WASHINGTON — In an unusual break with the White House, the Democratic leaders of Congress told the Supreme Court on Monday that President Obama was pursuing a misguided interpretation of federal Medicaid law that made it more difficult for low-income people to obtain health care.
The Democratic leaders said Medicaid beneficiaries must be allowed to file suit to enforce their right to care — and to challenge Medicaid cuts being made by states around the country.
The Obama administration maintains that beneficiaries and health care providers cannot sue state officials to challenge cuts in Medicaid payment rates, even if such cuts compromise access to care for the poor.
In a friend-of-the-court brief, the lawmakers said the administration’s position “would undermine the effectiveness of Medicaid.” In addition, they said, it conflicts with more than a century of court precedents that allow people to sue to block state actions that are inconsistent with federal law.
The brief was filed by seven influential Democrats, including Representative Henry A. Waxman of California, an architect of Medicaid; Representative Nancy Pelosi of California, the House minority leader; Senator Harry Reid of Nevada, the Senate majority leader; and Senator Max Baucus of Montana, the chairman of the Finance Committee.
Wisconsin Governor Scott Walker (R) has rejected more than $9 million in grants from the Affordable Care Act that would have “focused on fighting drug and alcohol abuse; assessing health impacts of public policies; and signing up state residents who qualify for state health programs.”
The next county down has the state record for number of beer cans in the ditches per mile for the country, or something. And they think it’s something to be proud of. A friend who signed up for Badger Care Basic, or whatever the Medicaid buy-in is called, thought it was outrageously expensive at $135 a month; it’s now $250, and she hasn’t had a raise in that year-and-a-half.
The silver lining here is that every health-care provider in the state whole-heartedly agrees with me: Scott Walker is truly a jerk.
WASHINGTON — Health insurance plans must cover birth control as preventive care for women, with no copays, the Obama administration said today in a decision with far-reaching implications for health care as well as social mores.
The requirement is part of a broad expansion of coverage for women’s preventive care under President Barack Obama’s health care law. Also to be covered without copays are breast pumps for nursing mothers, an annual “well-woman” physical, screening for the virus that causes cervical cancer and for diabetes during pregnancy, counseling on domestic violence, and other services.
“These historic guidelines are based on science and existing (medical) literature and will help ensure women get the preventive health benefits they need,” said Health and Human Services Secretary Kathleen Sebelius.
The new requirements will take effect Jan. 1, 2013, in most cases. Over time, they are expected to apply to most employer-based insurance plans, as well as coverage purchased individually. Plans that are considered “grandfathered” under the law will not be affected, at least initially. Consumers should check with their health insurance plan administrator.
So the leaders of a bunch of civic, policy and religious organizations — you know, the ones no one in the White House pays attention to because they’re a bunch of do-gooder whiners and they’ll have to vote for Democrats, anyway — are asking the administration and Congressional leaders to please stop hurting poor people with their budget cuts:
Washington, D.C. –– At a critical juncture in the deficit reduction talks, the leaders of prominent national religious, civil rights, charitable, economic research, and low-income advocacy organizations are calling on Executive and Congressional leadership to honor the precedent set by previous deficit reduction negotiations that have reduced the deficit without increasing poverty.
In a letter to policymakers involved in deficit reduction talks, these groups noted the precedent of bipartisan budgets that reduce both poverty and the deficit, stating:
“…all deficit reduction packages enacted in the 1990s reduced poverty and helped the disadvantaged even as they shrank deficits. In addition, every automatic budget cut mechanism of the past quarter-century has exempted core low-income assistance programs from any automatic across-the-board cuts triggered when budget targets or fiscal restraint rules were missed or violated. The 1985 and 1987 Gramm-Rudman-Hollings laws, the 1990 Budget Enforcement Act, the 1993 deficit reduction package, the 1997 Balanced Budget Act, and the 2010 pay-as-you-go law all exempted core low-income programs from automatic cuts.”
Now where did they get that idea? From the Center on Budget and Policy Priorities, a look at the administration’s proposal to cut Medicaid funding in order to appease the imaginary deficit gods:
An Obama Administration proposal that’s on the table for budget negotiators would reduce federal Medicaid expenditures by reducing the federal share of Medicaid and CHIP costs, shifting costs to states and likely prompting states to cut payments to health care providers and to scale back the health services that Medicaid covers for low-income children, parents, people with disabilities, and/or senior citizens (including those in nursing homes).
Reductions in provider payments would likely exacerbate the problem that Medicaid beneficiaries already face regarding access to physician care, particularly from specialists.
The proposal would replace the various matching rates at which the federal government reimburses states for their costs in insuring people through Medicaid and CHIP with a single “blended rate” for each state. A state’s blended rate would be set at a level that provided the state with less federal funding than under current law, thereby saving the federal government money.
The blended-rate concept has two significant weaknesses.
First, it would essentially shift costs to states, rather than constrain them. The proposal produces little administrative-cost or other efficiency savings, as explained below. States, which face their own budget problems, likely would compensate for the reduction in federal funding by scaling back the services that Medicaid and CHIP (the Children’s Health Insurance Program) cover, cutting payment rates to health care providers, or both. Some Medicaid beneficiaries already have limited access to physician care, particularly from specialists, due largely to Medicaid’s already-low reimbursement rates. The shift in costs to states under the blended-rate proposal would make that problem worse.
In English, the administration is proposing spending changes that, while not bad in themselves, make it very likely that states will slash their Medicaid programs, probably by making it almost impossible to qualify and, if you do qualify, you’ll be covered for very little. While the White House may not be doing it directly, their decisions will make those state cuts inevitable.
Now, as I said when I interviewed former White House economist Jared Bernstein at Netroots Nation, if the White House economic policies are aimed at controlling the growth of health care costs, how will cutting Medicaid (the backbone of the Affordable Care Act) accomplish that? This is a colossal mess.
Not to mention, of course, all the people who will continue to die from inadequate care and whose families will make the not unreasonable conclusion that the acclaimed healthcare coverage legislation is now “business as usual” under a different name.
Them that’s got shall get, them that’s not shall lose…
Let doctors whine all they want — we all know many doctors are turning away Medicaid patients, especially if they’re specialists. We’re not going to figure out how to solve this problem by simply guessing at how widespread the practice is:
WASHINGTON — Alarmed by a shortage of primary care doctors, Obama administration officials are recruiting a team of “mystery shoppers” to pose as patients, call doctors’ offices and request appointments to see how difficult it is for people to get care when they need it.
The administration says the survey will address a “critical public policy problem”: the increasing shortage of primary care doctors, including specialists in internal medicine and family practice. It will also try to discover whether doctors are accepting patients with private insurance while turning away those in government health programs that pay lower reimbursement rates.
Federal officials predict that more than 30 million Americans will gain coverage under the health care law passed last year. “These newly insured Americans will need to seek out new primary care physicians, further exacerbating the already growing problem” of a shortage of physicians in the United States, the Department of Health and Human Services said in a description of the project prepared for the White House.
Plans for the survey have riled many doctors because the secret shoppers will not identify themselves as working for the government.
“I don’t like the idea of the government snooping,” said Dr. Raymond Scalettar, an internist in Washington. “It’s a pernicious practice — Big Brother tactics, which should be opposed.”
In other words, he wants to take public money when it suits him, but he doesn’t want any serious oversight?
According to government documents obtained from Obama administration officials, the mystery shoppers will call medical practices and ask if doctors are accepting new patients and, if so, how long the wait would be. The government is eager to know whether doctors give different answers to callers depending on whether they have public insurance, like Medicaid, or private insurance, like Blue Cross and Blue Shield.
A 59-year-old man has been jailed in Gastonia, N.C., on charges of larceny after allegedly robbing an RBC Bank for $1 so he could get health care in prison. Richard James Verone handed a female teller a note demanding the money and claiming that he had a gun, according to the police report.
He then sat down and waited for police to arrive. “… I say, ‘I’ll be sitting right over here, on the chair, waiting for the police,'” Verone told reporters, recalling the June 9 robbery in an interview from Gaston County Jail.
[…] “He’s sitting on the sofa as you walk in the front door,” the bank teller said in a 911 call.
[…] Verone said he asked for $1 to show that his motives were medical, not monetary, according to news reports. With a growth in his chest, two ruptured disks and no job, Verone hoped a three-year stint in prison would afford him the health care he needed.
