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Aug 16
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Trump Signs Bill to Fund Veterans Medical Care Program

By News

Veterans to receive private medical care

President Donald Trump

President Donald Trump has signed an emergency spending bill that will pump more than $2 billion into a program that allows veterans to receive private medical care at government expense. Trump, who made improving veterans care a central campaign promise, signed the VA Choice and Quality Employment Act while at his New Jersey golf club on Saturday.

The bill, which addresses a budget shortfall at the Department of Veteran Affairs that threatened medical care for thousands of veterans, provides $2.1 billion to continue funding the Veterans Choice Program, which allows veterans to seek private care. Another $1.8 billion will go to core VA health programs, including 28 leases for new VA medical facilities.

Why the new Veteran program?

The Choice program was put in place after a 2014 wait-time scandal that was discovered at the Phoenix VA hospital and spread throughout the country. Veterans waited weeks or months for appointments while phony records covered up the lengthy waits. The program allows veterans to receive care from outside doctors if they must wait at least 30 days for an appointment or drive more than 40 miles to a VA facility.

VA Secretary David Shulkin has warned that without legislative action, the Choice program would run out of money by mid-August, causing delays in health care for thousands of veterans. The bill will extend the program for six months. Costs will be paid for by trimming pensions for some Medicaid-eligible veterans and collecting fees for housing loans.

Veterans Benefits

Veterans benefits are questions that all people who have served should seek the information to fully understand their options. Many who have served, while having the option to receive benefits in established Veterans hospitals and facilities, often choose to participate in private facilities. Veterans needing skilled nursing care have the option of receiving the care inside the VA hospital program, or, as with any private citizen, can qualify for Medicaid to pay for those medical needs. Speaking to a person who is certified in VA planning is a critical step in understanding what option is right for you or your loved one.
Source: ABC News

Mar 22
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Estimate: $595 million over five years to keep Medicaid coverage for Rhode Islanders

By Uncategorized

Impact of Proposed Changes To Medicaid Program

PROVIDENCE, R.I. — Rhode Island officials estimate it would cost the state $595 million more over five years to prevent 75,000 low-income adults from losing their Medicaid coverage under the House Republicans’ plan to overhaul healthcare. And that’s just for the adults without children who became newly eligible for coverage in 2014 under the Affordable Care Act. Medicaid insures close to 300,000 Rhode Islanders, or nearly one-third of the population. “It’s hard to Fathom that Rhode Island could make up for the funding losses that we’d have here,” Anya Rader Wallack, acting secretary of Health and Human Services, said during a media briefing Wednesday morning. “And that’s just roll back of the expansion.”

The total cost to Rhode Island of the GOP plan’s proposal to cap federal spending on Medicaid has not been calculated by the state. But the Urban Institute, a Washington-based think tank, reports that Rhode Island is among 10 states that would experience the steepest declines in Medicaid spending under the plan.

Rhode Island is among 31 states, along with the District of Columbia, that adopted the federal law’s expanded eligibility criteria for Medicaid. In Rhode Island, that meant low-income adults who are not disabled and have no dependent children. Their coverage currently costs $450 million — or one-fifth of the state’s $2.3-billion Medicaid program.

Under the GOP plan, state officials estimate it would an additional $9 million more than 70,000 adults in the Medicaid expansion population from losing insurance during the first year of program — and another $220 million for their coverage during the program’s fifth year.

(The Medicaid expansion population, currently at about 70,000, is expected to rise by year five to about 75,000.)

Rhode Island’s expansion of Medicaid, coupled with another 30,000 people who don’t have coverage through their employers and instead purchase insurance through the state exchange, have helped cut Rhode Island’s uninsured rate by nearly a third, to about 4 percent from close to 12 percent prior to Obamacare.

If the state is forced to scale back its Medicaid coverage and if people are no longer penalized for not having coverage, as they are under Obamacare, and go without insurance, hospitals — which accepted lower state reimbursement rates in anticipation of fewer uninsured patients — would be hit with higher costs for uncompensated care.

“There’s a good bet hospitals will be destabilized,” Radar Walleck said.

The 30,000 Rhode Islanders who buy coverage through HealthSource RI, state officials said, also are expected to pay more under the GOP plan.

Close to 90 percent of enrollees on the state exchange receive tax credits, which pay for about 70 percent of the monthly premiums. The Obamacare tax credits are based on income as well as age.

The average premium on the state exchange is about $458 per month — of which $247 per month is paid for through tax credits — so that the cost to the enrollee is $111 per month, according to HealthSource RI’s spokeswoman, Kyrie Perry.

The GOP plan provides age-based tax credits, which range from $2,000 for anyone under age 30 to $4,000 for people over age 60.

Under that plan, the individual premium costs on the exchange are projected to increase, on average, by 15 to 20 percent in 2018 and 2019, according to HealthSourceRI. They are expected to level out after 2019.

For the benchmark “Silver” plan, that amounts to about $1,700 less, on average, in tax credits and another $2,000 more in premiums, Zach Sherman, director of HealthSourceRI said.

“There are definitely winners and losers” under the age-based tax credits, Sherman said. “It will results in older folks having trouble affording coverage.”

larditi@providencejournal.com

(401)277-7335

On Twitter: @LynnArditi

Source: Estimate: $595 million over five years to keep Medicaid coverage for Rhode Islanders

Nov 23
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Bloomberg Editorial: How Trump Can Help Medicaid

By Uncategorized

President-elect Donald Trump has already stepped back from his campaign pledge to entirely repeal Obamacare, saying he’ll keep a couple of the law’s popular insurance protections. Soon enough, certain governors in his own party can be expected to argue that it would also be smart to retain the law’s most successful component: the expansion of Medicaid. Trump should take that advice.

Thirty-one states — 11 led by Republicans — have accepted Obamacare funding to extend Medicaid to anyone earning less than 138 percent of the federal poverty line (about $16,400 for an individual). As a result, at least 10 million Americans have insurance who would lose it without the expansion.donald-trump

Most of these beneficiaries say they’re satisfied with the coverage. And their governors — including Vice President-elect Mike Pence of Indiana — have credited the expansion with encouraging preventive care, cutting emergency-room visits and saving money on health care. What’s more, the Medicaid expansion has succeeded without discouraging employment, as some people worried it might.

Whatever the problems with other parts of Obamacare (chiefly, rising premiums in the state insurance exchanges), Medicaid expansion has worked. Rolling it back now would hurt state budgets, the health-care industry and, most of all, the newly insured.

That isn’t to say Republicans shouldn’t make changes. Many governors already have, with permission from the Obama administration. In Indiana, for example, beneficiaries are required to pay into health savings accounts. The Trump administration will be able to allow other innovations.

Ideally, Trump’s Medicaid officials will resist modifications that make it unduly difficult for qualified people to become insured. Requirements that beneficiaries have jobs, for example, or that they shoulder unaffordable copayments would undermine the purpose of the expansion. More counterproductive still would be for Congress to drastically reduce Medicaid’s funding, as some congressional Republicans have proposed. Far better to let the individual states continue to tailor their operations as need be.

At this point, Medicaid provides insurance to about one in four Americans. With the rest of the Affordable Care Act under threat of drastic change, it’s essential to keep this pillar of health security in place, and even work to persuade the remaining states to accept it.

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