Advocates: Disabled take huge hit under GOP health reform

Advocates for the disabled say the House Republican plan to replace the Affordable Care Act seriously threatens some of the most vulnerable Americans.

The website DisabilityScoop reports that advocates say the bill threatens home- and community-based services and other supports that people with developmental disabilities rely upon.

Photo: Joshua Zader/Creative Commons

“The American Health Care Act shows callous and dangerous disregard for the well-being of people with disabilities and their families and erases decades of progress,” said Peter Berns, CEO of The Arc, an organization that service people with intellectual and physical disabilities.

The House passed the bill 217 to 213, allowing President Donald Trump and Republicans to do a victory lap that they had finally succeeded in destroying Obamacare. The measure though was roundly criticized by doctors, hospital and senior groups. It must still pass the U.S. Senate, which gave it a lukewarm response and promised to address its more draconian measures.

While the disabled take a hit, the most wealthiest Americans are big winners with the new legislation as it delivers a big tax cut the would redistribute billions of dollars to the upper tier.

 

How does it hurt the disabled? The many groups who represent them say the bill would institute a per capita cap for Medicaid. This means the federal government would offer a fixed amount of money for each beneficiary.

“These huge cuts and caps will likely put pressure on states to cut home- and community-based waiver services, especially those that are ‘optional,’ like personal care services and therapies,” said Kim Musheno, chair of the Consortium for Citizens with Disabilities, a coalition of disability advocacy groups.

Schools also would be affected by the Medicaid shift because they are currently able to seek reimbursement for a variety of services provided to disabled children to a tune of $4 billion annually. That means money to reimburse schools for speech and occupational therapy, specialized playground equipment, and even wheelchairs is now in jeopardy.

Advocates for the disabled say House Republicans would allow states to no longer consider schools as eligible Medicaid providers.

To read all of the story by DisabilityScoop click here.

 

GOP Health Bill Could Undermine Coverage Under Employer Plans

Under the GOP’s repeal of Obamacare, the most wealthy get a tax break, while the poor will have benefits rolled back under the Medicaid program, according to an analysis by the New York Times.

But what about those who get their health insurance through their employer? Not our problem, right? Think again.

The Wall Street Journal reports that many people who obtain health insurance through their employers could be at risk of losing protections that limit out-of-pocket costs of catastrophic illness. That’s about half of the country, folks.

“It’s huge,” Andy Slavitt, former acting administrator of the Centers for Medicare and Medicaid Services under President Barack Obama told the Wall Street Journal. “They’re creating a back door way to gut employer plans, too.”

Hardly noticed among the debate over pre-existing conditions, this change came in a last-minute amendment to the House Republican health-care bill that passed by four votes.

The House bill would allow large employers to choose the benefit requirements from any state including those that are allowed to lower their benchmarks under a new waiver, The Wall Street Journal reported.

By choosing a waiver state, employers looking to lower their costs could impose lifetime limits and eliminate the out-of-pocket cost cap from their plans under the GOP legislation.

 

Health care analysts say the real question is, would employers do this?

“Many wouldn’t,” said Larry Levitt, a senior vice president at the Kaiser Family Foundation. “Many employers offer quality benefits to attract employees. But employers are always looking for ways to lower costs.”

Fifty-nine percent of covered employees who were in an employer plan had a lifetime limit on how much their insurance plans would cover before the ACA, Mr. Levitt said.

To read all of the Wall Street Journal story click here.

 

Study: Red states could lose big in Trump’s repeal of Obamacare

New President Donald Trump has made repealing the Affordable Care Act a top priority.

But a study out of Harvard finds that such a repeal could hurt some of his most ardent supporters in red states. The study focuses on Southern red states who have expanded Medicaid as part of Obamacare. Rolling this portion of the ACA back could have dire consequences for states like Arkansas, Kentucky and Louisiana.

States that have not expanded Medicaid for ideological reasons — such as Florida and Texas — may be less affected, the study from Harvard’s Department of Health Policy and Management. The survey of Texas found that Obamacare had a negative impact, for instance.

“The economics of rolling back Medicaid expansion strongly suggest that doing so would harm patients, hospitals, and state budgets,” stated an article in the New England Journal of Medicine published this week. 

Researchers Benjamin Sommers and Arnold M. Epstein have been doing telephone surveys for four years of low-income adults in Southern states to gauge the effectiveness of Obamacare.

“Our survey provides insight into the current views of many adults living in red states, and the verdict is clear: in states that have embraced coverage expansion despite their political leanings, the ACA’s Medicaid expansion has made a positive difference that is recognizable to the people whose lives have been most directly affected by it,” their article stated.

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Though 19 states declined to expand Medicaid under the ACA, 13 states won by Donald Trump in the 2016 presidential election have opted for expansion since 2014. West Virginia and Kentucky have experienced among the largest proportional increases in Medicaid enrollment in the country.

The researchers said that the question is not whether many Americans — even those in thoroughly red states — have benefited from the ACA, but whether that will be enough to save it.

Study: Red states could lose big in Trump’s repeal of Obamacare

New President Donald Trump has made repealing the Affordable Care Act a top priority.

But a study out of Harvard finds that such a repeal could hurt some of his most ardent supporters in red states. The study focuses on Southern red states who have expanded Medicaid as part of Obamacare. Rolling this portion of the ACA back could have dire consequences for states like Arkansas, Kentucky and Louisiana.

States that have not expanded Medicaid for ideological reasons — such as Florida and Texas — may be less affected, the study from Harvard’s Department of Health Policy and Management. The survey of Texas found that Obamacare had a negative impact, for instance.

“The economics of rolling back Medicaid expansion strongly suggest that doing so would harm patients, hospitals, and state budgets,” stated an article in the New England Journal of Medicine published this week. 

Researchers Benjamin Sommers and Arnold M. Epstein have been doing telephone surveys for four years of low-income adults in Southern states to gauge the effectiveness of Obamacare.

“Our survey provides insight into the current views of many adults living in red states, and the verdict is clear: in states that have embraced coverage expansion despite their political leanings, the ACA’s Medicaid expansion has made a positive difference that is recognizable to the people whose lives have been most directly affected by it,” their article stated.

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Though 19 states declined to expand Medicaid under the ACA, 13 states won by Donald Trump in the 2016 presidential election have opted for expansion since 2014. West Virginia and Kentucky have experienced among the largest proportional increases in Medicaid enrollment in the country.

The researchers said that the question is not whether many Americans — even those in thoroughly red states — have benefited from the ACA, but whether that will be enough to save it.

Audit: Florida Medicaid paid insurance companies for dead people

Florida’s Medicaid Program has come under criticism repeatedly in recent years for its failure to provide for the care of disabled and poor children in the state.

But it appears if you are dead, the state is willing to pay — especially if that money is landing in the pockets of insurance companies.

Florida is shifting all Medicaid recipients into managed care plans. First up: Nursing home and long-term-care recipients.
When Florida shifted all Medicaid recipients into managed care plans, it ended up paying HMOs $26 million for enrollees who had died.

A federal audit released Tuesday reported that over a five-year period the state’s Medicaid program overpaid HMS $26 million in monthly premiums for enrollees who had passed to the great beyond.

Florida Health News reports it appears monthly Medicaid premiums were paid for several thousands of Floridians who had died.

Medicaid is funded by the state and federal government — and the federal government wants its money back.

Officials with the Department of Health and Human Services said the Florida’s Agency for Health Care Administration needs to pay back $15 million in money lost through operational costs.

AHCA says it has already corrected the problem, recouping almost $24 million of the $26 million in overpayments — a 98 percent success rate.

The five-year period covers a time when Florida Medicaid was changing from a traditional fee-based model to a statewide managed care for all Medicaid participants. The state agency paid HMOs about $1.3 billion from July 1, 2009 through Nov. 5, 2014, the report found.

If you want to read more on the audit, click the Florida Health News Story here.

Health care refugees: Couple flees Florida after Medicaid nightmare

A Boynton Beach couple said they left Florida – a state they loved – because they could not get adequate health care for their ailing 5-year-old daughter through Medicaid.
CNN’s series on health care refugees started this week with Kim and Richard Muszynski. The couple in September packed their bags and took their ailing 5-year-old daughter, Abby, to Colorado.
Abby was born with a missing a piece of her brain and is subject to violent seizures.
Like Abby, nearly early half of all children in Florida get their health care through the state-run health insurance Medicaid. Abby ended up on Medicaid when Kim Muszynski left her job – and lost the health insurance that came with it – to care for her daughter full-time.
Abby ended up on Medicaid when Kim Muszynski left her job – and lost the health insurance that came with it — to care for her daughter full-time.
Florida Medicaid refused to pay for lifesaving medicines and initially denied payment for a wheelchair. CNN reported. Sometimes Medicaid took so long to pay some of her health care providers that they refused to treat Abby, CNN reported.
Sometimes Medicaid took so long to pay some of her health care providers that they refused to treat Abby, according to the cable news network.
The Agency for Health Care Administration, which runs Medicaid for Florida, disagreed with the CNN report. “The state has done everything in its power to support this family,” said Mallory McManus,  spokeswoman for the agency.
A federal judge ruled in a civil suit that 2015 that Florida had violated the law by underpaying doctors. The state later reached a settlement.
“Florida’s Medicaid program is currently operating at the highest level of quality in its history,” McManus said.
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State Sen. Joseph Abruzzo
AHCA and CNN also have clashed in the past.
AHCA criticized the cable news network for its story on the pediatric heart surgery program at St. Mary’s Medical Center.
AHCA characterized the June 2015 story as “sensationalized reporting.”
St. Mary’s program closed down shortly after the story ran.
The network is currently being sued for defamation by the surgeon who established the program.
Now CNN is back in South Florida reporting on the Muszynskis.
In February, the family got word she was being kicked off Medicaid by the state of Florida until state Sen. Joseph Abruzzo interceded, CNN reported.
The couple was told by the state Abby was dropped because of a computer glitch but still the family had trouble getting coverage for her. So, they decided it was time to leave Florida.
To read the whole CNN story on the Muszynskis click here.