Tuesday, February 25, 2014
10 Myths About the Obamacare Medicaid Expansion
As Obamacare’s Medicaid expansion is being debated in the
states, many myths are being perpetuated by its advocates. Here,
Heritage provides the research to debunk such myths:
1. Myth: Expanding Medicaid is “free money” for the states.
Reality: The expansion adds an estimated $638 billion in new government spending from 2013–2023. New spending at the federal or state level is reckless in light of the country’s trillion dollar budget deficits and over $16 trillion in national debt. As Governor Rick Perry (R–TX) stated, “[T]here is no such thing as ‘free’ money. We know there’s only money that’s collected from taxpayers, and money borrowed from other countries like China against the good credit of our children and grandchildren.”
2. Myth: Expanding Medicaid will entail little to no costs to the states.
Reality: Within three years, costs would exceed any projected savings. Heritage research shows 40 of 50 states would see increases in costs due the Medicaid expansion. If all states expand, state spending on Medicaid would increase by an estimated $41 billion by 2022.
3. Myth: Medicaid expansion can bring savings to the states.
Reality: Analysis by Heritage shows that by 2022 any projected state savings are dwarfed by costs. Moreover, these projected savings assume states will further reduce payments to hospitals and clinics for uncompensated care. But, as Heritage’s Ed Haislmaier points out, it is more likely that hospitals will lobby state legislatures for more money rather than less.
4. Myth: States can opt out of the Medicaid expansion if they change their mind later.
Reality: Some proponents of the expansion claim that states could drop out of the expansion if the federal government reneges on its commitments. But as legal experts Robert Alt and Dan Greenberg state, “[I]n fact, there is substantial reason to believe that when a state chooses Medicaid expansion, it is something like a decision to go down a one-way street” and that “legislators are mistaken to ignore the possibility that expansion cannot be abandoned as easily as it was entered.”
5. Myth: States can circumvent Medicaid requirements for the expansion population.
Reality: In its recent Frequently Asked Questions, the Centers for Medicare and Medicaid Services (CMS) clearly states that beneficiaries under any premium support arrangement would still be Medicaid beneficiaries, “entitled to all benefits and cost-sharing protections,” and that states must provide “wrap around” to fill in any gaps. As Ed Haislmaier has pointed out, “[A]ny state that agrees to the Medicaid expansion will get exactly what the term expansion implies: simply a bigger version of the same expensive and dysfunctional program.”
6. Myth: States must act quickly before Obamacare cuts hospital payments.
Reality: Hospitals are pushing states to expand Medicaid coverage because Obamacare is going to reduce their payments for uncompensated care by $56 billion over 10 years. However, the President’s latest budget proposes delaying the Medicaid disproportionate share hospital (DSH) payment reductions until 2015, which raises questions over the future of the cuts. But regardless, as Heritage’s Nina Owcharenko points out, “[m]aybe it is time for the states to tell the hospitals to shift their attention to the real problem: Obamacare.”
7. Myth: Hospitals will go out of business if states do not expand Medicaid coverage.
Reality: Hospitals have been lobbying hard on the idea that without expansion, the Obamacare uncompensated care payment cuts will be unsustainable for their business. But according to Ohio Media Trackers, about 80 percent of Ohio hospitals would still net millions in profits if their charity care was cut.
8. Myth: States can trust the federal government to keep its funding promises.
Reality: “Although Obamacare stipulates the federal government will pay at least 90 percent of the benefit costs of the Medicaid expansion,” Heritage explains, “state lawmakers have no guarantee future Congresses will keep that promise.” In fact, the Obama Administration has already proposed changing the deal in its fiscal year 2013 budget proposal.
9. Myth: Medicaid expansion will help low-income workers out of poverty.
Reality: Medicaid expansion actually locks low-income workers in poverty because of its backward incentives that discourage work. As Dan Greenberg explains for Advance Arkansas, “[E]mployees who earn too much money—or who work too many hours—face a set of unpleasant choices. They can quit. They can work fewer hours. They can decline raises. Realistically, a large number of employees who face such choices will opt to preserve Medicaid coverage by reducing the hours they legally work.”
10. Myth: Medicaid is quality health coverage.
Reality: Research has consistently shown that Medicaid produces worse access and health outcomes than private insurance. As Heritage’s Kevin Dayaratna writes, “By further expanding this broken program, Obamacare only exacerbates the situation by adding millions of low-income Americans to a failing program.”
1. Myth: Expanding Medicaid is “free money” for the states.
Reality: The expansion adds an estimated $638 billion in new government spending from 2013–2023. New spending at the federal or state level is reckless in light of the country’s trillion dollar budget deficits and over $16 trillion in national debt. As Governor Rick Perry (R–TX) stated, “[T]here is no such thing as ‘free’ money. We know there’s only money that’s collected from taxpayers, and money borrowed from other countries like China against the good credit of our children and grandchildren.”
2. Myth: Expanding Medicaid will entail little to no costs to the states.
Reality: Within three years, costs would exceed any projected savings. Heritage research shows 40 of 50 states would see increases in costs due the Medicaid expansion. If all states expand, state spending on Medicaid would increase by an estimated $41 billion by 2022.
3. Myth: Medicaid expansion can bring savings to the states.
Reality: Analysis by Heritage shows that by 2022 any projected state savings are dwarfed by costs. Moreover, these projected savings assume states will further reduce payments to hospitals and clinics for uncompensated care. But, as Heritage’s Ed Haislmaier points out, it is more likely that hospitals will lobby state legislatures for more money rather than less.
4. Myth: States can opt out of the Medicaid expansion if they change their mind later.
Reality: Some proponents of the expansion claim that states could drop out of the expansion if the federal government reneges on its commitments. But as legal experts Robert Alt and Dan Greenberg state, “[I]n fact, there is substantial reason to believe that when a state chooses Medicaid expansion, it is something like a decision to go down a one-way street” and that “legislators are mistaken to ignore the possibility that expansion cannot be abandoned as easily as it was entered.”
5. Myth: States can circumvent Medicaid requirements for the expansion population.
Reality: In its recent Frequently Asked Questions, the Centers for Medicare and Medicaid Services (CMS) clearly states that beneficiaries under any premium support arrangement would still be Medicaid beneficiaries, “entitled to all benefits and cost-sharing protections,” and that states must provide “wrap around” to fill in any gaps. As Ed Haislmaier has pointed out, “[A]ny state that agrees to the Medicaid expansion will get exactly what the term expansion implies: simply a bigger version of the same expensive and dysfunctional program.”
6. Myth: States must act quickly before Obamacare cuts hospital payments.
Reality: Hospitals are pushing states to expand Medicaid coverage because Obamacare is going to reduce their payments for uncompensated care by $56 billion over 10 years. However, the President’s latest budget proposes delaying the Medicaid disproportionate share hospital (DSH) payment reductions until 2015, which raises questions over the future of the cuts. But regardless, as Heritage’s Nina Owcharenko points out, “[m]aybe it is time for the states to tell the hospitals to shift their attention to the real problem: Obamacare.”
7. Myth: Hospitals will go out of business if states do not expand Medicaid coverage.
Reality: Hospitals have been lobbying hard on the idea that without expansion, the Obamacare uncompensated care payment cuts will be unsustainable for their business. But according to Ohio Media Trackers, about 80 percent of Ohio hospitals would still net millions in profits if their charity care was cut.
8. Myth: States can trust the federal government to keep its funding promises.
Reality: “Although Obamacare stipulates the federal government will pay at least 90 percent of the benefit costs of the Medicaid expansion,” Heritage explains, “state lawmakers have no guarantee future Congresses will keep that promise.” In fact, the Obama Administration has already proposed changing the deal in its fiscal year 2013 budget proposal.
9. Myth: Medicaid expansion will help low-income workers out of poverty.
Reality: Medicaid expansion actually locks low-income workers in poverty because of its backward incentives that discourage work. As Dan Greenberg explains for Advance Arkansas, “[E]mployees who earn too much money—or who work too many hours—face a set of unpleasant choices. They can quit. They can work fewer hours. They can decline raises. Realistically, a large number of employees who face such choices will opt to preserve Medicaid coverage by reducing the hours they legally work.”
10. Myth: Medicaid is quality health coverage.
Reality: Research has consistently shown that Medicaid produces worse access and health outcomes than private insurance. As Heritage’s Kevin Dayaratna writes, “By further expanding this broken program, Obamacare only exacerbates the situation by adding millions of low-income Americans to a failing program.”
Monday, February 24, 2014
American Action Forum Releases Updated Estimates on the Impact of the Health Insurance Tax
On Thursday,
the American Action Forum (AAF) released a new report on the projected
impact of the Health Insurance Tax on individuals and families.
According to the report, the Tax will result in:
·
A
premium increase of $109 per individual in employer-sponsored coverage
in 2014, and an increase of $195 per individual by 2018;
·
A premium increase of $266 per family in employer-sponsored coverage in 2014, and an increase of $476 per family by 2018;
·
A premium increase of $66 per individual in Exchange coverage in 2014, and an increase of $118 per individual by 2018;
·
A premium increase of $141 per Medicare Advantage beneficiary by 2014, and an increase of $252 per beneficiary by 2018; and
·
A premium increase of $34 per Medicaid beneficiary in 2014, and an increase of $60 per individual by 2018.
Health Insurance Marketplace
Key statistics include:
- Through December, 2.15 million enrolled in either the federal Marketplace (1.2 million) or state exchanges (950k). That figure is now around 3 million.
- Of 7.7 million applications through December, 5.1 million were eligible for an exchange plan (rather than Medicaid or Medicare). 53% of applicants were eligible for subsidy.
- 80% of enrollees were subsidy eligible.
- 33% of enrollees were ages 55-64.
- 60% of enrollees chose Silver plan. 20% chose Bronze plan. 1% enrolled in catastrophic plans.
Friday, February 21, 2014
Democrats defensive as CBO projects job loss from ObamaCare, minimum-wage hike
FoxNews.com
That forecast has forced Democrats into unfamiliar arguments to defend their own public policies, as they point to potential benefits of lost jobs and reduced hours.
"I don’t care what the CBO says about the job impact of ObamaCare," said Michael Mandel of the Progressive Policy Institute. "ObamaCare has a far-reaching impact and part of that is going to be to encourage entrepreneurship."
On NBC's Meet the Press, Sen. Charles Schumer, D-N.Y., described how statistical job loss translates into advantages for individual families.
"The single mom who is raising three kids [who] has to keep a job because of health care can now spend some time raising those kids. That's a family value," he said.
Rep. Keith Ellison, D-Minn., offered a similar defense on ABC's “This Week.”
"We're going to have parents being able to come home, working reasonable hours. People are going to be able to retire," he said.
ObamaCare in particular presents a unique quandary for the most productive workforce the world has ever known. Critics say that by lowering subsidies as a worker's pay increases, ObamaCare creates a disincentive to make more money -- and an incentive to rely on government aid.
"The idea of the rugged individual who is a self-reliant person and who makes his own way in the world is something that's deeply embedded in the American character and hard work is deeply embedded in the American character," the American Enterprise Institute's Michael Strain told Fox News." He added, "Public policy should be trying to encourage work, trying to support work."
House Minority Leader Nancy Pelosi, D-Calif., routinely has said ObamaCare would create greater job flexibility. She took that argument to a new level last week in light of the CBO findings.
"We want people to have the freedom to be a writer, to be a photographer, to make music, to paint, to start a business, to unleash the entrepreneurship of America," she told reporters.
While Republicans pointed to recent CBO findings as proof that ObamaCare and a minimum-wage hike are bad for the economy, supporters of those policies found plenty of other upsides in the studies. The report on the minimum wage said that while raising the rate would cost jobs, it would also raise wages for roughly 16.5 million people.
Doug McKelway joined Fox News Channel (FNC) in November 2010 and serves as a Washington-based correspondent.
American Action Forum Releases Updated Estimates on the Impact of the Health Insurance Tax
On Thursday,
the American Action Forum (AAF) released a new report on the projected
impact of the Health Insurance Tax on individuals and families.
According to the report, the Tax will result in:
·
A
premium increase of $109 per individual in employer-sponsored coverage
in 2014, and an increase of $195 per individual by 2018;
·
A premium increase of $266 per family in employer-sponsored coverage in 2014, and an increase of $476 per family by 2018;
·
A premium increase of $66 per individual in Exchange coverage in 2014, and an increase of $118 per individual by 2018;
·
A premium increase of $141 per Medicare Advantage beneficiary by 2014, and an increase of $252 per beneficiary by 2018; and
·
A premium increase of $34 per Medicaid beneficiary in 2014, and an increase of $60 per individual by 2018
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