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RWJA new report from Manatt Health Solutions on behalf of the Robert Wood Johnson Foundation finds that states that have tapped federal funds to expand Medicaid are seeing significant financial benefits. By the end of 2015 the savings and revenues across the eight states examined in the report are expected to exceed $1.8 billion.

This is consistent with the county level examination of expansion in North Carolina commissioned by the Cone Health Foundation and the Kate B. Reynolds Charitable Trust. That study, using conservative estimates, found that the savings and revenues more than offset the costs of expansion through 2020.

The states featured in the report — Arkansas, Colorado, Kentucky, Michigan, New Mexico, Oregon, Washington, and West Virginia — had direct budget savings from reduced spending on the uninsured, they experienced increased tax revenue from the new flow of federal funds into the state, and they realized additional savings from switching some existing Medicaid patients into the expansion program.

A source of significant savings, for example, comes from pregnant women. North Carolina has traditionally covered pregnant women in Medicaid up to 185 percent of the federal poverty level. This coverage, however, is only for pregnancy related services. Also, once a woman has the baby she oftentimes loses Medicaid because coverage for parents is quite stingy.

After expansion, pregnant women above 133 percent of federal poverty level would qualify for full Medicaid coverage. And, instead of the lower match rate, the federal government would pay 90 percent of the costs for these women. Once the baby is born many women would then be able to continue coverage through Medicaid. This would result in healthier babies, healthier parents, and major savings for the state.

The report notes that states will also garner savings in behavioral health and among the medically needy population.

States that opted to expand Medicaid early will have the largest benefits, but there are still plenty of positives for states like North Carolina that haven’t hit the leader board yet. The final year for the federal government to pay the full cost of expansion is 2016 so we need to act fast or our people, and our economy, will miss out on a much needed boost.

Commentary

The beneficial impacts of Obamacare continue add up, but unfortunately, North Carolina isn’t getting its fair share. That’s that’s one of the takeaways from a new report distributed yesterday on the fifth anniversary of the law. As health policy expert Tara Culp Ressler of Think Progress reports:

“According to a new report from the Department of Health and Human Services (HHS), hospitals saved at least $7.4 billion last year, thanks in large part to reforms under Obamacare. The savings reflect a reduction in the so-called “uncompensated care” that hospitals provide to uninsured Americans, and are even greater than HHS officials predicted they would be at the beginning of this year.

Since people without insurance typically don’t have any means to cover their medical bills, the cost of their treatment ends up falling on the hospital itself. Therefore, as more people gain coverage, it become less expensive for hospitals to care for their patients. More than 16 million previously uninsured Americans have gotten covered under Obamacare, contributing to the biggest drop in the national uninsurance rate over the past four decades.”

If states like North Carolina had gotten on board with closing the Medicaid gap, things would be even better:

“The savings have been most pronounced in the states that agreed to accept Obamacare’s optional Medicaid expansion, which seeks to extend public insurance to additional low-income people. Nearly 70 percent of the savings documented in the HHS report — a total of $5 billion — occurred in the 29 states that have expanded Medicaid. And, if every state had agreed to add more people to their Medicaid rolls, their hospitals could have saved an extra $1.4 billion.”

In other words, here’s more confirmation that,  in addition to helping hundreds of thousands of working people in need, Medicaid expansion would do wonders for some of the most important businesses in North Carolina (especially in rural North Carolina) hospitals. It’s hard to imagine that state leaders can resist taking this obvious and long overdue step much longer.

Commentary

Health careHard numbers and real life stories documented the impact of the Affordable Care Act today at an event in Durham commemorating the law’s fifth anniversary. “The Impact of the Affordable Care Act on Women” was a roundtable discussion that featured knowledgeable women from throughout Triangle region.

Women experts and advocates from Duke Regional Hospital, Enroll America North Carolina, the Durham County Commission, and Wake and Franklin Health Services were among those attending the event sponsored by the office of Congressman G.K. Butterfield and the U.S. Department of Health and Human Services at the Community Health Coalition in Durham. Congressman Butterfield joined the discussion via telephone and issued a call to action to continue the effort to reduce the number of uninsured in North Carolina. According to Butterfield, “Like the Civil Rights Act, the ACA is critical to ending discrimination, especially for women.”

Millions of women, of course, benefited directly from the ACA’s bar on being denied insurance because of “preexisting conditions” as well as the provision of subsidies to make health care more affordable. Women are more likely to experience social conditions such as poverty that act as barriers to accessing and utilizing health care.

Region Four of administrator, Dr. Pamela Roshell and senior advisor Stephanie Owens from HHS also participated in the panel and shared that, despite the numerous misconceptions about and attacks on the ACA, data show that 14.1 adults and 2.3 million children have gained health insurance and can now access primary and wellness care as a result of its implementation. In North Carolina, 560,000 residents are now insured as a result of the ACA – 70,000 of these individuals in the Raleigh-Durham area. Dr. Roshell congratulated our state on its enrollment and how the numbers are sending the message the ACA is needed and is working.

The roundtable discussion proceeded Read More

Commentary

Tara Culp-Ressler at Think Progress has one very impressive list:

More than 16 million people have gained insurance.

According to the most recent data from the Obama administration, about 16.4 previously uninsured Americans have gotten coverage under the law, either by purchasing private plans on the new state-level marketplaces or by gaining public insurance through the Medicaid expansion. That translates to a 35 percent reduction in the national uninsured rate, which is the largest drop in the number of Americans going without health care over the past four decades.

You don’t have to take the Obama administration’s word for it. In addition to the federal government’s data, multiple outside surveys have confirmed dramatic drops in the uninsured rate thanks to Obamacare.

Health reform is costing less than expected.

Earlier this month, the Congressional Budget Office (CBO) announced that implementing Obamacare over the next ten years will cost $142 billion less than the nonpartisan agency had previously predicted. That represents an 11 percent reduction from an earlier CBO projection released at the beginning of this year — and stands in sharp contrast to Obamacare opponents’ dire predictions about how the law was going to cripple the economy.

CBO officials have repeatedly slashed their cost projections for the law, largely because of a historic slowdown in national health care spending over the past several years that’s resulted in slower premium growth. There are multiple factors contributing to the dramatic slowdown in annual medical costs, and it’s unclear exactly how big of a role the Affordable Care Act has played. But the cost saving provisions included in Obamacare certainly haven’t hurt.

Employers aren’t cutting their workers’ benefits. Read More

Commentary

Out-of-state activist J. Scott Moody will be making the rounds on Monday in North Carolina to say that expanding Medicaid will hurt our economy.

Moody is from a South Carolina outfit called State Budget Solutions and he travels the country speaking out against policies disfavored by conservatives. His schtick is releasing cut-and-paste reports showing the economic harm done by the programs he opposes.

For example, in 2012 he lit off to New Hampshire to warn that allowing same sex marriage in that state would result in economic devastation and a “demographic winter.” You have to read the entire news article of his visit to capture his arguments in all of their glory, but this is one of my favorite parts:

Also, according to Moody, when same-sex couples adopt, they place the child in a situation where one or both of their parents isn’t their biological parent. However, according to Moody, statistics have shown that a relationship with a stepparent is not the same as a relationship with a biological parent and stepparents tend to not have the same bond or pay the same attention as the biological parent. Moody did not provide charts or actual sources for this claim.

These days Moody is taking a break from attacking adoptive parents and is focusing on Medicaid expansion. Moody has made presentations in several states and published opinion pieces arguing that an expansion of the public sector will crowd out private sector spending. This analysis is about as sophisticated as his arguments that gay marriage will destroy the economy and that stepparents don’t pay attention to their children.

Actual economists have responded to Moody everywhere he has spoken to point out that he is wrong. A good example is from Dr. Sven Wilson at BYU when Moody visited Utah to warn them of the dangers of federal funds flowing to the state. Again, you should read the entire piece but here’s a taste of Wilson’s response:

Many economists argue that spending on Healthy Utah will further expand the economy by generating new jobs and new private spending as the money works its way through the economy. Economists call this effect a multiplier. As a conservative, free-market economist, I think multipliers are generally small. But no serious economist of any political stripe thinks the multiplier is negative, which is what Moody is suggesting.

Imagine someone saying that when tourists spend their money in our state, their purchases end up costing us jobs and hurting our economy. Who would believe that? But that is exactly the argument Moody is making about Healthy Utah.

Luckily, we already have a study on the economic impacts of Medicaid expansion in North Carolina using respected REMI models. That study concludes that expansion will grow our economy, create 43,000 jobs, and provide much needed revenue to county and state budgets. It will also provide affordable coverage to 500,000 North Carolinians and bolster rural health care in the state. States that have already expanded coverage, like Kentucky, are seeing these positive economic predictions realized.

We aren’t seeing the winter Moody predicted in 2012. Instead the economy keeps heating up despite gay marriage sweeping the nation. I suspect we will see similar results as more states expand insurance coverage.