Monday Morning Medicaid Must Reads: July 10th, 2017

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


Article 1: Has Medicaid Made the Opioid Epidemic Worse? The National Review, Sam Adolphsen, July 5, 2017

Clay’s summary: Heck yes, it has. Duh.

Key Passage from the Article

In 2015, the seven states with the highest drug-overdose death rates were West Virginia, New Hampshire, Kentucky, Ohio, Rhode Island, Pennsylvania, and Massachusetts. These states all have something else in common: All were among the 31 states (not including D.C.) that expanded Medicaid through Obamacare. Two questions must now be asked: Did expansion actually make the problem worse? And was Medicaid partly responsible for initiating the problem to begin with? Ohio, which has enrolled more than 700,000 adults in its Obamacare Medicaid expansion, is seeing worse problems with opioids than ever before. This year alone, the state is on pace for more overdose deaths than the entire United States had in 1990, according to an Ohio county coroner. It’s important to recognize that the problem ultimately stems from legal prescription drugs, not the illegal drug market — though many prescription-drug addicts do switch to heroin as a cheaper alternative. According to Andrew Kolodny, a Brandeis University senior scientist and the executive director of Physicians Responsible for Opioid Prescribing, “overprescribing of opioids is fueling the epidemic.” CDC data indicate that overdose deaths involving prescription opioids have quadrupled since 1999, and that prescription opioids now account for half of all opioid-overdose deaths.


Read it here 

Article 2: Democrats’ Fearmongering Over Medicaid Ignores Just How Bad the Program Is, The Daily Signal, Betsy McCaughey, July 5, 2017

Clay’s summary: In all the bravado about how Medicaid will be gutted, few are talking about the shame of the inferior nursing home care Medicaid pays for every day and has for decades. If anyone has been in a position to address the issue, Medicaid officials have- and its not enough to just say there’s not enough money.

Key Passage from the Article

Because even rudimentary infection prevention is lacking, one-quarter of residents pick up dangerous, drug-resistant bacteria, according to new research by Columbia University School of Nursing. Columbia’s Carolyn Herzig warns infection rates are increasing across the board and action is urgently needed.

Medicaid recently adopted new standards calling for more infection precautions, but delayed the start date to November 2019. Why delay when hundreds of thousands of elderly residents will die from infection in the meantime?

Don’t count on the media to cover these deaths. The Washington Post is busy claiming repeal “takes a sledgehammer to Medicaid.” The New York Times reports that “steep cuts to Medicaid” will force some seniors out of their nursing homes.

Here’s the truth: There are no “cuts.” Medicaid spending will continue to increase every year, though at a slower rate.

The real threat to seniors isn’t Medicaid funding levels. It’s that Medicaid officials tolerate substandard nursing home care, when they could use the program’s market clout to demand safer care. About 66 percent of long-term residents are paid for by Medicaid.

The federal government rates nursing homes from one to five stars, based on periodic inspections, staffing levels, infection rates, and other quality measures.

But even nursing homes that get the lowest one-star rating year after year—indicating substandard care—are allowed to stay open. They should be shut down.

Read it here


Article 3: How A Bogus Claim About Medicaid Made It Into The Los Angeles Times With No Pushback, The Federalist, Jonathan Ingram, July 5, 2017

Clay’s summary: Expanding Medicaid to more healthy adults came at the cost of reduced coverage for the most vulnerable in multiple states. Also- the MSM hides facts that might tarnish the optics on ACA? No way! Somebody should bodyslam those guys. But not DDT – that’s taking it too far.

Key Passage from the Article

While Ohio eliminated Medicaid eligibility for more than 34,000 seniors and individuals with disabilities, it was busy moving able-bodied adults to the front of the line under Obamacare. The expansion has been particularly tough on Ohio, where the Kasich administration promised the number of able-bodied enrollees would never exceed 447,000. By May 2017, expansion enrollment topped more than 725,000 individuals.

The result? Ohio’s Obamacare expansion has already run nearly $7 billion over budget, costing taxpayers nearly twice what was initially promised. The state’s share of those costs started coming due earlier this year, and those overruns are now crowding out funding for other state priorities like education, public safety, and services for the most vulnerable. In a state where Medicaid already consumes nearly half of the operating budget, cost overruns in the Obamacare expansion can easily lead to devastating cuts to other priorities.

This isn’t an isolated event, either. The enrollment explosion is happening in every state that expanded Medicaid under Obamacare. As a result, states are facing mounting costs far higher than they expected, forcing them to cut funding for other priorities or pass new tax hikes. Domenech was right when he remarked that Obamacare made able-bodied adults a top priority, crowding out funding for the most vulnerable. And he wasn’t lying when he said that more than 34,000 seniors and individuals with disabilities in Ohio were pushed out of Medicaid shortly after the expansion went into effect.

Read it here


Article 4: 

Clay’s summary: It’s getting harder to ignore the fact that organized crime is behind a lot of the bigger Medicaid frauds.

Key Passage from the Article

Fraud tends to cluster in certain areas and in certain treatment categories. The reason for that is that this fraud is not random, not just the result of some yahoo general practitioner in Eucheeanna padding his bills. It’s the work of organized crime. As Sparrow points out, when there is a criminal case filed against one of these fraud artists, then billing in a particular category — some years ago, it was HIV fusion treatments — falls off steeply, by as much as 90 percent. The implication here is that fraudulent billing may make up the majority of Medicaid and Medicare spending in some categories.


Read it here