QuoteWASHINGTON — The Trump administration appears to have scrapped one of the key tools the Obama administration used to encourage states to expand Medicaid under the Affordable Care Act.
The shift involves funding that the federal government provides to help hospitals defray the cost of caring for low-income people who are uninsured. Under a deal with Florida, the federal government has tentatively agreed to provide additional money for the state's "low-income pool," in a reversal of the previous administration's policy.
https://www.nytimes.com/2017/04/30/us/politics/medicaid-expansion-trump-obama-florida.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region®ion=top-news&WT.nav=top-news&_r=0
Bravo, Governor Scott, bravo.
Too bad, Scott could steal more government money like he did to Medicare. I like the idea of filling our emergency rooms with people who could be better taken care of at a doctor and it would be incredibly cheaper. This is just Scott's way of helping to kill ACA. Welcome back to the start of the good old days. Let the poor die! Thank god Scott will be gone sooner than later.
ACA was dead the day it was passed; it was never meant to survive and it was all built on a "you can keep your doctor" lie.
And let the poor die? Stop, please. The days of that dramatic hyperbole carrying the day are dead as well.
Because facts matter.
Ask anyone about their health care and you are likely to hear about ailments, doctors, maybe costs and insurance hassles. Most people don't go straight from "my health" to a political debate, and yet that is what our country has been embroiled in for almost a decade.
A study out Thursday tries to set aside the politics to examine how the insurance markets function and what makes or breaks them in five specific states.
Researchers from The Brookings Institution were exploring a basic idea: If the goal is to replace or repair the Affordable Care Act, then it would be good to know what worked and what failed.
"The political process at the moment is not generating a conversation about how do we create a better replacement for the Affordable Care Act," said Alice Rivlin, senior fellow at The Brookings Institution, who spearheaded the project. "It's a really hard problem and people with different points of view about it have got to sit down together and say, 'How do we make it work?'"
The researchers focused on California, Florida, Michigan, North Carolina and Texas, interviewing state regulators, health providers, insurers, consumer organizations, brokers and others to understand why insurance companies chose to enter or leave markets, how state regulations affected decision making and how insurers built provider networks.
"Both parties miss what makes insurance exchanges successful," said Micah Weinberg, president of Bay Area Council Economic Institute who led the California research team. "And it doesn't have anything to do with red and blue states and it doesn't have anything to do with total government control or free markets."
Despite the political diversity of the five states, some common lessons emerged. Among them:
For full report:
http://www.pbs.org/newshour/rundown/affordable-care-act-succeed/
Here is where the real problem lies.
Primary Care Doctor Speaks Out: "The Problem Isn't Obamacare...It's The Insurance Companies"
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With premiums increasing for those with coverage through the ACA marketplace, a lot of people are criticizing Obamacare. But many doctors and healthcare professionals are saying that isn't really the problem.
Cathleen London is a primary care physician in Milbridge, a rural town in Maine. She claims the problem isn't Obamacare itself, but rather, the entire health insurance system and insurance companies are to blame.
Writing for the Portland Press Herald, London explains she is a a primary care physician who is on the front lines every single day, as her town is very remote, which means it takes 30 to 40 minutes to get to the emergency room, which is why her office operates as an urgent care facility as well as a family medical practice.
It's takes an ambulance about 20 minutes to get to her clinic and specialist care about 2 hours away, so Dr. London is trained to handle about 90 percent of medical problems.
DR. LONDON EXPLAINS THE FOLLOWING, WHICH WILL SHOW YOU EXACTLY WHAT'S WRING WITH HEALTH CARE:
One evening I was almost home after a full day's work. Around 7:30, I got a call on the emergency line regarding an 82-year-old man who had fallen and split his head open. His wife wanted to know if I could see him, even though he was not a patient of mine.
Instead of sending them to the ER, I went back to the office. I spent 90 minutes evaluating him, suturing his wound and making sure that nothing more sinister had occurred than a loss of footing by a man who has mild dementia. When I was sure that the man would be safe, I let them go.
I billed a total of $789 for the visit, repair, after-hours and emergency care costs. Stating that the after-hours and emergency services had been billed incorrectly, Martin's Point Health Care threw out the claims and reimbursed me $105, which does not even cover the suture and other materials I used.
I called them about their decision, said that it was not right and let them know they'd lose me if they reimbursed this as a routine patient visit. They replied, "Go ahead and send your termination letter" – which I did.
The same day, Anthem Blue Cross kept me on the phone for 45 minutes regarding a breast MRI recommended by radiologists on a woman whose mother and sister had died of breast cancer. She'd had five months of breast discharge that wasn't traceable to anything benign (and it turns out the MRI is highly suspicious for cancer).
Anthem did not want to approve the MRI unless it was to localize a lesion for biopsy, even though the mammogram had been inconclusive! This should have been a slam-dunk fast track to approval; instead, dealing with Anthem wasted a good part of my day.
Then Aetna told me there is no way to negotiate fees in Maine. I was somewhat flabbergasted. I do more here than I did in either Brookline, Massachusetts, or New York. The rates should be higher given the level of care I am providing. I have chosen not to participate with them. This only hurts patients; however, I cannot keep losing money on visits.
I do lose money on MaineCare – their reimbursement is below what it costs me to see a patient. For now, that is a decision that I am living with.
I had thought those losses would be offset by private insurance companies, but their cost shifting to patients is obscene. I pay half of my employees' health insurance, though I'm not required to by law – I just think it is the right thing to do.
My personal policy costs close to $900 a month for me and my sons (all healthy), and each of us has a $6,000 deductible. This means I am paying rack rate for a policy that provides only bare-bones coverage.
Something is wrong with the system. In one day, I encountered everything wrong with insurance. I am not trying to scam the system. I am literally trying to survive. I am trying to give care in an underserved area.
This is not the fault of Obamacare, which stopped the most egregious problems with insurance companies. Remember lifetime caps? Remember denials for pre-existing conditions? Remember the retroactive cancellation of insurance policies? Returning to that is not an option.
Indeed it is not an option, Dr. London. If Republicans get their way eventually by repealing Obamacare, it may be where we end up again. If Republicans really get their way, it'll be even worse than it was before.
http://www.bluedotdaily.com/primary-care-doctor-speaks-out-the-problem-isnt-obamacare-its-the-insurance-companies/