Archive for Tuesday, July 3, 2012

Ruling leaves Medicaid expansion decision to state

July 3, 2012


If the Affordable Care Act remains the law of the land, Kansas policyholders will have an important decision to make that would affect more than 150,000 Kansans.

That would be whether to expand the Medicaid program, which is the federal- and state-funded program that provides health care in Kansas to low-income families, children and people with disabilities.

The ACA required that states expand their Medicaid programs to include all non-elderly persons with incomes up to 133 percent of the federal poverty level, or about $30,000 annually for a family of four, or risk losing all federal Medicaid funding. That eligibility expansion would have had a significant impact in Kansas because currently only adults who earn less than 27 percent of the federal poverty level — $6,035 for a family of four — are eligible for Medicaid, and childless adults don’t qualify at all unless they are elderly or have a disability.

While the U.S. Supreme Court upheld most of the ACA, it struck down the Medicaid requirement, making expansion of the program optional.

“That raises a lot of questions for states,” Suzanne Schrandt, of the Kansas Health Institute, said at a recent forum on the court’s ruling.

Schrandt said that of the state’s 350,000 uninsured people, 151,000 would qualify for the expanded Medicaid if Kansas enacts the changes.

Of those 151,000 who would qualify, 130,000 are low-income adults who currently do not qualify for Medicaid in Kansas, she said.

Gov. Sam Brownback is an ardent opponent of President Barack Obama’s health care law and has said he hopes presumptive Republican presidential nominee Mitt Romney wins election in November and tries to repeal the law.

“Stopping Obamacare is now in the hands of the American people. It begins with a new president this fall,” Brownback said.

Attorney General Derek Schmidt said he was disappointed in the Supreme Court upholding the ACA but said the court’s ruling on Medicaid was a win for states. Kansas was one of 26 states that challenged the law and the proposed expansion of Medicaid was part of that challenge.

Referring to the court, Schmidt said, “It also rejected the federal government’s effort to transform the Medicaid program from a federal-state partnership into a centralized program run by Washington, from Washington and solely for Washington. These legal rulings will benefit the long-term vigor of our federal system.”

But Jay Angoff, the regional director of the U.S. Department of Health and Human Services, said when “cooler heads prevail,” states will expand Medicaid. Under the ACA, the federal government will pay the entire cost of newly eligible Medicaid population for three years. The federal contribution decreases to 90 percent by 2020 with the states picking up the remaining costs. The Obama administration has said 17 million people nationwide will be covered by the Medicaid expansion.

“The states will see what a good deal this is,” Angoff said.


woodscolt 5 years, 11 months ago

"If the Affordable Care Act remains the law of the land, Kansas policyholders will have an important decision to make that would affect more than 150,000 Kansans."

Well, the medal meets the floor. Sammy and all his cronies have health insurance to the hilt. However, Sammy is willing to forego the health and well being of 150,00 Kansan's (that he claims to represent). Sammy says, no, you cant have health coverage because it goes against my ideology. So, while sammy and all his cronies can bask in the finest health care available in the world, you should suffer and do without, just for sammy. You 150k kansas might want to reconsider your vote. You might want to consider voting for someone who is actually willing to lead you in your best interests rather than selfish ideology.(while not willing to make the sacrifices he is imposing on you.) Just something to think about while you can't go to the doctor , or your loved one is dying for sammy. Is sammy really worth dying for?

Time to run these a holes out of dodge. A lynching would be to kind.

Cant_have_it_both_ways 5 years, 11 months ago

Or you might consider getting a job? Sounds like non of your problems are self induced.

camper 5 years, 11 months ago

I know a lot of hardworking families under the proposed 30k amount. Would you believe 30k jobs are hard to find right now?

scaramouchepart2 5 years, 11 months ago

Can't. you want it both ways. You dont want to provide benefits at work or through the government. But man businesses sure demanded that the government pay them in the way of bailouts.

JayhawkFan1985 5 years, 11 months ago

The problem is a substantial part of the 150,000 people are children and therefore not eligible to vote.

KS 5 years, 11 months ago

woodscolt - I would like to know your proof that Brownback's "ideology" goes against healthcare coverage! For a man that has adopted children, I think you would be hard pressed to prove that he doesn't have compassion. I don't believe you can prove any of that. Brownback and the other 25 states are very concerned about how to pay for it. You say, "the metal meets the floor"; well, you are absolutley correct. The problem is not trying to get coverage for all, but more importantly, how the heck are we going to pay for it? Our country is already bust. We now owe China and others for 40% of every dollar we spend. The real question is, "how much should we borrow to pay for this and who do "YOU" expect to pay it back, or do you care as long as you get what you want?" Just who the heck do YOU think should pay for it? If your response is "the wealthy, because they don't pay their fair share", I would suggest you do a little reasearch before you jump onto that phony bus. You will be showing your ignorance. Boy, are you in for a surprise when you find out that the "free healthcare", you have longed for isn't free afterall. Now you too, can have an appointment with the IRS. Does that surprise you? BTW, to the American people, it will always be known as Obamacare. There is NOTHING affordable about it! Seventy five precent of the cost of this program will be passed on to families making UNDER $125,000 per year. (Wall Street Journal) You don't like that? Blame the folks that had to pass this bill so they would know what was in it because they didnt did not take the time to read it. Maybe they really didn't want to know? Personally, I think if you can afford a cell phone, internet access and cable TV, you too can afford to pay for your own healthcare. Priorities! Go get it before the IRS catches up with you. Now you too, can pay for the "mandate", oh I'm sorry, the TAX! BTW, don't go loolking for a job, because the job creators are not going to start jobs that cost them money for this "affordable" act. At this rate, I can see unemployment being up to about 8.4% by election time. Friday will tell which direction we are going on. Do you want more of that?

woodscolt 5 years, 11 months ago

Ks, your so full of the anti health care propaganda that your not worth wasting my time on.

Brock Masters 5 years, 11 months ago

Or maybe you just can't counter it? Just asking.

KS 5 years, 11 months ago

I guess I expected that type of answer. Personal attacks when you can't attack the problem.

booyalab 5 years, 11 months ago

Medicaid is a constant struggle to fund in every state. Given that fact, is it more likely that it's Brownback's fault we can't pay for it or is it a problem with the program itself?

KS 5 years, 11 months ago

I agree, you could repeal this new law, but that is only a fraction of the cost. Not enough and besides, why should it be the responsibility of the partnerships, LLC's, self employed, etc. to pay for it. You pay for your own. There is no such thing as a free lunch. Somebody has to pay. The free rides are coming to a close. The IRS is going to see to that. More government, more costs, more taxes.

camper 5 years, 11 months ago

How to fund it? By reducing insurance costs. How to reduce insurance costs? Increase insurance pool. How to increase insurance pool? Public Option.

Next up is reducing health care costs......different topic tho

KS 5 years, 11 months ago

Health care costs are NEVER going to be reduced. Get used to it! The Government controls you now! You say reduce insurance costs by increasing the pool! Well, don't you suppose that if you increase the pool, you just might increase the use and therefore the costs? Have you ever actually seen a government program that controls costs? We are broke because of that. The unfortunate part of this is that we are not going to have enough doctors. The ER problem has now been shifted to your doctor's office.

camper 5 years, 11 months ago

You've hit the real problem KS. I was only addressing the reduction of insurance costs. How to reduce costs is the bigger question. Somehow I think there should be lower cost options for patients. Maybe a move to more basic care for most, and the availability of advanced care for extreme medical conditions or emergencies.

chootspa 5 years, 11 months ago

How to fund it? By taking the three years of full funding from the feds and the 90% funding for the couple years after that. Because we're all going to pay for the uninsured one way or another.

KS 5 years, 11 months ago

And just who are the people that you are taking that money from (Feds)? It's called "We the people" and that includes you! Obamacare is resulting in the largest tax increase in the history of the world.

Michael LoBurgio 5 years, 11 months ago

So Washington has offered a huge incentive to the states to expand Medicaid: For the first three years, the feds will pay for it. After that, however, states have to pick up some of the additional costs — and by the end of the decade, they have to pay 10 percent of the expansion.

So far, several states led by Republican governors have said “no thanks.” You can hear similar noises from legislative leaders in Kansas and Missouri.

If enough states refuse to expand Medicaid, it would shave tens of billions of dollars from the federal deficit over the next decade. At the same time, if states stay out of the expansion, their taxpayers will essentially be sending money to Washington to help expand Medicaid in other states.

Read more here:

notorious_agenda 5 years, 11 months ago

All that it would take is one bill to make it much more than 10%. Would you trust politicians not to vote it higher due to out of control medical costs? 21,000 people to 151,000 people is a pretty large jump. How much of a rise over what we pay now is 10% of the cost for 151,000 people? How about if it was 50% of that cost? These very programs have numerous examples of exactly this type of price increase well documented in the past.

The majority of our state would prefer to opt out. Deal with it!

Michael LoBurgio 5 years, 11 months ago

KanCare is looking like another DMV disaster-to-be

Kansas is in the same rushed time frame as Kentucky. Here it is in the summer, and Kansas just picked its three managed care organizations.

Also, according to Anna Lambertson, executive director of the Kansas Health Consumer Coalition, “We don’t have a clear picture of what the legislative oversight is going to look like, or if there’s even going to be any.”

Of course, there should be legislative oversight. To leave this to officials working for Gov. Sam Brownback is asking for trouble. Who will represent the 380,000 citizens on KanCare, if not their legislators?

So much can go wrong.

Just ask the auditor in Kentucky.

He told KHI news service, right after the managed care plan went into effect, he started getting phone calls from patients who were “frustrated, because they couldn’t get in to see the doctors they were used to seeing.”

Then, he said, “I started hearing from providers who’d gone 90 days without being paid.”

Read more here:

Michael LoBurgio 5 years, 11 months ago

Privatizing public services always - ALWAYS - costs more for worse service. And in Kentucky it's destroying jobs by killing small businesses.

Kentucky legislators are threatening to subpoena three managed care companies after the state's 550 small pharmacies complained that they're being pushed out of business by the companies' low Medicaid reimbursements. Sen. Jimmy Higdon, a Lebanon Republican and co-chairman of the House-Senate Program Review Committee, said the panel has sent letters inviting officials from three managed care companies to appear at a meeting Feb. 13 to answer questions. If the committee doesn't get the information it wants, it is prepared to subpoena the companies to get it, he said.

"This is a drastic measure (issuing subpoenas), but they are putting our independent pharmacists out of business," Higdon said. "You can't sell things for less than they cost and stay in business."


The situation is bad enough that the Kentucky Medical Association says some doctors have discussed taking out short-term loans to offset delays in claims reimbursement from the companies.

Independent pharmacists have been among the most vocal critics because of the complicated pricing formula the managed care industry uses to pay for prescription drugs.

"This has hurt a lot of Main Street pharmacies," said Rosemary Smith, who operates eight Eastern Kentucky pharmacies with her husband, Luther. "We are the fabric of the economy in these small communities, and they are killing us."

The managed care system was implemented Nov. 1 by Gov. Steve Beshear's administration as a cost-saving measure.

Michele Dillon 5 years, 11 months ago

The money the Federal government is saving by investigating and stopping the trillons of dollars that are wasted on Medicare fraud. Part of the Affordable care act is setting up a better system to deal with the Fraud issue and has already been paid back millions of dollars.

The Affordable Care Act has also required wellness and preventative programs through Medicare saving millons of dollars. Now, those on Medicare don't have to wait until they are really sick to go the doctor.

Those who bilk the system have their cable, their internet and cell phones but the client I work with do not. These are the Senior Citizens who have paid into the system and deserve some help. I have helped them get cells phones so they have some way of communicating and helped them pay their electric bills. I have clients who won't turn on their air conditioning in the 100 degree heat because it costs too much and they have to bu their medicine. They are the ones who will benefit from increasing the poverty level. I am sick and tired of people using the abusers of the system as examples of how everyone is. Let's focus on punishing them with frauding the government like we do the big spenders.

I, for one, am tired of using my tax dollars to pay for the use of the emergency room because someone doesn't have insurance to go to the doctor. The Affordable Health CAre Act is a good plan if anyone actually reads it instead of listening to the hype. Our Governor would be happy corralling all the poor and sticking them on an island to fend for themselves.

deec 5 years, 11 months ago

You do realize that nearly all medicaid and medicare fraud is done by providers, not patients?

KS 5 years, 11 months ago

I would tend to agree on Medicare, but with the HCBS and Independent Living programs via Medicaid, you are soooo wrong. That is exactly why SRS was split up and those programs were placed under KDOA. They are a no nonsense agency.

Jayhawk1958 5 years, 11 months ago

Good for you because the low-income don't have the "cash" to pay it and get the reduction.

jafs 5 years, 11 months ago

Guess who's making up that lost income for those hospitals?

jafs 5 years, 11 months ago

Well, at least you're honest about your belief in brutal social Darwinism.

I'm willing to bet that they don't spend 50-60% of the cost on paperwork, and are losing money on you compared with other patients.

Keith 5 years, 11 months ago

We've heard of it, we just see no evidence of it in your posts.

paulveer 5 years, 11 months ago

Actually, I'm surprised FHNC believes in evolution, but he should be thankful that he lives in a society that protects our weak and less fortunate from its brutal results, as evidenced by the fact that he has survived thus far.

just_another_bozo_on_this_bus 5 years, 11 months ago

Eliminating medicaid, and eventually medicare, is the Tea Party/Kochistan method of rationing healthcare-- if you're not wealthy, you won't take up valuable space at hospitals and clinics that can be better used for the People Who Really Matter-- the 1%. And, ironically, that does not include the average Tea Partier.

camper 5 years, 11 months ago

Eliminating Medicare is a Tea Party goal? Yes, but only after the baby boomers are gone....I suspect.

Kevin Haislip 5 years, 11 months ago

your as cold as ice. you must have no loved ones.

booyalab 5 years, 11 months ago

Even if you like the idea of Medicaid, you probably wouldn't if you knew about the studies, even controlling for cultural and socioeconomic factors, that show how awful it is.

-Uninsured patients are 25% less likely to die in a hospital visit than Medicaid patients

-After angioplasty, Medicaid patients are more than twice as likely to have a major heart attack as are patients who have no health insurance.

-They are 8.1% less likely to survive a decade after a lung transplant for pulmonary disease than both privately insured and uninsured patients. The status of Medicaid insurance can significantly predict death after three years...even controlling for additional medical factors that could increase a bad outcome.

Medicaid sucks.

chootspa 5 years, 11 months ago

Correlation does not imply causation.

cowboy 5 years, 11 months ago

Health insurance should be a non profit entity period. Solves a lot of problems right out of the gate.

For those ill informed , uninsured are not unemployed bums. Once you are tagged a "pre existing " you are pretty well screwed. Kansas high risk pool , $1000 a month.

Flap Doodle 5 years, 11 months ago

What is the next industry you want the government to eliminate?

camper 5 years, 11 months ago

Financial derivatives and bundled mortgages.

camper 5 years, 11 months ago

Medicaid expansion for families of four and household income less than $30,000. I know many people that are in this group. I see that they work hard at their jobs. It would bother me to see that they and their kids do not have adequate care or our legislators elect not to include them.

Interesting also, the Brownback administration just awarded contracts to three private insurance to administer Kansas Medicaid. This will be a good "test" TO see if they are interested in Kansas people in addition to insurance companies.

weeslicket 5 years, 11 months ago

oddly enough, fhnc suggests the reading of some more novels by mr. charles dickens. another poster has already suggested melvile's great white whale of a tale. thank you falsehopenochange for suggesting more reading.

cowboy 5 years, 11 months ago

Wheres an ignore button when ya need one , sigh !

paulveer 5 years, 11 months ago

FHNC still hasn't realized that he wouldn't still exist if we didn't protect the weak and damaged among us.

Katara 5 years, 11 months ago

You obviously missed the point.

You stated "They are all covered under the Kansas CHIP Law even if their parents are not covered because they don't qualify based on income."

They are not all covered under the Kansas CHIP law. There are income restrictions. You also neglected to read about the other restrictions to obtaining this insurance for children.

But if you are going to assume that the reason that folks can't afford health insurance is simply because they are not living within their means, I don't expect you to be able to understand that there are other reasons that people would qualify for CHIP with income @ the maximum of 232% of the federal poverty line.

Phone_Man 5 years, 11 months ago

I’m 42, I did not go to college, was married at 19 and had a child at the age of 21. I have never been without health insurance. Why? I always had a job which provided it. I NEVER EVER entertained the thought of looking for employment someplace where health insurance was not a benefit. Many times it meant working a job most people would look down on me for or I had to take less money. Who cares, my family always had insurance and I never had a government handout.

paulveer 5 years, 11 months ago

So you're saying that you took jobs beneath your skills and your family was denied the benefits of higher wages because health care was not more universally available? And the government provides many things for those that proudly say they never had a government handout: Roads, schools, social security, police and army protection, subsidies for most large business, dependent and child care deductions on taxes, and much more.

scaramouchepart2 5 years, 11 months ago

Problem is benefits are becoming a thing of the past. What are you going to do when your retired early and there are no benefit providing jobs at your age.

Centerville 5 years, 11 months ago

The feds will run the exchanges. They are trying to get 50 little Vichys to cover for them.

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