Republican-led states are stepping up their efforts with the Trump administration to pursue work requirements and other changes to Medicaid, in the face of legal challenges and Democratic opposition.
Tennessee Republicans want permission to revamp Medicaid in exchange for a fixed amount from the federal government. Utah is testing whether it can get approval for a partial Medicaid expansion with capped payments from the federal government. And Kentucky lawmakers have weighed drug-testing recipients with criminal or substance-abuse histories, among other steps.
The pain radiated from the top of Annette Monachelli’s head, and it got worse when she changed positions. It didn’t feel like her usual migraine. The 47-year-old Vermont attorney turned innkeeper visited her local doctor at the Stowe Family Practice twice about the problem in late November 2012, but got little relief.
Two months later, Monachelli was dead of a brain aneurysm, a condition that, despite the symptoms and the appointments, had never been tested for or diagnosed until she turned up in the emergency room days before her death.
Eliminating profit from an entire sector of the national economy would be unprecedented. But the example of New York, on a smaller scale, shows why it is a recipe for dysfunction.
The Empire State’s hospital industry has been 100% nonprofit or government-owned for more than a decade. It’s a byproduct of longstanding, unusually restrictive ownership laws that squeeze for-profit general hospitals. The last one in the state closed its doors in 2008.
A report last year from the Albany-based Empire Center shows the unhappy results. The state health-care industry’s financial condition is chronically weak, with the second-worst operating margins and highest debt loads in the country. And there’s no evidence that expunging profit has reduced costs. New York’s per capita hospital spending is 18% higher than the national average.
“Medicare for All” may sound good to some Americans until they take a closer look at how it would actually work.
Take something pretty basic: how it would affect the number of medical professionals we have in this country. “Medicare for All” would drive out many doctors and nurses and compromise the accessibility and quality of medical care for millions of Americans.
The CMS rolled out new tools on Thursday to help states get approval to make changes to Medicaid such as implementing work requirements.
The CMS Administrator Seema Verma defended the administration’s push to get more states to pursue 1115 demonstration waivers even as the agency faces criticism over coverage losses due to work rules.
First, she douses progressives’ impeachment dreams in cold water, telling the Washington Post that such a divisive and drastic political step should only be taken over egregious criminality that’s “compelling and overwhelming and bipartisan.” She cagily adds, “he’s just not worth it,” a personal swipe at the president, likely deployed to placate Trump haters who will bristle at her stance. Insulting him is a little wink that she’s still ‘on the team.’ But even if the hard-Left wing of the party is willing to forgive Pelosi’s hesitant posture on impeachment, how might they react to her intense fiscal skepticism on ‘Medicare for All’ — the holy grail of the statist agenda?
Health and Human Services (HHS) Secretary Alex Azar revealed Thursday that his department is in talks with states about instituting block grants in Medicaid without congressional approval.
“We have discussions with states where they will come in and suggest ideas,” Azar said at a Senate hearing in response to questions from Sen. Bob CaseyJr. (D-Pa.). “There may be states that have asked about block granting, per capita, restructurings around especially expansion populations … It’s at their instigation.”
But he warned that how such a system would work — and who would pay for it — are big questions that have yet to be answered.
“For me, I think it’s a great opportunity for the industry to be able to expand the population that it’s coordinating care with,” Broussard said Tuesday at the Barclays Global Healthcare Conference in Miami Beach, Fla.
Surprise billing is an unexpected event that requires significant financial resources. That’s hardly a unique economic phenomenon, and the usual solution is … insurance! The unique aspect of this event, however, is that it takes place in the context of an insurance contract. What could be modified? There are really two pieces: the surprise and the bill. The former can be ameliorated by giving patients clear, up-front knowledge that they will be treated by an out-of-network provider and perhaps providing an estimate of the likely charge. That would reduce the surprise element of the phenomenon.
Legislators at both the federal and local level are trying to do something about the problem of surprise billing, what wonks often call “balance billing.” A modest, bipartisan measure proposed by state legislators in Texas would penalize emergency rooms that charge more than 200 percent above the average hospital charge for a comparable service.
A plethora of bills introduced in the U.S. Senate, including one from a group led by Sens. Michael Bennet (D., Colo.), Tom Carper (D., Del.), Bill Cassidy (R., La.), Chuck Grassley (R., Ia.), Claire McCaskill (D., Mo.), and Todd Young (R., Ind.), would limit out-of-network prices in the emergency setting to the greater of (1) the median in-network rate for a particular geographic area; or (2) 125 percent of the “average allowed amount” in a geographic area: a proxy for what hospitals charge regardless of insurer contracts.