Thursday, July 19, 2012

Quotable, Quote

 I found this quote from 'Count Me In' an organization that helps women owned businesses. When the President says it, it's bashed by his opposition, when a business owner says it, not so much! I guess it's the messenger not the message.

"No one gets to $1million or more in revenue by themselves. No one! No singer, no lawyer, no business owner. No One!"
Nell Merlino, President and Founder, Count Me In

Tuesday, July 17, 2012

A Closer Look at the Gruber Report
We covered this before in our September 1, 2011 HealthWatch Wisconsin Update, but the Walker Administration keeps singing the same tune:
When Governor Walker submitted his op-ed "Obamacare is an unhealthy prescription" to the Washington Post, he heavily "edited"  Dr. Jonathan Gruber’s report on the impact of health reform on Wisconsin. Dr. Gruber, a professor of Economics at MIT contracted to work with Gorman Actuarial, drafted a non-partisan, actuarial-based analysis to help Wisconsin understand the implications of the Affordable Care Act on Wisconsin, especially the development of exchanges. Citizen Action of WI responded to Governor Walker’s article in a press release, saying that the Governor mis-represented the report’s findings.

We have been here before! Just about a year ago, on August 24, 2011, there was a showdown at the Department of Health Services. In an invitation-only press conference, Wisconsin's Department of Health Services Secretary Dennis Smith and Commissioner of Insurance Ted Nickel announced that the Office of Free Market Health Care was releasing the results of a health reform study. Clear from lengthy powerpoint presentation that accompanied the press conference, were the instances where the Department of Health Services inserted their own "footnotes" and numbers into Dr. Gruber's report, referring to internal "DHS estimates" instead of Dr. Gruber's actual data. Reporters tried to hold Dennis Smith accountable, asking specific questions about instances where the powerpoint presentation contradicted itself, or where the number of individuals enrolled in Medicaid, for example, appeared mis-stated.

What Dennis Smith said a year ago:
  • It [the health reform law] will "drastically shrink" the numbers of people in the private insurance market;
  • It will cause "significant disruption" to employer-sponsored insurance; and
  • It will force "working families" to pay a "hidden tax" that will "subsidize" the purchase of health insurance for families earning up to $89,000, a "forced redistribution of wealth."
In fact, the conclusions Dennis Smith drew from the report were so different from what the drafters intended, that Dr. Gruber himself went on the record as saying, "Dennis Smith has long been clear in his opposition to health reform and I think that is reflected in the way he chose to present the results....Let's just say we went back and forth on the wording of the report and that they asked us to emphasize the negative far more than I would have chosen."

But that wasn’t enough to correct the record. On September 2, 2011, Dr. Gruber then submitted his own opinion piece that concluded, “The bottom line is that health care reform in the state of Wisconsin will dramatically reduce the number of uninsured in the state, while creating both winners and losers among the existing non-group insurance holders. The losers are those young and healthy individuals who benefited from discriminatory pricing in a lightly regulated insurance market. An important question for states like Wisconsin, who have such lightly regulated insurance markets, is how to help smooth the transition to this new regime for those young and healthy individuals. Reports such as the one I co-authored for the state of Wisconsin should be used to help states make those hard decisions - and not as a source of selective fact selection in support of one's political views.”

Not much has changed in a year, except that the “Office of Free Market Health Care” in Wisconsin has closed for business. Or, as Dennis Smith put it, “The best way to expand health insurance coverage is to get the economy moving again and Americans back to work."

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Walker Administration Questions Medicaid Expansion: An Analysis by HealthWatch Wisconsin

In the last issue of the HealthWatch Update newsletter, we looked at Supreme Court's historic decision to uphold the constitutionality of the Affordable Care Act. However, the Court's opinion left the door open for states to refuse to implement Medicaid expansion provision of health reform. In Wisconsin, the Walker Administration and Department of Health Services (DHS) have made it clear they intend to resist the implementation of the Affordable Care Act, a decision which may cost the state in the long run. Without the Medicaid expansion, tens of thousands of individuals, not eligible for coverage subsidies through insurance exchanges, will be completely uninsured. Moreover, thousands of people in Wisconsin could lose access to valuable coverage, and that affects everyone in our state.
Even worse, treatment delays by the uninsured may result in uncompensated emergency room expenses that cost thousands of dollars. Instead of using primary and preventive care available with BadgerCare, the uninsured will have few options but the emergency room. We know that uncompensated care spreads additional costs to the rest of us in the form of higher premiums, co-payments and deductibles. Remember the story we shared from the Kaiser Foundation about the $18 baby aspirin? So instead of billions in Medicaid dollars flowing into hospitals and clinics across Wisconsin, our uncompensated care rates and health care costs will spiral. Wisconsin providers already absorb over $1 billion annually in uncompensated care. And yes, sadly, people will not get the primary care and preventive care services they need and deserve.
Last week, Governor Walker submitted a partisan op-ed to the Washington Post indicating that the Affordable Care Act "will devastate Wisconsin." Using out-of-context statistics from the Gruber Report, a 2011 actuarial study which ultimately concludes that Health Reform has an overwhelmingly positive impact on Wisconsin, Walker makes Wisconsin out to be the victims of an economic assault by the federal government.
The Gruber Report made headlines last August, when DHS Secretary Dennis Smith held a closed door press conference and gave a presentation using the report as a pretext to make it seem as though the Affordable Care Act would harm Wisconsin's private health insurance market and working families.
CLICK HERE for more analysis on the interpretation of the Gruber Report!

Saturday, July 7, 2012

Interactive Map: Why the Supreme Court's Ruling on Medicaid Creates Uncertainty for Millions

By Maura CalsynEmily Oshima | July 5, 2012
The Supreme Court’s decision upholding the Affordable Care Act was a huge victory for millions of Americans. But the Court’s ruling on Medicaid expansion creates uncertainty about whether Americans with incomes below the poverty line can access health insurance.
Each state largely determines eligibility for Medicaid, a federal-state partnership to provide health care to nearly 50 million low-income Americans. Although all states must meet minimum federal requirements, state Medicaid programs vary widely. In most states Medicaid only covers certain groups of low-income individuals—mostly working parents with incomes well below the poverty line.
To ensure that those who most needed health coverage could access care, the Affordable Care Act expanded the federal minimum Medicaid eligibility level to all people with incomes up to 133 percent of the poverty line—$14,856 for individuals and $30,657 for a family of four.* Estimates showed that, once implemented, this expansion would result in 17 millionAmericans gaining critical health coverage.
The federal government would cover the vast majority of this expansion. Federal payments would provide 100 percent of the needed expansion funding from 2014–2016, gradually transitioning to 90 percent of needed funding for 2020 and future years. This arrangement would allow states to increase the number of insured people by an average of 25 percent, with an increased state cost of less than 3 percent.
This cost may even overstate the net effect on state budgets: If a state chooses to expand Medicaid, it will no longer have the same expense of paying for the care provided to its population’s uninsured.
But the Court ruled that this change to the Medicaid program was large enough to constitute not just an expansion of the existing program but the creation of an entirely new one. Because this is a new program, the Court concluded that Congress may not condition the receipt of a state’s existing federal Medicaid funds on its agreement to expand Medicaid eligibility. That eliminated the biggest incentive for states to agree to expand their Medicaid programs to meet the Affordable Care Act requirements. Now if states reject this offer, they will not lose their existing federal Medicaid funding.
If states opt not to expand their Medicaid programs, many low-income individuals and families living in those states will not gain needed coverage through Medicaid. The Affordable Care Act provides tax credits to help pay for coverage to people with incomes starting at the federal poverty line—$11,170 for individuals and $23,050 for a family of four—and up to 400 percent of the poverty line —$43,320 for individuals and $88,200 for a family of four. But even with these tax credits, the cost of insurance may still not be affordable for some low-income families.
Additionally, Americans with incomes below the federal poverty line are not eligible for tax credits because Congress assumed these people would be eligible for Medicaid under the provisions in the Affordable Care Act. Due to the Supreme Court’s decision, states may decide to not expand Medicaid coverage to these people because they no longer risk losing their existing Medicaid funds.
The result is that those who most need financial assistance to purchase insurance will be without any help.
In the map above, the Center for American Progress illustrates how people in each state will potentially be affected by their state’s decision.
*The numbers in the map include individuals and families with incomes equal to 138 percent of the poverty line. The Affordable Care Act includes a special deduction to income that effectively raises the eligibility level by 5 percentage points.