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Medicaid expansionIn case you missed it, the best editorial of the weekend dealt with the most important failure of North Carolina’s political leadership in recent years. The essay in Raleigh’s News & Observer was entitled:

NC losing funding and savings with Medicaid holdout: By balking on Medicaid expansion, N.C. forgoes billions of dollars and a chance to cut costs.”

As the editorial noted:

“In medicine, the small things can matter most. And it is the neglect of the small things that can lead to the biggest costs.

That’s why preventative care is so important and early intervention so significant. And that’s why North Carolina’s stubborn refusal to expand Medicaid is so wildly irresponsible and hugely expensive. As a result of its intransigence, the Republican-led General Assembly is struggling to find tax revenue on one end and turning away billions of dollars on the other.”

The piece goes on to explain how North Carolina’s award-winning nonprofit Medicaid manager, Community Care NC, is saving millions upon millions of dollars and thousands of lives already and to lament the toll in both categories that is being taken by the state leadership’s pigheaded refusal to close the Medicaid gap for hundreds of thousands of lower-income, working people. It also cites report which holds up the astounding amount in federal funds the state is foregoing:

“The report estimates that forgoing federal Medicaid expansion from 2013 to 2022 will cost North Carolina $39.6 billion. In addition, the state’s hospitals will lose out on $11.3 billion in federal funds intended to offset cuts in their Medicare and Medicaid reimbursements as required under the Affordable Care Act, which anticipated that all states would expand Medicaid.

That’s more than $50 billion in federal funding forgone over 10 years. Meanwhile, the state would have to spend about $3 billion for its share of expansion. That is a mindboggling deal to refuse so that conservatives can express their pique over ‘Obamacare.’

Republican leaders say they’re worried about being saddled with a higher entitlement cost if the federal government reneges on its promise to pay its full share, but the design and history of Medicaid do does not support that concern. Meanwhile, there are billions of reasons to expand Medicaid now.”

Amen. Read the entire editorial by clicking here.

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

News
SCOTUS Sketch

(Supreme Court sketch: Art Lien)

The U.S. Supreme Court gets a second shot at the Affordable Care Act this morning, with arguments set to start any minute in King v. Burwell.

If you were hoping to catch the arguments via live stream, well, you can’t. That’s because the nation’s highest court still does not allow cameras in the courtroom.

A number of open government organizations are taking advantage of the public interest in this case to make their case for the need of live coverage there, via the public announcement below.

In the meantime, some media outlets will be having reporters shuttling in and out of the courtroom with reports on the questioning and we’ll be posting some of those here as we see them.

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Justice Ruth Bader Ginsburg asking about standing of challengers to sue, per Wall Street Journal live blog:

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Here’s the mid-argument update from SCOTUSblog:

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Justices move from standing to questions about reading the statute literally — as challengers ask — and the problems with that.  More from SCOTUSblog:

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From Election Law Blog’s Rick Hasen:

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Here’s what Justice Anthony Kennedy was asking, per SCOTUSblog update:

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Questioning going overtime:

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Plenty of questioning on the merits means likely no ruling based upon lack of standing, says SCOTUSblog:

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Justice Kennedy pushed government lawyer Michael Carvin, asking if “pressuring” states into creating their own exchanges is problematic. His response, per WSJ:

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Justices Elena Kagan and Sonia Sotomayor jump in, per WSJ:

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Questioning of the Solicitor General, arguing in favor of the reading that subsidies were availalbe under either exchange, wasn’t much easier. Per SCOTUSblog:

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Arguments have ended.  Here’s a few post-game predictions from legal experts and court watchers:

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