Patti's Blog - Advocate for Elders, People with Disabilities and Their Families

Long, vexing process led to WVa Medicaid decision

Excerpt from: Charleston Daily Mail (click for full article)

 

Tomblin's decision to open Medicaid to more low-income West Virginians was reached neither quickly nor easily, administration officials say.

The path to last week's announcement began in June, when the U.S. Supreme Court upheld the federal health care law. The ruling struck down language that threatened existing federal Medicaid funding for states that didn't expand their programs as called for by the sweeping overhaul.

"When we found out we had a choice, we started studying it," Tomblin Chief of Staff Rob Alsop said Friday.

The governor at first sought wiggle room. He quizzed U.S. Health and Human Services Secretary Kathleen Sebelius in July about whether West Virginia could expand Medicaid more gradually or only partly and still count on the hefty federal funding promised by the health care law. After a September follow-up inquiry by the governor, Sebelius shot down that option for West Virginia and other states in December.

Florida rejects Medicaid expansion, leaves 1 million uninsured

Excerpt from: Washington Post (click for full article)

 

It seemed like a watershed moment for the Affordable Care Act when Florida Gov. Rick Scott (R), a staunch Obamacare opponent, embraced the Medicaid expansion in February.

“While the federal government is committed to paying 100 percent of the costs, I cannot deny Floridians who need access to health care,” Scott told reporters at a press conference.

Scott wouldn’t be the one to “deny Floridians” a part of the health care law—but the Florida legislature had other plans. Lawmakers adjourned Friday after passing a budget that does not include funding for a Medicaid expansion. Unless the Republican-controlled legislature comes back for a special session later this year—which some Democrats are calling for—Florida will not expand Medicaid in 2014.

Considering captives

Excerpt from: McKnight's (click for full article)

 

For most operators, owners and CFOs in long-term care facilities, control is not a word that comes to mind when insurance is the topic. But with price increases hitting commercial insurance lines, market and coverage limitations within the aging services sector, as well as reduced capacity to service this vertical, greater control is exactly what long-term care executives should demand.

When control is the goal, a captive can be the answer. Captives, either alone or part of a group, provide business owners with the unique alternative of owning their own insurance company. This can translate to greater control over claims handling, professional partners, stabilization and reduction of the cost of risk, risk management and loss control and ultimately, control over underwriting profits and investment income.

Is a new study of Medicaid a game changer?

Excerpt from: Politifact (click for full article)

 

The new study in the New England Journal of Medicine was published almost a month after our fact-check ran, and unlike the studies we evaluated initially, it was specifically designed to compare health outcomes for Medicaid patients against those who are uninsured.

Did the new study improve Cruz’s case?

We should note that we evaluate claims based only on evidence known at the time. We don’t go back and re-evaluate if new facts come to light later, because it doesn’t make sense to give people credit for evidence they couldn’t possibly have known about at the time.

In this case, though, we were curious about whether this study changed the debate on this important issue going forward. So we decided to take a fresh look.

The new paper represents the second phase of a study coauthored by Katherine Baicker of Harvard University and Amy N. Finkelstein of the Massachusetts Institute of Technology.

In 2008, Oregon expanded its Medicaid rolls, but only had enough funding to cover a portion of residents who wanted to sign up. To distribute spots in the program, officials set up a lottery.

The researchers compared 6,387 lottery winners to 5,842 who didn’t get a slot, tracking factors such as blood pressure, cholesterol, blood sugar, depression, and out-of-pocket medical spending.

The study produced mixed results. That has led both critics and advocates of expanding Medicaid to rush to portray the study’s results as evidence for their side.  Supporters of expanding Medicaid are pointing to the findings that beneficiaries had less depression and more financial security. Catastrophic out-of-pocket medical expenditures, for example, were "nearly eliminated."

Here’s what the Oregon Medicaid study really said

Excerpt from: Washington Post (click for full article)

 

A few years back, Oregon found the money to add 10,000 residents to the state’s Medicaid program. The only problem was that there were 90,000 residents who qualified for the program and desperately wanted in. So the state held a lottery. Welcome to the American health-care system. Greatest in the world, folks.

But 80,000 Oregonians’ loss was science’s gain. The lottery gave researchers an opportunity that’s almost never available in policymaking: They could create a randomized controlled study — the absolute gold-standard of experimental design — comparing the health outcomes of the lucky Oregonians who received Medicaid to those who didn’t. It would be the first time that kind of study had even been used to compare the insured and the uninsured.

The initial batch of results was released in August 2012. The data covered the first year of the Medicaid expansion and found that the folks on Medicaid were getting more care, reporting better health (both physical and mental), and seeing fewer financial problems than the people who weren’t on Medicaid.

The second set of results was released Wednesday. The data now covers two years and, importantly, includes clinical measures of health rather than relying on the reports of the study participants. These results are more mixed, but also more telling.

Here’s what we can say with certainty: Medicaid works as health insurance.

Medicaid Access Increases Use of Care, Study Finds

Excerpt from: The New York Times (click for full article)

 

Come January, millions of low-income adults will gain health insurance coverage through Medicaid in one of the farthest-reaching provisions of the Obama health care law. How will that change their finances, spending habits, use of available medical services and — most important — their health?

New results from a landmark study, released on Wednesday in The New England Journal of Medicine, go a long way toward answering those questions. The study, called the Oregon Health Study, compares thousands of low-income people in Oregon who received access to Medicaid with an identical population that did not.

It found that those who gained Medicaid coverage spent more on health care, making more visits to doctors and trips to the hospital. But the study suggests that Medicaid coverage did not make those adults much healthier, at least within the two-year time frame of the research, judging by their blood pressure, blood sugar and other measures. It did, however, substantially reduce the incidence of depression, and it made them vastly more financially secure.

CMS Chief Expresses Optimism About Federal Exchange Enrollment

Excerpt from: Kaiser Health News (click for full article)

 

But other signs, such as the number of insurance carriers applying to sell policies in Illinois' health insurance marketplace, suggest cause for concern. Meanwhile, Modern Healthcare reports on the downside of the Obama administration's shorter application form for purchasing insurance through the exchanges.

Kaiser Health Tracking Poll: April 2013

Excerpt from: Kaiser Family Foundation (click for full article)

 

As the federal government, state governments and other stakeholders gear up for public information campaigns tied to the October start of open enrollment in the ACA’s health insurance exchanges, Americans report that thus far they have been relying most heavily on their own personal networks and the news media for information about a law that continues to be only dimly understood by many. The most commonly cited sources of information in Kaiser’s April Health Tracking Poll are friends and family (named by 40 percent), “newspapers, radio or other online news” (36 percent), and cable news (30 percent).

Thus far, about one in ten Americans report getting any information from a health insurance company, their doctor, an employer, or a non-profit, and few name any of these as their most important source of information. About the same share (9 percent) report having gotten information from “federal agencies such as the Department of Health and Human Services,” with little difference across demographic groups. Eight percent say they have gotten some ACA information from “state agencies such as your state Medicaid office or health department,” a share which doubles among African Americans (17 percent). The poll provides a rough baseline before more intensive public information and consumer assistance begins.

Ditch Your Sky-High Long-Term Care Insurance?

Excerpt from: Fox Business (click for full article)

 

You're in good health and could probably shop for less expensive insurance if you so desired. Not true for a lot of seniors, however. Long-term care insurers need to do what long-term disability insurance companies did 30 or 40 years ago and offer policies with a guaranteed renewable premium for life. If they don't, the government will probably end up passing legislation prohibiting the kind of increase you're describing at any one time.

If it is any consolation, know that the state insurance department where you live had to approve the increase, so the insurance company truly has been losing money on long-term care insurance and was able to justify the increase by documenting poor claims experience. On top of that, when you bought your policy, interest rates were probably higher than they are today. Insurance companies project investment income when setting their prices. Needless to say, given today's very low rates, that projection has sorely missed the mark.

As for what you can do about your specific rate increase, you have choices besides either paying the increase in full or dropping the policy. Your insurance company probably gave you a few different options. You could lower the inflation percentage on the cost-of-living annual benefit increase (i.e., from 5% to 3%). You could lower your benefit duration -- how many years the policy will pay you benefits while you are receiving long-term care. For example, you may have a lifetime benefit now but could save 40% by lowering that benefit duration to six years.

How long term care insurance can help protect your assets

Excerpt from: myhartsville.com(click for full article)

 

How will you pay for long term care? The sad fact is that most people don’t know the answer to that question. But a solution is available.
As baby boomers leave their careers behind, long term care insurance will become very important in their financial strategies. The reasons to get an LTC policy after age 50 are very compelling.
Your premium payments buy you access to a large pool of money which can be used to pay for long term care costs. By paying for LTC out of that pool of money, you can preserve your retirement savings and income.
The cost of assisted living or nursing home care alone could motivate you to pay the premiums. Genworth Financial conducts a respected annual Cost of Care Survey to gauge the price of long term care in the U.S. Here is a summary of the 2013 survey’s key findings:
*In 2013, the median annual cost of a private room in a nursing home was $83,950 or $230 per day – up 3.6% from 2012. In the past five years, the cost has risen about 4.5% annually.
*A private one-bedroom unit in an assisted living facility has a median cost of $3,450 a month, or $41,400 annually. It was 4.5% cheaper last year.
*The median payment to a non-Medicare certified, state-licensed home health aide is $19 an hour in 2013, up 2.3% from 2012.1
Can you imagine spending an extra $40-85K out of your retirement savings in a year? What if you had to do it for more than one year?
The U.S. Department of Health & Human Services estimates that about 70% of Americans will need some kind of long term care during their lifetimes. Additionally, 69% of Americans older than 90 have some form of disability – often a direct cause for long term care.2
Why procrastinate? The earlier you opt for LTC coverage, the cheaper the premiums. This is why many people purchase it before they retire. Those in poor health or over the age of 80 are frequently ineligible for coverage.