Tag Archives: Healthcare Access

How will Trump change healthcare? 6 of the biggest questions answered

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , , , , • Leave a comment

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/how-will-trump-affect-healthcare-6-biggest-questions-answered?cfcache=true&ampGUID=A13E56ED-9529-4BD1-98E9-318F5373C18F&rememberme=1&ts=02122016

Throughout his campaign and in the days following the election, President-elect Donald Trump said that one of his top priorities as the commander in chief would be to repeal and replace Obamacare, a major component of the Affordable Care Act (ACA). By having a Republican president as well as the GOP holding a majority in Congress (which also support its repeal), it’s likely that this will occur, says Ashraf Shehata, MBA, advisory leader for health plans and partner of the firm’s Global Healthcare Center of Excellence, KPMG.

But how do you go about replacing Obamacare when 20 million Americans are now obtaining healthcare coverage from it?

Dental Care and Medicare Beneficiaries: Access Gaps, Cost Burdens, and Policy Options

Posted on by • Posted in Uncategorized • Tagged , , , , , • Leave a comment

http://www.commonwealthfund.org/publications/in-the-literature/2016/dec/dental-care-and-medicare-beneficiaries?omnicid=EALERT1137219&mid=henrykotula@yahoo.com

Synopsis

In 2012, more than half of Medicare beneficiaries reported they went without a dental visit in the past 12 months, with lower-income beneficiaries much less likely than higher-income ones to have received dental care. Overall, only 12 percent of beneficiaries reported having any kind of dental insurance. To expand access to care and reduce out-of-pocket exposure for older adults, the authors propose two policy options for adding dental benefits to Medicare’s benefit package.

The Issue

Despite evidence of a strong connection between oral health and physical health, Medicare explicitly excludes dental care from covered benefits. This leaves beneficiaries at risk for tooth decay and disease and exposed to high out-of-pocket costs. Moreover, the lack of regular preventive dental exams means missed opportunities for detecting the onset of certain diseases, including some cancers. A new Commonwealth Fund–supported study in Health Affairs looks at older adults’ access to dental care and their out-of-pocket expenses for dental services. The authors also suggest two policies for expanding dental care for seniors, along with cost estimates.

Key Findings on Use of Dental Services and Out-of-Pocket Spending

  • In 2012, less than half of all Medicare beneficiaries had any dental visits in the past 12 months.

    “Until dental care is appropriately considered to be part of one’s medical care, and financially covered as such, poor oral health will continue to be the ‘silent epidemic’ that impedes improving the quality of life for older adults.”

  • Use of services was sharply related to income. Only 26 percent of beneficiaries with incomes below 100 percent of the federal poverty level had a dental visit, compared with 73 percent of beneficiaries with incomes at or above 400 percent of poverty.
  • Only 12 percent of beneficiaries (6.6 million out of 56.1 million people) reported having at least some dental insurance to help pay bills. In contrast, around 80 percent of Americans under age 65 who were covered by employer-based health insurance had dental benefits.
  • Medicare beneficiaries reported spending an average of $427 on dental care in the past 12 months, of which $329 was spent out of pocket. About 7 percent of beneficiaries spent more than $1,500 in that period.

Major changes for Medicaid coming under Trump and the GOP

Posted on by • Posted in Uncategorized • Tagged , , , , , • Leave a comment

http://money.cnn.com/2016/11/21/news/economy/medicaid-trump/index.html

Image result for aca repeal

Donald Trump likely won’t let Medicaid collapse, but he will vastly change the health insurance program for low-income Americans.

Think less federal funding, more state control, fewer participants and higher costs for those in the program.

Here’s how Medicaid works now:

Nearly 73 million Americans are on Medicaid or the related Children’s Health Insurance Program (CHIP). The programs cost $509 billion in fiscal 2015, with the federal government shouldering 62% of the bill and states paying 38%.

Most enrollees are low-income children, pregnant women, parents, the disabled and the elderly. Under Obamacare, low-income adults with incomes of up to 138% of the poverty line — $16,400 for a single person — were allowed to sign up in states that opted to expand their Medicaid programs. So far, 31 states, plus the District of Columbia, have done so, adding about 15.7 million more people to the rolls since late 2013, just before the provision took effect. (This figure includes both those newly eligible under expansion and those who always met the criteria.)

While Democrats say the program is a vital part of the safety net, Republicans have long criticized it as being bloated, inefficient and rife with fraud. They want to limit the federal government’s financial responsibility, while giving states more direct control over whom to enroll and what kind of coverage participants receive.

On the campaign trail, Trump was emphatic about having the government provide coverage to the poor, even as he vowed to dismantle Obamacare.

“You cannot let people die on the street, ok?,” he said at a CNN town hall in February. “The problem is that everybody thinks that you people, as Republicans, hate the concept of taking care of people that are really, really sick and are gonna die. We gotta take care of people that can’t take care of themselves.”

California Braces For Medi-Cal’s Future Under Trump And The GOP

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , • Leave a comment

California Braces For Medi-Cal’s Future Under Trump And The GOP

Dollar CutDollar Cut

California grabbed the first opportunity to expand Medicaid and ran with it, helping cut the number of uninsured people in half in a few short years.

Thanks in part to billions of dollars in federal funding, a third of California’s residents — including half its children — are insured by Medi-Cal, the state’s version of Medicaid.

Now, with the election of Donald Trump and a Republican-controlled Congress, the state that bet so heavily on the Medicaid expansion is bracing to see how much of its work will be undone. While no one knows yet exactly what will happen, many policymakers and advocates fear the federal government will end or severely limit funding for the expansion.

“There are no easy cuts in Medi-Cal,” said Stan Rosenstein, a former Medi-Cal administrator. Reduced federal funding “could have a major impact on the uninsurance rate, on the viability of our hospitals, and it could have a very negative impact on the economy.”

Medi-Cal cuts could restrict who is eligible for coverage, slash health care benefits, limit access to doctors and reduce payment rates to medical providers — already among the lowest in the nation, health policy experts and advocates said. Medi-Cal covers a host of services for low-income residents, including maternity care, prescription drugs, long-term care services, mental health treatment and hospital stays.

Laurel Lucia, a health care program manager at the University of California, Berkeley Labor Center, said a well-funded Medicaid program benefits everyone, not just those currently on the program.

“A lot of people are just a layoff away from needing Medicaid,” she said. “The Republican plans for Medicaid threaten to undermine that safety net.”

Pence says Trump plans to repeal ACA right ‘out of the gate’

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , • Leave a comment

http://www.beckershospitalreview.com/hospital-management-administration/pence-says-trump-plans-to-repeal-aca-right-out-of-the-gate.html

Image result for trump aca repeal

President-elect Donald Trump has decided repealing the ACA will officially be among his top priorities when he takes office, Vice President-elect Mike Pence told Chris Wallace on Fox News Sunday.

“Decisions have been made by the President-elect that he wants to focus out of the gate on repealing Obamacare and beginning the process of replacing Obamacare with the kind of free market solutions that he campaigned on,” Mr. Pence said on Fox News.

The Trump-Pence transition team has been working with congressional leaders from both political parties to move Mr. Trump’s “aggressive policy agenda” forward, Mr. Pence said. This weekend Mr. Pence met with Senate Minority Leader Chuck Schumer, D-N.Y., Senate Majority Leader Mitch McConnell, R-Ky., House Minority Leader Nancy Pelosi, D-Calif., and House Speaker Paul Ryan, R-Wis., according to the interview.

Later on the show, Fox News spoke with Sen. Schumer, who said the ACA is one of the issues on which Democrats plan to “oppose [Mr. Trump] tooth and nail.” Sen. Schumer said Mr. Trump would not be successful in his efforts to repeal the healthcare reform law.

“He won’t be able to do it, because now even he, after his meeting with President Obama, said, ‘Oh, I want to keep the good things.’ Well, you can’t keep the good things without keeping [the] ACA,” Sen. Schumer told Fox News.

Scott Becker, publisher of Becker’s Hospital Review, says it is still unclear if Mr. Trump can or will be able to push through an ACA repeal. “It’s a fascinating statement because it’s not clear Republicans have the votes to repeal this without making complicated accommodations on a few levels, particularly for preexisting conditions and some funding issues,” Mr. Becker says.

It’s Easy for Obamacare Critics to Overlook the Merits of Medicaid Expansion

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , • Leave a comment

At a national level, the expansion of Medicaid continues to yield benefits. Its coverage was increased, and its quality raised. Some states that have expanded Medicaid are even expecting net savings for the next few years. In states where Medicaid was expanded, hospitals had fewer uninsured visits.

Focusing on only the positives can be as misleading as focusing on only the negatives. Policy decisions, including those involving health, need to be considered in terms of trade-offs. It is true that providing Medicaid can cost the federal government, and even states, a lot of money, which can’t then be spent on other worthy pursuits. It is true that Medicaid reimburses physicians and hospitals less generously, and that it often leaves beneficiaries with fewer choices than private insurance might.

But when we look at the balance sheet for Medicaid — health benefits, financial security, societal improvements through education — it’s not hard to argue that money allocated to Medicaid is well spent.

 

Many Insured Children Lack Essential Health Care, Study Finds

Posted on by • Posted in Uncategorized • Tagged , , , , , , , • Leave a comment

A new study to be released on Monday by the Children’s Health Fund, a nonprofit based in New York City that expands access to health care for disadvantaged children, found that one in four children in the United States did not have access to essential health care, though a record number of young people now have health insurance.

The report found that 20.3 million people in the nation under the age of 18 lack “access to care that meets modern pediatric standards.”

Guidelines issued by the American Academy of Pediatrics say that all children should get health maintenance visits for immunizations and other preventive services; management of acute and chronic medical conditions; access to mental health support and dental care; and have round-the-clock availability of emergency services and timely access to subspecialists.

While Medicaid and many private insurance plans recommend or require that all of those services be provided, under the umbrella of what is known as the medical home, the study found that millions of insured children are not receiving many of the benefits.

There are many children with insurance who cannot get primary care and those who do can often have problems getting specialty care.

As President-elect Donald J. Trump, a Republican, vows to repeal some, if not all, of the Affordable Care Act, which extended health care coverage to an additional 20 million people, the report’s authors worry that even more children could have trouble receiving the care they need.

“The fact that more than 20 million children in the U.S. experience insurance and noninsurance barriers to getting comprehensive and timely health care is a challenge that needs to get the highest-priority attention from the new administration,” said the report’s lead author, Dr. Irwin Redlener, president of the nonprofit Children’s Health Fund and a professor of pediatrics and health policy and management at Columbia University.

Over the past two decades, the number of children without health insurance has steadily decreased to 3.3 million last year from around 10 million in 1997, according to an analysis of federal data and the federal government’s 2015 National Health Interview Survey.

The effort to extend coverage began 50 years ago with the creation of Medicaid, which provides health insurance for the poor. It continued more recently with the Children’s Health Insurance Program, which offers low-cost coverage to those who make too much money to qualify for Medicaid and, under the Obama administration, with the Affordable Care Act, offering subsidized coverage and state exchanges.

 

Not Just Obamacare: Medicaid, Medicare Also On GOP’s Chopping Block

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , • Leave a comment

http://www.huffingtonpost.com/entry/obamacare-medicaid-medicare-gop-chopping-block_us_582a19b8e4b060adb56fbae7?jn7jtocg8bzqia4i

rious about repealing Obamacare, and doing so quickly. But don’t assume their dismantling of government health insurance programs will stop there.

For about two decades now, Republicans have been talking about radically changing the government’s two largest health insurance programs, Medicaid and Medicare.

The goal with Medicaid is to turn the program almost entirely over to the states, but with less money to run it. The goal with Medicare is to convert it from a government-run insurance program into a voucher system ― while, once again, reducing the money that goes into the program.

House Speaker Paul Ryan (R-Wis.) has championed these ideas for years. Trump has not. In fact, in a 2015 interview his campaign website highlighted, he vowed that “I’m not going to cut Medicare or Medicaid.” But the health care agenda on Trump’s transition website, which went live Thursday, vows to “modernize Medicare” and allow more “flexibility” for Medicaid.

In Washington, those are euphemisms for precisely the kind of Medicare and Medicaid plans Ryan has long envisioned. And while it’s never clear what Trump really thinks or how he’ll act, it sure looks like both he and congressional Republicans are out to undo Lyndon Johnson’s health care legacy, not just Barack Obama’s.

f course, whenever Trump or Republicans talk about dismantling existing government programs, they insist they will replace them with something better ― implying that the people who depend on those programs now won’t be worse off.

But Republicans are not trying to replicate what Medicaid, Medicare and the Affordable Care Act do now. Nor are they trying to maintain the current, historically high level of health coverage nationwide that these programs have produced. Their goal is to slash government spending on health care and to peel back regulations on parts of the health care industry, particularly insurers.

This would mean lower taxes, and an insurance market that operates with less government interference. It would also reduce how many people get help paying for health coverage, and make it so that those who continue to receive government-sponsored health benefits will get less help than they do now.

It’s difficult to be precise about the real-world effects, because the Republican plans for replacing existing government insurance programs remain so undefined. Ryan’s“A Better Way” proposal is a broad, 37-page outline without dollar figures, and Senate Republican leaders have never produced an actual Obamacare “replacement” plan.

But the Republican plans in circulation, along with the vague ― and shifting ― health care principles Trump endorsed during the campaign, have common themes. And from those it’s possible to glean a big-picture idea of what a fully realized version of the Republican health care agenda would mean.

What Would Block Grants or Limits on Per Capita Spending Mean for Medicaid?

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , , , , • Leave a comment

http://www.commonwealthfund.org/publications/issue-briefs/2016/nov/medicaid-block-grants

ABSTRACT

Issue: President-elect Trump and some in Congress have called for establishing absolute limits on the federal government’s spending on Medicaid, not only for the population covered through the Affordable Care Act’s eligibility expansion but for the program overall. Such a change would effectively reverse a 50-year trend of expanding Medicaid in order to protect the most vulnerable Americans.

Goal: To explore the two most common proposals for reengineering federal funding of Medicaid: block grants that set limits on total annual spending regardless of enrollment, and caps that limit average spending per enrollee.

Methods: Review of existing policy proposals and other documents.

Key findings and conclusions: Current proposals for dramatically reducing federal spending on Medicaid would achieve this goal by creating fixed-funding formulas divorced from the actual costs of providing care. As such, they would create funding gaps for states to either absorb or, more likely, offset through new limits placed on their programs. As a result, block-granting Medicaid or instituting “per capita caps” would most likely reduce the number of Americans eligible for Medicaid and narrow coverage for remaining enrollees. The latter approach would, however, allow for population growth, though its desirability to the new president and Congress is unclear. The full extent of funding and benefit reductions is as yet unknown.