Efforts To Close The Coverage Gap Inch Forward With Brighter Days Likely Coming

Despite the health, economic and fiscal benefits of closing the coverage gap for people who fall between state Medicaid eligibility levels and eligibility for subsidized Exchange coverage, 2016 has been a tough year to get new states to take advantage of federal funding with efforts coming up short in Idaho, Nebraska and South Dakota (so far, though there is still hope for later in the year). But support for closing the gap remains strong with important votes taking place in New Hampshire and Arkansas to continue their expanded Medicaid programs and an important procedural milestone occurring in Louisiana, where the House has taken steps to approve the financing needed to make  the expansion recently approved by Governor Edwards successful.

The logic of refusing federal funds is purely political and the costs of refusal are becoming clearer all the time. Refusal to do the right thing is provoking anger among state residents as political leaders in Tennessee and Florida have discovered. With 2017 perhaps offering a more favorable political environment and continued strong support from key interest groups and the general public, look for renewed momentum in the months ahead.

Health Care Is Not Crowding Out The Other Stuff We Need

It seems like the recent news on the health care spending front is mostly good, with spending growth still running well below historic averages. But recent growth in health care employment has prompted the usual hand-wringing about crowd-out. Here are two reasons why that anxiety is misplaced. First, it ignores the universal tendency of richer countries to devote more of their total economy to health care – because they can. Think about it. Imagine you are an anthropologist and you visit some remote island where the entire economy is subsistence agriculture, with maybe one medicine woman doing a little part-time doctoring. Then, they get much more efficient at farming (perhaps because you violated the Prime Directive on your previous trip) that allows them to devote more effort to other things. When you come back you now find that 20 percent of the population is now engaged in providing medical care so you file an emergency report back home saying that the populace is in danger of starvation because health care is growing so fast it is crowding out agriculture…

Still not convinced? Then consider this: the U.S. is practically the lowest taxed country in the Organisation for Economic Co-operation and Development (OECD) with only Mexico and Chile and lower. Our struggle to finance human needs in this country is a result of political choices, not economic constraints. The “health care crowd out” argument is a political argument masquerading as an analytic one that is often unwittingly advanced by people who actually do not support the agenda of economic austerity. Don’t fall for it. Not to say that we should waste money on inefficient or over-priced health care and speaking of which…

Another Week, Another Drug Pricing Outrage

Drug companies continue their price-gouging ways as yet another report shows that the industry routinely hikes the price of existing medications far faster and higher than any conceivable increase in production costs could justify. While a few outliers have drawn the most media attention, the problem is actually widespread and underscores the need for stronger action by government to keep medications available and affordable.

The ACA Has Done A Lot, But There Is A Lot More To Do

A new report from Gallup shows that, thanks to the ACA, the uninsurance rate in the U.S. has dropped to the lowest rate since they began tracking eight years ago. However, there is still a lot of room to make more coverage gains. A recent Robert Wood Johnson Foundation/Urban Institute report found that nearly half of the remaining uninsured are currently eligible for subsidized coverage in some form and an even greater number would be added if more states closed the coverage gap. But many people, especially in communities of color, are unaware that they or members of their family may be eligible for financial help. Fortunately, there is at least one easy way to spread the word. The IRS could notify families that qualify for the earned income tax credit and don’t have employer sponsored coverage that they are likely eligible for financial assistance and direct them to enrollment assisters who could help them get coverage.