California Faces Major Reversal If Trump, Congress Scrap Health Law

California Faces Major Reversal If Trump, Congress Scrap Health Law

Attendees speak with heath care volunteers during the WeConnect Health Enrollment Information & Wellness Event in Oakland, California, U.S., on Saturday, Sept. 21, 2013. The battle over Obamacare is taking on political importance as Democrats hope a successful roll-out among Hispanics will further bind those voters to the Democratic Party and undermine Republican efforts to build more support before the 2016 presidential election. Photographer: David Paul Morris/Bloomberg via Getty Images

California has a lot to lose if President-elect Donald Trump and the Republican-led Congress fulfill their campaign pledge to repeal Obamacare.

The Golden State fully embraced the Affordable Care Act by expanding Medicaid coverage for the poor and creating its own health insurance exchange for about 1.4 million enrollees. Supporters held California up as proof the health law could work as intended.

But now President Barack Obama’s signature law is in serious jeopardy and California officials are left wondering what Republicans in Washington may put in its place.

“There is no doubt that Obamacare is dead,” said Robert Laszewski, a health care consultant and expert on the California insurance market. “The only question is just exactly how Republicans will get rid of it.”

Health policy experts don’t expect Republicans to immediately kick millions of people off their insurance policies. Instead, they predict lawmakers may repeal parts of the law and allow for some transition period for consumers while a replacement plan is put together.

Still, the personal and financial impact for the state could be jarring. The number of uninsured Californians would more than double to 7.5 million people if the Affordable Care Act was repealed, according to a recent study by the Urban Institute.

Researchers also said California stands to lose an estimated $15 billion annually in federal funding for Medicaid expansion and insurance subsidies — more than any other state. That loss of federal money would make it difficult for California to pursue health reform on its own.

Hillary Clinton’s healthcare proposals a mixed bag for nonprofits, Trump plan lacks detail, Fitch says

http://www.healthcarefinancenews.com/news/hillary-clintons-healthcare-proposals-mixed-bag-nonprofits-trump-plan-lacks-detail-fitch-says

Clinton’s plan to expand Medicaid in the 19 states that declined to do so would benefit nonprofit hospitals in those states, Fitch says.

Paul Ryan Makes Huge (Yet Really Obvious) Admission About Obamacare

http://www.huffingtonpost.com/entry/paul-ryan-huge-admission-obamacare_us_5820b47ee4b0d9ce6fbd8499?hgh2kk4wa02j4i

House Speaker Paul Ryan (R-Wis.) hasn’t lost his grip on reality, he revealed Monday during an interview with conservative radio host Jay Weber.

Ryan admitted that a victory by Democratic presidential nominee Hillary Clintonwould mark the end of his quixotic quest to repeal the Affordable Care Act. That may seem like an obvious conclusion, but it qualifies as a noteworthy statement because it’s coming from the man who oversaw dozens of hopeless votes to overturn the 6-year-old health care law.

During the discussion on WISN, Weber laid out a series of “hard truths” with respect to the stakes in the presidential and congressional elections if Republicans fail to win the White House and lose the Senate, including Democrats being able to confirm Clinton’s Supreme Court nominees.

Here’s Weber and Ryan discussing the Affordable Care Act:

http://www.healthcaredive.com/news/ryan-accepts-aca-here-to-stay-if-clinton-wins/429898/

 

Uninsured In Coal Country: Desperate Americans Still Turn To Volunteer Clinics

http://khn.org/news/uninsured-in-coal-country-desperate-americans-still-turn-to-volunteer-clinics/

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Six years after the passage of the Affordable Care Act, and despite 20 million more Americans gaining health insurance, considerable gaps in health care remain.

The decision by states like Virginia not to expand Medicaid and the lack of dental and vision coverage even for those with insurance have meant that the demand for RAM’s free mobile clinics has stayed strong.

Healthcare Triage News: Health Care Reform, and the Issues We Face

Healthcare Triage News: Health Care Reform, and the Issues We Face

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As we approach the election this fall, it seems like the news media report on little else. Unfortunately, too little news coverage addresses health care reform. That’s wackadoo, because there is still so much to be done to improve the cost, quality, and access for patients within the US health care system.

So let’s talk about the major health policy issues we in the US face. This is Healthcare Triage News.

Healthcare Triage: Medicaid has a Huge Return on Investment

Healthcare Triage: Medicaid has a Huge Return on Investment

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As we pass the 3-year anniversary of the opening of the insurance exchanges, most news seems to focus on the private insurance people can purchase there. In recent months, many have complained about private insurers exiting the exchanges, networks being narrowed, premiums rising, and competition dwindling out of existence.

But it’s important to remember that many, if not most, of the newly insured are part of the Medicaid expansion. As of today, 19 states have still refused to participate in that program. Some cite reports and news that Medicaid offers poor quality and little choice of providers. But most seem to cite the cost of Medicaid, claiming that its growing cost will eventually bankrupt states.

Such declarations only consider one side of the equation, though. In most ways, Medicaid offers an excellent return on investment. That’s the topic of this week’s Healthcare Triage.

Lack Of Medicaid Expansion Hurts Rural Hospitals More Than Urban Facilities

http://khn.org/news/lack-of-medicaid-expansion-hurts-rural-hospitals-more-than-urban-facilities/

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It isn’t news that in rural parts of the country, people have a harder time accessing good health care. But new evidence suggests opposition to a key part of the 2010 health overhaul could be adding to the gap.

The finding comes from a study published Wednesday in the journal Health Affairs, which analyzes how the states’ decisions on implementing the federal health law’s expansion of Medicaid, a federal-state insurance program for low-income people, may be influencing rural hospitals’ financial stability. Nineteen states opted not to join the expansion.

Rural hospitals have long argued they were hurt by the lack of Medicaid expansion, which leaves many of their patients without insurance coverage and strains the hospitals’ ability to better serve the public. The study suggests they have a point.

Specifically, the researchers, from the University of North Carolina Chapel Hill, found that rural hospitals saw an improved chance of turning a profit if they were in a state that expanded Medicaid — while in city-based hospitals, there was no improvement to overall profitability. Across the board, hospitals earned more if they were in a state where more people had coverage and saw declines in the level of uncompensated care they gave.

To put it another way: All hospitals generally fared better under the larger Medicaid program, but there’s more at stake for rural hospitals when the state expands coverage.

 

Why the U.S. Needs Medicaid

http://www.commonwealthfund.org/publications/blog/2016/oct/value-of-medicaid?omnicid=EALERT1104254&mid=henrykotula@yahoo.com

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While most news stories about Medicaid focus on states’ decisions on whether to expand eligibility, the collective impact of the program on beneficiaries, health providers and systems, and state economies is rarely discussed. Given the large share of federal funds devoted to Medicaid, it’s reasonable to assume that policymakers on both sides of the aisle will be considering programmatic or financing changes for the program—or both—early in a new presidential administration. To inform that process, it’s helpful to look at the multifaceted role Medicaid plays in our health system.

When it was signed into law in 1965 as an extension of welfare, few would have anticipated Medicaid would evolve into the nation’s largest health insurer, covering nearly 73 million Americans.1 Today, Medicaid is at the center of the American health care safety net, providing benefits to adults and children otherwise unable to afford care—and helping to support and drive innovation in the hospitals and clinics that treat these patients, as well as supporting state economies.

Medicaid provides people with good insurance. While the program can vary somewhat by state, a growing body of evidence finds that Medicaid provides a comprehensive set of benefits as well as strong financial protections. A 2015 analysis of the Commonwealth Fund Biennial Health Insurance Survey suggests that people with Medicaid coverage have better access to health care services, including proven preventive care, and fewer medically related financial burdens than those who lack insurance (Exhibit 1). The same study found that Medicaid enrollees have nearly equivalent access to care as those with private coverage in many areas.

Rich hospital, poor hospital divided by politics and a river

http://www.chicagotribune.com/news/sns-wp-blm-health-states-972aeae8-7a71-11e6-8064-c1ddc8a724bb-20160914-story.html

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When hospital executive Jeanette Wojtalewicz visits CHI Health’s Mercy Council Bluffs facility across the Missouri River in Iowa, she sees the new clinics and doctors’ offices partly paid for by the state’s decision to expand Medicaid to thousands of residents.

Back on her side of the river is CHI Health’s Creighton University Medical Center in Omaha, Nebraska, a state that opposed making more low-income people eligible for the government health-insurance program. While Mercy thrives about seven miles away, Creighton is cutting 250 beds to raise efficiency amid slumping financial results.

“There’s not a big geographical difference, but because of the regulations, there are big differences in the numbers,” said Wojtalewicz, chief financial officer at CHI Health, a 15-facility, nonprofit hospital system.

President Barack Obama’s Patient Protection and Affordable Care Act is as divisive as ever six years after its passage, with Republicans including presidential candidate Donald Trump vowing to repeal it. Yet as critics focus on the legislation’s insurance mandates and penalties, the biggest impact has come from Medicaid expansion, a decision made at state level.