Monday, April 22, 2013

Rejecting Medicaid expansion too risky (with video)

Health care providers are urging Gov. Scott Walker and lawmakers to reverse course and expand Medicaid in Wisconsin. / AP Photo/Scott Bauer
There are many unknowns as the health care industry and other private businesses prepare for the implementation of the health care reform law known as Obamacare. The U.S. health care system is one of “Byzantine complexity,” as Dr. Larry Hegland, chief medical officer at Ministry Saint Clare’s Hospital, told the Daily Herald Media Editorial Board in an interview last week. Obamacare didn’t create that problem, and it doesn’t cure it.
One of the key and very positive provisions in the law is the expansion of Medicaid, the insurance program for low-income families and individuals, known in Wisconsin as BadgerCare. The expansion, which would make the program available to people with incomes up to 138 percent of the federal poverty level, was rejected by Gov. Scott Walker, who instead unveiled a system that would push people who fall between 100 percent and 138 percent of poverty into a new, private market for health insurance known as a health exchange.
Here’s the problem, according to a broad coalition of hospitals, doctors and other providers we interviewed: The exchanges might not work. They might be too complex for this population to navigate without help. They might be overloaded at first, and there might not be enough customer help to get people what they need.
We don’t know because the health insurance exchanges are not up and running yet. That in itself is a reason not to build a plan, as Walker has, that relies on Obamacare exchanges running smoothly when the reality seems likely to be anything but.
Health care leaders are right. It’s risky. And the fact that essentially the entire health care field is speaking with one voice on this issue — along with Hegland, we met with representatives of Aspirus Wausau Hospital, the Wisconsin Hospital Association and the Wisconsin Medical Society — ought to cause lawmakers to give this issue a second look as they write the budget for the coming biennium. There’s a strong argument for delaying the time when the state begins to push people onto the exchanges.

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