Health Care

Expand Medicaid, save money, lives

Icon June 10, 2013 - 21:44     The Virginian-Pilot© June 6, 2013 The folly of failing to expand Medicaid, as outlined in the federal Affordable Care Act, was underscored again this week with the publication of yet another study of the consequences. Leaders in more than a dozen states have refused to expand eligibility criteria to let more uninsured, lower-income residents enroll in the government-sponsored health coverage. Last year, the U.S. Supreme Court provided that option in upholding the constitutionality of the health insurance overhaul. The lead author of the latest study, conducted by the RAND Corp., noted that residents in every state will pay the taxes associated with implementation of the Affordable Care Act, regardless of whether they expand Medicaid. Researchers evaluated 14 states - not including Virginia - seen as least likely to expand the program because of their governors' opposition. The financial toll is significant. Those states are poised to lose $8.4 billion annually in federal payments, and could have to spend another $1 billion to treat the uninsured, according to findings published in the journal Health Affairs. The human toll, too, is staggering: With 3.6 million people more left uninsured, an estimated 19,000 deaths could result annually due to lack of care. "States that do not expand Medicaid will not receive the full benefit of the savings that will result from providing less uncompensated care," said Carter Price, the study's lead author. "Furthermore, these states will still be subject to the taxes, fees and other revenue provisions of the Affordable Care Act, without reaping the benefit of the additional federal spending." Still, many Republicans have maintained their opposition, including in Congress, where the House has held three dozen votes to repeal the law. These legislators, and their counterparts in state capitols, are shirking their fiduciary duty. Voters appear to be catching on. A recent survey by the Joint Center for Political and Economic Studies showed a majority of residents in Deep South states - Georgia, Alabama, Louisiana, Mississippi and South Carolina - actually favor Medicaid expansion, despite their leaders' strident opposition. Virginia lawmakers established a commission this year to determine whether to expand Medicaid, a move that allowed General Assembly Republicans and Gov. Bob McDonnell to defer a decision until federal officials accept a series of cost-cutting reforms. The strategy is just as misguided as outright refusal. Virginia, previous analyses have shown, would get back nearly all of the tax dollars its residents pay over the next several years if the commonwealth expands Medicaid. While the cost of Medicaid is generally split between states and the federal government, expansion under the ACA would be entirely covered by the federal government for three years, then gradually phase to 90 percent by 2021. That time period is critical for at least two reasons. First, states would provide health coverage for more residents without paying more for three years, and in fact, would save millions of dollars that they now spend on treatment of the uninsured and indigent. Second, as a study by Virginia Commonwealth University's medical school has shown, an uninsured person's health care costs decrease dramatically over the first three years in which he or she obtains coverage. That's because regular access to care helps to better manage chronic conditions and draws patients to family physicians rather than hospital emergency rooms. In short, failure to expand Medicaid is not only unwise; it is indefensible, on both moral and financial grounds.  

Virginia takes another step on the pathway to Medicaid expansion

Icon May 22, 2013 - 14:36   The Commonwealth Institute Virginia has taken a significant step toward Medicaid expansion, keeping the state on track to extend health insurance to nearly 400,000 low-income Virginians. Today, Virginia gained approval for an innovative demonstration project to better coordinate the care for individuals who receive care through both Medicare and Medicaid, according to an announcement from Governor McDonnell. This new program, called Commonwealth Coordinated Care, will launch in early 2014, and will serve more than 78,000 Virginians eligible for both Medicare and Medicaid. This reform holds the potential to not only help better manage people’s care, but also to save the state money. The state projects this demonstration project will save $11.3 million in fiscal year 2014 and $22.6 million in 2015. These, along with other reforms required for Virginia to expand Medicaid, stand to save the state up to $341 million over the next nine years. The creation of Commonwealth Coordinated Care is great news for Virginia since moving forward with this project satisfies one of the requirements for Virginia to expand Medicaid as part of health care reform. —Massey Whorley, Senior Policy Analyst

Getting the Coverage You Deserve

Icon May 14, 2013 - 16:40 The National Women’s Law Center has been working hard to make sure women and their families know about the preventive coverage provided through the health care law. We’ve heard from many women about how much this coverage has helped them but we’ve also heard about some women encountering problems while trying to get these services without cost-sharing. This toolkit is designed to provide women with information on the coverage of preventive services in the health care law and tools they can use if they encounter problems with this coverage. We have also provided detailed instructions on how to file an appeal with insurance companies and draft appeal letters on a range of preventive services. Click here to learn more!

Understanding the Affordable (Health) Care Act

Icon May 6, 2013 - 19:22 On April 23, Region III Director of Health and Human Services Joann Grossi visited Viriginia Beach to educate the public on the health insurance marketplace system that will open for enrollment in October. Norfolk Perspectives on Location spent some time with Director Grossi to learn more about the Affordable Care Act. Below is their interview posted on YouTube. 
See video

Coming this fall: New opportunities for health care for thousands of Virginians

Icon May 4, 2013 - 16:05   By Massie Whorley, The Commonwealth Institute Starting October 1, over 620,000 low-to-moderate-income Virginians will have new options to find out how to  access  quality, affordable health insurance, according to a recent report from Families USA, a national nonprofit group that promotes expanded access to health care. And a whopping 88 percent of them come from families where at least one family member is employed.   The help will come from the new health insurance exchange – a marketplace for private insurance plans and consumers – being set up under the Affordable Care Act. Open enrollment is scheduled to begin in October for coverage that will start in January 2014. In addition to helping consumers find coverage, however, the exchange is also set up to help people pay for coverage. Tax credits are available to people with incomes between 100 percent and 400 percent of the federal poverty level (FPL) – about $19,530 and $78,120, respectively, for a family of three. Just how much financial help will people get to pay for insurance through the exchange? The amount will vary based on income – the lower your income, the bigger your credit, and vice versa – and on the annual premium of the plan purchased. The tax credits are calculated so that individuals pay no more than a certain percentage of their income towards the cost. Let’s use a hypothetical annual premium of $5,000 for a single adult to illustrate how the tax credits will work and the amount of help available. Individuals who make $11,490 per year (100 percent of FPL) will generally be expected to pay no more than two percent of their income – about $230 per year for a health plan with an annual premium of $5,000. That works out to less than $20 per month for health insurance. That means their credit is worth $4,770. At the other end of the spectrum, individuals who make $45,960 per year (400 percent FPL), would receive a credit of $630 on the same plan. That leaves them paying $4,370 per year or $364 a month – 9.5 percent of their income.

Ehrenthal: My Experience Navigating the Health Care System

Icon April 4, 2013 - 16:06 By Ken Ehrenthal Recently, my wife gave me a card. It looked like a credit card. She told me that it was a card that I should use whenever I had to pay a doctor or purchase some prescription drugs. It was part of a “medical savings account” supplied by her employer. I’m not sure if it was an account she put money into or whether her employer put in money as a perk.   Several weeks ago, I received a letter from my Pension plan provider, The State of Connecticut, informing me of a change in my dental plan. Membership cards would be forthcoming. I just received a bill from my own medical care provider for a visit I made to by “primary care” doctor for a new prescription drug for my neurological pains, and for my “pacemaker” test, from my Cardiologist. I also use the services of EVMS’s Glennan Geriatric Center twice a year. I am also, since I am over 65, on Medicare.  My wife works for two different hospital groups in this area. For Sentara she is a certified lactation consultant and for Bon Secours she is a Pregnancy educator. As such she received a health plan from her major position at Sentara. My father-in-law is a veteran and uses either the Naval Hospital or the Veteran’s Hospital. There are also times he is admitted to Sentara Norfolk General Hospital. I live in Chesapeake, and in Chesapeake there is an independent regional hospital, as well as a branch of CHKD, a children’s hospital.  I listed all of these programs and health providers, to point out, what I consider, an interesting phenomenon in the United States. In all these cases there are different health providers and different ways to pay these providers. In each case, each provider and payer, have their own rules, their own bureaucracies and their own policies and procedures that I, as a client, have got to be aware of. We call this a free enterprise system.  If Rube Goldberg tried to come up with a more ridiculous system even he would fail. For anyone to make any sense of the health care system he or she would have to be a PhD in economics. Fortunately, my relatives and I don’t have to purchase health insurance. We should add that and then of course Medicaid and Famis (in Virginia). When are we going to demand from our law makers, and our medical providers, and “stake holders” in this system, some practical ways to stop this nonsense? When will it be easier to understand?

Medicaid Expansion Update

Icon March 28, 2013 - 16:41   Earlier this week, Governor Bob McDonnell released his amendments to the biennium budget, which added minimum conditions that must be met for the Medicaid Innovation and Reform Commission (MIRC) to move forward with Medicaid expansion in Virginia. The bottom line is that these amendments don't change the work we have ahead! We still believe we need to move forward with expansion without delay and will continue to work to make that happen!   Medicaid expansion will create about 30,000 health care jobs in Virginia. If Virginia delays expansion past January 1, 2014, we will lose $5 million a day of federal revenue. But the benefits of Medicaid expansion extend further than effects to our economy. Over 400,000 uninsured, hard-working Virginians who are unable to afford coverage now would be able to obtain insurance through Medicaid expansion.   Jim Lindsay, a member of Virginia Organizing’s Statewide Health Care Strategy Committee, said, “I am pleased that Virginia remains on a path to Medicaid expansion, the practical benefits of which are undeniable. Medicaid expansion should move forward without delay. Every day we delay adds to the needless loss of life simply for lack of health insurance.“   As more information becomes available, and as the MIRC begins to meet, we will keep you informed about how you can help! Thank you for all your hard work. It is because of you and people like you all over Virginia that Medicaid expansion is closer to a reality for more than 400,000 uninsured Virginians! 

Third Anniversary of Affordable Care Act Showcases Competing Visions of America

Icon March 23, 2013 - 14:03 March 23, 2013 From one of Virginia Organizing's national partners, Health Care for America Now (HCAN): Today marks the third anniversary of the Affordable Care Act, a landmark law that will extend health benefits to more than 30 million people who are now uninsured. Since the law survived a Supreme Court review and the 2012 election, we now know the law is here to stay. Affordable, quality health care will be woven into the fabric of American society, making us stronger and healthier as a nation. Already, we’ve seen people with pre-existing conditions enabled, for the first time, to buy affordable insurance. Children with health problems can no longer be turned down for coverage. Small businesses have access to tax credits to get health insurance for their employees. Women have access to preventive care without co-pays, seniors are paying less for prescription medicines and health insurers now must adhere to strict guidelines on the share of your premium dollar that must be used on medical care rather than overhead, salaries and marketing costs. Starting in October, individuals and small business owners will be able to buy health private insurance in state-based (or federally-run, as in Virginia) marketplaces or enroll in expanded Medicaid programs. Both will increase access to no-cost preventive care millions. In 2014, with law in full effect, annual limits on insurance coverage will be eliminated, exclusion of people with pre-existing conditions will be outlawed and tax credits for families and small business will be expanded.   Despite the good news, the fight to make sure that all Americans benefit from the law isn’t over. This week the House passed the 2014 spending plan with draconian cuts, including a provision to repeal the Affordable Care Act. Meanwhile, some states are fighting for the Medicaid expansion needed to make the Affordable Care Act work for those most in need. So even though we celebrate this great anniversary, HCAN will continue the fight to make sure everyone has access to quality, affordable health care. We will fight to ensure that the Obamacare provision guaranteeing no-cost contraception stays on the books. We will resist every repeal attempt, and oppose every budget item that raises prices for consumers to protect insurance and pharmaceutical companies.