Monday Morning Medicaid Must Reads: Feb 11, 2019

Helping you consider differing viewpoints. Before it’s illegal.

In this issue…

Article 1:     State wrestles with sizable backlog of Medicaid applications

Clay’s summary:     Expansion nearly doubled the AK Medicaid rolls. Doubled. 
Key Excerpts from the Article:
As of Jan. 29, Alaska had a backlog of 15,639 cases of new applicants or renewals on the books. About two-thirds of those, or 10,200 cases, were filed in 2018. The average wait time to be approved is currently 55 days, according to Clinton Bennett, the media relations manager for the Alaska Department of Health and Social Services… That’s the average, but not everyone is waiting that long, he wrote in an email…“Cases that are tagged as emergent, involve a pregnant woman or adding a newborn to any case are being processed on average within 2 days,” he wrote.
Alaska has a fairly large Medicaid population with about 210,276 people enrolled in the Medicaid and CHIP programs as of October 2018, according to the Centers for Medicare and Medicaid Services.
That’s about 24 percent of the state’s total population, and up from 123,335 people enrolled at the end of July 2015, just before the Medicaid expansion took effect in the state.
Though it’s still a sizable backlog, it’s significantly down from the total in May 2018, when the Alaska Ombudsman’s Office published a report highlighting the difficulties in the Division of Public Assistance. At the time, the ombudsman noted a backlog of more than 20,000 cases, itself down from 30,000 in July 2017.
Read full article in packet or at links provided

Article 2:     Medicare, Medicaid Enrollment Growing Faster Than Private Coverage

Clay’s summary:     New analysis says Care/Caid spending growth is nothing to be concerned about. What do they think we are, idiots? Of course they do. Shut up and pay your taxes. Don’t have opinions about how they are spent.
Key Excerpts from the Article:
 Over the course of 11 years, annual spending growth averaged 5.2% for Medicare and 6% for Medicaid. This eclipsed the 4.4% spending growth among private insurers.
However, spending per enrollee from 2006 to 2017 was markedly lower for public programs compared to their private counterparts. Medicare spending per enrollee amounted to 2.4% per year, Medicaid registered at even lower 1.6%, while private insurance posted 4.4% annually.
Medicaid and Medicare also achieved positive annual enrollment growth rates over the same period of time, 4.3% and 2.8% respectively, while private insurers finished with a flat enrollment growth rate.
The study’s findings conclude that while CMS projects Medicaid and Medicare spending per enrollee to grow sizably over the next decade, both programs have “successfully moderated growth.”
The Urban Institute states that the results indicate that neither program require “major restructuring” to reduce national health spending and that the more concerning spending figures lie in the private insurance market.
The study’s authors support “modest policy proposals,” such as limiting state use of provider taxes in Medicaid or modifications to Medicare cost-sharing.
Read full article in packet or at links provided

Article 3:     Medicaid cost concerns are valid

Clay’s summary:     An op-ed considers a litany of examples when the state was left to deal with federal funding changes that made programs cost a lot more than originally promised- AND they connect the dots to Medicaid expansion and the “free federal money.” How dare they use logic and past experience???!!? Evil Republicans!
Key Excerpts from the Article:
 Even if the state’s portion of Medicaid expansion costs doesn’t rise, the $150 million price tag is still significant. That $150 million is more than twice the amount required to provide a proposed $1,200 pay raise for every teacher this year. It’s more money than what would be saved if roughly 12,400 inmates were released from state prisons, according to one estimate. It’s more than four times the amount required to eliminate a backlog of local government reimbursements for emergency responses.
Every dollar spent on Medicaid expansion is a dollar that doesn’t go to other needs like schools, roads or public safety. And voter rejection of a 2016 sales tax increase shows limited public appetite for the kind of broad-based tax increases required to avoid such tradeoffs.
The real debate is not simply whether one supports Medicaid expansion, but whether one believes Medicaid expansion should be a higher priority than school funding increases or other causes. And, beyond fiscal considerations, debate should also focus on this question: Does Medicaid expansion improve health outcomes? Much research has found little real improvement.
Read full article in packet or at links provided