Great article from the wallstreet journal, why should anyone care about 5 million people who are to helplessly irresponsible to sign up for medicaid unless you put a gun to their head? Why should we all sacrifice the quality of our coverage for these people if they dont even want to take care of themselves?
IMO if you qualify for medicaid but cant even take the responsibility sign up for healthcare unless someone forces you, then you should not have access to hospitals.
With that said the Republican healthcare plan is still a steaming pile of dogshit that isnt very much more appealing than Obamacare.
Medicaid Is Free. So Why Does It Require a Mandate?
The CBO estimates that five million fewer people would sign up without the ObamaCare tax penalty.
The Congressional Budget Office is out with its analysis of the House Republicans’ ObamaCare replacement, the American Health Care Act (AHCA). The CBO’s report includes an implicit but powerful indictment of Medicaid, America’s second-largest health care entitlement.
Medicaid has been around since 1965; it was a core part of LBJ’s Great Society entitlement expansion. The program’s idiosyncratic design requires states to chip in around 40% of the program’s funding, while only getting to control about 5% of how the program is run. The federal Medicaid law—Title XIX of the Social Security Act—mandates a laundry list of benefits that states must provide through Medicaid, and bars states from charging premiums. Copays and deductibles cannot exceed a token amount.
Medicaid is the largest or second-largest line item in nearly every state budget. But for all practical purposes, the main tool states have to control costs is to pay doctors and hospitals less than private insurers pay for the same care. As a result, fewer doctors accept Medicaid patients, making it very hard for Medicaid enrollees to get access to care when they need it. Poor access, in turn, means that Medicaid enrollees—remarkably—have no better health outcomes than those with no insurance at all.
That brings us back to the AHCA. According to the CBO, able-bodied adults on Medicaid receive about $6,000 a year in government health-insurance benefits. They pay no premiums and minimal copays. You’d think that eligible individuals would need no prodding to sign up for such a benefit.
And yet, according to its analysis of the GOP ObamaCare replacement, the CBO believes that there are five million Americans who wouldn’t sign up for Medicaid if it weren’t for ObamaCare’s individual mandate. You read that right: Five million people need the threat of a $695 fine to sign up for a free program that offers them $6,000 worth of subsidized health insurance. That’s more than 1 in 5 of the 24 million people the CBO (dubiously) claims would end up uninsured if the AHCA supplanted ObamaCare.
On its face, there’s reason to doubt the CBO’s view. The mandate is enforced through the income-tax system, and enforcement of the mandate has been spotty for those in low tax brackets. Many of those eligible for Medicaid don’t work or file returns. Under rules established by the Obama administration, those who do can leave the “I have insurance” box blank and face no penalty.
Still, it’s remarkable that the CBO believes people need to be fined into signing up for Medicaid. That tells us something about the CBO’s assessment of Medicaid’s value to those individuals—and it buttresses the GOP’s case that Medicaid needs substantial reform.
Not coincidentally, the AHCA represents the most significant Medicaid reform since 1965, and thereby the most significant entitlement reform in American history. The 1996 welfare reform law is hailed by many conservatives as the most important domestic policy achievement of the past 25 years. Fiscally speaking, the AHCA is 10 times as significant.
The AHCA would put Medicaid on a budget, increasing Medicaid spending per beneficiary at the same rate as the medical component of the Consumer Price Index. This isn’t a far-right concept; President Clinton first proposed reforming Medicaid this way in 1995, as an alternative to the GOP idea of block grants. The 1996 law ended up including neither provision.
Combined with administrative reforms that may come from the Department of Health and Human Services, the bill would give states more flexibility to manage Medicaid’s costs in ways that could increase access to doctors and other providers, while reducing Medicaid spending by hundreds of billions in its first decade and trillions thereafter.
Ultimately, Medicaid for able-bodied low-income adults should be merged into the system of tax credits that the AHCA proposes for those above the poverty line. In that way, all Americans, rich and poor, would have the ability to choose the health coverage and care that reflects their needs, and build nest eggs in health savings accounts that could be passed on to their heirs.
The AHCA has its imperfections. The bill could do more to assist those just above the poverty line, so that they have a smooth transition from Medicaid into the individual health insurance market. But all in all, truly affordable health coverage is coverage that Americans want to buy of their own free will. The American Health Care Act promises to make historic progress toward that goal.
https://www.wsj.com/articles/medicaid-is-free-so-why-does-it-require-a-mandate-1489529946?mod=e2two
IMO if you qualify for medicaid but cant even take the responsibility sign up for healthcare unless someone forces you, then you should not have access to hospitals.
With that said the Republican healthcare plan is still a steaming pile of dogshit that isnt very much more appealing than Obamacare.
Medicaid Is Free. So Why Does It Require a Mandate?
The CBO estimates that five million fewer people would sign up without the ObamaCare tax penalty.
The Congressional Budget Office is out with its analysis of the House Republicans’ ObamaCare replacement, the American Health Care Act (AHCA). The CBO’s report includes an implicit but powerful indictment of Medicaid, America’s second-largest health care entitlement.
Medicaid has been around since 1965; it was a core part of LBJ’s Great Society entitlement expansion. The program’s idiosyncratic design requires states to chip in around 40% of the program’s funding, while only getting to control about 5% of how the program is run. The federal Medicaid law—Title XIX of the Social Security Act—mandates a laundry list of benefits that states must provide through Medicaid, and bars states from charging premiums. Copays and deductibles cannot exceed a token amount.
Medicaid is the largest or second-largest line item in nearly every state budget. But for all practical purposes, the main tool states have to control costs is to pay doctors and hospitals less than private insurers pay for the same care. As a result, fewer doctors accept Medicaid patients, making it very hard for Medicaid enrollees to get access to care when they need it. Poor access, in turn, means that Medicaid enrollees—remarkably—have no better health outcomes than those with no insurance at all.
That brings us back to the AHCA. According to the CBO, able-bodied adults on Medicaid receive about $6,000 a year in government health-insurance benefits. They pay no premiums and minimal copays. You’d think that eligible individuals would need no prodding to sign up for such a benefit.
And yet, according to its analysis of the GOP ObamaCare replacement, the CBO believes that there are five million Americans who wouldn’t sign up for Medicaid if it weren’t for ObamaCare’s individual mandate. You read that right: Five million people need the threat of a $695 fine to sign up for a free program that offers them $6,000 worth of subsidized health insurance. That’s more than 1 in 5 of the 24 million people the CBO (dubiously) claims would end up uninsured if the AHCA supplanted ObamaCare.
On its face, there’s reason to doubt the CBO’s view. The mandate is enforced through the income-tax system, and enforcement of the mandate has been spotty for those in low tax brackets. Many of those eligible for Medicaid don’t work or file returns. Under rules established by the Obama administration, those who do can leave the “I have insurance” box blank and face no penalty.
Still, it’s remarkable that the CBO believes people need to be fined into signing up for Medicaid. That tells us something about the CBO’s assessment of Medicaid’s value to those individuals—and it buttresses the GOP’s case that Medicaid needs substantial reform.
Not coincidentally, the AHCA represents the most significant Medicaid reform since 1965, and thereby the most significant entitlement reform in American history. The 1996 welfare reform law is hailed by many conservatives as the most important domestic policy achievement of the past 25 years. Fiscally speaking, the AHCA is 10 times as significant.
The AHCA would put Medicaid on a budget, increasing Medicaid spending per beneficiary at the same rate as the medical component of the Consumer Price Index. This isn’t a far-right concept; President Clinton first proposed reforming Medicaid this way in 1995, as an alternative to the GOP idea of block grants. The 1996 law ended up including neither provision.
Combined with administrative reforms that may come from the Department of Health and Human Services, the bill would give states more flexibility to manage Medicaid’s costs in ways that could increase access to doctors and other providers, while reducing Medicaid spending by hundreds of billions in its first decade and trillions thereafter.
Ultimately, Medicaid for able-bodied low-income adults should be merged into the system of tax credits that the AHCA proposes for those above the poverty line. In that way, all Americans, rich and poor, would have the ability to choose the health coverage and care that reflects their needs, and build nest eggs in health savings accounts that could be passed on to their heirs.
The AHCA has its imperfections. The bill could do more to assist those just above the poverty line, so that they have a smooth transition from Medicaid into the individual health insurance market. But all in all, truly affordable health coverage is coverage that Americans want to buy of their own free will. The American Health Care Act promises to make historic progress toward that goal.
https://www.wsj.com/articles/medicaid-is-free-so-why-does-it-require-a-mandate-1489529946?mod=e2two
Last edited: