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Screen Shot 2014-04-14 at 4.17.51 PMThe Congressional Budget Office (CBO) released the fourth year report on projections of the cost of the Affordable Care Act.  The news is good and consistent with the trend over the previous four years: CBO now projects $104 billion less in costs under the Act than it did last year.  The reduction in costs is due to a variety of factors but two big ones stand out.  First, plans being offered under the health exchanges have significantly lower premiums that were originally anticipated, largely a result of narrower networks of providers and tighter management of health care in the plans – a trade-off that has resulted in big savings.  Second, all health costs – both in government programs like Medicare and Medicaid and in the private sector – are projected to grow  more slowly than just last year.  The CBO points out that this is becoming a trend:

A notable influence is the substantial downward revision to projected health care costs both for the federal government and for the private sector. For example, since early 2010, CBO and JCT have revised downward their projections of insurance premiums for policies purchased through the exchanges in 2016 by roughly 15 percent, and CBO has revised downward its projection of total Medicaid spending per beneficiary in 2016 by roughly half that percentage.

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imageA popular theme on the Right is that having Medicaid health coverage is worse than having no health insurance at all.  After all the years I’ve spent traveling North Carolina and meeting people in poverty desperate for basic health care but with no way to pay for coverage I still can’t believe people can make this argument with a straight face.  Well, if you read one thing this weekend, read the incredibly moving story of the hardworking mom in Orlando, Florida who would have qualified for Medicaid but hasn’t because Florida, like NC, has refused to expand Medicaid.  She dropped dead – on a sales call for her vacuum cleaner sales job no less – of an existing heart condition she couldn’t adequately treat because she couldn’t adequately pay for coverage.

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Andrew Brod, senior research fellow in UNC Greensboro’s Center for Business and Economic Research, has a great column in the Charlotte Business Journal this week making the strong business case for why NC should accept the billions of federal dollars now available to expand Medicaid.  His reasons are wide ranging from more jobs to avoidance of business tax penalties and even lower rates of personal bankruptcies. Reasons like these are why many conservative states are now moving to close the Medicaid coverage gap – let’s hope NC can be as smart. Read Brod courtesy of the Charlotte Business Journal:

 

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I just found this amusing. Remember last month as Governor McCrory’s administration put forward its plans for reforming NC’s Medicaid program with much fanfare?  It was all about “Accountable Care Organizations” or “ACOs” – basically just a different and – possibly – more efficient and effective way to pay doctors and hospitals for delivering care.  ACOs represent incremental, cautious and responsible Medicaid reform. This is much better than selling off our Medicaid program to out-of-state insurance companies, a policy advocated by many ultra-conservatives in our General Assembly, which might give you an idea of how McCrory’s plan is being received.

Anyway, I was at the federal Centers for Medicare and Medicaid Services (the main part of the federal Department of Health and Human Services) website yesterday and what were they highlighting?  The role of Accountable Care Organizations in the implementation of the Affordable Care Act.  Glad to see that McCrory is embracing at least some of the ACA – now, if he could just explain to us how is he going to expand Medicaid and close the NC coverage gap.

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Chris Conover — the expert called by the NC General Assembly this month as the main witness for the anti-Affordable Care Act committee (convened for some reason four years after passage of the health law) — had  other digs in his presentation that betrayed his bias besides his quips about the “Abominable Care Act” and his denunciation of President Obama as a fascist last month.  This one was a jibe at Sandra Fluke, the lawyer who gained notice as a law student a couple years ago for saying the ACA should cover birth control for women – a truly radical concept for Conover and a few others it seems.  Why Conover should feel the need to bring up Fluke who is recently married,  lives in the Santa Monica, CA area, and is now running for a state senate seat there 3,000 miles away from Raleigh is anyone’s guess although, given the nature of his presentation, it likely was just one more hot button to push: