Friday, February 19, 2010
Over 3 million people joined Medicaid last year, increasing enrollment to 46.8 million and placing additional burdens on states already struggling to deal with budget concerns. The story in the Washington Post explains that
[t]he recession has fueled the greatest influx of Americans onto Medicaid since the earliest days of the public insurance program for the poor, according to new findings that show caseloads have surged in every state.
The analysis by the Kaiser Family Foundation, a health policy and research organization, found that in three-fifths of the jurisdictions, including Maryland and the District, people rushed into the safety net for health coverage at more than twice the rate as the year before.
Like the rising demand for food stamps and welfare benefits, the increase in people turning to Medicaid reflects the millions of Americans who have lost jobs and economic self-reliance and are asking the government for basic help, in many instances for the first time.
Because the program is large and expensive, the spurt in Medicaid caseloads has produced far more damaging effects on state budgets than the other two programs. In the past year or two, many states have responded by reducing the medical services available to Medicaid patients or payments to doctors, hospitals and other providers of health care.
Now, 29 states are considering further reductions or have made them since their current fiscal year began.... Such strains exist even though the federal government has been giving states extra money for Medicaid as part of the economic stimulus efforts Congress set in motion a year ago. The extra subsidies are due to expire at the end of this year, and states are lobbying hard to continue them for at least six months.
The worsening financial burden imposed by Medicaid also has heightened some governors' wariness about the approach to redesigning the nation's health-care system that is favored by the White House and congressional Democrats. In the health-care bills passed by the House and the Senate, an expansion of health coverage to the uninsured would rely substantially on Medicaid. If the legislation were enacted, the federal government would pick up the cost for the first few years, but, after that, states would contribute a small portion.
Tuesday, February 16, 2010
A New Study Disputes Belief that U.S. Immigrants Place a Disproportinately Large Financial Burden on U.S. Health Care System
A new article in Health Affairs disputes the widely held belief that U.S. immigrants place a disproportionately large financial burden on the U.S. health care system.
The study by Jim Stimpson of the University of North Texas and coauthors examined health care spending between 1999 and 2006 for both adult naturalized citizens and immigrant noncitizens, which included some undocumented immigrants. It found that the cost of providing health care to immigrants is lower than that of providing care to U.S. natives and that immigrants are not contributing disproportionately to high health care costs in public programs like Medicaid. However, with tighter residency requirements in public programs such as Medicaid, noncitizen immigrants were more likely than U.S. natives to have a health care visit classified as uncompensated care, although uncompensated care declined across all groups during the study period.
'Health care expenditures for the average immigrant have not been a growing problem relative to expenditures among U.S. natives,' conclude the authors. 'It is likely that lower expenditures among noncitizens are due to lower need for services and to increasing barriers to care such as fear, lack of insurance, or lack of a regular provider. These findings have important implications for both immigration and health care reform.'
Monday, February 15, 2010
The decision by Anthem Blue Cross to raise premiums 39% for some people in California is questionable in light of its fourth quarter earnings of $2.7 billion. The WSJ Blog points out that this dramatic increase comes at a convenient time for Democrats looking to regain a little health-care-overhaul momentum. In light of the huge profits,
... it’s no surprise that HHS Secretary Kathleen Sebelius sent a letter calling on the company to justify the rate increase. After WellPoint, Anthem’s parent company, responded with this letter, Sebelius released a skeptical statement that cited WellPoint’s fourth-quarter earnings of $2.7 billion.
The rate increase applies only to policies for people in the individual market. WellPoint’s letter says that, in the troubled economy, many people are choosing to go without health insurance. And many of those who are keeping their insurance are buying cheaper policies that offer less coverage.
The people who do tend to hold onto good insurance plans are those who need them most — people who are already sick. Of course, when you have healthy people bailing out of insurance plans and sick people hanging on, the average health-care cost per person in the plan is going to go way up — and that’s going to be reflected in rising premiums.
As the WSJ notes this morning, the insurance industry and the Obama administration actually agree on the solution to this problem: Require everyone to buy insurance. For their part, Republicans argue against such a mandate, saying that people should be allowed to choose whether or not to buy health insurance.
Sunday, February 14, 2010