The Supreme Court Ruling on Health Care, Its Impact on Medicaid, and 29 Republican Governors--Be Careful You Might Get What You Wish For

Conservatives wanted the Supreme Court to do the work of killing the Affordable Care Act (ACA) for them. They didn’t get their wish but the Court may have put conservatives into a political corner they will find very uncomfortable.

Under the new health law, the Medicaid program will be substantially expanded. Those making up to 133% of the federal poverty level (about $30,000 in annual income

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2012: A Year of Huge Uncertainty in Health Care Policy

2013 may be the most significant year in health care policy ever.But we have to get through 2012 first.Once the 2012 election results are in there will be the very real opportunity to address a long list of health care issues.If Republicans win, the top of the list will include “repealing and replacing” the Affordable Care Act. If Obama is reelected, but Republicans capture both houses of

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The Debt Super Committee—Will We Get a Deal?

It’s back to work in Washington, DC and all the attention is now on the Super Committee and their goal of cutting spending by at least $1.2 trillion over ten years.If the committee fails to come up with a plan that passes the Congress, there would be $1.2 trillion in automatic cuts. The health care special interests have reason to hope they will fail—the fallback cuts would only impact Medicare

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The Debt Deal: There Will Be Blood on the Floor on November 23rd

The debt deal is finally done. But it really isn’t an agreement on what cuts will be made, just the process that will be used to make them.The real work is left to the Congressional appropriators for the first $917 billion and for a super-committee of Congress for the second $1.2 trillion to $1.5 trillion in ten-year cuts.That second tranche is where health care will make its contribution. The

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The Budget Fight: It Will Be A Long Hot Summer, and Fall, and Winter…

The good news is that Democrats and Republicans are finally seriously engaged over the country’s fiscal crisis.And, each side is presenting a starkly different course for the voters to choose from.When it comes to the health care entitlements, Republicans want to cut the health care entitlement benefits and therefore ease the pressure on federal spending.Obama wants to largely leave the programs

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Shame on AARP For Their Response to the Deficit Commission Co-Chairs' Report

The Co-Chairs of the President’s Deficit Reduction Commission are out with their preliminary recommendations.They’ve done a great job—they’ve offended about everyone!But we have a nearly impossible but unsustainable challenge in front of us if we are ever going to crawl out of this deep hole.It is not so much what is on their list as what this list tells us about just how fundamental the changes

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CBO to Health Care Reformers: Naive Policy Makers Need Not Apply

The Congressional Budget Office (CBO) has released two comprehensive papers detailing the policy and financial options for health care reform: Key Issues in Analyzing Major Health Insurance Proposals and Budget Options, Volume I: Health Care.I can't overestimate the importance of these documents to health care reform.I recently did a post as sort of an open letter to the CBO: To the Congressional

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If Grady Fails--The Crisis At Atlanta's Grady Health System Is A Symptom Of Bigger Problems In The U.S. Health Care System

Brian Klepper joins us again today this time with a post on Atlanta's Grady Health System. Grady is an inner city safety-net hospital now going to extraordinary lengths to remain open. Brian makes the point that the Grady situation is by no means unique but instead represents a national issue as safety net hospitals struggle to maintain health care for the uninsured while being underpaid by their

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President Bush is Not Backing Down on His SCHIP Veto Threat

The President is sticking to his guns over his threatened veto of the Senate Finance Committee bipartisan deal to reauthorize and expand the State Children's Health Insurance Plan (SCHIP) at a cost of $35 billion. The deal would expand S-CHIP and pay for it with a big 61 cent cigarette tax--taking the federal per pack tax to $1.A White House spokesman said on Saturday that his advisers "will

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Key Republican Senators Call on President Bush Not to Veto S-CHIP Reauthorization--A President Acting Like He Has Nothing to Lose

On Thursday I commented on the Senate Finance deal to reauthorize the State Children's Health Insurance Plan (S-CHIP). The bipartisan deal calls for a $35 billion expansion of the program, reversing state efforts to use it to cover adults, and pays for it with a whopping new 61 cent per pack tobacco tax.Yesterday, two very important Republican members--Grassley and Hatch--of the Senate Finance

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Senate Finance Committee Reaches Bipartisan Agreement to Fund S-CHIP Expansion With a Tobacco Tax--No Cuts to Medicare Advantage

The Senate Finance Committee has reached a tentative agreement to expand the State Children’s Health Insurance Program (S-CHIP) by increasing the tobacco tax by another 61 cents—for a total per pack federal tax of $1. With state taxes, the average per pack tax would rise to about $1.68.Under the agreement, the Senate would not go forward with any Medicare Advantage cuts to fund S-CHIP.While 2

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Can the Democrats Take the Health Care Agenda Back? S-CHIP is the First Test and the Test is On

The debate over how the State Children's Health Insurance Plan (S-CHIP) will be reauthorized is really about whether the Democrats can finally take the health care agenda back from the Republicans.If the Congress cuts private Medicare plan payments to pay for a bigger S-CHIP, it will be a double whammy--a bigger government health plan and potentially a smaller private Medicare program.Congress is

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The Reauthorization of the State Children's Health Insurance Program (S-CHIP)--A Surprising Contrary View

Bill Boyles, the publisher of Health Market Survey, fills the role of guest commentator again today reporting on a very different view on the issue of the reauthorization of the State Children's Health Insurance Program (S-CHIP).His report just goes to show that nothing in health care policy is simple:House Black Caucus Not Buying S-CHIP ExpansionIt seems like every interest group in the country

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Rural Health Care and Medicare Advantage Plans--A Sacred Cow for Both Republicans and Democrats?

If you have been reading this site for any time you know that I believe the Democrats are going to cut Medicare Advantage payments to the HMOs the first time they get their hands on the federal budget (see earlier post).But I also think there may be an exception to what will generally happen to Medicare Advantage (MA) HMOs--payments to plans operating in "rural" areas.The original Medicare

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10 Bipartisan Senators Offer a Health Care Reform Outline

Just a few weeks ago I wrote a post that began, it's a new day in the health care debate. Health care reform is breaking out all over.My point was that I haven't seen such enthusiasm for reform since the early 90's and the resulting Clinton Health Plan effort. Everyone seems to have a plan--not the least of which are offered by some very powerful bedfellows.That trend continued this week when

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The Bush Budget--It's One Thing for People to Call You a "Lame Duck" and Another to Act Like It!

On health care, this Bush budget just tells me this President has given up.To start with, he would let scheduled Medicare physician fee cuts simply take place. Those cuts, now estimated to be 8.5% on January 1, 2008, will under no circumstances take place at anywhere near that level (if at all) and everyone in Washington, DC knows that.So why include this in your budget.The Bush budget calls for

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Medicare Advantage Payments to Insurers Will Be Cut

The State Children's Health Insurance Program (S-CHIP) needs to be reauthorized by the Congress. That will cost $13 to $15 billion over the next five years--something I detailed in an earlier post.Compounding the S-CHIP budget dilemma, Medicare physicians are scheduled to have their fee payments cut by 10% on January 1, 2008.When the last Congress reversed the scheduled 5% fee cut for 2007, in

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SCHIP Reauthorization--Will Medicare HMOs Pay for Some of It????

In the post below, I reviewed the need to reauthorize the very successful State Children's Health Insurance Program (S-CHIP).The Congress will have a real challenge coming up with the needed money--$13 billion to $15 billion. Finding the money will be hard because of the House Democrat's pledge to fully fund any spending--their "pay-as-you-go" policy.Where will the money come from?First, the

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Back to "Regular Order"--The House Medicare Part D Drug Bill and SCHIP Reauthorization

The debate over the House Medicare drug negotiation bill is now moving over to the Senate.My post from last Friday (next post below) still reflects what I am seeing on this issue. The Senate will move a drug bill on "regular order" which means we will see the standard committee hearings and process that could lead to floor action later in the spring or summer. The House Medicare Part D drug

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