Health and Poverty News
"Wyoming began discussions with the federal government this summer about crafting a plan for Medicaid expansion. As voters look toward the Nov. 4 general election, candidates for governor have staked out positions on the issue. Democrat Pete Gosar and Libertarian Dee Cozzens say they would expand Medicaid. Incumbent Gov. Matt Mead, a Republican, says he is committed only to looking at options that take into consideration Wyoming's specific needs. Independent Don Wills stands opposed. Whether Wyoming joins the growing list of states that have expanded Medicaid depends in part on the outcome of this election. At last count, some 28 states have accepted expansion; 21 states are not moving forward with the program."
"Twenty-nine of 50 eligible schools in Vermont have chosen to participate in this program, according to the governor's office. The program is part of the federal Healthy Hunger-Free Kids Act of 2010, Concannon said. The 'Community Eligibility Provision' of that law has already been introduced in several states but this year opened to all 50 states. Schools qualify if they have a high number of children whose family income is 185 percent or less of the federal poverty level (for a family of four that means $23,850) and if they have a high percentage of children whose family income has been verified through another state or federal program, such as ReachUp or food stamps, Concannon said."
"And according to RurAL CAP, recent Medicaid billing changes have led to a crippling budget shortage that could reduce local housing options even further. The issue surfaced earlier this month at an Anchorage Assembly committee meeting addressing drug and alcohol abuse among the municipality’s chronically homeless. Bill Evans, the committee's chairman, said the group planned to gather information from various sources before making a final policy recommendation to the full Assembly. "
"Child-welfare and food-assistance organizations said the food-insecure data translate to more than 650,000 Ohio children. The foodbanks association is asking for $20 million a year in the state's next biennial budget to boost its work in all 88 counties. Under the current budget, the association receives $14.5 million a year."
"One small area of agreement in the health-care field is that no group is harder to help than patients who are homeless. That is true for a variety of easy-to-understand reasons: They move around a lot, their lives are less sanitary than that of someone with a home, they often don't eat properly, they often lack health insurance."
"Rather than simply expanding Medicaid - a program that sometimes essentially denies care to the poor because doctors avoid its low reimbursement rates - Corbett sought to reform it. Corbett's program seeks to provide coverage to an estimated 600,000 additional Pennsylvanians by offering them federal subsidies to purchase private insurance. This will reduce disruption for those whose incomes rise enough to no longer qualify for the program and likely provide better coverage overall."
“The relentless economics of the U.S. health care system have sapped resources in poor areas for decades as hospitals and doctors follow the money in the form of well-insured patients. Doctors and medical care facilities serving large numbers of poor patients have trouble staying afloat because uninsured patients and those on Medicaid are expensive.”
“Yet while SSI expenditures may now exceed those for welfare, the real problem is the devastating changes in welfare that leave many poor children and families without sufficient income to assure basic food, shelter, and clothing. Eligibility for welfare is a complex calculation in Massachusetts. For a family of four, yearly income must generally fall below $12,000. Families who do receive welfare have not had an increase in the cash payment support since 2000, and the current payment is only about $24,000 for a family of four — certainly not enough to provide food and clothing for a family, much less adequate housing.”
“If the 23 states that have rejected expanding Medicaid under the 2010 health-care law continue to do so for the next eight years, they'll pay $152 billion to extend the program in other states -- while receiving nothing in return. This exodus of federal tax dollars from 2013 through 2022 would pay 37 percent of the cost to expand Medicaid in the 27 remaining states and Washington, D.C., over that time. Most of the money, nearly $88 billion, would come from taxpayers in just five non-expansion states: Texas, Florida, North Carolina, Georgia and Virginia.”
"Some Missouri Republicans say they're willing to expand Medicaid - provided that new recipients look for jobs as a condition of eligibility. But a new agreement between the federal government and Pennsylvania suggests that strategy probably won't work. Pennsylvania's plan to provide coverage to as many as 600,000 low-income residents was approved last week, but only after its work-search requirement was dropped after stiff resistance from the federal government"
"Transportation tied in with one of the other main topics discussed at the meeting, the expansion of Medicaid in the state. Medicaid funds can be used as match money for new vehicle and operational costs, Seurer said. Perhaps not surprisingly, Democrats and Republicans debated the pros and cons of Medicaid expansion. Earlier this year, the Legislature voted along party lines not to expand Medicaid benefits to more low-income residents."
"Georgia has opted out of expanding Medicaid under Obamacare, aiming to avoid increased costs. On top of that, at the close of this year’s legislative session Gov. Nathan Deal signed a bill making sure Medicaid cannot be expanded in Georgia without approval by the legislature. HB 990 bars any expansion of Medicaid eligibility 'through an increase in the income threshold without prior legislative approval.' The law specifies the approval must be by a legislative act or joint resolution of the General Assembly. Maybe this is a hedge against the possibility of pro-Medicaid expansion Democratic nominee for governor Jason Carter winning in November? Carter, trailing Deal, is trying to make Medicaid a key issue in the race."
"It turns out that the Republican-led General Assembly did give a substantial tax break to people other than the rich. The problem is that the relief went to people in other states. A McClatchy Newspapers analysis shows that the legislature’s refusal to expand Medicaid means that North Carolina taxpayers could spend more than $10 billion by 2022 to provide medical care for low-income residents of other states. For its largess, North Carolina will get nothing."
"MaineCare, the state’s Medicaid program, has an annual budget within the DHHS of roughly $2.4 billion a year, Mayhew told the Rotarians. She added that at the start of his administration, Governor Paul LePage requested more than $200 million to stabilize the foundation of the program. In Fiscal Year 2014, she said, there was zero-percent growth in MaineCare spending as the DHHS seeks to identify deficiencies and provide services to those who need it most — namely, seniors and individuals with disabilities."
"From 2013 to 2015, the new report says, federal spending on Medicaid will increase 27 percent to $323 billion, from $254 billion. In those years, it said, Medicaid spending by state and local governments will rise 12 percent to $218 billion, from $195 billion. The federal government will initially pay all the costs resulting from the expansion of Medicaid eligibility in states that choose to cover certain childless adults with low incomes. States will have to pay some of the cost for new beneficiaries who could have qualified for Medicaid under old eligibility rules."
“Americans are eating better — filling up on more heart-healthy whole grains, fruits and vegetables than they were a decade ago. On an index of healthy eating in which 110 is a perfect score, U.S. adults averaged 40 points in 2000 but climbed to 47 points in 2010, according to a 12-year Harvard study. For low-income, adults, however, the score has barely budged. They averaged almost four points lower than high-income adults, putting them at higher risk for obesity and chronic illnesses like heart disease and diabetes. Researchers call the ‘diet gap’ disconcerting and predict that it will ‘have important public health implications,’ according to study co-author Dr. Frank Hu.”
“North Carolina taxpayers could spend more than $10 billion by 2022 to provide medical care for low-income residents of other states while getting nothing in return, a McClatchy Newspapers analysis shows. The Affordable Care Act tried to expand Medicaid to millions of low-income, uninsured adults. But many Republican-led states, including both Carolinas, opted out of the plan championed by President Barack Obama. If the 23 states still rejecting Medicaid expansion stick with that decision, they'll contribute $152 billion over 10 years to states that take the federal money, the analysis shows. North Carolina would be one of the top five contributors.”
“With the long-awaited deal to expand Medicaid finally struck last week between Pennsylvania and the Obama administration, 27 states and the District of Columbia have adopted a key coverage plank of the Affordable Care Act. And the momentum continues to grow in Republican-led states as Tennessee and several others look to expand coverage to low-income residents in 2015. Indiana has an expansion plan pending with the Centers for Medicare & Medicaid Services.”
“We've watched food stamps pull millions of Americans out of deep poverty; improve the health and nutrition of children, veterans and seniors; and boost the economies of urban and rural areas. When we moved from actual stamps to electronic cards, the process became more efficient and less stigmatized, which resulted in more low-income working families participating, with a low fraud rate that is the envy of other programs.”
"As attorney general and now as governor, Gov. Tom Corbett has continually fought against Obamacare. That's why, when states were given the choice to expand Medicaid, an entitlement program, he said no. Expansion would have put 1 in 4 Pennsylvanians on public welfare, which is simply not sustainable for our taxpayers. Obamacare has significantly increased government bureaucracy and served only to drive up costs for families and small businesses. There is a better way to achieve true health care reform for Pennsylvania, and Pennsylvanians deserve more than a Washington, D.C., one-size-fits-all approach. Healthy Pennsylvania is an innovative, Pennsylvania-specific plan to reform Medicaid, protect taxpayers and increase access to quality, affordable health care on the private, commercial market."
“When hundreds of desperate dental patients converge on the Charlotte Convention Center next week, it will be a testament to civic generosity and systemic failure.
Over the past decade, North Carolina’s Missions of Mercy program has become one of the nation’s largest providers of free mobile dental clinics. The work is done by dentists and support staff working without pay, aided by community volunteers and donors. People in pain stand in line for hours or even days, grateful for help they can’t otherwise afford. But dentists say the demand for free emergency clinics signals the state’s failure to develop a network of affordable dental care that would avert much of the damage that sends people here. So far the Affordable Care Act has made little difference, several dentists say.”
“Florida's dental care crisis is a long-standing problem, earning the state a failing grade from a national foundation that looks at how well states provide dental care for children. Less than 15 percent of dentists accept Medicaid, the federal insurance program for the poor, notorious for its low reimbursement rates and high paperwork. In 2011, less than a quarter of Florida's children on Medicaid saw a dentist. Last year, Florida shifted all Medicaid dental patients into managed care, a move that state officials said would save money so dentists could get better rates. But that hasn't happened so far, said Dr. Richard Stevenson, president of the Florida Dental Association.”
“Last year Idaho lawmakers wisely decided that our state should roll up its sleeves and build its own health insurance exchange rather than defer to the federal exchange. The staterun marketplace has forced insurance companies to compete in a fair way and given 76,000 Idahoans access to affordable coverage. Many received tax credits to help pay for their premiums. Unfortunately, some Idahoans were left out. When they shop for coverage through the exchange, they learn that their incomes are "too low" for them to qualify for help. Meanwhile those with slightly higher incomes receive help with their premiums. Approximately 70,000 Idahoans fall into the "coverage gap." They earn too little to qualify for discounted coverage, but earn too much to qualify for traditional Medicaid.”
“But what's now called the Supplemental Nutrition Assistance Program (SNAP), now employed through electronic benefit transfer (EBT) cards instead of the stamps it started with, is also rife with abuse. Benefits, transferred to EBT cards, are supposed to be used only for healthy foods such as bread, cereal, fruits, vegetables, meat and dairy products, according to the United State Department of Agriculture. Supposedly verboten are hot food, pet food, soap, household supplies, beer, cigarettes and wine. But SNAP historically has not been good at enforcing its own rules. Thus, as enrollment in SNAP rose from 26 million Americans (one in 12) in 2007 to nearly 47 million (one in seven) in 2012, abuse of the program in an increasingly technological world did not abate.”
“Medicaid expansion is nothing new in the commonwealth. The General Assembly has been expanding Medicaid almost every year for decades. What has resulted is an unsustainable Medicaid program that consumes over 20 percent of our state budget, an amount that continues to grow. Studies show that the cost to Virginia taxpayers for low-income, uninsured Virginians not only includes over $1.2 billion in the past decade, but is also responsible for up to 10 percent of their health insurance premiums. Continuing with our current Medicaid system is no longer an option. Further expansion doesn't make sense. What is needed is reform. Everything from the expectations of those in the system, to how services are delivered, to creating a path off Medicaid, needs to be addressed and reformed.”