Nel's New Day

January 9, 2013

Health Coverage in 2013

Filed under: Uncategorized — trp2011 @ 8:56 PM
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No one yet knows how many Republican governors are going to keep the poor in their state from getting health care, but Susanna Martinez of New Mexico isn’t one of them. She said that her state will follow Obama care that expands the Medicaid program to 170,000 low-income adults. About one-fourth of New Mexico’s population already receives Medicaid, but these people are primarily children, disabled, and extremely low-income adults. The 2014 expansion gives Medicaid to single adults with an annual income of $15,400 or in families of three with incomes of $26,000. The additional federal money will create jobs and help the state’s economy.

As of Monday, ten governors are refusing to allow more of the poor in their states to receive  federal health care:  C.L. “Butch” Otter (ID), Rick Perry (TX), Phil Bryant (MS), Mary Fallin (OK), Robert Bentley (AL), Nikki Haley (SC), Terry Branstad (IA), Bobby Jindal (LA), Dennis Daugaard (SD), and Paul LePage (ME). Otter, the most recent joiner of the governors’ “Death Panel,” is contradicting a unanimous recommendation from his appointed commission and will leave 107,000 people in his state without health care. In Idaho, 280,700 people, 18 percent of the population, are uninsured.

Scott may be moving into the “undecided” group. But just in case he decides against it, he’s covering himself by lying about the cost of the new plan. Florida has one of the highest rates of uninsured people; Obamacare would extend health coverage to approximately one million people. He has continually said that the Medicaid expansion would cost the state $26 billion in the next 10 years. This figure doesn’t consider the federal money that Florida would get by doing this which drops the state cost to $1 billion—over ten years. That’s $100 million a year.

The first report from Florida’s Agency for Health Care Administration (AHCA) computed the amount using the false figure that the federal government would pay for only 58 percent of the cost, not the actual amount. Under Obamacare, the federal government would pay for the full costs of additional people receiving Medicaid for the first two years and then scale back to 90 percent of the expenditures by 2022. The federal funds would save the state hospitals and health care providers from paying for the poor’s medical bills. Later AHCA corrected its mistake, but Scott has ignored them. State spending on Medicaid would increase 2.9 percent while more than 20 million people would have health coverage.

According to reports from three states with Medicaid expansion, Obamacare would reduce deaths by 6.1 percent, especially among elders, non-whites, and residents of poorer counties. The governors refusing to put poor people in their states on Medicaid are following the philosophy of conservative economist Tyler Cowen: “We need to accept the principle that sometimes poor people will die just because they are poor.” In other words, “Let them die.”

While the Medicaid piece of Obamacare doesn’t go into effect until 2014, approximately 50 million Americans still lack health insurance. The changes for 2013 are mainly getting health facilities and government offices ready for the changes in the next year.

Last week eight more states were conditionally approved to establish their own health insurance exchange programs, making a total of 19 states and the District of Columbia. In addition, Arkansas and Delaware will run an exchange in partnership with the federal government. States that plan to partner with the federal government need to do so by February 15. If they don’t do it, the federal government will operate the exchange program.

Exchanges help people by providing comparisons of insurance costs and perhaps creating a lower cost of the health coverage.

These changes will be effective this year:

  • Preventative Services. Federal money for state Medicaid programs will offer preventative services for free or at little cost including tests for high blood pressure, diabetes, and high cholesterol; many cancer screenings including colonoscopies and mammograms; counseling to help people lose weight, quit smoking or reduce alcohol use; routine vaccinations; flu and pneumonia shots; and others.
  • Increased Medicaid Payments. Medicaid payments to doctors are now at the same level as Medicare.
  • Pilot Program for Bundling Services. Rather than have each service billed separately under Medicare, a flat rate would be paid for an episode of care.
  • Medicare Tax Increase. The wealthy are charged a 0.9% tax increase on individual income over $200,000  and couples over $250,000 to boost the Medicare trust fund.
  • Medical Device Tax. A new 2.3% tax on the price of medical devices doesn’t include hearing aids or corrective lenses but does include devices like defibrillators, pacemakers, artificial joints and others.
  • Medical Deductions. Taxpayers get a deduction only if total medical expenses add up to at least 10 percent.
  • Cap on FSAs. The limit for Flexible Spending Accounts will be $2,500.
  • Health Benefits Spelled Out. W-2 tax forms issued this year for wages paid in 2012 must now include a line on the form showing the benefit employees receive from their employer-sponsored health care.

Obamacare is set in motion and will proceed no matter how many times the House votes against it. Thanks to Rep. Michele Bachmann (R-MN) this was the first bill introduced in the 113th Congress on January 3.


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