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- Naomi on What Sequestration Could Mean to Medicare Advantage Claims Payment
- callcenter972 on Call Center Metrics Reporting Should Be Robust and Actionable
- Sione Ayers on Diagnosing the ObamaCare Glitches: Who Farted and Is Pointing at the Dog?
- Tim Leary on New ACO Reg has some zingers
- Lisa Jefferson on What Happens to Medicare/Medicaid If There’s a Government Shutdown?
With summer drawing to a spectacular close here in Washington, it’s abundantly clear that the “train wreck” everyone’s expecting won’t involve the launch of ObamaCare, but rather an epic legislative pile-up in Congress. With the collision of the debate on Syria, the immigration bill tearing the GOP apart, and now a near-concurrent exhaustion of government funding and the debt ceiling at the end of September/early October, the President and Speaker Boehner will be picking up the pieces of their agendas come Halloween. The question is whether government-sponsored health programs will have to give up another pound of flesh in the process.
The Kaiser Commission on Medicaid and the Uninsured is out with a new study illustrating the sickening human cost of the Red States throwing a middle finger to President Obama on the Affordable Care Act’s (ACA) Medicaid expansion. Twenty-one states are not expanding Medicaid coverage under Obamacare and would gain considerably more than the 23 states that are expanding eligiblity. Partisans like Texas Governor Rick Perry and Kansas Governor Sam Brownback govern states with the highest rates of uninsured — and millions of their own citizens won’t get health insurance so they can score cheap political points.
The Congressional Budget Office released its new economic outlook yesterday and predicts a slower start to enrollment in the new exchanges: 7 million people in 2014 — down from 9 million last July — and rising by 2016. The CBO report also estimates that 8 million people will enroll in Medicaid in 2014, so about 15 million people will obtain health insurance next year.
Just days after President Obama’s full-throated support of defending Medicare from structural reforms in his Inaugural Address, Senator Orrin Hatch (R-UT) yesterday threw down the gauntlet and maintained that reforms are needed in both Medicare and Medicaid in order to reduce the national debt. Hatch, the ranking Republican on the Senate Finance Committee, laid out five proposals that have enjoyed bipartisan support in the past and should be included in deficit reduction talks. They include raising the Medicare eligibility age, changing Medigap coverage, streamlining Medicare cost-sharing under Parts A and B and adding a catastrophic cap, competitive bidding in Medicare, and Medicaid per capita caps.
Inauguration Day in Washington is a blessedly nonpartisan event celebrating our messy yet peaceful democracy with great pomp. But President Obama, with renewed certainty, drew a hard line in his inaugural address against entitlement cuts that could fundamentally change Medicare and Medicaid. And in doing so he doubled down with Republicans in the next rounds of the deficit reduction cagematch.
I hate to have to say it, but the “fiscal cliff” debate/debacle last month is going to feel like a speed bump compared to what’s coming here in DC on the debt ceiling next month. At the height of its dysfunction right now, the relationship between the President and the Congress points to a near-inevitable government shutdown in the next 60-90 days. Which raises the question of what happens to Medicare and Medicaid when DC closes its doors. The answer? It depends on how long the shutdown lasts, but it ain’t pretty no matter what. If it goes longer than 30 days, it’s going to hurt, bad.
You’d never guess from what you see in the news, but the fiscal cliff negotiations are proceeding on two tracks and there is a deal to be done in the coming weeks. One track is public: the screeds in the media and parliamentary chicanery on the Hill, all with the goal of proving their ideological purity to their respective bases and beating the crap out of the guys across the aisle. Speaker Boehner last Friday: “There isn’t a progress report, because there’s no progress to report.” That piece has been depressing as hell to watch. Didn’t we do this with disastrous results last August? The two parties are like little boys with toys.