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You can follow her on Twitter: \u003ca title=\"https://twitter.com/laliferis\" href=\"https://twitter.com/laliferis\">@laliferis\u003c/a>","avatar":"https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=blank&r=g","twitter":"laliferis","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["subscriber"]},{"site":"futureofyou","roles":["subscriber"]},{"site":"stateofhealth","roles":["subscriber"]},{"site":"science","roles":["subscriber"]},{"site":"food","roles":["contributor"]}],"headData":{"title":"Lisa Aliferis | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/lisaaliferis"},"adembosky":{"type":"authors","id":"3205","meta":{"index":"authors_1591205172","id":"3205","found":true},"name":"April Dembosky","firstName":"April","lastName":"Dembosky","slug":"adembosky","email":"adembosky@kqed.org","display_author_email":false,"staff_mastheads":["news","science"],"title":"KQED Health Correspondent","bio":"April Dembosky is the health correspondent for KQED News and a regular contributor to NPR. She specializes in covering altered states of mind, from postpartum depression to methamphetamine-induced psychosis to the insanity defense. Her investigative series on insurance companies sidestepping mental health laws won multiple awards, including first place in beat reporting from the national Association of Health Care Journalists. She is the recipient of numerous other prizes and fellowships, including a national Edward R. Murrow award for investigative reporting, a Society of Professional Journalists award for long-form storytelling, and a Carter Center Fellowship for Mental Health Journalism.\r\n\r\nDembosky reported and produced \u003cem>Soundtrack of Silence\u003c/em>, an audio documentary about music and memory that is currently being made into a feature film by Paramount Pictures.\r\n\r\nBefore joining KQED in 2013, Dembosky covered technology and Silicon Valley for \u003cem>The Financial Times of London,\u003c/em> and contributed business and arts stories to \u003cem>Marketplace \u003c/em>and \u003cem>The New York Times.\u003c/em> She got her undergraduate degree in philosophy from Smith College and her master's in journalism from the University of California, Berkeley. She is a classically trained violinist and proud alum of the first symphony orchestra at Burning Man.","avatar":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twitter":"adembosky","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["author"]},{"site":"stateofhealth","roles":["editor"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"April Dembosky | KQED","description":"KQED Health Correspondent","ogImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/adembosky"},"cfeibel":{"type":"authors","id":"11314","meta":{"index":"authors_1591205172","id":"11314","found":true},"name":"Carrie Feibel","firstName":"Carrie","lastName":"Feibel","slug":"cfeibel","email":"cfeibel@KQED.org","display_author_email":false,"staff_mastheads":[],"title":"KQED Contributor","bio":"Carrie Feibel is a former health editor at KQED, where she has also reported for radio and online. Her stories have appeared on the national NPR shows \u003cem>Morning Edition\u003c/em>, \u003cem>All Things Considered\u003c/em>, and \u003cem>Here & Now\u003c/em>, and on the national website, Kaiser Health News. Her print career included stints at the \u003cem>Houston Chronicle\u003c/em>, \u003cem>The (Bergen) Record,\u003c/em> and the Associated Press in New York City. A native of St. Louis, Feibel attended Cornell University, and earned a master's in journalism from Columbia University.","avatar":"https://secure.gravatar.com/avatar/c64a7e3c9a910e1bffd4ad32a5264aa9?s=600&d=blank&r=g","twitter":"KQEDHealth","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["subscriber"]},{"site":"stateofhealth","roles":["administrator"]}],"headData":{"title":"Carrie Feibel | KQED","description":"KQED Contributor","ogImgSrc":"https://secure.gravatar.com/avatar/c64a7e3c9a910e1bffd4ad32a5264aa9?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/c64a7e3c9a910e1bffd4ad32a5264aa9?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/cfeibel"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"stateofhealth_361327":{"type":"posts","id":"stateofhealth_361327","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"361327","score":null,"sort":[1507145585000]},"guestAuthors":[],"slug":"hepatitis-c-drugs-lower-cost-paves-way-for-medicaid-prisons-to-expand-treatment","title":"Hepatitis C Drug’s Lower Cost Paves Way For Medicaid, Prisons To Expand Treatment","publishDate":1507145585,"format":"standard","headTitle":"Kaiser Health News | State of Health | KQED News","labelTerm":{"term":3007,"site":"stateofhealth"},"content":"\u003cp>Valerie Green is still waiting to be cured.\u003c/p>\n\u003cp>The Delaware resident was diagnosed with hepatitis C more than two years ago, but she doesn’t qualify yet for the Medicaid program’s criteria for treatment with a new class of highly effective but pricey drugs. The recent approval of a less expensive drug that generally cures hepatitis C in just eight weeks may make it easier for more insurers and correctional facilities to expand treatment.\u003c/p>\n\u003cp>The drug, \u003ca href=\"https://www.mavyret.com\" target=\"_blank\" rel=\"noopener\">Mavyret\u003c/a>, is the first to be \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm570038.htm\" target=\"_blank\" rel=\"noopener\">approved by the Food and Drug Administration\u003c/a> that can cure all six genetic types of hepatitis C in about two months in patients who haven’t previously been treated. Other approved drugs generally require 12 weeks to treat the disease and often aren’t effective for all types of hepatitis C.\u003c/p>\n\u003cp>In addition, Mavyret’s price tag of $26,400 for a course of treatment is significantly below that of other hepatitis C drugs whose sticker price ranges from about \u003ca href=\"https://www.macpac.gov/wp-content/uploads/2017/03/High-Cost-HCV-Drugs-in-Medicaid-Final-Report.pdf\" target=\"_blank\" rel=\"noopener\">$55,000 to $95,000\u003c/a> to beat the disease. Patients and insurers often pay less, however, through negotiated insurance discounts and rebates.\u003c/p>\n\u003cp>“It certainly stands to reason that the continual march downwards on cost would lead to continual opening up of criteria,” said Matt Salo, executive director of the National Association of Medicaid Directors.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Hepatitis C is a viral liver infection spread through blood that affects an estimated 3.5 million people in the United States. It can take years to cause problems. Many baby boomers who contracted it decades ago before blood was screened for the virus don’t realize they have it until they develop liver disease. In addition, the growing heroin epidemic is adding to the problem as people become infected by sharing contaminated needles.\u003c/p>\n\u003cp>“Direct acting antiviral” therapies like Harvoni, a once-a-day pill introduced in 2014 that generally cured hepatitis C in 12 weeks, are much more effective than earlier treatments that required weekly interferon injections and multiple daily pills for nearly a year. But the newer regimens came at a price: $94,500, in Harvoni’s case.\u003c/p>\n\u003cp>State Medicaid programs, which cover a high proportion of people with hepatitis C, \u003ca href=\"http://www.governing.com/news/headlines/how-some-state-medicaid-programs-limit-drugs-to-only-sickest-patients.html\" target=\"_blank\" rel=\"noopener\">balked at the high prices\u003c/a>, even with the 23 percent drug discount the programs typically receive. Many threw up roadblocks to limit drug approval until the disease was advanced. Some required people to be drug- and alcohol-free for six months or more before treatment would be approved.\u003c/p>\n\u003cp>Those moves prompted advocates to push for better access, in some cases \u003ca href=\"https://khn.org/news/medicaid-private-insurers-begin-to-lift-curbs-on-pricey-hepatitis-c-drugs/\" target=\"_blank\" rel=\"noopener\">filing suit\u003c/a> to force the programs to cover more people.\u003c/p>\n\u003cp>Faced with a lawsuit in Delaware, the state Medicaid program began loosening up treatment criteria this year, and in January will \u003ca href=\"https://www.chlpi.org//wp-content/uploads/2016/06/DMMA-Prior-Authorization-Policy.pdf\" target=\"_blank\" rel=\"noopener\">begin approving enrollees\u003c/a> regardless of the severity of their disease.\u003c/p>\n\u003cp>The state joins more than a dozen others that no longer (or never did) restrict hepatitis C treatment based on disease severity, said Kevin Costello, director of litigation at Harvard Law School’s Center for Health Law and Policy Innovation, which has been a key player \u003ca href=\"https://www.chlpi.org/in-face-of-class-action-lawsuit-delaware-medicaid-removes-unlawful-restrictions-to-the-cure-for-the-hepatitis-c-virus/\" target=\"_blank\" rel=\"noopener\">in litigation in Delaware\u003c/a> and other states.\u003c/p>\n\u003cp>It can’t happen soon enough, said Green, 58, who believes she contracted the disease 31 years ago when she suffered complications during childbirth and required a blood transfusion. Although her liver isn’t damaged, Green said, she’s suffered with abdominal and joint pain, weight loss and fatigue for decades, symptoms that doctors attribute to the hepatitis C virus.\u003c/p>\n\u003cp>“It’s been a difficult fight for us Medicaid patients,” she said.\u003c/p>\n\u003cp>People who are incarcerated \u003ca href=\"http://content.healthaffairs.org/content/35/10/1893.abstract\" target=\"_blank\" rel=\"noopener\">face an even tougher battle\u003c/a> to get treatment for hepatitis C. Roughly 17 percent of prisoners are infected with hepatitis C, compared with about 1 percent of the general population.\u003c/p>\n\u003cp>Prisons have a duty not to be deliberately indifferent to the medical needs of incarcerated people. Prisons don’t get the price discounts that the Medicaid programs have, and their budgets are fixed.\u003c/p>\n\u003cp>“Administrators have to make do with what is there,” said Dr. Anne Spaulding, an associate professor at Emory University’s public health school who has worked as a medical director in corrections and published research on hepatitis C among prisoners.\u003c/p>\n\u003cp>Lawyers in a handful of states are pursuing class action lawsuits to force prisons to provide hepatitis C treatment. Mavyret may make a difference, said David Rudovsky, a civil rights lawyer who’s litigating a class action lawsuit against the Pennsylvania Department of Corrections.\u003c/p>\n\u003cp>“Everyone recognizes that it’s going to make it easier to cover people,” he said.\u003c/p>\n\u003cp>People with regular private insurance may face some obstacles to coverage of hepatitis C, but coverage is typically less problematic. For example, Mavyret is one of seven hepatitis C drugs that are included in the 2018 \u003ca href=\"http://lab.express-scripts.com/lab/insights/drug-options/2018-national-preferred-formulary\" target=\"_blank\" rel=\"noopener\">national preferred formulary\u003c/a> by Express Scripts, which manages the pharmacy benefits for 83 million people.\u003c/p>\n\u003cp>“The benefit to patients and payers is the additional competition, which brings down costs across the class, thus resulting in greater access and affordability,” said Jennifer Luddy, director of corporate communications at Express Scripts.\u003c/p>\n\u003cp>\u003cem>Please visit \u003ca href=\"http://khn.org/columnists/\" target=\"_blank\" rel=\"noopener\">khn.org/columnists\u003c/a> to send comments or ideas for future topics for the Insuring Your Health column.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003c/em>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a> (KHN). KHN is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\" target=\"_blank\" rel=\"noopener\">Henry J. Kaiser Family Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"The drug, sold under the name Mavyret, can cure all six genetic types of the liver disease in eight weeks at a cost of $26,400, well below other options.","status":"publish","parent":0,"modified":1507146691,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":933},"headData":{"title":"Hepatitis C Drug’s Lower Cost Paves Way For Medicaid, Prisons To Expand Treatment | KQED","description":"The drug, sold under the name Mavyret, can cure all six genetic types of the liver disease in eight weeks at a cost of $26,400, well below other options.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Hepatitis C Drug’s Lower Cost Paves Way For Medicaid, Prisons To Expand Treatment","datePublished":"2017-10-04T19:33:05.000Z","dateModified":"2017-10-04T19:51:31.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"361327 https://ww2.kqed.org/stateofhealth/?p=361327","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/10/04/hepatitis-c-drugs-lower-cost-paves-way-for-medicaid-prisons-to-expand-treatment/","disqusTitle":"Hepatitis C Drug’s Lower Cost Paves Way For Medicaid, Prisons To Expand Treatment","nprByline":"\u003ca href=\"https://californiahealthline.org/news/author/michelle-andrews/\">\u003cstrong>Michelle Andrews\u003c/strong>\u003c/a>","path":"/stateofhealth/361327/hepatitis-c-drugs-lower-cost-paves-way-for-medicaid-prisons-to-expand-treatment","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Valerie Green is still waiting to be cured.\u003c/p>\n\u003cp>The Delaware resident was diagnosed with hepatitis C more than two years ago, but she doesn’t qualify yet for the Medicaid program’s criteria for treatment with a new class of highly effective but pricey drugs. The recent approval of a less expensive drug that generally cures hepatitis C in just eight weeks may make it easier for more insurers and correctional facilities to expand treatment.\u003c/p>\n\u003cp>The drug, \u003ca href=\"https://www.mavyret.com\" target=\"_blank\" rel=\"noopener\">Mavyret\u003c/a>, is the first to be \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm570038.htm\" target=\"_blank\" rel=\"noopener\">approved by the Food and Drug Administration\u003c/a> that can cure all six genetic types of hepatitis C in about two months in patients who haven’t previously been treated. Other approved drugs generally require 12 weeks to treat the disease and often aren’t effective for all types of hepatitis C.\u003c/p>\n\u003cp>In addition, Mavyret’s price tag of $26,400 for a course of treatment is significantly below that of other hepatitis C drugs whose sticker price ranges from about \u003ca href=\"https://www.macpac.gov/wp-content/uploads/2017/03/High-Cost-HCV-Drugs-in-Medicaid-Final-Report.pdf\" target=\"_blank\" rel=\"noopener\">$55,000 to $95,000\u003c/a> to beat the disease. Patients and insurers often pay less, however, through negotiated insurance discounts and rebates.\u003c/p>\n\u003cp>“It certainly stands to reason that the continual march downwards on cost would lead to continual opening up of criteria,” said Matt Salo, executive director of the National Association of Medicaid Directors.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Hepatitis C is a viral liver infection spread through blood that affects an estimated 3.5 million people in the United States. It can take years to cause problems. Many baby boomers who contracted it decades ago before blood was screened for the virus don’t realize they have it until they develop liver disease. In addition, the growing heroin epidemic is adding to the problem as people become infected by sharing contaminated needles.\u003c/p>\n\u003cp>“Direct acting antiviral” therapies like Harvoni, a once-a-day pill introduced in 2014 that generally cured hepatitis C in 12 weeks, are much more effective than earlier treatments that required weekly interferon injections and multiple daily pills for nearly a year. But the newer regimens came at a price: $94,500, in Harvoni’s case.\u003c/p>\n\u003cp>State Medicaid programs, which cover a high proportion of people with hepatitis C, \u003ca href=\"http://www.governing.com/news/headlines/how-some-state-medicaid-programs-limit-drugs-to-only-sickest-patients.html\" target=\"_blank\" rel=\"noopener\">balked at the high prices\u003c/a>, even with the 23 percent drug discount the programs typically receive. Many threw up roadblocks to limit drug approval until the disease was advanced. Some required people to be drug- and alcohol-free for six months or more before treatment would be approved.\u003c/p>\n\u003cp>Those moves prompted advocates to push for better access, in some cases \u003ca href=\"https://khn.org/news/medicaid-private-insurers-begin-to-lift-curbs-on-pricey-hepatitis-c-drugs/\" target=\"_blank\" rel=\"noopener\">filing suit\u003c/a> to force the programs to cover more people.\u003c/p>\n\u003cp>Faced with a lawsuit in Delaware, the state Medicaid program began loosening up treatment criteria this year, and in January will \u003ca href=\"https://www.chlpi.org//wp-content/uploads/2016/06/DMMA-Prior-Authorization-Policy.pdf\" target=\"_blank\" rel=\"noopener\">begin approving enrollees\u003c/a> regardless of the severity of their disease.\u003c/p>\n\u003cp>The state joins more than a dozen others that no longer (or never did) restrict hepatitis C treatment based on disease severity, said Kevin Costello, director of litigation at Harvard Law School’s Center for Health Law and Policy Innovation, which has been a key player \u003ca href=\"https://www.chlpi.org/in-face-of-class-action-lawsuit-delaware-medicaid-removes-unlawful-restrictions-to-the-cure-for-the-hepatitis-c-virus/\" target=\"_blank\" rel=\"noopener\">in litigation in Delaware\u003c/a> and other states.\u003c/p>\n\u003cp>It can’t happen soon enough, said Green, 58, who believes she contracted the disease 31 years ago when she suffered complications during childbirth and required a blood transfusion. Although her liver isn’t damaged, Green said, she’s suffered with abdominal and joint pain, weight loss and fatigue for decades, symptoms that doctors attribute to the hepatitis C virus.\u003c/p>\n\u003cp>“It’s been a difficult fight for us Medicaid patients,” she said.\u003c/p>\n\u003cp>People who are incarcerated \u003ca href=\"http://content.healthaffairs.org/content/35/10/1893.abstract\" target=\"_blank\" rel=\"noopener\">face an even tougher battle\u003c/a> to get treatment for hepatitis C. Roughly 17 percent of prisoners are infected with hepatitis C, compared with about 1 percent of the general population.\u003c/p>\n\u003cp>Prisons have a duty not to be deliberately indifferent to the medical needs of incarcerated people. Prisons don’t get the price discounts that the Medicaid programs have, and their budgets are fixed.\u003c/p>\n\u003cp>“Administrators have to make do with what is there,” said Dr. Anne Spaulding, an associate professor at Emory University’s public health school who has worked as a medical director in corrections and published research on hepatitis C among prisoners.\u003c/p>\n\u003cp>Lawyers in a handful of states are pursuing class action lawsuits to force prisons to provide hepatitis C treatment. Mavyret may make a difference, said David Rudovsky, a civil rights lawyer who’s litigating a class action lawsuit against the Pennsylvania Department of Corrections.\u003c/p>\n\u003cp>“Everyone recognizes that it’s going to make it easier to cover people,” he said.\u003c/p>\n\u003cp>People with regular private insurance may face some obstacles to coverage of hepatitis C, but coverage is typically less problematic. For example, Mavyret is one of seven hepatitis C drugs that are included in the 2018 \u003ca href=\"http://lab.express-scripts.com/lab/insights/drug-options/2018-national-preferred-formulary\" target=\"_blank\" rel=\"noopener\">national preferred formulary\u003c/a> by Express Scripts, which manages the pharmacy benefits for 83 million people.\u003c/p>\n\u003cp>“The benefit to patients and payers is the additional competition, which brings down costs across the class, thus resulting in greater access and affordability,” said Jennifer Luddy, director of corporate communications at Express Scripts.\u003c/p>\n\u003cp>\u003cem>Please visit \u003ca href=\"http://khn.org/columnists/\" target=\"_blank\" rel=\"noopener\">khn.org/columnists\u003c/a> to send comments or ideas for future topics for the Insuring Your Health column.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003c/em>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a> (KHN). KHN is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\" target=\"_blank\" rel=\"noopener\">Henry J. Kaiser Family Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/361327/hepatitis-c-drugs-lower-cost-paves-way-for-medicaid-prisons-to-expand-treatment","authors":["byline_stateofhealth_361327"],"categories":["stateofhealth_2442","stateofhealth_13"],"tags":["stateofhealth_2808","stateofhealth_2867","stateofhealth_3172","stateofhealth_218","stateofhealth_2519"],"affiliates":["stateofhealth_3007"],"featImg":"stateofhealth_361331","label":"stateofhealth_3007"},"stateofhealth_348688":{"type":"posts","id":"stateofhealth_348688","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"348688","score":null,"sort":[1498775776000]},"guestAuthors":[],"slug":"nursing-homes-worry-proposed-medicaid-cuts-will-force-cuts-closures","title":"Nursing Homes Worry Proposed Medicaid Cuts Will Force Cuts, Closures","publishDate":1498775776,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>The Senate vote on the health care bill has been pushed back, but it still has a lot of people in the nursing home industry worried. About two-thirds of nursing home residents are paid for by Medicaid. And the Congressional Budget Office \u003ca href=\"https://www.cbo.gov/system/files/115th-congress-2017-2018/costestimate/52849-hr1628senate.pdf\">found\u003c/a> that the Senate health care bill would cut Medicaid by more than $770 billion over the next decade.\u003c/p>\n\u003cp>That could mean trouble for people like 88-year-old Betty Redlin. She's lived at the \u003ca href=\"http://victoriacarecenter.com/\">Victoria Care Center\u003c/a> in Ventura, Calif. for about 2 1/2 years.\u003c/p>\n\u003cp>She explains that she fell and broke her hip and never regained her ability to walk. \"I was living with my granddaughter,\" she says, \"and my doctor won't [allow] going back to her place.\"\u003c/p>\n\u003cp>Betty had a career as a bookkeeper. She also raised three children. Now she's spent everything she had. There's no way she could afford the roughly $80,000 a year this nursing home costs. (That fee is pretty standard for nursing homes.) So it's Medicaid that enables her to stay here.\u003c/p>\n\u003cp>\"There's nothing I can do about it,\" she says. \"It's gotta be [Medicaid] or [I'm] out on the street. One or the other.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.npr.org/player/embed/534764940/534764941\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>John Gardner, executive director of the Victoria Care Center, says that most of the long-term care residents like Redlin are on Medicaid or, as it's called in California, Medi-Cal.\u003c/p>\n\u003cp>\"If you look at what it costs to provide that service and what we get from Medi-Cal, we're actually losing a little bit of money every day on that.\" He says they make up the difference with short-term residents who have Medicare, which pays more than Medicaid does. Private pay patients also pay more than Medicaid.\u003c/p>\n\u003cp>Gardner says he's an optimist. Whatever Congress does, he doesn't think that Victoria Care Center would close down, though there might have to be cuts in staff and in the costs of food and supplies. Also, Gardner says that Victoria Care Center is part of a chain of 200 facilities, which could cushion the blow.\u003c/p>\n\u003cp>But not everyone is as optimistic as he is. According to the \u003ca href=\"https://www.ahcancal.org/Pages/Default.aspx\">American Health Care Association\u003c/a> (AHCA), a national trade group for nursing homes, the current Senate bill's cuts to Medicaid could mean that a typical nursing home would eventually run deficits of hundreds of thousands of dollars a year. James Gomez is the CEO of The \u003ca href=\"http://www.cahf.org/\">California Association of Health Facilities\u003c/a>, the AHCA's California chapter.\u003c/p>\n\u003cp>[contextly_sidebar id=\"mrVakER0R6f0AToNbkAK83dprja2VTaO\"]\u003c/p>\n\u003cp>\"If you can't break even or make a few dollars, you're not going to keep running your business,\" says Gomez. And that could lead to closures. \"So access [to nursing home beds] will become a huge issue.\"\u003c/p>\n\u003cp>The repercussions of cuts and closures would be felt across the nation's health care system, says Katie Smith Sloan, the president of \u003ca href=\"http://www.leadingage.org/\">Leading Age\u003c/a>, which represents non-profit nursing homes and other services for older adults.\u003c/p>\n\u003cp>\"People who are in nursing homes are there because they need the kind of services that a nursing home provides\" says Sloan. \"Without those services, they'll be forced to get that kind of care in a hospital, which will simply increase costs to Medicare.\"\u003c/p>\n\u003cp>Reining in Medicaid has been on conservatives' to-do list for a long time. House Speaker Paul Ryan has said he's \u003ca href=\"http://www.cnbc.com/2017/03/20/paul-ryan-has-wanted-to-reform-medicaid-since-his-frat-days.html\">dreamed of it\u003c/a> since his college days. Robert Moffit, a senior fellow in health policy studies at the conservative \u003ca href=\"http://www.heritage.org/\">Heritage Foundation\u003c/a>, argues that the program isn't being used as intended.\u003c/p>\n\u003cp>\"Do we want Medicaid, which was a program designed for the poor and the indigent, to become a kind of backdoor mechanism to establish a middle class entitlement for long-term care? Medicaid was never really intended to do that,\" says Moffit.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Senate bill is likely to change. But leader Mitch McConnell has indicated that Medicaid cuts will still be part of it.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Nursing+Homes+Worry+Proposed+Medicaid+Cuts+Will+Force+Cuts%2C+Closures&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Two-thirds of nursing home residents are paid for by Medicaid.","status":"publish","parent":0,"modified":1498776331,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":true,"iframeSrcs":["https://www.npr.org/player/embed/534764940/534764941"],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":19,"wordCount":676},"headData":{"title":"Nursing Homes Worry Proposed Medicaid Cuts Will Force Cuts, Closures | KQED","description":"Two-thirds of nursing home residents are paid for by Medicaid.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Nursing Homes Worry Proposed Medicaid Cuts Will Force Cuts, Closures","datePublished":"2017-06-29T22:36:16.000Z","dateModified":"2017-06-29T22:45:31.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"348688 https://ww2.kqed.org/stateofhealth/?p=348688","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/06/29/nursing-homes-worry-proposed-medicaid-cuts-will-force-cuts-closures/","disqusTitle":"Nursing Homes Worry Proposed Medicaid Cuts Will Force Cuts, Closures","nprByline":"\u003ca href=\"http://www.npr.org/people/2100677/ina-jaffe\" target=\"_blank\">Ina Jaffe\u003c/a>","nprImageAgency":"Ina Jaffe/NPR","nprStoryId":"534764940","nprApiLink":"http://api.npr.org/query?id=534764940&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2017/06/28/534764940/proposed-medicaid-cuts-likely-to-put-pressure-on-nursing-homes?ft=nprml&f=534764940","nprRetrievedStory":"1","nprPubDate":"Thu, 29 Jun 2017 13:53:00 -0400","nprStoryDate":"Wed, 28 Jun 2017 17:15:00 -0400","nprLastModifiedDate":"Thu, 29 Jun 2017 13:53:00 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/atc/2017/06/20170628_atc_proposed_medicaid_cuts_likely_to_put_pressure_on_nursing_homes.mp3?orgId=1&topicId=1128&d=213&p=2&story=534764940&t=progseg&e=534685874&seg=2&ft=nprml&f=534764940","nprAudioM3u":"http://api.npr.org/m3u/1534764941-043df7.m3u?orgId=1&topicId=1128&d=213&p=2&story=534764940&t=progseg&e=534685874&seg=2&ft=nprml&f=534764940","path":"/stateofhealth/348688/nursing-homes-worry-proposed-medicaid-cuts-will-force-cuts-closures","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/atc/2017/06/20170628_atc_proposed_medicaid_cuts_likely_to_put_pressure_on_nursing_homes.mp3?orgId=1&topicId=1128&d=213&p=2&story=534764940&t=progseg&e=534685874&seg=2&ft=nprml&f=534764940","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Senate vote on the health care bill has been pushed back, but it still has a lot of people in the nursing home industry worried. About two-thirds of nursing home residents are paid for by Medicaid. And the Congressional Budget Office \u003ca href=\"https://www.cbo.gov/system/files/115th-congress-2017-2018/costestimate/52849-hr1628senate.pdf\">found\u003c/a> that the Senate health care bill would cut Medicaid by more than $770 billion over the next decade.\u003c/p>\n\u003cp>That could mean trouble for people like 88-year-old Betty Redlin. She's lived at the \u003ca href=\"http://victoriacarecenter.com/\">Victoria Care Center\u003c/a> in Ventura, Calif. for about 2 1/2 years.\u003c/p>\n\u003cp>She explains that she fell and broke her hip and never regained her ability to walk. \"I was living with my granddaughter,\" she says, \"and my doctor won't [allow] going back to her place.\"\u003c/p>\n\u003cp>Betty had a career as a bookkeeper. She also raised three children. Now she's spent everything she had. There's no way she could afford the roughly $80,000 a year this nursing home costs. (That fee is pretty standard for nursing homes.) So it's Medicaid that enables her to stay here.\u003c/p>\n\u003cp>\"There's nothing I can do about it,\" she says. \"It's gotta be [Medicaid] or [I'm] out on the street. One or the other.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.npr.org/player/embed/534764940/534764941\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>John Gardner, executive director of the Victoria Care Center, says that most of the long-term care residents like Redlin are on Medicaid or, as it's called in California, Medi-Cal.\u003c/p>\n\u003cp>\"If you look at what it costs to provide that service and what we get from Medi-Cal, we're actually losing a little bit of money every day on that.\" He says they make up the difference with short-term residents who have Medicare, which pays more than Medicaid does. Private pay patients also pay more than Medicaid.\u003c/p>\n\u003cp>Gardner says he's an optimist. Whatever Congress does, he doesn't think that Victoria Care Center would close down, though there might have to be cuts in staff and in the costs of food and supplies. Also, Gardner says that Victoria Care Center is part of a chain of 200 facilities, which could cushion the blow.\u003c/p>\n\u003cp>But not everyone is as optimistic as he is. According to the \u003ca href=\"https://www.ahcancal.org/Pages/Default.aspx\">American Health Care Association\u003c/a> (AHCA), a national trade group for nursing homes, the current Senate bill's cuts to Medicaid could mean that a typical nursing home would eventually run deficits of hundreds of thousands of dollars a year. James Gomez is the CEO of The \u003ca href=\"http://www.cahf.org/\">California Association of Health Facilities\u003c/a>, the AHCA's California chapter.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"If you can't break even or make a few dollars, you're not going to keep running your business,\" says Gomez. And that could lead to closures. \"So access [to nursing home beds] will become a huge issue.\"\u003c/p>\n\u003cp>The repercussions of cuts and closures would be felt across the nation's health care system, says Katie Smith Sloan, the president of \u003ca href=\"http://www.leadingage.org/\">Leading Age\u003c/a>, which represents non-profit nursing homes and other services for older adults.\u003c/p>\n\u003cp>\"People who are in nursing homes are there because they need the kind of services that a nursing home provides\" says Sloan. \"Without those services, they'll be forced to get that kind of care in a hospital, which will simply increase costs to Medicare.\"\u003c/p>\n\u003cp>Reining in Medicaid has been on conservatives' to-do list for a long time. House Speaker Paul Ryan has said he's \u003ca href=\"http://www.cnbc.com/2017/03/20/paul-ryan-has-wanted-to-reform-medicaid-since-his-frat-days.html\">dreamed of it\u003c/a> since his college days. Robert Moffit, a senior fellow in health policy studies at the conservative \u003ca href=\"http://www.heritage.org/\">Heritage Foundation\u003c/a>, argues that the program isn't being used as intended.\u003c/p>\n\u003cp>\"Do we want Medicaid, which was a program designed for the poor and the indigent, to become a kind of backdoor mechanism to establish a middle class entitlement for long-term care? Medicaid was never really intended to do that,\" says Moffit.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Senate bill is likely to change. But leader Mitch McConnell has indicated that Medicaid cuts will still be part of it.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Nursing+Homes+Worry+Proposed+Medicaid+Cuts+Will+Force+Cuts%2C+Closures&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/348688/nursing-homes-worry-proposed-medicaid-cuts-will-force-cuts-closures","authors":["byline_stateofhealth_348688"],"categories":["stateofhealth_2442","stateofhealth_15","stateofhealth_14","stateofhealth_1"],"tags":["stateofhealth_2808","stateofhealth_99","stateofhealth_218","stateofhealth_2519","stateofhealth_2829"],"featImg":"stateofhealth_348689","label":"stateofhealth"},"stateofhealth_348224":{"type":"posts","id":"stateofhealth_348224","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"348224","score":null,"sort":[1498603938000]},"guestAuthors":[],"slug":"californias-leaders-warn-health-bill-remains-a-dangerous-threat","title":"Feinstein: Health Care of 14 Million Californians At Risk Under GOP Plan","publishDate":1498603938,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Though Senate Republicans decided Tuesday to delay a vote on their controversial health plan until after the July 4 recess, Democrats in California are calling on residents to keep up their resistance to the plan.\u003c/p>\n\u003cp>Gov. Jerry Brown joined Sens. Dianne Feinstein and Kamala Harris for a call with reporters early Tuesday. Brown said the GOP bill's proposed Medicaid cuts, and its rollback of Obamacare's insurance regulations, would be disastrous for millions of Californians.\u003c/p>\n\u003cp>Feinstein said one in three Californians are covered by Medi-Cal. The loss of funding could put up to 14 million Californians at risk of losing health coverage or critical medical services, she said.\u003c/p>\n\u003cp>\"One of the things we all try not to do is never turn the haves or the have-nots against each other ... and this bill does that,\" she said.\u003c/p>\n\u003cp>\"This is a bad plan through and through and through, she added. \"There aren’t one or two amendments that can fix it. So it’s got to be defeated.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Brown condemned the Senate bill, saying it \"will be the most divisive maneuver, cutting right into the heart of what is already a divided nation.\"\u003c/p>\n\u003cp>He noted it would cut billions of federal dollars from the Medi-Cal budget and that if California couldn't take care of low-income people, there would be ripple effects.\u003c/p>\n\u003cp>\"There's no doubt this bill will exacerbate homelessness, crime,\" Brown said. \"[The bill hurts] the kinds of people who really need help and are getting it under the Medi-Cal program.\"\u003c/p>\n\u003cp>The Senate is expected to reconvene on July 10, and the House or Representatives on July 11.\u003c/p>\n\u003cp>Congress needs to work on improving health care, not taking it away, said Feinstein, noting Democrats' strategy was \"to defeat this [GOP bill] solidly.\"\u003c/p>\n\u003cp>\"I've always believed there are a couple of things that maybe should be fixed in Obamacare, but the basic bill is a good bill. It has worked,\" she said.\u003c/p>\n\u003cp>In a statement late Tuesday, California Republican Rep. Ken Calvert said the Senate bill was like the House legislation that passed in May, aiming \"to refocus Medicaid on the most vulnerable Americans, while not pulling the rug out from anyone who has benefited from the Medicaid expansion.\"\u003c/p>\n\u003cp>That contradicts the \u003ca href=\"https://www.cbo.gov/system/files/115th-congress-2017-2018/costestimate/52849-hr1628senate.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">analysis\u003c/a> released Monday by the nonpartisan Congressional Budget Office. That report said the number of people covered by Medicaid would decrease by 15 million over the next decade, and federal payments for Medicaid would be cut by $772 billion.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"In the long run, massive expansions of expensive government programs like Medicaid are simply not fiscally sustainable,\" Calvert said.\u003c/p>\n\n","blocks":[],"excerpt":"Though Senate Republicans have delayed a vote on their health bill, California Dems are urging people to keep up the pressure.","status":"publish","parent":0,"modified":1498611249,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":452},"headData":{"title":"Feinstein: Health Care of 14 Million Californians At Risk Under GOP Plan | KQED","description":"Though Senate Republicans have delayed a vote on their health bill, California Dems are urging people to keep up the pressure.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Feinstein: Health Care of 14 Million Californians At Risk Under GOP Plan","datePublished":"2017-06-27T22:52:18.000Z","dateModified":"2017-06-28T00:54:09.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"348224 https://ww2.kqed.org/stateofhealth/?p=348224","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/06/27/californias-leaders-warn-health-bill-remains-a-dangerous-threat/","disqusTitle":"Feinstein: Health Care of 14 Million Californians At Risk Under GOP Plan","path":"/stateofhealth/348224/californias-leaders-warn-health-bill-remains-a-dangerous-threat","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Though Senate Republicans decided Tuesday to delay a vote on their controversial health plan until after the July 4 recess, Democrats in California are calling on residents to keep up their resistance to the plan.\u003c/p>\n\u003cp>Gov. Jerry Brown joined Sens. Dianne Feinstein and Kamala Harris for a call with reporters early Tuesday. Brown said the GOP bill's proposed Medicaid cuts, and its rollback of Obamacare's insurance regulations, would be disastrous for millions of Californians.\u003c/p>\n\u003cp>Feinstein said one in three Californians are covered by Medi-Cal. The loss of funding could put up to 14 million Californians at risk of losing health coverage or critical medical services, she said.\u003c/p>\n\u003cp>\"One of the things we all try not to do is never turn the haves or the have-nots against each other ... and this bill does that,\" she said.\u003c/p>\n\u003cp>\"This is a bad plan through and through and through, she added. \"There aren’t one or two amendments that can fix it. So it’s got to be defeated.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Brown condemned the Senate bill, saying it \"will be the most divisive maneuver, cutting right into the heart of what is already a divided nation.\"\u003c/p>\n\u003cp>He noted it would cut billions of federal dollars from the Medi-Cal budget and that if California couldn't take care of low-income people, there would be ripple effects.\u003c/p>\n\u003cp>\"There's no doubt this bill will exacerbate homelessness, crime,\" Brown said. \"[The bill hurts] the kinds of people who really need help and are getting it under the Medi-Cal program.\"\u003c/p>\n\u003cp>The Senate is expected to reconvene on July 10, and the House or Representatives on July 11.\u003c/p>\n\u003cp>Congress needs to work on improving health care, not taking it away, said Feinstein, noting Democrats' strategy was \"to defeat this [GOP bill] solidly.\"\u003c/p>\n\u003cp>\"I've always believed there are a couple of things that maybe should be fixed in Obamacare, but the basic bill is a good bill. It has worked,\" she said.\u003c/p>\n\u003cp>In a statement late Tuesday, California Republican Rep. Ken Calvert said the Senate bill was like the House legislation that passed in May, aiming \"to refocus Medicaid on the most vulnerable Americans, while not pulling the rug out from anyone who has benefited from the Medicaid expansion.\"\u003c/p>\n\u003cp>That contradicts the \u003ca href=\"https://www.cbo.gov/system/files/115th-congress-2017-2018/costestimate/52849-hr1628senate.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">analysis\u003c/a> released Monday by the nonpartisan Congressional Budget Office. That report said the number of people covered by Medicaid would decrease by 15 million over the next decade, and federal payments for Medicaid would be cut by $772 billion.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"In the long run, massive expansions of expensive government programs like Medicaid are simply not fiscally sustainable,\" Calvert said.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/348224/californias-leaders-warn-health-bill-remains-a-dangerous-threat","authors":["11314"],"categories":["stateofhealth_15","stateofhealth_14"],"tags":["stateofhealth_2808","stateofhealth_28","stateofhealth_99","stateofhealth_218","stateofhealth_2519","stateofhealth_2865","stateofhealth_365"],"featImg":"stateofhealth_348225","label":"stateofhealth"},"stateofhealth_346757":{"type":"posts","id":"stateofhealth_346757","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"346757","score":null,"sort":[1498162582000]},"guestAuthors":[],"slug":"analysis-why-senate-health-bill-is-even-meaner-for-california","title":"Analysis: Why Senate Health Bill Is Even 'Meaner' for California","publishDate":1498162582,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>At last, Republican senators have \u003ca href=\"https://ww2.kqed.org/news/2017/06/22/senate-republicans-reveal-obamacare-repeal-bill/\" target=\"_blank\" rel=\"noopener noreferrer\">unveiled their crafted-in-secret health bill\u003c/a>, and everyone, including other Republican senators, are scrambling to understand the 142-page \"\u003ca href=\"https://www.budget.senate.gov/imo/media/doc/SENATEHEALTHCARE.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Better Care Reconciliation Act of 2017\u003c/a>.\"\u003c/p>\n\u003cp>To know whether it's truly \"better care,\" and for which patients, if any, we still need the Congressional Budget Office to weigh in. But some California advocates say the “discussion draft” is clear enough to conclude that the bill would be “disproportionately devastating” for California’s health care system.\u003c/p>\n\u003cp>“If the House bill was mean, as the President termed it, the Senate bill was actually meaner and crueler,” said Anthony Wright, executive director of Health Access California. “It has harsher cuts, especially to the Medicaid program that covers 14 million Californians.\"\u003c/p>\n\u003cp>In the meantime, here are my five takeaways from the bill:\u003c/p>\n\u003cp>\u003cstrong>1. 'Repeal and Replace' Rhetoric Should Be … Repealed\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>At this point, it’s inaccurate and misleading. The Republican bill doesn’t repeal all of President Obama's health care law known as the Affordable Care Act, or Obamacare. Nor does it replace it with anything. The bill maintains the basic mechanics of the ACA but rolls back the financial assistance and some of the consumer protections. In addition, a huge part of this bill has nothing to do with Obamacare: It proposes a radical dismemberment of Medicaid as we know it.\u003c/p>\n\u003cp>Let’s describe what the bill actually does: It’s an Obamacare \u003cem>rollback\u003c/em> and a Medicaid \u003cem>cutback\u003c/em>.\u003c/p>\n\u003cp>\u003cstrong>2. Much Less Aid for Medicaid\u003c/strong>\u003c/p>\n\u003cp>The Senate bill will phase out one of the ACA’s most visible accomplishments: the \u003cem>expansion\u003c/em> of Medicaid (Medi-Cal in California) to poor, uninsured adults. That means 3.7 million Californians who got Medi-Cal since 2014 will eventually lose it.\u003c/p>\n\u003cp>But there's more. The Senate plan will also cut funding for \u003cem>traditional\u003c/em> Medi-Cal, and the cuts will be deeper, over time, than even the House Republicans proposed.\u003c/p>\n\u003cp>In California, Medi-Cal covers one-third of all residents, half of all children, and two-thirds of seniors in nursing homes.\u003c/p>\n\u003cp>Who pays for their care if the feds pay less? The short answer is no one -- or state taxpayers.\u003c/p>\n\u003cp>\u003cstrong>3. What About Covered California? Could It help?\u003c/strong>\u003c/p>\n\u003cp>Not really. The Senate version tries to assuage pre-Medicare seniors (below age 65) who were alarmed that the House bill would have given them only a maximum tax credit of $4,000 to buy a plan, no matter the plan’s price. The Senate bill reverts to the ACA mechanism of offering tax credits based on income, not age. But, insurers can still charge older people five times what they charge younger people.\u003c/p>\n\u003cp>And tax credits would only be offered to people with incomes below 350 percent of the federal poverty level, down from the ACA’s 400 percent. Do you make $42,000-$48,000 a year? You would no longer qualify for any subsidies on Covered California.\u003c/p>\n\u003cp>That’s not all. Other complicated changes to the exchanges mean premiums and deductibles would go up, and special ACA grants that help reduce those deductibles disappear.\u003c/p>\n\u003cp>\u003cstrong>4. Winners? Or Just Losers: Pre-existing conditions vs. Planned Parenthood\u003c/strong>\u003c/p>\n\u003cp>The Senate bill appears to drop a wildly unpopular provision that is still in the House bill -- the possibility that your state might allow insurers to refuse to cover people with pre-existing conditions, or charge them much more. That seems like good news for cancer survivors and millions of others with chronic illnesses. They can't be denied coverage, or charged more up front.\u003c/p>\n\u003cp>But experts who have read the bill closely say there are loopholes that would allow individual states to loosen regulations on insurers -- enabling those insurers to carve away coverage that people with pre-existing conditions need. As Kaiser Health News \u003ca href=\"http://khn.org/news/promises-made-to-protect-preexisting-conditions-prove-hollow/\" target=\"_blank\">reports\u003c/a>: \u003c/p>\n\u003cblockquote>\u003cp>Somebody with cancer might be able to buy insurance but find it doesn’t cover expensive chemotherapy. A plan might pay for opioids to control pain but not recovery if a patient became addicted. People planning families might find it hard to get childbirth coverage.\u003c/p>\u003c/blockquote>\n\u003cp>The Senate bill also retains a proposal to eliminate all federal funding for Planned Parenthood, for one year. The feds never paid for abortions; this is money the organization uses for breast exams, contraception and testing for sexually transmitted diseases.\u003c/p>\n\u003cp>\u003cstrong>5. The Senate Bill Still Ignores Health Care’s Real Problem: Cost\u003c/strong>\u003c/p>\n\u003cp>The frustrations that many voters have with the Affordable Care Act are understandable. Very little in that law reduced health care spending, or got at the root causes of excessive charges -- though the ACA did slow down the growth rate compared to previous years.\u003c/p>\n\u003cp>It’s a valid criticism to point out that premiums continued to rise under the ACA, and quite sharply in some places. If you don’t qualify for any of the ACA assistance to shield you from those price increases, you -- or your employer -- are paying those increases out-of-pocket. It’s a difficult and chronic pre-existing condition of American health care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If you are interested in learning more about \u003cem>how\u003c/em> the U.S. health care system became so expensive for patients, I recommend \u003ca href=\"http://www.npr.org/books/titles/523005656/an-american-sickness-how-healthcare-became-big-business-and-how-you-can-take-it-\" target=\"_blank\" rel=\"noopener noreferrer\">this book\u003c/a>.\u003c/p>\n\n","blocks":[],"excerpt":"Five takeaways from the new draft bill, and why it's not really 'repeal and replace.'","status":"publish","parent":0,"modified":1498253090,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":887},"headData":{"title":"Analysis: Why Senate Health Bill Is Even 'Meaner' for California | KQED","description":"Five takeaways from the new draft bill, and why it's not really 'repeal and replace.'","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Analysis: Why Senate Health Bill Is Even 'Meaner' for California","datePublished":"2017-06-22T20:16:22.000Z","dateModified":"2017-06-23T21:24:50.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"346757 https://ww2.kqed.org/stateofhealth/?p=346757","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/06/22/analysis-why-senate-health-bill-is-even-meaner-for-california/","disqusTitle":"Analysis: Why Senate Health Bill Is Even 'Meaner' for California","path":"/stateofhealth/346757/analysis-why-senate-health-bill-is-even-meaner-for-california","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>At last, Republican senators have \u003ca href=\"https://ww2.kqed.org/news/2017/06/22/senate-republicans-reveal-obamacare-repeal-bill/\" target=\"_blank\" rel=\"noopener noreferrer\">unveiled their crafted-in-secret health bill\u003c/a>, and everyone, including other Republican senators, are scrambling to understand the 142-page \"\u003ca href=\"https://www.budget.senate.gov/imo/media/doc/SENATEHEALTHCARE.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Better Care Reconciliation Act of 2017\u003c/a>.\"\u003c/p>\n\u003cp>To know whether it's truly \"better care,\" and for which patients, if any, we still need the Congressional Budget Office to weigh in. But some California advocates say the “discussion draft” is clear enough to conclude that the bill would be “disproportionately devastating” for California’s health care system.\u003c/p>\n\u003cp>“If the House bill was mean, as the President termed it, the Senate bill was actually meaner and crueler,” said Anthony Wright, executive director of Health Access California. “It has harsher cuts, especially to the Medicaid program that covers 14 million Californians.\"\u003c/p>\n\u003cp>In the meantime, here are my five takeaways from the bill:\u003c/p>\n\u003cp>\u003cstrong>1. 'Repeal and Replace' Rhetoric Should Be … Repealed\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At this point, it’s inaccurate and misleading. The Republican bill doesn’t repeal all of President Obama's health care law known as the Affordable Care Act, or Obamacare. Nor does it replace it with anything. The bill maintains the basic mechanics of the ACA but rolls back the financial assistance and some of the consumer protections. In addition, a huge part of this bill has nothing to do with Obamacare: It proposes a radical dismemberment of Medicaid as we know it.\u003c/p>\n\u003cp>Let’s describe what the bill actually does: It’s an Obamacare \u003cem>rollback\u003c/em> and a Medicaid \u003cem>cutback\u003c/em>.\u003c/p>\n\u003cp>\u003cstrong>2. Much Less Aid for Medicaid\u003c/strong>\u003c/p>\n\u003cp>The Senate bill will phase out one of the ACA’s most visible accomplishments: the \u003cem>expansion\u003c/em> of Medicaid (Medi-Cal in California) to poor, uninsured adults. That means 3.7 million Californians who got Medi-Cal since 2014 will eventually lose it.\u003c/p>\n\u003cp>But there's more. The Senate plan will also cut funding for \u003cem>traditional\u003c/em> Medi-Cal, and the cuts will be deeper, over time, than even the House Republicans proposed.\u003c/p>\n\u003cp>In California, Medi-Cal covers one-third of all residents, half of all children, and two-thirds of seniors in nursing homes.\u003c/p>\n\u003cp>Who pays for their care if the feds pay less? The short answer is no one -- or state taxpayers.\u003c/p>\n\u003cp>\u003cstrong>3. What About Covered California? Could It help?\u003c/strong>\u003c/p>\n\u003cp>Not really. The Senate version tries to assuage pre-Medicare seniors (below age 65) who were alarmed that the House bill would have given them only a maximum tax credit of $4,000 to buy a plan, no matter the plan’s price. The Senate bill reverts to the ACA mechanism of offering tax credits based on income, not age. But, insurers can still charge older people five times what they charge younger people.\u003c/p>\n\u003cp>And tax credits would only be offered to people with incomes below 350 percent of the federal poverty level, down from the ACA’s 400 percent. Do you make $42,000-$48,000 a year? You would no longer qualify for any subsidies on Covered California.\u003c/p>\n\u003cp>That’s not all. Other complicated changes to the exchanges mean premiums and deductibles would go up, and special ACA grants that help reduce those deductibles disappear.\u003c/p>\n\u003cp>\u003cstrong>4. Winners? Or Just Losers: Pre-existing conditions vs. Planned Parenthood\u003c/strong>\u003c/p>\n\u003cp>The Senate bill appears to drop a wildly unpopular provision that is still in the House bill -- the possibility that your state might allow insurers to refuse to cover people with pre-existing conditions, or charge them much more. That seems like good news for cancer survivors and millions of others with chronic illnesses. They can't be denied coverage, or charged more up front.\u003c/p>\n\u003cp>But experts who have read the bill closely say there are loopholes that would allow individual states to loosen regulations on insurers -- enabling those insurers to carve away coverage that people with pre-existing conditions need. As Kaiser Health News \u003ca href=\"http://khn.org/news/promises-made-to-protect-preexisting-conditions-prove-hollow/\" target=\"_blank\">reports\u003c/a>: \u003c/p>\n\u003cblockquote>\u003cp>Somebody with cancer might be able to buy insurance but find it doesn’t cover expensive chemotherapy. A plan might pay for opioids to control pain but not recovery if a patient became addicted. People planning families might find it hard to get childbirth coverage.\u003c/p>\u003c/blockquote>\n\u003cp>The Senate bill also retains a proposal to eliminate all federal funding for Planned Parenthood, for one year. The feds never paid for abortions; this is money the organization uses for breast exams, contraception and testing for sexually transmitted diseases.\u003c/p>\n\u003cp>\u003cstrong>5. The Senate Bill Still Ignores Health Care’s Real Problem: Cost\u003c/strong>\u003c/p>\n\u003cp>The frustrations that many voters have with the Affordable Care Act are understandable. Very little in that law reduced health care spending, or got at the root causes of excessive charges -- though the ACA did slow down the growth rate compared to previous years.\u003c/p>\n\u003cp>It’s a valid criticism to point out that premiums continued to rise under the ACA, and quite sharply in some places. If you don’t qualify for any of the ACA assistance to shield you from those price increases, you -- or your employer -- are paying those increases out-of-pocket. It’s a difficult and chronic pre-existing condition of American health care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If you are interested in learning more about \u003cem>how\u003c/em> the U.S. health care system became so expensive for patients, I recommend \u003ca href=\"http://www.npr.org/books/titles/523005656/an-american-sickness-how-healthcare-became-big-business-and-how-you-can-take-it-\" target=\"_blank\" rel=\"noopener noreferrer\">this book\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/346757/analysis-why-senate-health-bill-is-even-meaner-for-california","authors":["11314"],"categories":["stateofhealth_15","stateofhealth_14","stateofhealth_1"],"tags":["stateofhealth_38","stateofhealth_3117","stateofhealth_2808","stateofhealth_28","stateofhealth_99","stateofhealth_218","stateofhealth_2519","stateofhealth_2865","stateofhealth_365"],"featImg":"stateofhealth_346802","label":"stateofhealth"},"stateofhealth_301729":{"type":"posts","id":"stateofhealth_301729","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"301729","score":null,"sort":[1488846223000]},"guestAuthors":[],"slug":"gop-bill-would-repeal-obamacare-taxes-and-penalties-keep-some-subsidies","title":"GOP Bill Would Repeal Obamacare Taxes and Penalties, Keep Some Subsidies","publishDate":1488846223,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>After years of waiting, it's finally here.\u003c/p>\n\u003cp>The \u003ca href=\"https://waysandmeans.house.gov/event/markup-budget-reconciliation-recommendations-repeal-replace-obamacare/\">Republican plan\u003c/a> to \u003ca href=\"https://energycommerce.house.gov/news-center/press-releases/energy-and-commerce-republicans-release-legislation-repeal-and-replace\">reshape \u003c/a>the Affordable Care Act — what they call \"repeal and replace\" — kills the requirement that everyone buy health insurance by eliminating the tax penalty for those who don't have coverage. It also makes significant changes in the financial assistance people can receive to buy a health plan.\u003c/p>\n\u003cp>\"Our legislation transfers power from Washington back to the states,\" said House Ways and Means Committee Chairman Kevin Brady in a statement. \"We dismantle Obamacare's damaging taxes and mandates so states can deliver quality affordable options.\"\u003c/p>\n\u003cp>The bill would offer tax credits, refundable in advance, to people with incomes below $75,000. But those credits will be lower in many cases than the subsidies now offered in the ACA.\u003c/p>\n\u003cp>The bill, which will go through many revisions and challenges, was released late Monday by two House committees, Ways and Means and Energy and Commerce. Members are expected to start voting on parts of the bill Wednesday.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Rep. Frank Pallone, D-N.J., and Richard Neal, D-Mass., the ranking Democrats on the Energy and Commerce and Ways and Means committees, issued a joint statement saying the bill would \"rip healthcare away from millions of Americans, ration care for working families and put insurance companies back in charge.\"\u003c/p>\n\u003cp>The legislation will need approval by the full House and the Senate before it goes to President Trump for his signature. Until then, most of what is known as Obamacare will stay in place.\u003c/p>\n\u003cp>But it's far from clear that Republicans in the House are unified in their support of the bill. Members of the far-right Freedom Caucus have said they oppose giving tax credits to people who don't pay any federal income tax.\u003c/p>\n\u003cp>And with only a slim majority in the Senate, only a few Republican defections could defeat the bill there.\u003c/p>\n\u003cp>Four Republican senators wrote a letter to Majority Leader Mitch McConnell saying they were concerned an early draft of the House plan would not adequately protect people who have insurance through Obamacare's Medicaid expansion. And Sen. Rand Paul was among three conservative Republicans who criticized an earlier version of the bill as \"Obamacare lite.\"\u003c/p>\n\u003cp>Under the proposed bill, tax credits would start at $2,000 a year for individuals under age 30, rising to $4,000 for those of 60. The proposal, first seen in a Feb. 10 draft of the bill, has been \u003ca href=\"http://www.npr.org/sections/health-shots/2017/02/24/517074764/gop-health-bill-draft-would-cut-medicaid-emphasize-tax-credits\">criticized \u003c/a>as too meager to cover the full cost of a health insurance plan that provides full benefits.\u003c/p>\n\u003cp>But the proposed tax credit could potentially pay for insurance that protects only against a catastrophic health event.\u003c/p>\n\u003cp>They would begin to be phased out at incomes of $75,000 for individuals and $150,000 for families.\u003c/p>\n\u003cp>To encourage people to buy coverage, the plan allows insurers to charge a 30 percent penalty to people who let their insurance lapse, and then try to buy a new policy.\u003c/p>\n\u003cp>In states that expanded Medicaid, people who are eligible can continue to enroll until January 1, 2020, and those states would continue to benefit from the federal government paying a greater share of the health costs of those beneficiaries.\u003c/p>\n\u003cp>Several taxes contained in the ACA would be repealed at the end of this year. These include taxes on health insurers, pharmaceutical and medical device manufacturers, and a tax on high-cost employer-sponsored group health plans (aka Cadillac plans).\u003c/p>\n\u003cp>An analysis by \u003ca href=\"http://avalere.com/expertise/managed-care/insights/capped-funding-in-medicaid-could-significantly-reduce-federal-spending\">Avalere Health\u003c/a> and \u003ca href=\"https://cdn2.vox-cdn.com/uploads/chorus_asset/file/8045899/Scanned_from_a_Xerox_Multifunction_Printer.0.pdf\">McKinsey\u003c/a> of an earlier draft of the bill, which contained many of the same provisions, concluded that it would lead to millions of people losing coverage.\u003c/p>\n\u003cp>The plan offered by the House Republicans falls short of the outright repeal that has been demanded by more conservative members, including those in the House Freedom Caucus.\u003c/p>\n\u003cp>That could be due to the shift in public attitudes toward the ACA in recent weeks.\u003c/p>\n\u003cp>Public opinion has grown more favorable as major changes appeared imminent. A Kaiser Family Foundation \u003ca href=\"http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-future-directions-for-the-aca-and-medicaid/\">tracking poll\u003c/a> in late February found 48 percent having a favorable opinion versus 42 percent viewing the law unfavorably. Kaiser says the shift is due largely to a change in the view of political independents, among which 50 percent now view the law favorably.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>We will have more on this story as it develops.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=GOP+Bill+Would+Repeal+Obamacare+Taxes+And+Penalties%2C+Keep+Some+Subsidies&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"After weeks of internal debate, House Republicans have released their plan for the Affordable Care Act, aka Obamacare. It faces challenges from within the GOP, from interest groups — and the public.","status":"publish","parent":0,"modified":1488853545,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":734},"headData":{"title":"GOP Bill Would Repeal Obamacare Taxes and Penalties, Keep Some Subsidies | KQED","description":"After weeks of internal debate, House Republicans have released their plan for the Affordable Care Act, aka Obamacare. It faces challenges from within the GOP, from interest groups — and the public.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"GOP Bill Would Repeal Obamacare Taxes and Penalties, Keep Some Subsidies","datePublished":"2017-03-07T00:23:43.000Z","dateModified":"2017-03-07T02:25:45.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"301729 https://ww2.kqed.org/stateofhealth/?p=301729","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/03/06/gop-bill-would-repeal-obamacare-taxes-and-penalties-keep-some-subsidies/","disqusTitle":"GOP Bill Would Repeal Obamacare Taxes and Penalties, Keep Some Subsidies","source":"NPR","nprByline":"Joe Neel & Alison Kodjak \u003cbr>NPR","nprImageAgency":"Allison Shelley/Getty Images","nprStoryId":"518864390","nprApiLink":"http://api.npr.org/query?id=518864390&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2017/03/06/518864390/gop-bill-would-repeal-obamacare-taxes-and-penalties-keep-some-subsidies?ft=nprml&f=518864390","nprRetrievedStory":"1","nprPubDate":"Mon, 06 Mar 2017 19:18:00 -0500","nprStoryDate":"Mon, 06 Mar 2017 18:49:00 -0500","nprLastModifiedDate":"Mon, 06 Mar 2017 19:18:28 -0500","path":"/stateofhealth/301729/gop-bill-would-repeal-obamacare-taxes-and-penalties-keep-some-subsidies","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>After years of waiting, it's finally here.\u003c/p>\n\u003cp>The \u003ca href=\"https://waysandmeans.house.gov/event/markup-budget-reconciliation-recommendations-repeal-replace-obamacare/\">Republican plan\u003c/a> to \u003ca href=\"https://energycommerce.house.gov/news-center/press-releases/energy-and-commerce-republicans-release-legislation-repeal-and-replace\">reshape \u003c/a>the Affordable Care Act — what they call \"repeal and replace\" — kills the requirement that everyone buy health insurance by eliminating the tax penalty for those who don't have coverage. It also makes significant changes in the financial assistance people can receive to buy a health plan.\u003c/p>\n\u003cp>\"Our legislation transfers power from Washington back to the states,\" said House Ways and Means Committee Chairman Kevin Brady in a statement. \"We dismantle Obamacare's damaging taxes and mandates so states can deliver quality affordable options.\"\u003c/p>\n\u003cp>The bill would offer tax credits, refundable in advance, to people with incomes below $75,000. But those credits will be lower in many cases than the subsidies now offered in the ACA.\u003c/p>\n\u003cp>The bill, which will go through many revisions and challenges, was released late Monday by two House committees, Ways and Means and Energy and Commerce. Members are expected to start voting on parts of the bill Wednesday.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Rep. Frank Pallone, D-N.J., and Richard Neal, D-Mass., the ranking Democrats on the Energy and Commerce and Ways and Means committees, issued a joint statement saying the bill would \"rip healthcare away from millions of Americans, ration care for working families and put insurance companies back in charge.\"\u003c/p>\n\u003cp>The legislation will need approval by the full House and the Senate before it goes to President Trump for his signature. Until then, most of what is known as Obamacare will stay in place.\u003c/p>\n\u003cp>But it's far from clear that Republicans in the House are unified in their support of the bill. Members of the far-right Freedom Caucus have said they oppose giving tax credits to people who don't pay any federal income tax.\u003c/p>\n\u003cp>And with only a slim majority in the Senate, only a few Republican defections could defeat the bill there.\u003c/p>\n\u003cp>Four Republican senators wrote a letter to Majority Leader Mitch McConnell saying they were concerned an early draft of the House plan would not adequately protect people who have insurance through Obamacare's Medicaid expansion. And Sen. Rand Paul was among three conservative Republicans who criticized an earlier version of the bill as \"Obamacare lite.\"\u003c/p>\n\u003cp>Under the proposed bill, tax credits would start at $2,000 a year for individuals under age 30, rising to $4,000 for those of 60. The proposal, first seen in a Feb. 10 draft of the bill, has been \u003ca href=\"http://www.npr.org/sections/health-shots/2017/02/24/517074764/gop-health-bill-draft-would-cut-medicaid-emphasize-tax-credits\">criticized \u003c/a>as too meager to cover the full cost of a health insurance plan that provides full benefits.\u003c/p>\n\u003cp>But the proposed tax credit could potentially pay for insurance that protects only against a catastrophic health event.\u003c/p>\n\u003cp>They would begin to be phased out at incomes of $75,000 for individuals and $150,000 for families.\u003c/p>\n\u003cp>To encourage people to buy coverage, the plan allows insurers to charge a 30 percent penalty to people who let their insurance lapse, and then try to buy a new policy.\u003c/p>\n\u003cp>In states that expanded Medicaid, people who are eligible can continue to enroll until January 1, 2020, and those states would continue to benefit from the federal government paying a greater share of the health costs of those beneficiaries.\u003c/p>\n\u003cp>Several taxes contained in the ACA would be repealed at the end of this year. These include taxes on health insurers, pharmaceutical and medical device manufacturers, and a tax on high-cost employer-sponsored group health plans (aka Cadillac plans).\u003c/p>\n\u003cp>An analysis by \u003ca href=\"http://avalere.com/expertise/managed-care/insights/capped-funding-in-medicaid-could-significantly-reduce-federal-spending\">Avalere Health\u003c/a> and \u003ca href=\"https://cdn2.vox-cdn.com/uploads/chorus_asset/file/8045899/Scanned_from_a_Xerox_Multifunction_Printer.0.pdf\">McKinsey\u003c/a> of an earlier draft of the bill, which contained many of the same provisions, concluded that it would lead to millions of people losing coverage.\u003c/p>\n\u003cp>The plan offered by the House Republicans falls short of the outright repeal that has been demanded by more conservative members, including those in the House Freedom Caucus.\u003c/p>\n\u003cp>That could be due to the shift in public attitudes toward the ACA in recent weeks.\u003c/p>\n\u003cp>Public opinion has grown more favorable as major changes appeared imminent. A Kaiser Family Foundation \u003ca href=\"http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-future-directions-for-the-aca-and-medicaid/\">tracking poll\u003c/a> in late February found 48 percent having a favorable opinion versus 42 percent viewing the law unfavorably. Kaiser says the shift is due largely to a change in the view of political independents, among which 50 percent now view the law favorably.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>We will have more on this story as it develops.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=GOP+Bill+Would+Repeal+Obamacare+Taxes+And+Penalties%2C+Keep+Some+Subsidies&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/301729/gop-bill-would-repeal-obamacare-taxes-and-penalties-keep-some-subsidies","authors":["byline_stateofhealth_301729"],"categories":["stateofhealth_2442","stateofhealth_15","stateofhealth_14","stateofhealth_1"],"tags":["stateofhealth_2808","stateofhealth_2874","stateofhealth_218","stateofhealth_105","stateofhealth_2519","stateofhealth_2865","stateofhealth_365"],"featImg":"stateofhealth_301730","label":"source_stateofhealth_301729"},"stateofhealth_93349":{"type":"posts","id":"stateofhealth_93349","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"93349","score":null,"sort":[1445018427000]},"guestAuthors":[],"slug":"for-former-foster-kids-moving-out-of-state-can-mean-losing-medicaid","title":"For Former Foster Kids, Moving Out of State Can Mean Losing Medicaid","publishDate":1445018427,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>Soon after moving to Utah this summer, Rainbow Sky Buck ended up at the hospital with a painful ear infection. There, Buck learned she no longer had access to the free health coverage she had in California as a former foster youth.\u003c/p>\n\u003cp>To pay for the care, Buck emptied out her bank account and borrowed money. “Luckily, I got my antibiotics and I am okay now,” she said. “But what is going to happen next time?”\u003c/p>\n\u003cp>Under the health law, young adults who age of out of the foster care system are eligible for free Medicaid coverage \u003ca href=\"http://khn.org/news/foster-children-california-adults-medicaid/\" target=\"_blank\">until they turn 26.\u003c/a> The provision was an attempt to give them the same opportunity as other young people who can stay on their parents’ insurance until their 26\u003csup>th\u003c/sup> birthday.\u003c/p>\n\u003cp>But these young adults are encountering a major barrier: They are only guaranteed coverage in the state where they were in foster care. States have the option of extending the benefit to all former foster youths, but only about a dozen have done so.\u003c/p>\n\u003cp>Now, advocates and policymakers are trying to change the law at the federal level, so former foster youths don’t lose access to Medicaid coverage no matter where they move.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"quDmgipf5B7js5fILKqbBJCNiiZBBixc\"]Reps. Karen Bass, D-Calif., and Jim McDermott, D-Wash., have proposed \u003ca href=\"http://bass.house.gov/press-release/reps-bass-mcdermott-introduce-legislation-ensure-former-foster-youth-can-keep-health\" target=\"_blank\">legislation\u003c/a> that would allow them to qualify for Medicaid, the government health program for low-income Americans, in any state. Sen. Bob Casey, D-Pa., has introduced a similar \u003ca href=\"http://www.casey.senate.gov/newsroom/releases/casey-introduces-bill-to-fix-glitch-that-could-kick-former-foster-youth-off-of-medicaid\" target=\"_blank\">bill\u003c/a> that he said would be a simple clarification of what Congress intended. Meanwhile, advocates are pushing the Centers for Medicare & Medicaid Services to change its interpretation of the original provision.\u003c/p>\n\u003cp>\u003ca href=\"http://firstfocus.org/\" target=\"_blank\">First Focus\u003c/a>, which advocates for foster youths, has been receiving calls from young people who had no idea that they would lose health insurance when they moved.\u003c/p>\n\u003cp>“We really do feel an urgency about this,” said Shadi Houshyar, vice president of child welfare policy at the organization. “So many people who have aged out have significant health needs and coverage is so important. There shouldn’t be an additional barrier.”\u003c/p>\n\u003cp>Former foster youths are more likely than their peers to have physical and mental health needs, experts say. Ongoing \u003ca href=\"http://www.chapinhall.org/research/report/midwest-evaluation-adult-functioning-former-foster-youth\" target=\"_blank\">research\u003c/a> in Illinois, Wisconsin and Iowa shows that 22 percent of former foster youths had been hospitalized at least once in the previous year and one-third had two or more emergency room visits.\u003c/p>\n\u003cp>Just like other young people, former foster youths move to different states for school, jobs or family, said Fatima Morales, policy and outreach associate for the advocacy group \u003ca href=\"http://www.childrennow.org/\" target=\"_blank\">Children Now\u003c/a>. Morales said they shouldn’t be penalized for doing so.\u003c/p>\n\u003cfigure id=\"attachment_94773\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/Screen-Shot-2015-10-19-at-9.27.56-AM.png\">\u003cimg class=\"size-thumbnail wp-image-94773\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/Screen-Shot-2015-10-19-at-9.27.56-AM-400x367.png\" alt=\"Lezlie Martinez, 19, holds her two-year-old son. She would like to move from California to Colorado where she says it would be cheaper to live, but she worries about losing her health coverage. \" width=\"400\" height=\"367\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/Screen-Shot-2015-10-19-at-9.27.56-AM-400x367.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/Screen-Shot-2015-10-19-at-9.27.56-AM.png 594w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lezlie Martinez, 19, holds her two-year-old son. She would like to move from California to Colorado where she says it would be cheaper to live, but she worries about losing her health coverage. \u003ccite>(Courtesy: Jordan Verdin )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Morales said her organization is trying to inform youths what they might face if they move. “They need to know how their health coverage might be impacted,” she said. “It’s just something that they need to weigh.”\u003c/p>\n\u003cp>Lezlie Martinez, 19, is weighing her options now. She is hoping to move from California to Colorado because she wants to live in a place with a lower cost of living. Her boyfriend is already there and she is looking for hospitality jobs to support herself and her 2-year-old son.\u003c/p>\n\u003cp>But she worries that she may be left uninsured and unable to pay for medical treatment for eczema, allergies and fibromyalgia. “It is causing foster youth to be stuck in the same state they were raised in,” said Martinez, who lives in Oceanside, Calif. “It is really stressing me out.”\u003c/p>\n\u003cp>Buck said she decided to move to Sandy City, Utah, because of the limited job prospects in the small northern California town of Crescent City. Before moving, she asked social workers about whether she would still qualify for free health coverage and was told that she would. Buck said she was shocked to learn otherwise.\u003c/p>\n\u003cp>She is no longer seeing a therapist for depression and said she is weaning herself off antidepressants because she can’t afford them. Buck said she also worries about getting another ear infection and not being able to afford treatment.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It is just scary to think I am completely on my own,” said Buck, who recently got a job at an automotive shop but doesn’t get insurance from her employer. “I don’t want to leave, but this is almost forcing me to move back to California.”\u003c/p>\n\n","blocks":[],"excerpt":"Advocates and some members of Congress want to fix the loophole.","status":"publish","parent":0,"modified":1445272422,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":791},"headData":{"title":"For Former Foster Kids, Moving Out of State Can Mean Losing Medicaid | KQED","description":"Advocates and some members of Congress want to fix the loophole.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"For Former Foster Kids, Moving Out of State Can Mean Losing Medicaid","datePublished":"2015-10-16T18:00:27.000Z","dateModified":"2015-10-19T16:33:42.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"93349 http://ww2.kqed.org/stateofhealth/?p=93349","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/10/16/for-former-foster-kids-moving-out-of-state-can-mean-losing-medicaid/","disqusTitle":"For Former Foster Kids, Moving Out of State Can Mean Losing Medicaid","source":"Kaiser Health News","sourceUrl":"www.khn.org","nprByline":"Anna Gorman","path":"/stateofhealth/93349/for-former-foster-kids-moving-out-of-state-can-mean-losing-medicaid","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Soon after moving to Utah this summer, Rainbow Sky Buck ended up at the hospital with a painful ear infection. There, Buck learned she no longer had access to the free health coverage she had in California as a former foster youth.\u003c/p>\n\u003cp>To pay for the care, Buck emptied out her bank account and borrowed money. “Luckily, I got my antibiotics and I am okay now,” she said. “But what is going to happen next time?”\u003c/p>\n\u003cp>Under the health law, young adults who age of out of the foster care system are eligible for free Medicaid coverage \u003ca href=\"http://khn.org/news/foster-children-california-adults-medicaid/\" target=\"_blank\">until they turn 26.\u003c/a> The provision was an attempt to give them the same opportunity as other young people who can stay on their parents’ insurance until their 26\u003csup>th\u003c/sup> birthday.\u003c/p>\n\u003cp>But these young adults are encountering a major barrier: They are only guaranteed coverage in the state where they were in foster care. States have the option of extending the benefit to all former foster youths, but only about a dozen have done so.\u003c/p>\n\u003cp>Now, advocates and policymakers are trying to change the law at the federal level, so former foster youths don’t lose access to Medicaid coverage no matter where they move.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Reps. Karen Bass, D-Calif., and Jim McDermott, D-Wash., have proposed \u003ca href=\"http://bass.house.gov/press-release/reps-bass-mcdermott-introduce-legislation-ensure-former-foster-youth-can-keep-health\" target=\"_blank\">legislation\u003c/a> that would allow them to qualify for Medicaid, the government health program for low-income Americans, in any state. Sen. Bob Casey, D-Pa., has introduced a similar \u003ca href=\"http://www.casey.senate.gov/newsroom/releases/casey-introduces-bill-to-fix-glitch-that-could-kick-former-foster-youth-off-of-medicaid\" target=\"_blank\">bill\u003c/a> that he said would be a simple clarification of what Congress intended. Meanwhile, advocates are pushing the Centers for Medicare & Medicaid Services to change its interpretation of the original provision.\u003c/p>\n\u003cp>\u003ca href=\"http://firstfocus.org/\" target=\"_blank\">First Focus\u003c/a>, which advocates for foster youths, has been receiving calls from young people who had no idea that they would lose health insurance when they moved.\u003c/p>\n\u003cp>“We really do feel an urgency about this,” said Shadi Houshyar, vice president of child welfare policy at the organization. “So many people who have aged out have significant health needs and coverage is so important. There shouldn’t be an additional barrier.”\u003c/p>\n\u003cp>Former foster youths are more likely than their peers to have physical and mental health needs, experts say. Ongoing \u003ca href=\"http://www.chapinhall.org/research/report/midwest-evaluation-adult-functioning-former-foster-youth\" target=\"_blank\">research\u003c/a> in Illinois, Wisconsin and Iowa shows that 22 percent of former foster youths had been hospitalized at least once in the previous year and one-third had two or more emergency room visits.\u003c/p>\n\u003cp>Just like other young people, former foster youths move to different states for school, jobs or family, said Fatima Morales, policy and outreach associate for the advocacy group \u003ca href=\"http://www.childrennow.org/\" target=\"_blank\">Children Now\u003c/a>. Morales said they shouldn’t be penalized for doing so.\u003c/p>\n\u003cfigure id=\"attachment_94773\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/Screen-Shot-2015-10-19-at-9.27.56-AM.png\">\u003cimg class=\"size-thumbnail wp-image-94773\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/Screen-Shot-2015-10-19-at-9.27.56-AM-400x367.png\" alt=\"Lezlie Martinez, 19, holds her two-year-old son. She would like to move from California to Colorado where she says it would be cheaper to live, but she worries about losing her health coverage. \" width=\"400\" height=\"367\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/Screen-Shot-2015-10-19-at-9.27.56-AM-400x367.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/Screen-Shot-2015-10-19-at-9.27.56-AM.png 594w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lezlie Martinez, 19, holds her two-year-old son. She would like to move from California to Colorado where she says it would be cheaper to live, but she worries about losing her health coverage. \u003ccite>(Courtesy: Jordan Verdin )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Morales said her organization is trying to inform youths what they might face if they move. “They need to know how their health coverage might be impacted,” she said. “It’s just something that they need to weigh.”\u003c/p>\n\u003cp>Lezlie Martinez, 19, is weighing her options now. She is hoping to move from California to Colorado because she wants to live in a place with a lower cost of living. Her boyfriend is already there and she is looking for hospitality jobs to support herself and her 2-year-old son.\u003c/p>\n\u003cp>But she worries that she may be left uninsured and unable to pay for medical treatment for eczema, allergies and fibromyalgia. “It is causing foster youth to be stuck in the same state they were raised in,” said Martinez, who lives in Oceanside, Calif. “It is really stressing me out.”\u003c/p>\n\u003cp>Buck said she decided to move to Sandy City, Utah, because of the limited job prospects in the small northern California town of Crescent City. Before moving, she asked social workers about whether she would still qualify for free health coverage and was told that she would. Buck said she was shocked to learn otherwise.\u003c/p>\n\u003cp>She is no longer seeing a therapist for depression and said she is weaning herself off antidepressants because she can’t afford them. Buck said she also worries about getting another ear infection and not being able to afford treatment.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It is just scary to think I am completely on my own,” said Buck, who recently got a job at an automotive shop but doesn’t get insurance from her employer. “I don’t want to leave, but this is almost forcing me to move back to California.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/93349/for-former-foster-kids-moving-out-of-state-can-mean-losing-medicaid","authors":["byline_stateofhealth_93349"],"categories":["stateofhealth_2442","stateofhealth_14"],"tags":["stateofhealth_2544","stateofhealth_99","stateofhealth_218","stateofhealth_2519"],"featImg":"stateofhealth_93353","label":"source_stateofhealth_93349"},"stateofhealth_57722":{"type":"posts","id":"stateofhealth_57722","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"57722","score":null,"sort":[1438880514000]},"guestAuthors":[],"slug":"even-with-insurance-medicaid-recipients-still-go-to-er-for-dental-problems","title":"Even With Insurance, Medicaid Recipients Still Go to ER for Dental Problems","publishDate":1438880514,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>States that provide Medicaid adult dental care still have high rates of dental patients who show up at hospital emergency departments, particularly in urban underserved areas, according to a \u003ca href=\"https://med.stanford.edu/news/all-news/2015/08/medicaid-dental-coverage-may-not-prevent-tooth-related-er-visits.html\" target=\"_blank\">study released this week\u003c/a>. The study -- by researchers at Stanford University, UC San Francisco, Truven Health Analytics and the federal Agency for Healthcare Research and Quality -- was published in \u003cem>\u003ca href=\"http://content.healthaffairs.org/content/34/8/1349.abstract?=right\" target=\"_blank\">Health Affairs\u003c/a>\u003c/em>.\u003c/p>\n\u003caside class=\"pullquote alignright\">“People say there are plenty of dentists, but there’s a subtler argument we’re trying to make: that there is a low rate of dentists who take Medicaid.”\u003c/aside>\n\u003cp>Researchers said a dearth of dental providers who accept Medicaid patients, particularly in those urban underserved areas, has limited the effectiveness of Medicaid dental coverage in states that provide it.\u003c/p>\n\u003cp>\"We found that, in urban counties there were large concentrations of all providers, but not really to serve the poor,\" said Maria Raven, senior author of the study and associate professor of emergency medicine at UCSF.\u003c/p>\n\u003cp>\"There may be a higher density of dentists [in urban areas], but they're still not accepting Medi-Cal patients,\" Raven said. \"Coverage doesn't equal access.\"\u003c/p>\n\u003cp>That has resulted in high ED use even in states with Medicaid dental coverage, she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Medi-Cal is California's Medicaid program, and it did not have adult dental coverage in 2010, when the study's data were collected.\u003c/p>\n\u003cp>Katie Fingar, lead author of the study and research leader in health care at Truven, said the numbers were slightly better in rural areas.\u003c/p>\n\u003cp>\"We did see that for those in rural areas, a greater supply [of dental providers] was associated with lower ED use,\" Fingar said. But, she said, 90 percent of Medicaid dental visits are in urban areas.\u003c/p>\n\u003cp>[contextly_sidebar id=\"sT9KtJ06HSo5xPfgl6TvmZCmlYYDZAHP\"]As a result, she said, more than 2 percent of all emergency department visits are related to non-traumatic dental conditions.\u003c/p>\n\u003cp>In April, the American Dental Association released \u003ca href=\"http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0415_2.ashx\" target=\"_blank\">a similar study\u003c/a> that drew similar conclusions.\u003c/p>\n\u003cp>\"One of the important things about the study we did is we looked at provider density,\" Raven said. \"People say there are plenty of dentists, but there's a subtler argument we're trying to make, that there is a low rate of dentists who take Medicaid.\"\u003c/p>\n\u003cp>Provider rates in California are among the lowest Medicaid rates in the nation, she said, but care can still be worked out in underserved urban areas, such as the use of mid-level dental providers -- or getting more dentists to see Medi-Cal patients.\u003c/p>\n\u003cp>\"It's too bad provider rates aren't higher,\" she said, \"but everyone needs to pitch in. Coverage is a necessity, but you have to pair it with providers.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>David Gorn is a senior reporter with \u003ca href=\"http://www.californiahealthline.org\" target=\"_blank\">California Healthline. \u003c/a>\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Researchers say while there are likely enough dentists, the problem is the low rate of those accepting Medicaid. ","status":"publish","parent":0,"modified":1438908691,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":461},"headData":{"title":"Even With Insurance, Medicaid Recipients Still Go to ER for Dental Problems | KQED","description":"Researchers say while there are likely enough dentists, the problem is the low rate of those accepting Medicaid. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Even With Insurance, Medicaid Recipients Still Go to ER for Dental Problems","datePublished":"2015-08-06T17:01:54.000Z","dateModified":"2015-08-07T00:51:31.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"57722 http://ww2.kqed.org/stateofhealth/?p=57722","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/08/06/even-with-insurance-medicaid-recipients-still-go-to-er-for-dental-problems/","disqusTitle":"Even With Insurance, Medicaid Recipients Still Go to ER for Dental Problems","nprByline":"David Gorn","path":"/stateofhealth/57722/even-with-insurance-medicaid-recipients-still-go-to-er-for-dental-problems","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>States that provide Medicaid adult dental care still have high rates of dental patients who show up at hospital emergency departments, particularly in urban underserved areas, according to a \u003ca href=\"https://med.stanford.edu/news/all-news/2015/08/medicaid-dental-coverage-may-not-prevent-tooth-related-er-visits.html\" target=\"_blank\">study released this week\u003c/a>. The study -- by researchers at Stanford University, UC San Francisco, Truven Health Analytics and the federal Agency for Healthcare Research and Quality -- was published in \u003cem>\u003ca href=\"http://content.healthaffairs.org/content/34/8/1349.abstract?=right\" target=\"_blank\">Health Affairs\u003c/a>\u003c/em>.\u003c/p>\n\u003caside class=\"pullquote alignright\">“People say there are plenty of dentists, but there’s a subtler argument we’re trying to make: that there is a low rate of dentists who take Medicaid.”\u003c/aside>\n\u003cp>Researchers said a dearth of dental providers who accept Medicaid patients, particularly in those urban underserved areas, has limited the effectiveness of Medicaid dental coverage in states that provide it.\u003c/p>\n\u003cp>\"We found that, in urban counties there were large concentrations of all providers, but not really to serve the poor,\" said Maria Raven, senior author of the study and associate professor of emergency medicine at UCSF.\u003c/p>\n\u003cp>\"There may be a higher density of dentists [in urban areas], but they're still not accepting Medi-Cal patients,\" Raven said. \"Coverage doesn't equal access.\"\u003c/p>\n\u003cp>That has resulted in high ED use even in states with Medicaid dental coverage, she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Medi-Cal is California's Medicaid program, and it did not have adult dental coverage in 2010, when the study's data were collected.\u003c/p>\n\u003cp>Katie Fingar, lead author of the study and research leader in health care at Truven, said the numbers were slightly better in rural areas.\u003c/p>\n\u003cp>\"We did see that for those in rural areas, a greater supply [of dental providers] was associated with lower ED use,\" Fingar said. But, she said, 90 percent of Medicaid dental visits are in urban areas.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>As a result, she said, more than 2 percent of all emergency department visits are related to non-traumatic dental conditions.\u003c/p>\n\u003cp>In April, the American Dental Association released \u003ca href=\"http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0415_2.ashx\" target=\"_blank\">a similar study\u003c/a> that drew similar conclusions.\u003c/p>\n\u003cp>\"One of the important things about the study we did is we looked at provider density,\" Raven said. \"People say there are plenty of dentists, but there's a subtler argument we're trying to make, that there is a low rate of dentists who take Medicaid.\"\u003c/p>\n\u003cp>Provider rates in California are among the lowest Medicaid rates in the nation, she said, but care can still be worked out in underserved urban areas, such as the use of mid-level dental providers -- or getting more dentists to see Medi-Cal patients.\u003c/p>\n\u003cp>\"It's too bad provider rates aren't higher,\" she said, \"but everyone needs to pitch in. Coverage is a necessity, but you have to pair it with providers.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>David Gorn is a senior reporter with \u003ca href=\"http://www.californiahealthline.org\" target=\"_blank\">California Healthline. \u003c/a>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/57722/even-with-insurance-medicaid-recipients-still-go-to-er-for-dental-problems","authors":["byline_stateofhealth_57722"],"categories":["stateofhealth_11"],"tags":["stateofhealth_380","stateofhealth_99","stateofhealth_218"],"featImg":"stateofhealth_57727","label":"stateofhealth"},"stateofhealth_22054":{"type":"posts","id":"stateofhealth_22054","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"22054","score":null,"sort":[1413358292000]},"guestAuthors":[],"slug":"spike-in-er-hospitalization-use-short-lived-after-medicaid-expansion","title":"Spike in ER, Hospitalization Use Short-Lived After Medicaid Expansion","publishDate":1413358292,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_22069\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000006096996_Large-e1413358030830.jpg\">\u003cimg class=\"size-large wp-image-22069\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000006096996_Large-640x428.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>While the Medicaid expansion \u003ca title=\"http://www.kaiserhealthnews.org/daily-reports/2014/january/03/oregon-study-medicaid-expansion-higher-emergency-visits.aspx\" href=\"http://www.kaiserhealthnews.org/daily-reports/2014/january/03/oregon-study-medicaid-expansion-higher-emergency-visits.aspx\" target=\"_blank\">may lead to a dramatic rise\u003c/a> in emergency room use and hospitalizations for many of the previously uninsured, that increase is largely temporary and should not lead to a dramatic impact on state budgets, according to \u003ca title=\"http://healthpolicy.ucla.edu/publications/search/pages/detail.aspx?PubID=1338\" href=\"http://healthpolicy.ucla.edu/publications/search/pages/detail.aspx?PubID=1338\" target=\"_blank\">a new analysis\u003c/a> from the UCLA Center for Health Policy Research released Wednesday.\u003c/p>\n\u003cp>Researchers reviewed two years of claims data from nearly 200,000 Californians who had enrolled in public programs in advance of the expansion of Medi-Cal, the state's version of Medicaid, in January. These programs were designed to ease the expansion of Medicaid by providing insurance to low-income adults who were not eligible for Medi-Cal at that point but would be when the health law's expansion went into effect earlier this year.\u003c/p>\n\u003cp>Researchers then divided the group into four categories, based on the researchers' assessment of each group's pent-up demand for health care.\u003c/p>\n\u003cp>In July, 2011, after being enrolled in California's \u003ca title=\"http://www.dhcs.ca.gov/provgovpart/Pages/lihp.aspx\" href=\"http://www.dhcs.ca.gov/provgovpart/Pages/lihp.aspx\" target=\"_blank\">Low Income Health Program\u003c/a>, the so-called \"bridge to reform,\" the group with the highest pent-up demand had a rate of costly emergency room visits triple -- or more -- that of the other groups. But from 2011 to 2013, that high rate dropped by more than two-thirds and has remained \"relatively constant,\" according to the analysis.\u003c!--more-->\u003c/p>\n\u003cp>\"We were hoping that this would be the case,\" said lead author Jerry Kominski, director of the UCLA Center for Health Policy Research, \"because we think that that's what access to care does for low-income individuals … that there's an additional increase in demand for services and that that demand, or utilization, drops off pretty rapidly.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Rates of hospitalization for the \"highest pent-up demand\" group also started high and dropped by almost 80 percent over the two-year period. Curiously, if ER and hospitalization rates were dropping, it's reasonable that outpatient visits might rise. But that wasn't the case; the rate of outpatient visits was largely unchanged during the two-year period.\u003c/p>\n\u003cp>Kominski said that one of the fears of the Medicaid expansion was the potential high cost of low-income patients. He argued that this analysis should ease those fears. \"What our findings say to the country is (that) concerns about Medicaid expansion being financially unsustainable into the future are unfounded.\" Under the Affordable Care Act, the federal government provides 100 percent of the cost of the newly eligible under the Medicaid expansion, but in 2017 that contribution will phase down until it reaches 90 percent in 2020.\u003c/p>\n\u003cp>Twenty-seven states have implemented the Medicaid expansion; 21 have not, and in two states, Indiana and Utah, the question of expansion is an \"open discussion,\" \u003ca title=\"http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/\" href=\"http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/\" target=\"_blank\">according to a tally\u003c/a> from the Kaiser Family Foundation.\u003c/p>\n\u003cp>Matt Salo, executive director of the National Association of Medicaid Directors, said the study was \"certainly consistent with what we hope to do\" by expanding health insurance access. He said insurance is \"just the first step, the next step is health care homes so that the individual can actually get better care.\"\u003c/p>\n\u003cp>One factor in helping drive down the higher rates of utilization, Kominski said, is coordinated care initiatives in place for Medi-Cal beneficiaries. For example, virtually all Medi-Cal beneficiaries are now enrolled into a Medi-Cal managed care plan. \"To the extent that other states don't have adequate coordinated care mechanisms in place for their Medicaid populations, then the kinds of drop off that we observed in California may not occur there,\" Kominski said.\u003c/p>\n\u003cp>The UCLA analysis makes explicit reference to -- and rebuts -- a similar study, the \u003ca title=\"http://www.nber.org/oregon/#recent-results\" href=\"http://www.nber.org/oregon/#recent-results\" target=\"_blank\">Oregon Health Insurance Experiment\u003c/a>. In Oregon in 2008, 10,000 residents literally won Medicaid coverage in a lottery, creating a true randomized controlled trial opportunity for researchers who compared those who won coverage with those who didn't, rarely possible to do in social policy research. Researchers later reported \u003ca title=\"http://www.nber.org/oregon/\" href=\"http://www.nber.org/oregon/\" target=\"_blank\">a 40 percent increase in ER visits\u003c/a> in the 18-months after that expansion.\u003c/p>\n\u003cp>Kate Baicker, a health economist at the Harvard School of Public Health, was one of the researchers in the Oregon experiment. She said they did not find \"any evidence of utilization tailing off over that 18-month window\" and stands by her results.\u003c/p>\n\u003cp>Still, Baicker said that an increase in use of health care services, such as emergency room visits or hospitalizations, \"does not mean that Medicaid should not be expanded. Part of the goal is to increase access to health care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The UCLA study was funded by the California Department of Health Care Services and Blue Shield of California Foundation.\u003c/p>\n\n","blocks":[],"excerpt":"Earlier fears that expanding health insurance actually increased costly ER use appear unfounded.","status":"publish","parent":0,"modified":1413570311,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":770},"headData":{"title":"Spike in ER, Hospitalization Use Short-Lived After Medicaid Expansion | KQED","description":"Earlier fears that expanding health insurance actually increased costly ER use appear unfounded.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Spike in ER, Hospitalization Use Short-Lived After Medicaid Expansion","datePublished":"2014-10-15T07:31:32.000Z","dateModified":"2014-10-17T18:25:11.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"22054 http://blogs.kqed.org/stateofhealth/?p=22054","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/10/15/spike-in-er-hospitalization-use-short-lived-after-medicaid-expansion/","disqusTitle":"Spike in ER, Hospitalization Use Short-Lived After Medicaid Expansion","path":"/stateofhealth/22054/spike-in-er-hospitalization-use-short-lived-after-medicaid-expansion","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22069\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000006096996_Large-e1413358030830.jpg\">\u003cimg class=\"size-large wp-image-22069\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000006096996_Large-640x428.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>While the Medicaid expansion \u003ca title=\"http://www.kaiserhealthnews.org/daily-reports/2014/january/03/oregon-study-medicaid-expansion-higher-emergency-visits.aspx\" href=\"http://www.kaiserhealthnews.org/daily-reports/2014/january/03/oregon-study-medicaid-expansion-higher-emergency-visits.aspx\" target=\"_blank\">may lead to a dramatic rise\u003c/a> in emergency room use and hospitalizations for many of the previously uninsured, that increase is largely temporary and should not lead to a dramatic impact on state budgets, according to \u003ca title=\"http://healthpolicy.ucla.edu/publications/search/pages/detail.aspx?PubID=1338\" href=\"http://healthpolicy.ucla.edu/publications/search/pages/detail.aspx?PubID=1338\" target=\"_blank\">a new analysis\u003c/a> from the UCLA Center for Health Policy Research released Wednesday.\u003c/p>\n\u003cp>Researchers reviewed two years of claims data from nearly 200,000 Californians who had enrolled in public programs in advance of the expansion of Medi-Cal, the state's version of Medicaid, in January. These programs were designed to ease the expansion of Medicaid by providing insurance to low-income adults who were not eligible for Medi-Cal at that point but would be when the health law's expansion went into effect earlier this year.\u003c/p>\n\u003cp>Researchers then divided the group into four categories, based on the researchers' assessment of each group's pent-up demand for health care.\u003c/p>\n\u003cp>In July, 2011, after being enrolled in California's \u003ca title=\"http://www.dhcs.ca.gov/provgovpart/Pages/lihp.aspx\" href=\"http://www.dhcs.ca.gov/provgovpart/Pages/lihp.aspx\" target=\"_blank\">Low Income Health Program\u003c/a>, the so-called \"bridge to reform,\" the group with the highest pent-up demand had a rate of costly emergency room visits triple -- or more -- that of the other groups. But from 2011 to 2013, that high rate dropped by more than two-thirds and has remained \"relatively constant,\" according to the analysis.\u003c!--more-->\u003c/p>\n\u003cp>\"We were hoping that this would be the case,\" said lead author Jerry Kominski, director of the UCLA Center for Health Policy Research, \"because we think that that's what access to care does for low-income individuals … that there's an additional increase in demand for services and that that demand, or utilization, drops off pretty rapidly.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Rates of hospitalization for the \"highest pent-up demand\" group also started high and dropped by almost 80 percent over the two-year period. Curiously, if ER and hospitalization rates were dropping, it's reasonable that outpatient visits might rise. But that wasn't the case; the rate of outpatient visits was largely unchanged during the two-year period.\u003c/p>\n\u003cp>Kominski said that one of the fears of the Medicaid expansion was the potential high cost of low-income patients. He argued that this analysis should ease those fears. \"What our findings say to the country is (that) concerns about Medicaid expansion being financially unsustainable into the future are unfounded.\" Under the Affordable Care Act, the federal government provides 100 percent of the cost of the newly eligible under the Medicaid expansion, but in 2017 that contribution will phase down until it reaches 90 percent in 2020.\u003c/p>\n\u003cp>Twenty-seven states have implemented the Medicaid expansion; 21 have not, and in two states, Indiana and Utah, the question of expansion is an \"open discussion,\" \u003ca title=\"http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/\" href=\"http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/\" target=\"_blank\">according to a tally\u003c/a> from the Kaiser Family Foundation.\u003c/p>\n\u003cp>Matt Salo, executive director of the National Association of Medicaid Directors, said the study was \"certainly consistent with what we hope to do\" by expanding health insurance access. He said insurance is \"just the first step, the next step is health care homes so that the individual can actually get better care.\"\u003c/p>\n\u003cp>One factor in helping drive down the higher rates of utilization, Kominski said, is coordinated care initiatives in place for Medi-Cal beneficiaries. For example, virtually all Medi-Cal beneficiaries are now enrolled into a Medi-Cal managed care plan. \"To the extent that other states don't have adequate coordinated care mechanisms in place for their Medicaid populations, then the kinds of drop off that we observed in California may not occur there,\" Kominski said.\u003c/p>\n\u003cp>The UCLA analysis makes explicit reference to -- and rebuts -- a similar study, the \u003ca title=\"http://www.nber.org/oregon/#recent-results\" href=\"http://www.nber.org/oregon/#recent-results\" target=\"_blank\">Oregon Health Insurance Experiment\u003c/a>. In Oregon in 2008, 10,000 residents literally won Medicaid coverage in a lottery, creating a true randomized controlled trial opportunity for researchers who compared those who won coverage with those who didn't, rarely possible to do in social policy research. Researchers later reported \u003ca title=\"http://www.nber.org/oregon/\" href=\"http://www.nber.org/oregon/\" target=\"_blank\">a 40 percent increase in ER visits\u003c/a> in the 18-months after that expansion.\u003c/p>\n\u003cp>Kate Baicker, a health economist at the Harvard School of Public Health, was one of the researchers in the Oregon experiment. She said they did not find \"any evidence of utilization tailing off over that 18-month window\" and stands by her results.\u003c/p>\n\u003cp>Still, Baicker said that an increase in use of health care services, such as emergency room visits or hospitalizations, \"does not mean that Medicaid should not be expanded. Part of the goal is to increase access to health care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The UCLA study was funded by the California Department of Health Care Services and Blue Shield of California Foundation.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/22054/spike-in-er-hospitalization-use-short-lived-after-medicaid-expansion","authors":["240"],"categories":["stateofhealth_14"],"tags":["stateofhealth_99","stateofhealth_218"],"featImg":"stateofhealth_22069","label":"stateofhealth"},"stateofhealth_17086":{"type":"posts","id":"stateofhealth_17086","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"17086","score":null,"sort":[1389258999000]},"guestAuthors":[],"slug":"long-fought-medi-cal-provider-rate-cuts-take-effect","title":"Long-Fought Medi-Cal Provider Rate Cuts Take Effect","publishDate":1389258999,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_17094\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/californiamedicalassociation/8978559463/sizes/l/\">\u003cimg class=\"size-large wp-image-17094\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/8978559463_6e3a52ef6d_b-640x425.jpg\" alt=\"Health care providers joined in a rally at the state capitol to protest cuts in Medi-Cal reimbursement rates in June, 2013. (California Medical Association/Flickr)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Health care providers joined in a rally at the state capitol to protest cuts in Medi-Cal reimbursement rates in June, 2013. (California Medical Association/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>A long-awaited and much-feared ten percent rate cut goes into effect Thursday for doctors and clinics reimbursed through Medi-Cal –- the state’s health insurance for low-income patients. This comes at the same time the federal health overhaul is expanding that program to as many as 2 million Californians.\u003c/p>\n\u003cp>Provisions of the Affordable Care Act will protect primary care doctors from the cuts for the next two years, but specialty doctors that treat the poor are bracing for the hit. Many physicians in dermatology, neurology, cardiology, and urology will now be losing money on every Medi-Cal patient they see. Some will have no choice but to turn low-income patients away.\u003c/p>\n\u003cp>“Bottom line, they cannot continue to provide care for below the cost of care,” says Shannon Smith-Crowley, a lobbyist who works closely with the California Medical Association.\u003c!--more-->\u003c/p>\n\u003cp>She says the situation could be especially dire for clinics that have a heavy load of low-income patients –- some may be forced to close: “There’s no way that a lot of those practices can keep their doors open. It simply does not pencil out,” she says. “It’s really, really scary.”\u003c/p>\n\u003cp>Doctors are also worried about having to pay back years’ worth of retroactive cuts, dating back to 2011 when they were first signed into law. The state was in financial turmoil then. But now the fiscal picture is much improved and clinics have been pressuring lawmakers to reverse the cuts. Democrats have drawn a budget blue print that does just that.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Gov. Jerry Brown is expected to release his budget later Thursday, and early indications are that he will rescind the retroactive cuts. Advocates are hopeful.\u003c/p>\n\u003cp>“California does have a surplus,” says Kathy Kneer, president and CEO of Planned Parenthood Affiliates of California. “I’m hoping that he’ll feel less need to continue cutting the Medi-Cal program and that we can just catch our breath.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Doctors will be competing with advocates from a range of other causes, including education and the environment, who all want to see funds reinstated to previously slashed programs. If Brown does reduce or reverse the Medi-Cal cuts, the changes would have to be approved by the state legislature and the federal Centers for Medicare and Medicaid Services.\u003c/p>\n\n","blocks":[],"excerpt":"A long-awaited and much-feared ten percent rate cut goes into effect today, January 9, for doctors and clinics reimbursed through Medi-Cal – the state’s health coverage for low-income patients. This comes at the same time the federal health overhaul is expanding that program to as many as 2 million Californians.","status":"publish","parent":0,"modified":1389375604,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":10,"wordCount":427},"headData":{"title":"Long-Fought Medi-Cal Provider Rate Cuts Take Effect | KQED","description":"A long-awaited and much-feared ten percent rate cut goes into effect today, January 9, for doctors and clinics reimbursed through Medi-Cal – the state’s health coverage for low-income patients. This comes at the same time the federal health overhaul is expanding that program to as many as 2 million Californians.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Long-Fought Medi-Cal Provider Rate Cuts Take Effect","datePublished":"2014-01-09T09:16:39.000Z","dateModified":"2014-01-10T17:40:04.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"17086 http://blogs.kqed.org/stateofhealth/?p=17086","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/01/09/long-fought-medi-cal-provider-rate-cuts-take-effect/","disqusTitle":"Long-Fought Medi-Cal Provider Rate Cuts Take Effect","path":"/stateofhealth/17086/long-fought-medi-cal-provider-rate-cuts-take-effect","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17094\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/californiamedicalassociation/8978559463/sizes/l/\">\u003cimg class=\"size-large wp-image-17094\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/01/8978559463_6e3a52ef6d_b-640x425.jpg\" alt=\"Health care providers joined in a rally at the state capitol to protest cuts in Medi-Cal reimbursement rates in June, 2013. (California Medical Association/Flickr)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Health care providers joined in a rally at the state capitol to protest cuts in Medi-Cal reimbursement rates in June, 2013. (California Medical Association/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>A long-awaited and much-feared ten percent rate cut goes into effect Thursday for doctors and clinics reimbursed through Medi-Cal –- the state’s health insurance for low-income patients. This comes at the same time the federal health overhaul is expanding that program to as many as 2 million Californians.\u003c/p>\n\u003cp>Provisions of the Affordable Care Act will protect primary care doctors from the cuts for the next two years, but specialty doctors that treat the poor are bracing for the hit. Many physicians in dermatology, neurology, cardiology, and urology will now be losing money on every Medi-Cal patient they see. Some will have no choice but to turn low-income patients away.\u003c/p>\n\u003cp>“Bottom line, they cannot continue to provide care for below the cost of care,” says Shannon Smith-Crowley, a lobbyist who works closely with the California Medical Association.\u003c!--more-->\u003c/p>\n\u003cp>She says the situation could be especially dire for clinics that have a heavy load of low-income patients –- some may be forced to close: “There’s no way that a lot of those practices can keep their doors open. It simply does not pencil out,” she says. “It’s really, really scary.”\u003c/p>\n\u003cp>Doctors are also worried about having to pay back years’ worth of retroactive cuts, dating back to 2011 when they were first signed into law. The state was in financial turmoil then. But now the fiscal picture is much improved and clinics have been pressuring lawmakers to reverse the cuts. Democrats have drawn a budget blue print that does just that.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Gov. Jerry Brown is expected to release his budget later Thursday, and early indications are that he will rescind the retroactive cuts. Advocates are hopeful.\u003c/p>\n\u003cp>“California does have a surplus,” says Kathy Kneer, president and CEO of Planned Parenthood Affiliates of California. “I’m hoping that he’ll feel less need to continue cutting the Medi-Cal program and that we can just catch our breath.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Doctors will be competing with advocates from a range of other causes, including education and the environment, who all want to see funds reinstated to previously slashed programs. If Brown does reduce or reverse the Medi-Cal cuts, the changes would have to be approved by the state legislature and the federal Centers for Medicare and Medicaid Services.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/17086/long-fought-medi-cal-provider-rate-cuts-take-effect","authors":["3205"],"categories":["stateofhealth_14"],"tags":["stateofhealth_218"],"featImg":"stateofhealth_17094","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. 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