A project of the Galen Institute

Issue: "Medicare"

Medicare Isn’t Fixed

James Capretta for National Review Online
Fri, 2014-07-18
"Medicare spending growth will be slow again in 2014 relative to historical standards, and some of the usual suspects are now crediting the Affordable Care Act — Obamacare — for the good news. For instance, a recent post at Vox suggests that the slowdown in Medicare spending can be attributed, in part, to the ACA’s provision penalizing hospitals for excessive readmissions of previously treated patients. This is nonsense. At the time of the ACA’s enactment in March 2010, the Congressional Budget Office estimated that the readmission provision would reduce Medicare spending by $0.3 billion in 2014, and only $7.1 billion over a decade. That’s about one tenth of 1 percent of total Medicare spending over that time period. There has been no information from any source since 2010 suggesting that the savings from the readmission provision has escalated into a major cost-cutting reform.

California Releases Proposal For Clearing Medicaid Backlog

Helen Shen, Kaiser News Service
Wed, 2014-07-16
""Responding to inquiries from federal officials, the California health department has released a plan it says will dramatically slash its backlog of Medi-Cal applications within six weeks. For months, the state has labored under the largest such pile-up in the country, with 900,000 pending cases reported in May—the combined result of unexpectedly high application numbers and bug-ridden computer systems. In a letter to the Centers for Medicare & Medicaid Services on Monday, the California Department of Health Care Services said that it had reduced its application backlog to 600,000 by the start of this month. State officials also outlined a plan for technology fixes and administrative workarounds that they project will nearly halve that figure by the end of August—with most of those applications being processed within the allowed 45-day window. The letter was made public Tuesday."

Three Conservative Ideas Buried Within Obamacare

Greg Scandlen, The Federalist
Tue, 2014-07-15
"The Affordable Care Act is the worst piece of legislation ever passed into law in the United States. It was poorly conceived, poorly written, poorly enacted, and is being poorly implemented. The thing is a mess. However, it does open up some doors that were firmly locked before—things that most free-market economists have been espousing for years without success. We should not run away from those things just because they have President Obama’s name on it. I am not talking about the things the idiot media think are popular—the slacker mandate, open enrollment, equal premiums for men and women, and free “preventative” services. These are all terrible ideas for reasons I won’t go into here (unless you insist). I’m talking specifically about several more important elements of the law that were not well crafted in this particular bill, but can now be used as precedents for major improvements in American health care."

What We Learned About Obamacare July 8-14, 2014

Natalie Scholl, American Enterprise Institute
Tue, 2014-07-15
"1.) AEI’s Joseph Antos and James Capretta present “A health reform framework: Breaking out of the Medicaid model.” Here’s a peek: The Congressional Budget Office (CBO) projects that about one-third of the additional insurance coverage expected to occur because of the law will come from expansion of the existing, unreformed Medicaid program. The rest of the coverage expansion will come from enrolling millions of people into subsidized insurance offerings on the ACA exchanges — offerings that have strong similarities to Medicaid insurance. Unfortunately, ample evidence demonstrates that this kind of insurance model leaves the poor and lower-income households with inadequate access to health care…. 2.) “Some still lack coverage under health law,” notes The Wall Street Journal: Months after the sign-up deadline, thousands of Americans who purchased health insurance through the Affordable Care Act still don’t have coverage due to problems in enrollment systems.

What’s Trending in Health Care? Conservative Ideas.

Drew Altman in Wall Street Journal
Tue, 2014-07-15
"Conservative criticism of the Affordable Care Act has created the impression that liberal, “big government” ideas are driving the health-care system. But plenty of ideas that conservatives like are taking hold in health care as well. To wit: *The number of Medicare beneficiaries in private Medicare Advantage plans reached nearly 16 million this year, a record, and the Congressional Budget Office projects that it will hit 22 million by 2020. This partial privatization of Medicare is happening despite concerns that reductions in payments to private plans (what some call over-payments) would curtail enrollment. *More than half of people on Medicaid are enrolled in managed-care plans, which are typically run by private insurers that contract with states on a capitated, or risk, basis. More than 30 million low-income Medicaid beneficiaries are in private plans.

Hospitals' Prices for Common Services on the Rise

Stephanie Armour, Christopher Weaver, & Melinda Beck, Wall Street Journal
Mon, 2014-06-02
"Federal data released Monday show an increase in the average price hospitals charge to treat common conditions, with vascular procedures and chest-pain treatment showing some of biggest upticks. The numbers from the Centers for Medicare and Medicaid Services include 2012 prices at 3,376 hospitals for the 100 most common inpatient stays by Medicare patients. It is the second year the agency has released such data, and it reflects $57 billion in payments from Medicare, the federal insurance program for the elderly and disabled."

GOP trains fire on Medicare Advantage cuts

Elise Viebeck, The Hill
Tue, 2014-05-13
"Republicans are redoubling their effort to halt future cuts to private Medicare plans under the Affordable Care Act, arguing the reductions would harm vulnerable seniors. In a letter Monday, GOP members of the House Energy and Commerce Committee urged the Obama administration not to implement further Medicare Advantage cuts ordered by the healthcare law."

Rural Hospitals Feel Pinch

Valerie Bauerlein, Wall Street Journal
Sun, 2014-05-11
"Now, the Obama administration, saying that some rural hospitals have been receiving subsidies they weren't meant to get, has proposed eliminating a further $2.1 billion in Medicare payments next fiscal year for hospitals designated as providing "crucial access." In addition, under the new federal health law, hospitals are losing government subsidies for providing care to the uninsured. The law envisioned that those who couldn't afford insurance would be covered by an expansion of Medicaid, but two dozen states, including North Carolina, opted not to do so."
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Obamacare’s Latest Broken Promise: It’s Raising Taxes on the Middle Class

Grace-Marie Turner & Tyler Hartsfield, National Review Online
Thu, 2014-05-08
"When the president said in his first inaugural address that middle-income Americans “will not see your taxes increased a single dime,” most still believed in his supreme powers to solve the nation’s toughest problems, including health reform, that had so thwarted his predecessors."

Medicare Advantage: Take Another Look

Tricia Neuman & Gretchen Jacobson, Kaiser Family Foundation
Wed, 2014-05-07
"While health policy observers are mainly focused on the number of people enrolled in the new federal and state marketplaces, fewer are keeping a close eye on fairly big changes in the estimates and projections for enrollment in Medicare Advantage plans. The number of Medicare beneficiaries in Medicare private plans reached an all-time high this year of nearly 16 million beneficiaries, 6.3 million higher than the Congressional Budget Office (CBO) had projected in 2010 soon after the Affordable Care Act (ACA) was enacted (Figure 1). The CBO now projects Medicare Advantage enrollment will reach 22 million beneficiaries by 2020, more than double the number projected shortly after the ACA was enacted."
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