Medicaid Grows in Good Times and Bad

Monday’s federal bailout of government unions threw a big chunk of change at Medicaid, the joint federal-state program for low-income Americans.

According to neo-classical economics, Medicaid should be an automatic stabilizer, i.e. growing during recessions and shrinking during prosperous times.

Unfortunately, this is not the case: Medicaid shows no evidence of counter-cyclicality. It just grows and grows, in both booms and busts.

Complete analysis here.

Did Judge Tauro Kill ObamaCare?

On July 8, a federal judge in Boston, Joseph Tauro, took it upon himself to find the Defense of Marriage Act (DOMA) unconstitutional. His decisions in two cases might have unwittingly facilitated the legal challenges to Obamacare.

Read entire article here.

Kentucky Anticipates 13% Growth in Medicaid

A task force Kentucky of the Kentucky legislature needs to find out how to pay for an expected 13% growth in Medicaid over the next two years. Optional services are on the table.

Pennsylvania in Budget Hole Due to Medicaid Gamble

Pennsylvania, like most states, gambled on getting an extension of increased federal matching funds for Medicaid. It lost.

Now it’s talking about laying off teachers and emergency responders.

It’s Safer to be Uninsured than to be on Medicaid

New research shows that Medicaid recipients have a 13% increased risk for dying while in the hospital than the uninsured. Medicaid patients also have longer, more expensive hospitals stays.

Researchers studied outcomes for nearly 900,000 patients across the United States who underwent one of eight major surgical procedures. They found that patients covered by Medicaid incurred a 97% increased risk for dying while in the hospital, and uninsured patients had a 74% increase in risk compared with privately insured patients.

So why does federal health care law will put 500,000 more North Carolinians on Medicaid?

Legislator Laments “Federal Incoherency” in Medicaid

A Democrat state representative in Washington discusses his frustration in trying to deal with federal chaos in funding for Medicare and Medicaid. He writes, “expect cash-strapped states to cut Medicaid eligibility, reduce benefits and increase co-pays. All with an additional 16 million Medicaid enrollees expected in 2014 when the federal health-care-reform bill expands eligibility. This is hardly what was hoped for back in March. A federal commitment to health care cannot be only rhetorical. Nor can we feel sanguine about the ability to assume new obligations when old ones are neglected.”

How Much Will Medicaid Grow in Your State?

The Washington Post reports: “Under the new healthcare law, Medicaid will expand by at least 16 million people as eligibility is raised in 2014 to a new nationwide standard of 133 percent of the poverty level. The surge in enrollment will be highest in states in the South and West, where eligibility standards have been stringent.” See what the impact on your state will be in the graphic here.

If You Love the NHS, You’ll Love This

The policy and political world is abuzz today with the news that President Obama has made a recess appointment to fill the long-vacant position that oversees the Medicaid and Medicare programs. My first thought is that the recess appointment, which bypasses the Senate confirmation process, is not that big of a deal. Republican and Democratic presidents have alike abused recess confirmations. The more serious problem, I believe, is not even the viewpoint of Obama’s new Medicaid chief, as odious as that is, but the fact that government of any sort, and especially the U.S. government, is in a position such that who heads an agency is in fact a big deal. Donald Berwick may love the National Health Service of the UK, despise a role for market forces in health care, and favor rationing by bureaucrats such himself. Then again, it’s the U.S. Congress, not Berwick, who put the U.S. on the road to health care serfdom.

But I’ll leave it to others to comment on the appointment. SHC contributor Grace-Marie Turner has some words in “Critical Condition,” a blog published by National Review. You can read it here. She writes, in part, “[Donald] Berwick will have authority over an agency with the largest single budget in the entire U.S. government and over implementation of the most sweeping legislative overhaul of our health sector ever.  Without so much as a congressional hearing!”

A blog by The Heritage Foundation, meanwhile, asks, “why did the Obama administration wait until April 2010, a full 15 months after President Obama was sworn into office, to nominate Dr. Berwick?”

Finally, Benjamin Domenech of The Heartland Institute says, “There is nothing—not precedent, not tradition, not even the most basic notions of fairness or responsible governance—that will stop Obama and his allies in their quest to remake American social policy in their image.”

Medicaid Long-Term Care: The Ticking Time Bomb

The convergence of an aging population, growing fiscal pressures and health care reform’s mandate for increased access to care will have far-reaching consequences for state-administered Medicaid long-term care (LTC) programs, according to Deloitte’s Center for Health Solutions. This paper (PDF) examines the Medicaid expenditures for LTC, in both institutional and community-based settings. If the current trend continues as demonstrated in this paper’s base model, more than 35% of a state’s budget will be needed for Medicaid by 2030, of which half will be for LTC services. The paper also examines how the health overhaul law’s mandate for increased access will worsen Medicaid’s expenditure trend. While the law states that new Medicaid enrollees will be subsidized through 100% federal funds from 2014 to 2016, state budget deficits are projected to be more than $350 billion between 2010 and 2011, a dangerous fiscal scenario for which there is no short-term solution.

Texas Legislator Arrested for Medicaid Fraud

Entrusting health care to the politicians. What could possibly go wrong?

Here’s a story from Austin, Texas:

Federal marshals on Wednesday arrested a state representative who was one of four South Texas dentists indicted on federal charges of taking kickbacks for Medicaid referrals.

Not your usual case of Medicaid fraud, I’ll admit.Allegedly, the kickback came from another dentist, who then committed more standard fraud, billing for services never delivered.