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Thursday, April 23, 2015

Health Care Reform Articles - April 23, 2015

Obamacare, Hands Off My Medicare



A number of factors underpin the anti-redistributionist shift in public opinion that I wrote about last week.
First, and perhaps most important, is the emergence of significant resistance to downward redistribution among the elderly, a major voting bloc.
The views of older voters deserve scrutiny. They “worry that redistribution will come at their expense, in particular via cuts to Medicare,” Vivekinan Ashok, a Ph.D. candidate in political science at Yale; Ilyana Kuziemko, a professor of economics at Princeton; and Ebonya Washington, a professor of economics at Yale, write in a March 2015 Brookings Institution essay, “Support for Redistribution in an Age of Rising Inequality”— an essay my Times colleague Neil Irwin also discussed in a recent column that asked why Americans don’t want to soak the rich.
In the end, Ashok, Kuziemko and Washington conclude that
the elderly have grown increasingly opposed to government provision of health insurance and that controlling for this tendency explains roughly half of their declining relative support of redistribution.

What the Brookings essay neglects to explore are the material circumstances of over-65 voters that might affect their views on redistribution. Over a third of retirees depend on Social Security for 90 percent or more of their annual income, according to the Social Security Administration. In the zero-sum competition for federal dollars, the cost of major spending programs like the Affordable Care Act has to be made up by spending cuts elsewhere.

http://www.nytimes.com/2015/04/22/opinion/obamacare-hands-off-my-medicare.html?hp&action=click&pgtype=Homepage&module=c-column-top-span-region&region=c-column-top-span-region&WT.nav=c-column-top-span-region&_r=0



It’s time for Maine to reconsider Medicaid expansion


Gov. Paul LePage and his administration have claimed repeatedly over the past few years that Maine can’t afford to expand Medicaid to about 70,000 low-income parents and adults without children.
But policymakers in Maine can now inform their decisions with the experience so far of states where Medicaid coverage expanded on Jan. 1, 2014. Drawing on that experience, a new analysis of Medicaid expansion’s potential impact on Maine’s state budget complicates the narrative that extending health coverage would be prohibitively expensive.
The analysis, released Wednesday by the Maine Health Access Foundation, projects a $26.7 million budget benefit in 2016 if Maine expands Medicaid due to a combination of savings from shifting expenses elsewhere in the state budget to Medicaid and new revenues the state would take in from hospitals treating newly covered patients. Those $43.9 million in projected savings and new revenues for 2016 would more than offset the $17.2 million projected in new costs.
The organization that conducted the analysis, Manatt Health Solutions, drew on its examination of the expansion-related costs and savings experienced by eight states that extended Medicaid coverage. Those states all faced costs due to the expansion — to be sure, Maine would see higher initial costs than many — but the savings more than offset them.
Those savings came in part from enrolling newly eligible residents in Medicaid who would otherwise qualify for services funded entirely or mostly with state funds. By shifting state spending for mental health services, breast and cervical cancer screening, and prescription drug assistance for older residents to Medicaid, the federal government effectively takes over the responsibility of paying for them.

What It Means For Your Health When Your State Refuses to Expand Medicaid

Nearly 60 percent of African Americans and 40 percent of Latinos live in states that have not expanded the program.


Even though the Affordable Care Act (ACA) has helped millions of people get health insurance, quality health care is still out of reach for a large number of people of color, low-income families and those with language barriers. The high cost of insurance premiums and co-pays was the main reason cited for those who remain uninsured. The complexity of the enrollment process was also a deterrent.

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