Tag Archives: medicaid

NEW HEALTH CARE DEAL: THEY’RE ON THE RUN! By DICK MORRIS & EILEEN MCGANN

Posted on December 10, 2009 by

Faced with a massive center-right uprising, the Obama liberals have been forced to abandon a public option. But in doing so, they are throwing the Medicare program under the bus.

Already, we have been asking how you can treat a growing number of elderly with a Medicare program that this bill cuts by $500 billion dollars. Now, by adding tens of millions of people 55-64 to the program, it makes it even more financially untenable.

Nonetheless, a brief congratulations to all on having seemingly killed the public option. Without our efforts, it would be en route to becoming law. Now there will not be a government owned, government run and government subsidized insurance company that will put all others out of business.

But the current proposal Reid is loudly trumpeting is horribly flawed as well.

It has all of the old flaws (minus the public option) in that the government, through the Secretary of Health, will decide who gets what treatment at what cost and will force rationing through an artificial scarcity on all people, particularly the elderly. And it still has such high premiums for young uninsured people that it will compete with student loans for the honor of being their number one headache.

But the compromise itself is flawed. Here’s why:

1. By breeching the historic dividing line between private and public plans now at 65, it opens the door for an expansion of Medicare to become just the single payer we are trying to stop.

2. How can you expand Medicare, potentially to tens of millions more people while cutting it by $500 billion?

3. The cuts in doctor and hospital reimbursement rates written into this bill will force hundreds of thousands of medical providers to refuse to treat Medicare patients. By applying these low reimbursements to patients 55-64, now, you are driving doctors out of the profession and discouraging others from entering it. A permanent scarcity of doctors will be the inevitable result.

4. The expansion of Medicaid to 150% of the poverty level imposes huge new financial burdens on states. It will cost Texas $3 billion, Pennsylvania $2 billion, California $2 billion, and Florida $1.3 billion. It will cost Arkansas and Louisiana $500 million each. This is net of federal aid and only counts the 10% share of expanded Medicaid costs the states must pay.

The federal purchasing program that solicits bids from insurance companies and offers the policies to members of Congress actually functions quite well. It does tend to widen coverage and hold down costs and, at least in its current form, does not pretend to be an insurance company, just a kind of broker.

If the program is unchanged in the new law, its work could be valuable in helping consumers choose adequate and affordable insurance. But who knows whether Reid will try to ramp it up to be a government run and owned insurer?

The strategic message from all of this is that we have them on the run! We have forced Obama to retreat from a very dangerous excursion into socialism. Our pressure is working and we must keep it up.

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HARDEST HIT BY OBAMACARE! by Dick Morris & Eileen McGann – Nov 30, 2009

Posted on December 5, 2009 by

The “health-care reform” bills in Congress would hit 39 states hard with new expenses, by raising Medicaid eligibility above the current income cutoffs.

The only states that won’t have to raise eligibility because of the Senate bill are Connecticut, Illinois, Maine, Massachusetts, Minnesota, New Jersey, New York, Rhode Island, Tennessee, Vermont and Wisconsin (plus the District of Columbia). And the House bill would force even Massachusetts and Vermont to pay more.

Hardest hit would be Texas ($2,750 million a year in extra state spending under the Senate bill), Pennsylvania ($1,450 million), California ($1,428 million) and Florida ($909 million). Who knows if Florida could avoid imposing an income tax if it has to meet so high an unfunded mandate?

The required increases in state spending are likely to be quite high in some states whose senators are swing votes on ObamaCare:

* In Arkansas, home to swing Sens. Mark Pryor and Blanche Lincoln, the annual increased state spending would come to $402 million (not counting the federal share) — about a 10 percent increase in the state budget, which is now $4 billion a year.

* In Louisiana, whose Sen. Marie Landrieu sold her vote on a key procedural motion in return for more Medicaid funding, the increase would come to $432 million (a 5 percent hike in state spending) — more than wiping out the extra funds she got in return for her vote.

* In Sen. Evan Bayh’s Indiana, spending would go up by $586 million a year, a rise of 4 percent.

* In Sen. Ben Nelson’s Nebraska, the added state spending would be $81 million a year, a 2 percent increase.

The Sebate ObamaCare bill would cost North Dakota, home of Sens. Kent Conrad and Byron Dorgan, $14 million. South Dakota, represented by Sen. Tim Johnson, would have to boost Medicaid spending by $33 million.

The Medicaid-expansion provisions of the Senate bill are complex. In the first year of the program (2013), states must enroll anyone who earns less than 133 percent of the poverty level in their programs. For a family of four, the national average poverty level in 2009 is $22,000 a year. So any family that size that makes less than $29,000 would be eligible for Medicaid.

Many states, particularly in the South, actually have Medicaid cutoffs below the poverty level. Arkansas, for example, cuts off its Medicaid eligibility at only 17 percent of poverty level, and in Louisiana it goes up to only 26 percent. For these states, the spending increase required by the new bill is huge.

For the first three years of the program (2013-15) the federal government would pay for all of the costs of the Medicaid expansion. But, starting in the fourth year of operation — 2016 — the average state would be obliged to pay 10 percent of the extra cost.

For Democratic governors, this provision means sudden death. Particularly in states with limited Medicaid coverage, it would require huge tax increases.

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Prepare for Massive HEALTHCARE TAXES! by Dick Morris

Posted on December 5, 2009 by

The Obama healthcare initiative will be the biggest unfunded federal mandate on the states in history. It will force dozens of states, particularly in the South, to abandon their low-tax ways and to move toward dramatically higher rates of taxation. It may even force Florida and Texas to impose an income tax!

In the Senate version of the bill, states must expand their Medicaid eligibility to cover everyone with an income that is 133 percent of the poverty level.

The House bill brings it up to 150 percent. But a host of states have kept their state taxes low precisely by so limiting eligibility for Medicaid that it essentially is only for seniors needing long-term care and not for poor younger people who require acute care.

For example, Texas covers only those who make 27 percent of the poverty level or less. Florida covers only 55 percent. Pennsylvania covers only 36 percent. Arkansas covers only 17 percent. North Dakota covers only 62 percent. Nebraska covers only 58 percent. Louisiana covers only 26 percent. Indiana covers only 26 percent.

The revenue required to bring these states up to the 133 percent level in the Senate bill or the 150 percent level in the House would be enormous. Even California only covers up to 106 percent of the poverty level.

All states except for Connecticut, Illinois, Maine, Massachusetts, Minnesota, New Jersey, New York, Rhode Island, Tennessee, Vermont and Wisconsin (plus the District of Columbia) will have to raise their eligibility for Medicaid under the Senate healthcare bill. And they will have to pay for part of the cost. Under the House bill, with a higher Medicaid eligibility standard, Massachusetts and Vermont would also have to pay more.

The Medicaid expansion provisions of the Senate bill are complex. In the first year of the program (2013), states must enroll anyone who earns less than 133 percent of the poverty level in their programs. For a family of four, the national average poverty level in 2009 is $22,000 a year. So any family that size that makes less than $29,000 would be eligible for Medicaid.

For the first three years of the program (2013-2015) the federal government would pay for all of the costs of the Medicaid expansion. But starting in the fourth year of operation — 2016 — states would be obliged to pay 10 percent of the extra cost.

While Obama has often spoken about how he won’t raise taxes on the middle class, his healthcare legislation will require the governors to do so.

Particularly in those states with Democratic governors, it is easy to see how the backlash against these new taxes could fundamentally alter state politics.

The following table is a rough calculation of the cost each state will have to bear once it has to pick up 10 percent of the cost. These calculations are based on guidelines laid down for me by the Republican staff of the Senate Finance Committee. There has been no official data yet generated on how much the Senate or House provisions will cost the taxpayers in each state.

STATE SPENDING INCREASES IN MEDICAID REQUIRED BY SENATE HEALTH BILL

Alaska $39M

Ariz. $217M

Ark. $402M

Calif. $1,428M

Colo. $163M

Del. $35M

Fla. $909M

Ga. $495M

Hawaii $41M

Idaho $97M

Iowa $77M

Ind. $586M

Kan. $186M

Ky. $199M

La. $432M

Md. $194M

Mich. $570M

Miss. $136M

Mo. $836M

Mont. $29M

Neb. $81M

Nev. $54M

N.H. $59M

N.M. $102M

N.C. $599M

N.D. $14M

Ohio $399M

Okla. $190M

Ore. $231M

Pa. $1,490M

S.C. $122M

S.D. $33M

Texas $2,749M

Utah $58M

Va. $601M

Wash. $311M

W.Va. $132M

Wyo. $25M

These estimates were obtained by calculating the increase in Medicaid spending in each state to bring it up to the 133 percent level specified in the Senate bill. Then I applied the percentage of Medicaid spending in each state on acute care (mainly for the poor) as opposed to long-term care (mainly for the elderly). Finally, I took 10 percent of the increased state share of spending and listed it in the table above.

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The Case of the Expensive Wheelchair

Posted on November 15, 2009 by

There may be no greater challenge in reforming the health care system than eliminating waste. Federal examiners estimate that at least 10 percent of the $500 billion spent annually on Medicare is wasted—from overblown or fraudulent bills, or payments to misidentified or nonexistent patients, doctors or institutions.

Consider power wheelchairs. As the population has aged, their use—and cost—has soared. Under Medicare, several hundred suppliers across the country buy wheelchairs from manufacturers and then generally lease them to beneficiaries. In 1997, Medicare and Medicare beneficiaries paid just over $100 million to buy or lease power wheelchairs; today they pay more than $1 billion.

The Office of Inspector General (OIG) for the Department of Health and Human Services has examined thousands of vouchers and invoices for wheelchairs and reported that the average annual cost to Medicare in 2007 was $4,018, nearly four times the $1,048 paid by suppliers.

For more elaborate power wheelchairs, the average Medicare allowance was $11,507, almost twice the $5,880 price paid by suppliers.

Efforts to address the excess have been stymied—classic Washington. The medical equipment lobby, which spent $6.3 million in presidential and congressional campaign contributions last year, is as effective as any group of federal lobbyists. The Centers for Medicare & Medicaid Services, in its oversight role, has been slow to act. And Congress has blocked attempts to impose competitive bidding.

Industry leaders complain that servicing the machinery is getting more expensive and that their companies have been hurt by inflation and reduced Medicare rates. Medicare compensation has indeed been scaled back with a 9.5 percent cut in payments. According to the OIG, that brought the average payment down to $3,641 in 2009, still three times the price paid by suppliers.

The problem has been explored intensely over the past five years by the OIG, the Government Accountability Office, the Senate Finance Committee and the FBI, which brought dozens of arrests and convictions from Florida to California.

Medicare officials agreed with most of the OIG’s recent suggestions that the fee structure be reevaluated. But they balked at the conclusion that the payments were “grossly higher” than the suppliers’ cost.

Sen. Chuck Grassley, R-Iowa, has a different perspective: “At a time when every health care dollar counts, it’s infuriating to learn that the government is throwing away money and is still overpaying for power wheelchairs. This translates into hundreds of millions of dollars wasted and cost beneficiaries millions of dollars in copayments. It’s only common sense that you don’t pay more for something than is on the price tag.”

He’s right. The disparity in prices to supplier and to beneficiary defies common sense. The longer this imbalance continues, the greater the threat to Medicare. And the failure to crack down on waste threatens the credibility of the ambitious effort to overhaul the nation’s health care system. Jim Toedtman, Editor – AARP Bulletin http://www.bulletin.aarp.org

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Unhealthy from Pueblo Chieftain

Posted on November 11, 2009 by

NANCY PELOSI got her political victory Saturday night when the U.S. House of Representatives narrowly passed a bill that would ultimately give the government total control of health care and 20 percent of the nation’s economy.

The bill passed by only five votes – 220-215, after 39 Democrats refused to be bullied into supporting this monstrosity. And a monstrosity it is.
It requires all Americans to enroll in a “qualified plan.” If you get your insurance at work, your employer will have a “grace period” to switch you to a “qualified plan,” one which is designed by the secretary of health and human services.

What’s more, it provides that 18 months after the bill becomes law, the secretary of health and human services will decide what a “qualified plan” covers and how much you’ll be legally required to pay for it. Would you sign a bank loan that allowed the banker to decide 18 months later the interest rate and repayment terms?

The bill makes it clear that, although the “qualified plan” is not yet designed, it will be of the “one size fits all” category. The bill claims to offer choice, but the benefits are the same. Only the co-pays and deductibles differ. The bill says that when you file your federal income tax returns, you will have to include proof that you are in a “qualified plan.” If not, you will be fined thousands of dollars.

In one effort to “pay” for the so-called public option, the bill eviscerates Medicare by an estimated $500 billion. This at a time when the Baby Boom generation is getting ready to retire and enroll in Medicare.

But not to worry. Because Washington bureaucrats will decide what kind of care retirees can get – meaning how much or how little of it.

Rationing will be right around the corner.

Three sections of the bill initiate programs to reduce payments for patient care to what it costs in the lowest cost regions of the country. Boy, we can see doctors flocking to treat all those new Medicare Baby Boomers.

Of course, the Pelosis of this world tell us with certitude how much the total cost of this government boondoggle will cost the taxpayers. Don’t believe a word of it.

Rather, let history be the guide. In 1965, when Congress was considering Medicare legislation, the House Ways and Means Committee estimated that the hospital insurance portion of the program, Part A, would cost about $9 billion annually by 1990. But the actual cost by 1990 was $67 billion a year.

That same committee predicted the entire cost of Medicare by 1990 would be about $12 billion. Actual medicare spending in 1990 was $110 billion – off by nearly a factor of 10.

Two sections of the Pelosi plan establish racial and ethnic preferences in awarding grants for training nurses. Gee, we thought the Obama presidency was supposed to be post-racial.

The Pelosi plan forces the states to spend more on Medicaid at a time when state budgets are taking body blows from the sour economy. So, state taxes will have to go up or other state functions will have to absorb even more losses so the Medicaid welfare program can grow.

The Senate now takes up its own health plans in earnest – the president gave those deliberations a rah-rah send-off on Sunday. All we can hope is that Majority Leader Harry Reid can’t muster the 60 votes he needs to pass a Senate version of the monstrosity that would be government-run health care.

When the vast majority of Americans find out what’s in store for them, the politicians who support this madness will find themselves looking for employment elsewhere.

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