|The latest news from and for state health care advocates
In each edition, we'll feature an action, victory, campaign, or interesting tactic shared by a state advocate. Send us your updates.
In This Issue:
Buzz around the States
Advocates at the North Carolina Justice Center hosted an event with Dr. Don Berwick to educate providers about the system reform provisions of the Affordable Care Act that reduce costs while increasing the quality of care.
Citizen Action of Wisconsin embarked on a weeklong ambulance tour throughout the state to remind Wisconsinites of the need to protect health care programs and the social safety net.
Michigan Consumers for Healthcare testified at a state legislative hearing to oppose the legislation that would remove all state oversight of rate increases by Blue Cross Blue Shield of Michigan, allowing such rate increases to go into effect immediately.
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States in Focus
Written by Anna Strong, Health Policy Director, Arkansas Advocates for Children and Families
Originally posted on the ARVoices Blog on September 12, 2012
Arkansas: Add Gov. Beebe to List of Supporters of Medicaid Extension
Yesterday, Governor Beebe publicly announced his support for extending Medicaid to those who would qualify under the Affordable Care Act. The list of supporters is growing.
We are glad our Governor agrees with us that this is the right thing to do for Arkansas. We know that Medicaid and ARKids First help kids stay healthy and succeed in school, they ease parents' minds when their children need care, and they take care of families during hard times. However, many adults in Arkansas are unable to access affordable health coverage. Arkansas has one of the most restrictive Medicaid programs in the country, and income limits are very low for non-disabled parents to qualify for Medicaid. Non-disabled childless adults don't qualify for Medicaid at all. This limited eligibility for Medicaid means that, in some counties in our state, about half of lower-income adults age 19-64 are uninsured. Add to that private insurance premiums averaging almost $12,000 per family in Arkansas, and it can be very hard to afford health coverage.
Thankfully, the Affordable Care Act will help families access affordable health coverage. Arkansas can help a quarter of a million uninsured adults access coverage if the state takes the opportunity to extend Medicaid to those who earn up to 138 percent of the poverty level as the law allows. This would set income cutoffs for Medicaid at $15,414 for an individual or $31,809 for a family of four.
If the Arkansas legislature does not choose to extend Medicaid during the upcoming 2013 legislative session, hundreds of thousands of Arkansans will remain without an option for affordable health coverage. Low-income adults do not qualify for subsidies to purchase private plans through the Health Insurance Exchanges that will help higher-income families afford coverage. Many of our neighbors will be left out in the cold when it comes to their health coverage and care.
AACF applauds Governor Beebe's endorsement for extending Medicaid to uninsured Arkansans. In addition to helping our neighbors stay healthy, extending Medicaid will actually make money for the state over the first six years. In fact, for the first three years of the program (2014 - 2016), the federal government will pick up the entire cost for these newly eligible Medicaid enrollees. This allows us to get sicker Arkansans healthy before the state has to start picking up 10 percent of the tab in 2020. Additionally, hospitals will have help paying for those patients who, today, come to the Emergency Room with no insurance. This helps local hospitals remain an integral part of the business community, keeping jobs in town.
Extending Medicaid is the right thing to do, just as covering children through the ARKids First Program is the right thing to do. It's a bonus that it will help local communities stay strong while making money for the state, too. (Take a look at this fact sheet from the Arkansas Center for Health Improvement for more detailed stats).
We are in good company with our support of Governor Beebe's endorsement. Check out the growing list of organizations who have publicly endorsed extending Medicaid to low-income families in our state.
The Arkansas Medical Society
Community Health Centers of Arkansas
Arkansas State Board of Health
Arkansas Hospital Association
Arkansas Foundation for Medical Care
University of Arkansas for Medical Sciences Chancellor Dan Rahn
Medicaid Director Andy Allison, Surgeon General Joe Thompson, and Insurance Commissioner Jay Bradford
Attorney General Dustin McDaniel
The Arkansas Minority Health Commission
The American Cancer Society
Written by Greg Mellowe, Florida Chain
Originally posted on CHAIN Reaction on September 14, 2012
Florida: The Future of Medicare: Cutting Through the Noise
An even larger than usual amount of information has been circulating recently regarding the future of Medicare, with the issue taking center stage as the 2012 elections loom. In fact, most everyone who finds their way to this blog has seen such information in some form. Unfortunately, not all of the information out there is accurate. Given the high stakes for this vitally important safety-net program and those who depend on it, it’s worth recapping the answers to two key Medicare policy questions that have dominated the discussion in recent months:
1. By reducing Medicare spending by $716 billion over 10 years, does the Affordable Care Act (ACA) hurt seniors?
No. The ACA does not cut any services or benefits from Medicare. None. In fact, the ACA improves Medicare services by providing access to preventive benefits like potentially life-saving screenings with zero out-of-pocket costs and by gradually eliminating the “donut hole” coverage gap in Medicare Part D prescription drug coverage.
In fact, the ACA slows the growth in Medicare spending by changing the way payments are made to providers. For one, the ACA curbs the extra payments that for-profit HMOs (Medicare Advantage plans) receive in excess of the traditional Medicare rates. For another, the ACA alters the way Medicare pays for certain complex services, paying for the coordinated delivery of care rather than paying separately for each contributing piece of it. Those are the kind of common-sense changes that ACA opponents would be hailing, if it wasn’t the ACA making it happen. They malign and misrepresent these efforts for political gain. Politics is the only reason you’re hearing “Obamacare” and “Medicare cuts” in the same sentence.
2. Would the so-called House Republican budget (often called the Ryan budget) proposal, which seeks to replace the current Medicare program with a voucher system, “end Medicare as we know it?”
For many, yes. Under the budget blueprint approved by the House, starting in 2023, Medicare would become a “premium support” program, which provides vouchers to seniors to purchase either a private health insurance plan or a traditional Medicare plan. By design, the voucher amount would not keep pace with costs. As a result, seniors would be stuck paying the difference, which would continue to increase over time.
Based on Congressional Budget Office estimates, this cost-shifting alone would increase total health costs paid by a senior who qualifies for Medicare in 2023 by an average of $32,900 (8 percent of their lifetime Social Security benefits) and by $225,200 (42 percent of their lifetime benefits) for a recipient who qualifies in 2050.
To make matters worse, that’s not even the full price tag. After factoring in a conservative guess about how much more Medicare costs will rise due to decreased bargaining power and higher administrative costs and profits, seniors qualifying for Medicare in 2023 would actually incur an additional $59,500 in health costs, while those qualifying in 2050 would pay $331,200 more!
That would certainly seem to put the Medicare coverage that seniors rely on now out of reach for many or most. For them, Medicare as we know it would end.
Finally, the claim that the proposal would only affect those qualifying for Medicare after 2022 is also inaccurate. Repealing the ACA would increase total health costs of today’s 65 year-olds by $11,000, on average, mostly due to higher drug costs and Medicare premiums. Proposed cuts to Medicaid, which pays for long-term care, would only add to that total.
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New Mexico: Testifying about the Benefits of Health Care Reform
Bill Jordan and I testified recently in Las Cruces about the health and economic benefits to the state from fully implementing the Affordable Care Act (ACA). The audience was the Legislative Revenue Stabilization and Tax Policy Committee. Bill explained that $8 to $11 billion of new federal funds for health care will enter the state economy as a result of the ACA if the state chooses to insure all lower-income adults through Medicaid. The expense will be completely covered by the federal government from 2014 through 2016, and then phase down to 90 percent in 2020, where it will remain indefinitely. The state’s Human Services Department (HSD) has estimated that the state costs over the first seven years will be between $320 and $500 million.
Bill pointed out a study by economist Kelly O’Donnell, PhD, commissioned by NM Voices, that shows the state will take in twice that amount — between $693 and $953 million — in new state revenues during those first seven years. This revenue will come in thanks to existing state tax laws.
Most of the federal ACA funds — including both Medicaid and the tax subsidies to help middle-income families buy health insurance on the new Exchange — will be paid initially to insurance carriers and therefore will be subject to the state’s Insurance Premium Tax. Portions of the spending will also be subject to the gross receipts tax (which also generates revenues for local governments, which won’t have to spend any money on the ACA).
Bill explained that there is no significant upfront cost to the state. The state costs will ramp up very gradually starting in 2017 and will always be less than the state tax revenue generated by the much larger federal spending, as shown below.
I reminded the Committee that, for uninsured New Mexicans, this is literally a matter of life and death. It is estimated that more than 300 New Mexicans die every year because they don’t get the kind of medical treatment they need due to not having health insurance. Having health insurance means people can get the kind of preventive and follow-up care that saves lives (and saves money).
I also pointed out that the Hilltop Institute report commissioned by HSD estimates that the state’s hospitals will save more than $2 billion in “uncompensated care” costs during the 2014-2020 period. These are the costs incurred by our hospitals when treating uninsured patients, mostly in the emergency room. These costs get passed along to all of us as higher local taxes and higher insurance premiums. Getting many more New Mexicans covered by health insurance will help lower these pass-along costs.
Las Cruces Sun-News coverage of the hearing.
Albuquerque Journal’s editorial in favor of expanding Medicaid.
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Beat of the Month
In honor of Halloween and Ryan Gosling, here’s a spooky tune from Dead Man’s Bones. Enjoy this track as you push through and plan for the scary battles ahead!
Make a Meme to Help Your Message Go Viral
With traditional forms of communication, breaking through requires an interesting, attention-grabbing message delivered in an innovative way. When it comes to social media, it’s no different.
And being innovative online doesn’t have to be difficult. Creating memes (humorous cultural references with visual components) can be an easy and fun way to make your message heard and to increase the chances of your organization’s message going viral.
Mashable has a great beginners guide about memes and how they work. Free online tools like quickmeme.com or PicFrame offer easy ways to create your own memes. And of course, once you’ve created your meme, don’t forget to post it to Facebook, Pinterest, and Tumblr, and to tweet it on Twitter.
New Resources from Families USA and Stand Up for Health Care
Take me to back issues of the Beat!
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