Monday Morning Medicaid Must Reads: July 3rd, 2017

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


Article 1: Are Medicaid patients more likely to die than uninsured, as Heritage Action CEO says? Politifact, June 28th, 2017, Amy Sherman

Clay’s summary: I think most “fact-checking” sites (unfortunately including Snopes) have become pretty biased, but this is a decent article. Makes a good case for diving deeper on true impact of Medicaid on health outcomes. Too simple to say “Medicaid makes outcomes worse.” But also too simple to say “Millions will die without Medicaid.”

Key Passage from the Article


“This implication that somehow you get worse care with an insurance plan — Medicaid — than you would by not having an insurance plan at all — no coverage, just going to the ER for emergencies — for most reasonable people that doesn’t make any sense,” he said.

PolitiFact has previously found at least seven academic papers that detected a link between securing health insurance and a decline in mortality. In general, these papers present a stronger consensus that having insurance saves lives.

Harvard researchers recently wrote a piece summarizing the evidence on the effect of Medicaid or other insurance on mortality. Their review of the evidence concludes that insurance like Medicaid significantly reduces mortality relative to being uninsured, said Katherine Baicker, one of the authors. The researchers found that “coverage expansions significantly increase patients’ access to care and use of preventive care, primary care, chronic illness treatment, medications, and surgery. These increases appear to produce significant, multifaceted, and nuanced benefits to health.”

Read it here 

Article 2: Republicans are trying to undo Obama’s Medicaid disaster, NY Post, Besty McCaughey, June 27th, 2017

Clay’s summary: The idea that Medicaid today is not what it was ever intended to be is lost on most. Part of the reason is because we are such a wealthy nation we have lost all concept of what true poverty is. Today’s middle class now thinks of itself as poor.

Key Passage from the Article

Medicaid was created in 1965 as a safety net for the poor. But ObamaCare distorted it, edging the US health-care system closer to a Medicaid-for-all or single-payer system. Swelling the Medicaid rolls — instead of making private insurance affordable — was the main trick ObamaCare used to boost the number of insured.

A whopping 75 million people are now enrolled on Medicaid, 20 million more than in Medicare, the program for the elderly. If the repeal bill doesn’t pass, Medicaid enrollment will soar to 86 million by 2026, according to a Congressional Budget Office analysis released Monday.

Who’s picking up the tab for this vast Medicaid expansion? You. Worse, you pay twice — once as a taxpayer, then again as an insurance consumer.

Families with private insurance pay $1,500 to $2,000 or more in added premiums yearly already to keep Medicaid afloat. The more Medicaid expands, the higher their premiums will go.

That’s because Medicaid shortchanges hospitals and doctors, paying less than the actual cost of care. They make up for it by shifting the costs onto privately insured patients. Ouch.

That cost-shifting only works until Medicaid enrollment grows too large. The Mayo Clinic warned three months ago that Medicaid enrollment has reached the tipping point. The renowned clinic announced it will have to turn away some Medicaid patients, or put them at the back of the line, behind patients with private insurance.


Read it here


Article 3: Veterans Helped By Obamacare Worry About Republican Repeal Efforts, NPR, Stephanie O’Neill June 28, 2017 

Clay’s summary: I recently learned that vets have to pay premiums for their healthcare. And I am still angry about that so hard for me to summarize this article. Can we make their care free before we cover everyone else in Medicaid?

Key Passage from the Article

There are about 22 million veterans in the U.S. But less than half get their health care through the Veterans Affairs system; some don’t qualify for various reasons, or may live too far from a VA facility to easily get primary health care there.

Many vets instead rely on Medicaid for their health insurance. Thirty one states and the District of Columbia chose to expand Medicaid to cover more people — and many of those who gained coverage are veterans.

The GOP health care bill working its way through the Senate would dramatically reduce federal funding for Medicaid, including rolling back the expansion funding entirely between 2021 and 2024.

Medicaid coverage recently has become especially important to Ramos — a routine checkup and blood test this year showed he’s infected with hepatitis C. California was one of the states that chose to expand Medicaid, and the program covers Ramos’ costly treatment to eliminate the virus.

“Right now, I’m just grateful that I do have it,” he says. “If they take it away, I don’t know what I’m going to end up doing.”

Read it here


Article 4: Cardiac Arrests Dropped Under Obamacare Medicaid Expansion, Forbes, Tara Helle, June 29, 2017

Clay’s summary: There are clearly specific procedures and conditions improved by having easier access to care. Can we focus on those?

Key Passage from the Article

Cardiac arrests among previously uninsured middle-aged adults dropped by 17% after they got insurance through the Affordable Care Act, or Obamacare, a new study shows. The incidence of cardiac arrests remained the same among adults age 65 and older, a group that had consistently high rates of health insurance coverage before and after the ACA, primarily through Medicare.

“The fact that was this decrease was not observed in the elderly, who have near-universal access to healthcare, makes the availability of insurance one of the likely causes of the drop in cardiac arrest rate,” said lead author Eric Stecker, MD, MPH, an associate professor of cardiology at Oregon Health & Science University in Portland. “This study reinforces the results of prior studies which have shown that pretty consistently giving access to insurance significantly improves engagement in preventive care.”

Read it here


Article 5: Why the fear-mongering on Medicaid is totally overblown, Washington Post, June 28th, 2017

Clay’s summary: You might want to put down your Andy Slavitt, Michael Moore, and KFF Foundation echo-chamber devices (twitter feeds) before reading this one. And if they find out you read this one, you’re totally kicked out of the #Resist club.

Key Passage from the Article

A recent New York Times op-ed from three health-care experts described the effort as a “direct attack on our elderly, our disabled and our dignity.” A Post commentary charged lawmakers with “gutting Medicaid so they can give a giant tax break to their billionaire buddies,” threatening life-saving treatments for a young boy with a congenital heart condition. A long-time political adviser charged on national television that sponsors would “kick some kid out of his wheelchair.” And a left-leaning think tank further upped the ante by publishing contrived estimates of the numbers of people (handily broken down by state) who will supposedly be killed by the proposed legislation.

You don’t need to support the pending health-care bills to recognize they bear little resemblance to this explosive rhetoric, nor do you have to support the legislation to realize that our deteriorating political environment is making it impossible to make policy decisions with the appropriate reflection and care.



Read it here