Tag Archives: medicaid

Donald Trump’s Big Lie on Health Care

by ReganGoodell Posted on March 4, 2016

Mother Jones

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I realize that criticizing a Donald Trump policy is pointless, but Trump’s health care “plan” deserves a bit more attention. Say what you will about his immigration policies, but at least his written plan more-or-less matched his rhetoric. His health care plan doesn’t even come close. Here are its six proposals:

  1. Allow insurance companies to sell policies across state lines. Whatever you think of this idea, it only makes sense if you can truly buy a policy that’s regulated by another state. Ramesh Ponnuru: “But the plan says that people should be allowed to buy insurance out of state only ‘as long as the plan purchased complies with state requirements.’ That defeats the whole purpose of the reform, and means either that Trump is coming out for the status quo or that whoever wrote his plan garbled it.” Or that Trump has no idea what he’s talking about.
  1. Allow individuals to “fully deduct health insurance premium payments from their tax returns.” This may or may not be a good idea in concept, but implementing it as a deduction makes it meaningless for nearly everyone at the median wage or below. They already pay little or no income tax, so a deduction does them no good. This is why other Republicans have proposed doing this as a tax credit, which would benefit anyone. Even conservatives agree about this: “That’s not going to help,” said Joe Antos, a conservative health policy expert at the American Enterprise Institute.
  1. Allow individuals to use HSAs. Individuals have been allowed to set up HSAs since 2003. The only new wrinkle in Trump’s plan is that an HSA can be used by any family member. This is trivial.
  1. Price transparency. This is fine. It won’t do much to improve health care, but it’s a good idea.
  1. Block grant Medicaid. This would accomplish nothing except, probably, to make health care worse. States tend to do everything they can to use Medicaid dollars for non-health purposes, and giving them total control over Medicaid would only make this worse. Also, it would eliminate the automatic increase in Medicaid spending during recessions, when it’s needed most. Overall, this proposal would almost certainly result in less Medicaid spending and less effective Medicaid spending.
  1. Allow importation of prescription drugs. This is fine.

Trump has been extravagant in his promises about health care: “I would end Obamacare and replace it with something terrific, for far less money for the country and for the people.” He’s said that he would cover everyone. He’s said he would cover pre-existing conditions. He’s said he wouldn’t let people die in the streets. He’s said he would allow Medicare to negotiate drug prices.

His plan includes none of that. He just flatly hasn’t kept any of his promises. Instead he’s offered up something that looks like a fourth grader cribbed it from other Republican plans without really understanding what they said. Even by GOP standards—which is a very low bar—his health care plan offers virtually nothing of substance. It’s completely hollow.

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Donald Trump’s Big Lie on Health Care

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Medicaid Provides Pretty Good Health Coverage for Children

by TanjaPflaum0174 Posted on November 18, 2015

Mother Jones

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Via Harold Pollack, here’s an interesting study of children’s health care. The researchers investigated how good Medicaid coverage was, and the results were surprisingly positive. I have painstakingly modified the chart so that higher numbers are always better, and as you can see, reported satisfaction with Medicaid was equal to or better than private insurance on most measures, and very close on the others.

Now, this is only for children, and the results might be different for adults. Still, a lot of people—including me—generally think of Medicaid as fairly lousy coverage. If this study is correct, we need to rethink this.

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Medicaid Provides Pretty Good Health Coverage for Children

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John Kasich Wants to Slash Everything Except the Pentagon

by LutherDetwiler Posted on November 11, 2015

Mother Jones

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How would John Kasich cut spending? Answer: his father was a mail carrier blah blah blah. OK, but did you want to name any specific steps, sir? Why certainly:

We would move the Medicare system from a 7 percent growth down to about a 5 percent growth. And I have a whole series of ways to do that. In Ohio, we reduced Medicaid funding for the poor from 10 percent to 2.5 percent, didn’t cut one benefit or didn’t take anybody off the rolls. Why? Because we’re innovators. I’ve been an innovator my entire career. And I really don’t care what special interests or lobbyists have to say. I have a job to do when I take over a public office. Now, we freeze non-defense discretionary for eight years. We also put an increase in defense spending. Our tax cuts balance out. And at the end of the day, we will get to a balanced budget.

So here is Kasich’s plan: cut Medicare, cut Medicaid, cut domestic discretionary spending, and increase defense spending. And we already know he wants to cut Social Security. So his plan is to cut every single aspect of domestic spending and increase defense spending. And this guy is the moderate in the field.

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John Kasich Wants to Slash Everything Except the Pentagon

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With Matt Bevin’s Victory, Health Insurance for 400,000 Kentuckians Now At Risk

by ChristiDkb Posted on November 4, 2015

Mother Jones

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Republican businessman Matt Bevin was elected governor of Kentucky on Tuesday. This is good news if you’re Matt Bevin. It’s potentially very bad news if you’re one of the 521,000 formerly uninsured Kentuckians who have received health insurance through the Affordable Cart Act.

Over the last five years, term-limited Democratic Gov. Steve Beshear cut the state’s uninsured rate by more than half by accepting federal funding to expand Medicaid, and by setting up a state-run health-insurance exchange called Kynect. Today, approximately 400,000 Kentuckians have received health insurance via Medicaid expansion.

As John Oliver masterfully explained, Bevin has promised to eliminate Kynect—a bright spot at the state level amid the chaotic HealthCare.gov rollout—and he’s been cagey about his plans for Medicaid. After campaigning on repealing Obamacare wholsesale during his unsuccessful 2014 Senate primary, he changed tune toward the end of his race this fall, suggesting that he would ask the administration for a waiver to restructure Medicaid but not kick anyone “to the curb.”

Up until this point, Kentucky has been one of the most compelling arguments not just for why the law was needed, but also that it can work. Just check out this map, compiled by the lone Democrat in the state’s Congressional delegation, Rep. John Yarmuth:

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With Matt Bevin’s Victory, Health Insurance for 400,000 Kentuckians Now At Risk

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Here Are 6 Things You Should Care About in Today’s State Elections

by JewelLabarbera Posted on November 3, 2015

Mother Jones

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As John Oliver reminded viewers this week, the much-hyped presidential election may still be 12 months away but important state and local elections are on Tuesday. From the battle over health care in Kentucky to the return of Michigan’s tea party lovebirds, here are six states to watch in Tuesday’s elections.

1. Medicaid in Kentucky: Kentucky’s gubernatorial race has also turned into a battle over Obama’s Affordable Care Act. The race pits the state’s current attorney general, Democrat Jack Conway, against millionaire Republican businessman Matt Bevin. Bevin has sworn to roll back current Gov. Steve Beshear’s expansion of the state’s Medicaid program, saying that Kentucky taxpayers can’t afford it, even though this expansion allowed an additional 400,000 residents to receive health care coverage. It also made Kentucky one of the only Southern states to expand Medicaid under Obamacare. If Bevin wins, it would become the first state to reverse that expansion, according to the Associated Press. Bevin, who has never before held political office, was trailing Conway by 5 points in a recent poll.

2. Gun control in Virginia: The state Senate race in Virginia has attracted millions of dollars in outside funding from groups eager to make headway in the national fight over gun control. Everytown for Gun Safety, the gun control advocacy group backed by billionaire former New York Mayor Michael Bloomberg, has put $2.2 million into television ads supporting two Democratic candidates for the Senate, Reuters reported. A win by either of these candidates would give Democrats the majority in the 40-seat state Senate, which could allow Gov. Terry McAuliffe to push through gun control measures that were blocked by a state Senate committee in January. The National Rifle Association, which is based in Virginia, has contributed to the Republican campaigns.

3. Campaign finance reform in Maine and Seattle: Both Maine and Seattle residents will vote Tuesday on initiatives to limit the power of money in politics. Seattle’s city ballot includes a novel initiative to create a system of “democracy vouchers,” which would give voters four $25 vouchers to contribute to the campaign of their choosing. It would also limit contributions in city races to $500 or less. Meanwhile, Maine—historically a leader in campaign finance regulation—will vote on a package of reforms that would require additional disclosures in political advertising and gubernatorial races, raise penalties for breaking campaign finance rules, and add $1 million to the state’s fund for public campaign financing.

4. Restrictions on Airbnb in San Francisco: San Francisco residents will vote Tuesday on Proposition F, a measure to limit short-term rentals in the city—which would strike a potentially precedent-setting blow to locally based hospitality startup Airbnb. For its part, Airbnb has poured more than $8 million into lobbying against the initiative. The company tried to win favor before the vote with a tongue-in-cheek ad campaign last month that backfired, prompting an apology from the company’s management.

5. Education funding in Mississippi: While no surprises are expected in Mississippi’s gubernatorial election, in which an unknown truck driver is running as the Democratic nominee against Republican incumbent Phil Bryant, a racially tinged battle over an amendment to the state’s constitution is one to watch. Initiative 42, which gathered 200,000 signatures to get on the ballot, would force the state to meet levels of education funding that lawmakers set in 1997 but have repeatedly failed to meet. If the measure passes, and lawmakers again fail to appropriate sufficient funds, a state court could step in and rule on the issue. Republicans have opposed the measure, arguing that it would give the courts control over the state’s budget. But the issue has also taken on distinctly racial overtones, with one state lawmaker, Bubba Carpenter, caught on camera last month telling constituents they should be afraid of what a “black judge” might do with their tax dollars. “If 42 passes in its form, a judge in Hinds County, Mississippi, predominantly black—it’s going to be a black judge—they’re going to tell us where the state education money goes,” Carpenter said. Carpenter later apologized for his statement.

6. Tea party tryst in Michigan: And last but not least, two tea party politicians in Michigan who left office after their extramarital affair and peculiar attempts to cover it up were revealed are running for the same positions they just vacated. Todd Courser, who resigned after the scandal broke, and Cindy Gamrat, who was kicked out of the Legislature in September, are running less than two months after the left their respective offices. Courser in May famously sent a fake email to journalists and politicians claiming he had been caught having sex with a male prostitute—a ruse he believed at the time would make news of the affair appear less credible. He was wrong.

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Here Are 6 Things You Should Care About in Today’s State Elections

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John Oliver Explains Why Tuesday’s Elections—Not Trump or 2016—Demand Your Immediate Attention

by KenReesemy Posted on November 2, 2015

Mother Jones

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As he bluntly told Stephen Colbert a few weeks ago, John Oliver truly couldn’t “give less of a shit” about Donald Trump or the 2016 election.

Yet, as the Last Week Tonight host lamented on Sunday, the national conversation remains fixated on presidential candidates, largely ignoring several key races that could ultimately determine the expansion of Medicaid and Obamacare in their states. It’s an issue, according to Oliver, all Americans should pay close attention to, even if you don’t live in one of these three states.

“There are American lives at stake here, because a number of these elections could determine whether hundreds of thousands of people remain in or even fall into what’s known as the Medicaid gap,” Oliver said.

“I know that sounds like a terrible clothing chain where you can buy khaki hospital gowns sewn by children in India, but amazingly, it’s even worse than that.”

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John Oliver Explains Why Tuesday’s Elections—Not Trump or 2016—Demand Your Immediate Attention

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Red States Spent $2 Billion in 2015 to Screw the Poor

by RashadPettis352 Posted on October 22, 2015

Mother Jones

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Medicaid funding is shared by the states and the federal government. Between 2000 and 2013—the most recent year reported by the CMS actuaries—the share of Medicaid spending shouldered by the states increased by an average of 6.1 percent per year. This is not total spending. It’s just the portion the states themselves paid for.

In 2015, according to a survey by the Kaiser Foundation, spending by states that refused to expand Medicaid grew by 6.9 percent. That’s pretty close to the historical average. However, spending by states that accepted Medicaid expansion grew by only 3.4 percent. Obamacare may have increased total Medicaid enrollment and spending, but the feds picked up most of the tab. At the state level, it actually reined in the rate of growth.

In other words, the states that have refused the expansion are cutting off their noses to spite their faces. They’re actually willing to shell out money just to demonstrate their implacable hatred of Obamacare. How much money? Well, the expansion-refusing states spent $61 billion of their own money on Medicaid in 2014. If that had grown at 3.4 percent instead of 6.9 percent, they would have saved about $2 billion this year.

Here’s what this means: the states that refuse to expand Medicaid are denying health care to the needy and paying about $2 billion for the privilege. Try to comprehend the kind of people who do this.

POSTSCRIPT: Actually, there’s more. The residents of every state pay taxes to fund Obamacare, whether they like it or not. Residents of the states that refuse to expand Medicaid are paying about $50 billion in Obamacare taxes each year, and about $20 billion of that is for Medicaid expansion. Instead of flowing back into their states, this money is going straight to Washington DC, never to be seen again.

So they’re willing to let $20 billion go down a black hole and pay $2 billion extra in order to prevent Obamacare from helping the needy. It’s hard to fathom, isn’t it?

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Red States Spent $2 Billion in 2015 to Screw the Poor

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A Federal Judge Just Gave an Epic Defense of Planned Parenthood That Everyone Should Read

by DannielleLay Posted on October 19, 2015

Mother Jones

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In a blistering opinion, a federal judge blocked Louisiana Gov. Bobby Jindal’s attempt to defund Planned Parenthood in the state, saying the move would cause “irreparable harm” to the 5,200 women who depend on the organization for health care.

In July, Jindal ordered an investigation into the group following the release of a series of highly edited videos that show Planned Parenthood officials discussing fetal tissue donation. He also ordered the Louisiana Department of Health and Hospitals (DHH) to cancel Planned Parenthood Gulf Coast’s (PPGC) Medicaid contract, which it did in August, effectively defunding the organization in the state. Neither of the two Planned Parenthood clinics in Louisiana offer abortions. Planned Parenthood took the DHH to court later that month.

US District Judge John W. deGravelles issued a restraining order against the DHH’s move late Sunday. The order will remain in place for at least two weeks while the judge makes a final ruling on the case. However, in his opinion, deGravelles was outspoken in his support of Planned Parenthood. He wrote that the DHH attack on the organization was baseless:

The uncontradicted evidence in the record at this time is that PPGC does not perform abortions in Louisiana, is not involved in the sale of fetal tissue and none of the conduct in question occurred at the PPGC’s two Louisiana facilities. Based on the record before it, it appears likely that Plaintiff will be able to prove that the attempted termination against it are motived and driven, at least in large part, by reasons unrelated to its competence and unique to it.

He also disputed a common Republican argument (which former Mother Jones reporter Molly Redden debunked last month) that closing Planned Parenthood won’t burden its patients, who would have access to other reproductive health providers in the area. According to deGravelles, defunding Planned Parenthood would leave thousands of women without options:

The Court turns to the uncontested and unquestioned facts—PPGC serves 5,200 poor and needy women, and PPGC has repeatedly been deemed a ‘competent’ provider by DHH—and honors the public interest in affording these women access to their provider of choice…For decades, PPGC has served numerous at-risk individuals and helped DHH combat a host of diseases, and, in the process, become the regular provider of over 5,000 women.

Several other states, including Arkansas, Utah, and Alabama, have cut funding for Planned Parenthood by canceling Medicaid contracts. In August, the Obama administration notified Alabama and Louisiana that cutting Planned Parenthood’s Medicaid funding may violate federal law.

For its part, Jindal’s office said on Monday that the governor would “continue to fight to ensure Planned Parenthood no longer receives taxpayer funding.”

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A Federal Judge Just Gave an Epic Defense of Planned Parenthood That Everyone Should Read

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There Are Thousands of Clinics That Could Replace Planned Parenthood, Right? Nope.

by DamianSpivakovs Posted on September 29, 2015

Mother Jones

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This week, the Congressional controversy over Planned Parenthood could come to a head as investigations continue through the House of Representatives. Today, Cecile Richards, the president of Planned Parenthood Federation of America, will testify before the House Oversight Committee, one of several committees conducting an investigation in the wake of videos from anti-abortion activist David Daleiden, who is also expected to testify in the continuing discussion.

One of the claims they may address has been neatly presented in a map circulating on social media. The graphic claims that there are 13,540 clinics where women can find comprehensive health care, as opposed to a mere 665 Planned Parenthood locations. It has become a popular talking point in the conservative push to defund Planned Parenthood—most notably mentioned by Jeb Bush in the GOP debate earlier this month. The map in question seems to be referring to a list of clinics, organized by state, from the Centers for Medicare and Medicaid Services, a branch of the Department of Health and Human Services.

But what the graphic doesn’t mention is that most of the clinics listed don’t even appear to have a certified OB-GYN on staff. The clinics are mostly general practice, meaning they may lack equipment and expertise to deliver reproductive health care to women. It’s not clear what criteria the groups circulating the map used to define viable options to replace Planned Parenthood’s services, and the groups did not respond to requests for comment.

While the clinics on this list do accept Medicaid, they are not set up to take the massive influx of patients that would result from a shutdown of Planned Parenthood. What’s more, many private reproductive health care clinics—those that aren’t represented on the list—don’t take Medicaid at all. That’s because the program pays just a fraction of what private insurers will reimburse.

Planned Parenthood, on the other hand, is set up to handle large numbers of Medicaid patients. Nearly half of all Planned Parenthood patients use Medicaid coverage, and more than a third of women who receive publicly funded family planning care rely on Planned Parenthood.

Mark DeFrancesco, president of the American Congress of Obstetrics and Gynecologists, says it’s common for practitioners not to accept Medicaid patients, because the reimbursement rates can’t come close to offsetting the operating costs of their clinics. “The reimbursement is such that Medicaid just by definition doesn’t pay anywhere near what private insurers pay for OB-GYN visits,” says DeFrancesco.

Sara Rosenbaum, a health law professor at George Washington University, agrees. In a blog post for Health Affairs, she writes that the claim that community clinics could replace Planned Parenthood represents “a fundamental misunderstanding of how the health care system works.”

Additionally, the Congressional Budget Office estimated in a report issued earlier this month that if Planned Parenthood were defunded, “as many as 650,000 women in areas without access to other health care clinics or medical practitioners who serve low-income populations” would lose their reproductive health care. And a survey by the Guttmacher Institute found that women often value specialized family planning clinics such as Planned Parenthood over primary care clinics for reasons such as affordability, increased confidentiality, and a greater range of contraceptive options. Guttmacher also reports that in 103 counties, Planned Parenthood is the only “safety net” family planning service, meaning that a large portion of their patients are either uninsured or reliant on Medicaid.

If Planned Parenthood were to lose a third of its entire budget, DeFrancesco warns, “these patients won’t have anywhere else to go.”

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There Are Thousands of Clinics That Could Replace Planned Parenthood, Right? Nope.

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Louisiana: Women Don’t Need Planned Parenthood. They Have Dentists.

by BrandiPeden Posted on September 10, 2015

Mother Jones

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The task seems straightforward: Make a list of health care providers that would fill the void if Louisiana succeeded in defunding Planned Parenthood. But the state, which is fighting a court battle to strip the group of hundreds of thousands of dollars in Medicaid funds, is struggling to figure out who would provide poor women with family planning care if not Planned Parenthood.

Nowhere is this struggle more apparent than in a recent declaration by Louisiana’s attorneys that there are 2,000 family planning providers ready to accommodate new patients. A federal judge, reviewing the list in an early September court hearing, found hundreds of entries for specialists such as ophthalmologists; nursing homes caregivers; dentists; ear, nose, and throat doctors; and even cosmetic surgeons.

“It strikes me as extremely odd that you have a dermatologist, an audiologist, a dentist who are billing for family planning services,” said the judge, John deGravelles, who will determine in the next week whether it is legal for the state to end Planned Parenthood’s Medicaid contracts. “But that is what you’re representing to the court? You’re telling me that they can provide family planning and related services?”

His harsh questioning sent the state back to the drawing board. On Tuesday, the state’s attorneys acknowledged that the dentists and other specialists didn’t belong on the list. They filed a pared-down version that lists just 29 health care providers.

Gov. Bobby Jindal, a Republican contender for the presidency, moved to cut off $730,000 in Medicaid reimbursements to the state’s two Planned Parenthood clinics in late August in response to several heavily edited, widely circulated videos purporting to show Planned Parenthood employees selling fetal parts, which is illegal.

Planned Parenthood denies the charges and has asked for an injunction to block Jindal.

In straining to identify alternate providers, the state has added to a growing body of evidence that other health care providers would have a difficult time accommodating low-income women if Planned Parenthood were no longer able to take Medicaid. Planned Parenthood clinics in Louisiana do not provide abortions. Instead, the clinics provide thousands of annual cancer and STI screenings, overwhelmingly to low-income women on Medicaid. In Louisiana alone, the group last year performed 2,100 well-woman exams, 1,200 pap smears, and 11,000 STI tests, and it administered long-lasting contraceptives 4,100 times, to 5,200 patients, a spokeswoman for Planned Parenthood of the Gulf Coast said.

Several Louisiana health care providers that would have to take over Planned Parenthood’s patients have stressed that their capacity to do so is very limited. “You can’t just cut Planned Parenthood off one day and expect everyone across the city to absorb the patients,” Stephanie Taylor, who oversees the state’s efforts to curb sexually transmitted diseases, told the New York Times. “There needs to be time to build the capacity.”

Another obstacle is the dearth of family planning clinics and doctors that accept women on Medicaid or other forms of public funding. Across the country, Planned Parenthood provides contraception to almost 40 percent of women who rely on public programs for family planning. The Times notes that four out of five Planned Parenthood patients have incomes below 150 percent of the poverty level, at a time when two-thirds of states reported difficulties ensuring there are enough health providers, especially OB-GYNs, for Medicaid patients.

On Tuesday, there was fresh evidence for what the fight to defund Planned Parenthood means for poor women. The Guttmacher Institute, a reproductive rights think tank, published an analysis of nearly 500 counties where Planned Parenthood operates clinics. In 103 of those counties, Planned Parenthood is the health care provider for every single woman who relies on public funding for contraception. In an additional 229 counties, Planned Parenthood clinics provide care for at least half of patients who rely on Medicaid.

“Certainly in the short term, it is doubtful that other providers could step up in a timely way to absorb the millions of women suddenly left without their preferred source of care and whether those providers could offer the same degree of accessible, quality contraceptive care offered by Planned Parenthood,” the Guttmacher researchers wrote.

But the notion that patients could turn elsewhere remains a key rationale when abortion foes attempt to strip the group of $528 million in federal funding. The argument came up frequently in a Wednesday hearing before the House Judiciary Committee on the Planned Parenthood sting videos. “We often hear that if Planned Parenthood were to be defunded, there would be a health crisis among women without the services they provide,” testified Gianna Jessen, an anti-abortion activist who was born after an unsuccessful abortion. “This is absolutely false. Pregnancy resource centers are located nationwide as an option for the woman in crisis.” Abortion foes have also touted a map showing more than 13,500 clinics that could replace Planned Parenthood.

Sen. Bill Cassidy, the junior Republican from Louisiana, has said there were more than 100 community health care centers “scattered all over the state” that could accept Planned Parenthood’s patients.

Lawyers for the state appeared to contradict him after they whittled down their list of capable providers to 29. And even among those providers, their ability to pick up Planned Parenthood’s slack is questionable. In Baton Rouge, the site of one of two Louisiana Planned Parenthood clinics, the state lists five alternate providers. But only three of those offer contraception, according to the state’s filing, and two of those have wait times ranging from two to seven weeks. One of the Baton Rouge clinics the state suggested is not accepting any new patients for STI, breast cancer, or cervical cancer screenings.

The state did not withdraw its original list without a fight. When pressured by Judge deGravelles, an attorney for Louisiana stood by the list, saying it represented every provider in the state that had used a family-planning billing code for insurance reimbursement. Here is an excerpt of the transcript:

The judge is set to rule on Planned Parenthood’s call for an injunction before September 15, when the state’s contract with Planned Parenthood would expire and Medicaid reimbursements would stop flowing.

In the September 2 hearing, deGravelles expressed reluctance to allow the contract to expire, since the state hadn’t articulated a good reason for doing so. “You have 5,200 women who are getting their care at these facilities,” he said. “If these contracts are terminated that care is going to be disrupted…for no reason related to the health care they’re getting.…They’re going to have to get other doctors, they’re going to have to seek out other places to get their health care. Correct?”

“They will have to do that,” a lawyer for the state replied. “Correct.”

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Louisiana: Women Don’t Need Planned Parenthood. They Have Dentists.

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