Despite receiving billions of dollars in taxpayer money, Medicaid insurers are lax in ferreting out fraud and neglect to tell states about unscrupulous medical providers, according to a federal report released Thursday.
The U.S. Health and Human Services’ inspector general’s office said a third of the health plans it examined had referred fewer than 10 cases each of suspected fraud or abuse to state Medicaid officials in 2015 for further investigation. Two insurers in the program, which serves low-income Americans, didn’t identify a single case all year, the report found.
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The expansion in coverage due to the Affordable Care Act (ACA) increased the number of insured Americans by 20 million. Although access to health insurance has expanded significantly in recent years, and the ACA instituted important protections for patients, those who gained insurance through ACA health insurance exchanges are being offered plans that make them bear an increasing portion of their healthcare costs since the law was implemented. Access to health insurance is not sufficient if patients cannot afford to purchase coverage or utilize their benefits due to high premiums, high out-of-pocket costs, limited networks, and insufficient state and federal patient protections.
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More than half of American adults want to transition to a single-payer healthcare system, according to a Washington Post-Kaiser Family Foundation poll conducted earlier this year. Most of these people have no idea how challenging such a switch would be — or the trade-offs it would entail.
Even the pied piper of single-payer, Sen. Bernie Sanders, I-Vt., recently admitted “there will be pain” in the process of implementing his proposed “Medicare for all” plan.
Just consider the economic devastation single-payer would sow. In 2016, the health insurance industry employed more than 460,000 folks. A government-run insurer might hire some of these workers, but tens, if not hundreds of thousands of them would surely lose their jobs.
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I give the President great credit for shining his spotlight on the ridiculous place the U.S. finds itself over drug prices. They are way too high, the private market has proven incapable of dealing with it––PBMs have only made the drug market more opaque, and the biggest drug purchaser in the world, the U.S. government, has been politically unwilling to deal with it.
All while other industrialized countries have nowhere near the problem.
What is even more frustrating is to see an easy solution that has worked for years in these other industrialized countries that, rather than being a single-payer government-run solution, is as American-style free market as it could be.
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Obamacare, which Republicans spent months trying but failing to overturn, will play a starring role again in Congress this summer, this time helping determine the fate of Supreme Court nominee Brett Kavanaugh. Democrats said Tuesday they plan to make the confirmation of Kavanaugh a fight over the future of Obamacare, which is under a lower court challenge that is winding its way toward possible consideration by the Supreme Court.
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The Centers for Medicare and Medicaid Services announced that it would suspend $10.4 billion in risk adjustment payments, which are designed to compensate insurers that enroll sick, expensive patients. Unlike with other ObamaCare subsidy programs, risk adjustment payments shuffle money from insurers with relatively healthy populations to others. Some co-ops have sued on grounds that the funding formula is unfair to small insurers. In January a federal court in Massachusetts ruled the formula wasn’t arbitrary and capricious. But a month later a federal judge in New Mexico said it was. The left is complaining that HHS halted the payments too casually, but on all the evidence the Trump Administration is trying to abide by the ruling while the courts resolve the dispute. This is called following the law.
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Giving consumers the choice of purchasing renewal guarantees, either in conjunction with a short-term plan or as a standalone product protecting enrollees from re-underwriting in that market, would produce significant benefits well in excess of any costs. It would increase the number of Americans with health insurance, allow Americans to purchase insurance that respects their religious beliefs, and improve ObamaCare’s risk pools.
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The House Ways and Means Committee on Thursday approved legislation that would chip away at ObamaCare, including a measure that would temporarily repeal the law’s employer mandate. The bill sponsored by GOP Reps. Devin Nunes (CA) and Mike Kelly (PA) would suspend penalties for the employer mandate for 2015 through 2019 and delay implementation of the tax on high-cost employer-sponsored health plans for another year, pushing it back to 2022.
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Over the weekend, former Centers for Medicare and Medicaid Services (CMS) acting administrator and Obamacare defender Andy Slavitt took to Twitter to denounce what he viewed as the Trump administration’s “aggressive and needless sabotage” of the health care law:
Unfortunately for Slavitt, the facts suggest otherwise. The Trump administration took actions to comply with a federal court order that vacated rules promulgated by the Obama administration—including rules CMS issued when Slavitt ran the agency. If Slavitt wants to denounce the supposed “sabotage” of Obamacare, he need look no further than the nearest mirror.
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One of the few major pieces of legislation moving this summer is the farm bill. Versions of the farm bill have passed both the House and the Senate, and a conference committee will begin the process of reconciling their differences shortly. Among the most striking and contentious differences are the House reforms to the Supplemental Nutrition Assistance Program (SNAP, or “food stamps”) that include work requirements. The Senate bill contains no work requirements.
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