurance policies. Most of that increase is attributable to the insurance reforms in the 2010 law, also known as the Affordable Care Act. The bill's title is not ironic -; its provisions will slow the growth of healthcare costs and lead over time to a more rational and efficient system. But the transition will have some rough patches, and we're about to hit one (3/29). 

Houston Chronicle: The Affordable Care Act Is A Poor Solution
Senator Orrin Hatch has speculated that the Affordable Care Act was designed to fail. A close look at the Act's contents and history suggests he may be right. The Affordable Care Act is nothing more than a political stopgap, a waypoint on the road to something that might work. Republicans could stand around complaining or we could seize this opportunity to determine what comes next (Chris Ladd, 4/1).

Richmond Times-Dispatch: Moving Forward On Medicaid: More Important Than Ever
As a community physician for more than eight years, I've seen how medical care helps keep families strong and secure. When parents and their kids can access health care -; and have a way to pay for it -; they are much less likely to face unpaid bills or have to put off doctor visits. Instead of worrying about how their family is going to survive, they can focus on how their family is going to thrive. Unfortunately, too many Virginians -; more than a million, in fact -; find that getting health care is a real challenge because they don't have insurance (Dr. Christopher Lillis, 4/1).

The Wall Street Journal: The Skinny On Anti-Obesity Soda Laws 
New York Mayor Michael Bloomberg's anti-obesity campaign to ban the sale of certain sugary drinks in large servings, especially sodas, was struck down last month in state court. A proposal for a penny-per-ounce excise tax on sweetened beverages also floundered in Vermont's House of Representatives in February. ... As an economist, I have two big gripes with such paternalistic public-health initiatives: The proposals aren't grounded in data or compelling economic models, and soda taxes might catalyze a dismal chain reaction, with escalating government intrusions on personal freedom (Michael L. Marlow, 3/31).

Oregonian: Don't Take Portland's Sick-Leave Mistake Statewide: Agenda 2013
By voting to mandate paid sick leave last month, Amanda Fritz and her city council colleagues furthered Portland's reputation as a place where businesses fear to tread. One way to protect city employers burdened by this mandate is to adopt a similar requirement statewide, erasing a competitive advantage a restaurant in, say, Beaverton might have over one in Portland. In other words, bail out Portland by making things tougher all over (3/31).

USA Today: ER Key To Curb Painkiller Abuse
Most opioids are prescribed in the doctor's office, which has prompted some states to restrict primary care physicians like myself from prescribing them and to encourage referrals to pain specialists. New York City Mayor Michael Bloomberg has taken these curbs a step further by focusing on emergency departments. In January, he announced a voluntary initiative to limit prescription of opioid painkillers in the emergency rooms of the city's 11 public hospitals. This approach should be expanded across the nation. From 2004 to 2009, the number of emergency visits in New York City hospitals related to opioid abuse or misuse more than doubled (Dr. Kevin Pho, 3/31).