Most Governors Refuse to Set Up Health Exchanges
By ROBERT PEAR
WASHINGTON — The Obama administration said Friday that more than half the states had rejected its pleas to set up their own health insurance exchanges, dealing a setback to President Obama’s hopes that Republicans would join a White House campaign to provide health insurance to all Americans.
Friday was the deadline for states to notify the federal government of their plans, and administration officials had been hoping that Mr. Obama’s re-election would overcome resistance to the new health care law.
Federal officials said they knew of 17 states that intended to run their own exchanges, as Congress intended.
Two of those states, New York and Kentucky, won conditional federal approval on Friday for their plans to create and run state-based exchanges. Kathleen Sebelius, the secretary of health and human services, also approved an application from the District of Columbia.
In seeking federal money, New York estimated that one million people could obtain insurance through its exchange. In addition, said Josh Vlasto, a spokesman for Gov. Andrew M. Cuomo, the exchange will lower the cost of coverage for many New York businesses.
But in Virginia, after more than a year of planning and research, Gov. Bob McDonnell said his state would not operate its own exchange. “Despite repeated requests for information, we have not had any clear direction or answers from Washington until recent days,” Mr. McDonnell said.
On Monday, Ms. Sebelius gave preliminary approval to state-based exchanges being established by Colorado, Connecticut, Maryland, Massachusetts, Oregon and Washington.
The exchanges are online supermarkets where people can shop for private health insurance and obtain federal subsidies to help defray the cost. The Congressional Budget Office has estimated that 25 million people will eventually receive coverage through the exchanges.
Where each state stands on ACA's Medicaid expansion
A roundup of what each state's leadership has said about their Medicaid plans
December 12, 2012
- Three key resources: Learn more about the Supreme Court's ruling, listen to our expert takeaways, and model the impact on your organization.
Text last updated on Dec. 12 at 10 a.m. ET.
The Supreme Court's ruling on the Affordable Care Act (ACA) allowed states to opt out of the law's Medicaid expansion, leaving each state's decision to participate in the hands of the nation's governors and state leaders.
Based on lawmakers' statements, press releases, and media coverage, the Daily Briefing and American Health Line editorial teams have rounded up where each state currently stands on the expansion.
We will continue to update this map and list as more information becomes available. Send us news, tips, and feedback by commenting below or emailing dailybriefing@advisory.com.
Click to expand a quick-to-scan graphic or an interactive graphic. (Note: The interactive graphic may not be optimized for mobile devices.)
J. Sytsma: Consider Medicare for everyone
I am responding to a column by Matt Miller of the Washington Post, printed in the Sun Journal Nov. 30. He suggests that President Obama appoint a panel of experts, chaired by Mitt Romney, to solve the serious problems the nation faces in financing health care.
Rather than asking Romney to chair a panel, Obama should listen to the majority of U.S. physicians and many others who have studied the problem for years and come up with the only system that makes sense — a single-payer national health policy.
| Health care change needed |  |  |
| December 13, 2012 |
More than a few detractors of the Affordable Health Care Act decry the advance towards “socialism.” What many Americans don’t realize is that there has been a very sophisticated, orchestrated campaign in this country for decades by the for-profit insurance companies and pharmaceuticals, and even the American Medical Association, devoted to all-out war against “socialized” health care. They know that the very word “socialized” is enough to make people panic and run in circles. Wendell Potter, former communications head at the CIGNA Health Insurance Company, writes about it in his book “Deadly Spin.” It is time to see the propaganda, churned out by the well-funded special interests, for what it really is.
Insurance companies and the pharmaceuticals all put profits ahead of people and employ sneaky methods to shift costs back to the consumer in order to put more money into the pockets of shareholders and greedy insurance executives. One way is dream up reasons to refuse to cover treatment, effectively rationing care, as the 9-20-12 Coastal Journal article about Woolwich resident Pam Creamer illustrates (Pam’s insurance company refused to cover treatments for Lyme disease).
Healthcare crisis: not enough specialists for the poorWith months-long waits for Medi-Cal patients to see specialists, some turn to emergency rooms — exactly what healthcare reform is banking on avoiding.
By Anna Gorman, Los Angeles Times
4:48 PM PST, December 15, 2012
The blurry vision began early last year. Roy Lawrence ignored it as long as he could. But after falling off a ladder at his construction job, he knew he had to see a doctor.
He went to a community health clinic in South Los Angeles, where doctors determined he had diabetes and cataracts. The clinic could manage his illness but referred him early this year to the county health system for eye surgery. Nearly a year later, Lawrence, a Jamaican immigrant without insurance, still is waiting for the operation. His vision has deteriorated so much he is considered legally blind. PHOTOS: Waiting in vain to be seen "I want to see again," he said. "I've been waiting a long time." Lawrence, 49, and patients like him are posing a critical challenge for the planned overhaul of the nation's healthcare system. Federal officials are investing billions in community health centers like the To Help Everyone (T.H.E.) Clinic, where Lawrence's problem was diagnosed, with the hope that they can keep more patients out of high-cost emergency rooms. But a dearth of specialists available to low-income patients presents one of the bigger hurdles facing the country as it tries to bring spiraling healthcare costs under control. Doctors say meeting new government mandates to keep patients healthy and out of hospitals — a linchpin in reducing medical spending — will be virtually impossible without the ability to make timely patient appointments with specialists. By the end of the decade, the nation will be short more than 46,000 surgeons and specialists, a nearly tenfold increase from 2010, according to the Assn. of American Medical Colleges. Healthcare reform is expected to worsen the problem as more patients — many with complex and deferred health needs — become insured and seek specialized treatment. Many of the newly insured will receive Medi-Cal, the government plan for the needy as administered through the state of California. Clinics already struggle to get private specialists to see Medicaid patients because of the low payments to doctors. Last week, an appellate court decision that authorized the state to move forward with 10% cuts in Medi-Cal reimbursement, which could make finding doctors for those patients even more difficult. Health care reform: the issue is equity
By Gabriel Edwards
The Pulse (OHSU Student Newsletter), Fall 2012 edition The process of getting through medical school is fraught with uncertainty. What kind of residency will I apply to? Which lunch talks this week are offering free food? What innervates the palatoglossus muscle? There’s another question I’ve considered as I get through the first year. I wonder what our country’s health care system (the system in which I will practice medicine) will look like in the next few years. Embedded in this question is one thing I’m certain of: our health care system is broken. We spend double the money of every other developed nation in the world, and our health is worse for it. We are fairly unique among developed countries in the degree to which our quality of health care depends on income or employment. Wealthy Americans receive some of the best health care ever devised by humans. Less wealthy Americans are denied care because of lack of resources, succumbing to preventable illnesses at rates higher than our industrialized counterparts. Both major political parties say that the health care system needs to be reformed, that costs need to be contained lest they eventually bankrupt the country. During the latest battle of reforming health care there was talk about what would happen to various stakeholders in our current systems. What would reform mean for doctors? For private insurers? For patients? For President Obama’s political prospects? For the opposition’s political prospects? Another question is asked far less frequently: What does it say about us as a society that, compared to other countries, so many more people are dying from preventable diseases or going bankrupt due to health care costs? Our country has already decided that every American is entitled to education, police protection, and fire protection. Prisoners have a guaranteed right to health care. Right now there are tens of millions of Americans who don’t have the right to adequate health care. Obamacare, fully implemented, would cut the number of uninsured only by half, leaving 23 million Americans without health insurance – 23 million who can’t afford all the health care necessary to ensure a high quality of life. And the problem doesn’t stop there. Insured individuals declare the majority of medically related bankruptcies. This is not a problem of insurance versus noninsurance. This is a problem of equity. The solution to this problem, I believe, is to create a health care system that covers everyone, without exception. Obamacare will not do this, but a single-payer system could. I believe that this is the most moral solution. http://www.pnhp.org/print/news/2012/december/health-care-reform-the-issue-is-equity |
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