Webster’s will be soon changing the definition of “free.” The new definition will read: “paid for by US taxpayers.” Medicaid is going to be the picture next to the definition. There are a number of enormous problems with ObamaCare, probably the biggest is its impact on Medicaid.
Medicaid is a program that has historically covered the poor, until ObamaCare it covered children under 6 and pregnant women whose family income was less than 133% of the federal poverty level and children 6-18 for families at 100% of the FPL. ObamaCare changed all that.
States that accepted the Medicaid expansion now have to cover everyone below 133% of the FPL. Everyone.
The Obama administration offered some cheese to the mouse in order to get the states to accept this suicide pact. The feds are paying (that means you) for 100% of the incremental cost of the new enrollees. Except that they’re going to phase down to 90% of the incremental cost by 2020.
In addition, there’s a group of people known as the “Medicaid woodwork” who aren’t included in the “Fed pays for it” deal. It turns out that the participation rate for people who are eligible for Medicaid is about 62%. As those who are eligible come into Medicaid, thanks to a huge advertising program, those costs are going to add to the state’s burden for health care cost. Right now the states pay for 57% of the Medicaid cost.
Oh, and there’s no “guarantee” that the feds are going to continue to pay up at 90% for the incremental people they are covering.
The Medicaid population is expanding by huge numbers. Just try and get those new medical welfare recipients off the rolls.
Then there’s the “doctor problem” illustrated by, where else, California.
The number of Medi-Cal patients has grown sharply, thanks to Obamacare, but the number of doctors willing to see them has not. In fact, the number of doctors in California willing to take Medi-Cal patients could drop once planned cuts to reimbursement rates kick in next year.
States will be cutting reimbursement rates to doctors in order to balance their budgets. Remember that most states have requirements to balance their state budgets.
Dr. Esteban Lovato is a longtime supporter of the Medi-Cal program. He told the Times that he currently gets about $42 to see each Medi-Cal patient. But next year when rates revert to Medi-Cal rates, including a ten percent cut included in next year’s budget, his reimbursement per patient could drop to $21. That would make it very difficult for him to continue to take Medi-Cal patients. It would also ensure that his colleagues in the medical profession would be less likely to start seeing them.
There’s another problem connected to the new Medi-Cal enrollees. The push to enroll people in Obamacare also brought hundreds of thousands of people who were previously eligible out of the woodwork. But unlike expanded Medicaid where the federal government pays the cost, in the case of people who were previously eligible, the state pays half the cost of their coverage. Governor Jerry Brown just added $1.2 billion to next year’s budget to cover the costs of the additional 800,000 Medi-Cal recipients who fall into this category.
That $1.2 billion is just the start. Just wait until the federal 90% target drops to, oh say, 47%. And, for states like California, if Obama/Boehner get their way on illegal aliens, they’ll get another three or four million Medi-Cal enrollees overnight. Don’t expect the feds to cover those either.
If you’d like to know where all this is going, just look at the VA Hospital scandal.
Either there will be backlogs of patients unable to make appointments because there are not enough doctors to see them, or the state will be forced to increase the amount doctors are reimbursed. In the former case, the patients will experience delayed care. In the latter, the taxpayers will be asked to come up with billions more to cover the cost.
About those Death Panels Democrats said were a lie…
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