Tag Archives: health care

Medicaid Enrollment Has Soared Under Obamacare

by Bart Jameson Posted on January 21, 2014

Mother Jones

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The New York Times reports that Medicaid expansion has been a huge success in West Virginia:

Enrollment in private insurance plans has been sluggish, but sign-ups for Medicaid, the federal insurance program for the poor, have surged in many states. Here in West Virginia, which has some of the shortest life spans and highest poverty rates in the country, the strength of the demand has surprised officials, with more than 75,000 people enrolling in Medicaid….In West Virginia, where the Democratic governor agreed to expand Medicaid eligibility, the number of uninsured people in the state has been reduced by about a third.

It’s not just West Virginia, either. Probably not, anyway. Charles Gaba, who is basically the Nate Silver of Obamacare numbers, writes today that he’s now pretty sure the total number of enrollments in Medicaid since October 1st isn’t the 4 million or so that we previously thought, but more likely 6.2 million. We still don’t know for sure how many of these represent new enrollments vs. re-enrollments, but the higher number makes it pretty likely that a very large chunk of this 6.2 million are new enrollees. Anecdotal evidence backs this up, and preliminary figures from the states that break out new enrollees separately suggest that roughly two-thirds of total signups are new enrollees.

If that’s true, it means that about 4 million new people have signed up for Medicaid since October 1st. That’s 4 million people who feel like this:

Waitresses, fast food workers, security guards and cleaners described feeling intense relief that they are now protected from the punishing medical bills that have punched holes in their family budgets. They spoke in interviews of reclaiming the dignity they had lost over years of being turned away from doctors’ offices because they did not have insurance.

“You see it in their faces,” said Janie Hovatter, a patient advocate at Cabin Creek Health Systems, a health clinic in southern West Virginia. “They just kind of relax.”

We’re the richest country in the world. We can afford this.

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Medicaid Enrollment Has Soared Under Obamacare

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Map of the Day: The High Cost of Vaccine Hysteria

by Seymour89E Posted on January 20, 2014

Mother Jones

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This map shows outbreaks of measles and mumps over the past five years:

It’s no surprise that Africa has been heavily hit, but why are the United States and Europe seeing so many outbreaks? Aaron Carroll explains:

All of that red, which seems to dominate? It’s measles. It’s even peeking through in the United States, and it’s smothering the United Kingdom.
If you get rid of the measles, you can start to see mumps. Again, crushing the UK and popping up in the US.
Both measles and mumps are part of the MMR vaccine.

Use of the MMR vaccine plummeted during the aughts, as vaccine-autism hysteria was spread by charlatans and the ignorati. Needless to say, this did nothing to affect the incidence of autism, but it sure had an effect on measles and mumps. To this day, though, I don’t think any of the vectors of this hysteria have so much as apologized. It’s shameful.

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Map of the Day: The High Cost of Vaccine Hysteria

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Chart of the Day: Being Poor Is Bad for Your Health

by Jeff Howard Posted on January 8, 2014

Mother Jones

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Hypoglycemia is an ever-present threat among diabetics who are being treated with insulin injections. Generally speaking, it’s caused by inadequate nutrition leading to dangerously low blood sugar, and it can usually be fixed by simply eating enough. But what if you’re poor, and at the end of the month you don’t have enough money left to buy adequate food? Adrianna McIntyre passes along this devastatingly simple chart that shows exactly what happens:

Take a look at the top three lines. Among those with high incomes, the risk of hypoglycemia is about the same all month long. But the red line shows the incidence of hypoglycemia among the poor. It goes down at the beginning of the month, when money is available for food, rises a bit in the middle of the month, and then jumps dramatically in the final week when money is tight. As a check to make sure that tight budgets really are at fault, the authors ran the same test on the incidence of appendicitis, which should be unrelated to income. It was.

McIntyre uses this as an object lesson: although policy wonks tend to focus a lot of attention on insurance and health care financing, there are plenty of other things that affect health. What’s more, solutions aren’t simple:

These findings also illustrate the difficulty in finding policy solutions to address health disparities. The authors note that food pantries and soup kitchens already ramp up staffing and resources toward the end of the month. We could explore different ways to distribute existing benefits, but that may have other negative impacts (ie: making it harder to pay rent or bills at the beginning of the month).

Nothing is ever easy.

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Chart of the Day: Being Poor Is Bad for Your Health

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Medicaid Expansion Is a Stealth Success, and That’s Just Fine

by PhoenixBrook3 Posted on January 6, 2014

Mother Jones

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Obamacare ended the year with about 2 million people who signed up through the insurance marketplaces and maybe three times that many who signed up for Medicaid. That makes the Medicaid expansion a big success, but neither party really wants to admit it:

To Drew Altman, president of the Kaiser Family Foundation, this exposes a core reality of U.S. health-care politics. “Republicans don’t like entitlement programs, and Democrats want to portray the ACA as mostly a marketplace solution based on private insurance and not another expansion of a government program,” he said, “so neither side wants to emphasize the ACA’s success enrolling people in Medicaid even though it may be the law’s biggest achievement so far in terms of expanding coverage.”

This has left both the Obama administration and Republicans in a tight spot. The White House can’t really tout the Medicaid expansion because it’ll revive fears on the right that Obamacare is really a stealthy effort to create a single-payer health-care system, and it’ll arouse criticism on the left that the administration should have expanded Medicaid to all.

As for Republicans, they can’t admit the Medicaid expansion is going well because doing so is dangerously close to advocating a single-payer health-care system. The exchanges, marred by their troubled introduction, are also a problem as they are a Republican idea, enshrined in Rep. Paul Ryan’s health-care bill.

I think I’d analyze this a bit differently. I don’t really have a sense that much of anyone associates Medicaid expansion with a push for single-payer. Rather, Democrats don’t want to talk about it because Medicaid is a program for the poor, and they don’t want middle-class voters thinking that Obamacare is just another way to funnel their tax dollars into welfare programs for other people. Likewise, Republicans oppose Medicaid expansion simply because they don’t like entitlement programs; they don’t like higher taxes; and they’ve always wanted to block-grant Medicaid and starve it to death. I don’t think it’s really any more complicated than that.

In any case, I’m fine with this. I think Medicaid expansion is great, but unlike a lot of lefties, I also think it’s a dead end. It’s not going to lead to single-payer, and it’s never going to be a template for future health care reforms. The marketplaces, despite all their problems, have far more potential to eventually lead to health care coverage for all. I think they also have more potential to produce delivery reforms down the road and to rein in cost growth. For that reason, I’m OK with the Medicaid expansion staying under the radar. That’s a fine place for it.

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Medicaid Expansion Is a Stealth Success, and That’s Just Fine

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Today Is Your Last Chance to Sign Up For Obamacare*

by qdj9iiiej Posted on December 23, 2013

Mother Jones

*OK, not really. This isn’t literally your last chance to sign up for Obamacare. But if you want coverage to start on January 1, today’s the deadline. Go sign up!

Link – 

Today Is Your Last Chance to Sign Up For Obamacare*

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Obamacare Enrollments Are Starting to Surge

by CarmonRoy Posted on December 19, 2013

Mother Jones

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Over the past 24 hours, I have managed to say not a single word about either Duck Dynasty or Pajama Boy. So what do I get for my reward? This:

HORSEBACK GUESSTIMATE WARNING: Unless it’s hidden away somewhere, California hasn’t released weekly enrollment numbers. But they’ve released numbers for October, and for the first two weeks of November, and then for October+November. Then today they released numbers for the first three days of this week: 13K on Monday, 19K on Tuesday, and 20K on Wednesday. If you put that all together and then take a reasonable swag at filling in the gaps, you get the chart above. It’s not official or anything, but it’s probably not too far off.

And what it shows is that with deadlines finally looming, all those people who have been shopping for the past month or two are finally enrolling at a furious pace. Other states are reporting a similar surge. Obamacare still has a long way to go, but things are definitely starting to perk up.

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Obamacare Enrollments Are Starting to Surge

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Most Americans Have No Clue How Health Insurance Works in America

by IndiaDeloach Posted on December 19, 2013

Mother Jones

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EBRI has released its annual workplace benefits survey, and for the most part it’s a triumph of status quo bias. Most people are fairly satisfied with their benefits and not especially eager for change. But there’s one particular question that produced a different response. Here it is:

I’m scratching my head a bit over this. The thing is, employer health insurance is the gold standard of American health insurance. Sure, every year employee cost sharing rises and copays go up, but it’s still great compared to nearly all individual plans. Deductibles are small and out-of-pocket maxes are low. Plus it’s nontaxable. If you have a choice between employer insurance and individual health insurance, about 99 percent of the time you’d be crazy not to take the employer plan.

And yet, 66 percent (!) of respondents wanted to go out and choose a plan on the open market and then get reimbursed in one way or another. The only thing I can figure is that this demonstrates just how little most people know about health insurance. They have no idea that the full value of employer health insurance is free of income tax, which makes it a great deal compared to spending your own money. Nor, as so many people are suddenly discovering about Obamacare, do they realize that individual plans usually have large deductibles and stratospheric out-of-pocket maxes. For those reasons, buying an individual plan on the open market and then getting reimbursed for it is almost certainly a losing proposition.

Maybe I’m missing something here, and people understood the question differently than me. But on the surface, this sure seems to indicate that most Americans simply have no clue about how health insurance works in this country.

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Most Americans Have No Clue How Health Insurance Works in America

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Even Doctors Believe in Obamacare’s Death Panels

by JackJanesgql Posted on December 19, 2013

Mother Jones

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I learned something new this morning. Two things, actually. First, Sarah Kliff points us to a recent study telling us that even a lot of doctors believe that Obamacare institutionalizes death panels:

This is just a survey of head and neck doctors, so maybe they’re just especially ignorant among the MD set. But probably not.

So what else did I learn? Well, Obamacare has never had death panels in the sense of the question above, but it does reimburse physicians for having end-of-life conversations with their patients. You know, so they can decide about things like DNR notices, how much extraordinary care they want, living wills, and so forth. All perfectly sensible, except that it’s what prompted the death panel nonsense in the first place.

And it’s gone. I didn’t know that. Apparently, after the New York Times put it on the front page in 2011, this provision was eliminated. So the yahoos won another victory, and it didn’t stop the death panel talk anyway. Hooray.

UPDATE: Thanks to a tweet from Austin Frakt, I did a little more digging and it turns out that a weakened version of end-of-life counseling remained in the bill and was implemented by a new regulation adopted in 2010:

The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit.

Under the rule, doctors can provide information to patients on how to prepare an “advance directive,” stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves.

So if a patient asks about end-of-life treatment, doctors are allowed to talk about it and bill the time as an office visit. Death panels!

Link – 

Even Doctors Believe in Obamacare’s Death Panels

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Charts: Catholic Hospitals Don’t Do Much for the Poor

by mlodyseo7 Posted on December 18, 2013

Mother Jones

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Catholic hospitals have been on a merger spree over the last few years, as Mother Jones reported earlier this year. Ever-expanding swaths of the country are now served only by a Catholic hospital, where patients have no choice but to receive care dictated by Catholic bishops whose religious edicts don’t always align with what’s best for a patient. Catholic hospitals generally follow the Ethical and Religious Directives for Catholic Health Care, which restrict abortion even in cases where a fetus isn’t viable, for instance, a practice that has resulted in hospitals denying proper care for women suffering from miscarriages. The ACLU recently filed suit against the US Conference of Catholic Bishops on behalf of a Michigan woman who was suffering a second-trimester miscarriage and was sent home twice by a Catholic hospital, developing a serious infection because the hospital refused to even talk to her about the possibility of an abortion. Her baby died two hours after she miscarried.

Despite this heavy mixing of theology and health care, Catholic hospitals in 2011 received $27 billion—nearly half of their revenues—from public sources, according to a new report put out today by the American Civil Liberties Union and MergerWatch, a reproductive rights advocacy group. And that figure doesn’t even include other tax subsidies the hospitals receive thanks to their nonprofit status.

The hospitals have long justified their tax status and restrictions on care by pointing to their religious mission of serving the poor and their delivery of charitable care. But the new ACLU/MergerWatch report suggests, and the chart below illustrates, Pope Francis might be on to something when he’s said that the church needs to shift its priorities to focus less on abortion and more on the poor. MergerWatch data show that Catholic hospitals, where executives often earn multimillion-dollar salaries, aren’t doing any better providing charity care than other religious non-profit hospitals that don’t restrict care. They’re barely any better than ordinary secular nonprofits.

ACLU/MergerWatch

The charitable care figures also don’t give a complete picture of how well Catholic hospitals serve the poor and uninsured because it doesn’t include patients who are covered by Medicaid, the government health care plan for the low-income and disabled. As it turns out, Catholic hospitals, which in 2011 had more than $200 billion in gross patient revenue, had the lowest percentage of revenue from Medicaid of any type of hospital. Even for-profit hospitals earned more revenue from Medicaid than Catholic hospitals.

ACLU/MergerWatch

All of these numbers suggest that as Catholic hospitals have merged and expanded into a multi-billion dollar enterprise, they’ve moved far beyond their religious mission and become like any other large corporation. Given those trends, and the hospitals’ reliance on public funding, it’s hard to see how they can continue to justify their mixing of Catholic doctrine with health care, especially when it disproportionately violates standards of care for women.

The ACLU/MergerWatch report calls on the US Department of Health and Human Services to crack down on Catholic hospitals and to insist that they follow federal law requiring all hospitals that receive Medicare and Medicaid funding to provide emergency treatment to any patient, even if that care requires an emergency abortion. Other advocacy groups have made similar requests in the past few years, but HHS thus far has refused to pick a fight with the Catholic Church, which has turned into one of the Obama administration’s biggest foes thanks to the contraceptive mandate in the Affordable Care Act. The church has proven to be a powerful enemy—a wealthy special interest in a holy war—and even the new Pope seems unlikely to persuade it to give up this particular fight.

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Charts: Catholic Hospitals Don’t Do Much for the Poor

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Soon, Obamacare Will Get the Blame For Your Kid’s Acne

by jjhhhjz Posted on December 15, 2013

Mother Jones

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From the Associated Press:

Americans who already have health insurance are blaming President Barack Obama’s health care overhaul for their rising premiums….In the survey, nearly half of those with job-based or other private coverage say their policies will be changing next year — mostly for the worse. Nearly 4 in 5 (77 percent) blame the changes on the Affordable Care Act, even though the trend toward leaner coverage predates the law’s passage.

….Employers trying to control their health insurance bills have been shifting costs to workers for years, but now those changes are blamed increasingly on “Obamacare” instead of the economy or insurance companies.

Obamacare has been a boon for employers and insurers who want to cut back their health benefits but don’t want to take the blame for it. They just blame Obamacare instead. This will only work for a year or two, but for now it’s a godsend. Better to have your employees pissed off at the guy in the White House than pissed off at the guy in the corner office.

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Soon, Obamacare Will Get the Blame For Your Kid’s Acne

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