{"id":111817,"date":"2017-08-14T05:45:14","date_gmt":"2017-08-14T09:45:14","guid":{"rendered":"https:\/\/canadianinquirer.net\/v1\/?p=111817"},"modified":"2017-08-14T05:45:14","modified_gmt":"2017-08-14T09:45:14","slug":"a-stronger-medicaid-emerges-from-gop-health-overhaul-debate","status":"publish","type":"post","link":"https:\/\/canadianinquirer.net\/v1\/2017\/08\/14\/a-stronger-medicaid-emerges-from-gop-health-overhaul-debate\/","title":{"rendered":"A stronger Medicaid emerges from GOP health overhaul debate"},"content":{"rendered":"
\"Centers<\/a>
Centers for Medicare and Medicaid Services (Medicaid administrator) logo (Photo By Centers for Medicare and Medicaid Services – CMS Branding Guidelines, Public Domain<\/a>)<\/figcaption><\/figure>\n

WASHINGTON — Medicaid, a 1960s Great Society pillar long reviled by conservatives, seems to have emerged even stronger after the Republican failure to pass\u00a0health\u00a0overhaul legislation.<\/p>\n

The federal-state\u00a0health\u00a0insurance program for low-income Americans hasn’t achieved the status of Social Security and Medicare, considered practically untouchable by politicians, like an electrified \u201cthird rail.\u201d But it has grown to cover about 1 in 5 U.S. residents, ranging from newborns to Alzheimer’s patients in nursing homes, and even young adults trying to shake addiction. Middle-class working people are now more likely to personally know someone who’s covered.<\/p>\n

Increased participation — and acceptance — means any new GOP attempt to address problems with the Affordable Care Act would be unlikely to achieve deep Medicaid cuts.<\/p>\n

\u201cThis was an important moment to show that people do understand and appreciate what Medicaid does,\u201d said Matt Salo, executive director of the National Association of Medicaid Directors, a nonpartisan group that represents state officials. \u201cThe more people understand what Medicaid is and what it does for them, the less interested they are in seeing it undermined.\u201d<\/p>\n

With Republicans in control of the White House, both chambers of Congress, and 34 out of 50 governorships, it would have been hard to imagine a more politically advantageous alignment for a conservative overhaul of Medicaid.<\/p>\n

President Barack Obama’s Affordable Care Act expanded Medicaid to cover more low-income adults, many of them working jobs without\u00a0health\u00a0insurance. Thirty-one states have accepted the ACA’s expansion, covering about 11 million people.<\/p>\n

The GOP bills would have phased out funding for the Obama expansion, but they also placed a limit on future federal spending for the entire program — a step now seen as overreach.<\/p>\n

The per-beneficiary spending caps in the House and Senate bills translated to deep cuts that divided Republicans.<\/p>\n

Also, GOP governors who had expanded the program couldn’t swallow the idea of denying coverage to hundreds of thousands of constituents. Some Republican governors went public with their opposition, while others quietly warned their congressional delegations about dire consequences.<\/p>\n

\u201cI think there is a recognition among many that Medicaid is not just a welfare program but an underpinning of our social system,\u201d said Diane Rowland of the Kaiser Family Foundation.<\/p>\n

An AP-NORC poll taken last month found the public overwhelmingly opposed to GOP Medicaid cuts, by 62-22.<\/p>\n

\u201cYou just can’t do this to people who are in situations that they didn’t put themselves in,\u201d said Sara Hayden of Half Moon Bay, California. Unable to work as a data journalist due to complications of rheumatoid arthritis, she was able to get\u00a0health\u00a0insurance when her state expanded Medicaid.<\/p>\n

Hayden estimates that one of the medications she takes for the disease would cost about $16,000 a month if she were uninsured. She pays nothing with Medi-Cal, as the Medicaid program is known in California.<\/p>\n

\u201cIf they are going to repeal and replace, then I am dead in the water,\u201d she said.<\/p>\n

Brian Kline of Quakertown, Pennsylvania, works as a customer service representative, and got coverage after his state expanded Medicaid in 2015. Early last year he was diagnosed with colon cancer following a colonoscopy. After treatment that Medicaid paid for, his last CT scan was clear.<\/p>\n

\u201cYou just wonder if the Republican bill had passed…what would have happened to me?\u201d said Kline. \u201cWould I have had access to my doctors and the tests to make sure my cancer didn’t come back? I’m not sure what the answer to that question would have been.\u201d<\/p>\n

Many Republicans view Obama’s Medicaid expansion as promoting wasteful spending, because the federal government pays no less than 90 per cent of the cost of care, a higher matching rate than Washington provides for the rest of the program.<\/p>\n

\u201cThat is not a good recipe for encouraging states to implement better, lower-cost models of care,\u201d said Mark McClellan, who oversaw Medicare and Medicaid under former President George W. Bush.<\/p>\n

Nonetheless, the debate showed Congress can’t just elbow its way to a Medicaid overhaul.<\/p>\n

‘You are going to have to be gentle and thoughtful, working in a bipartisan way to see what ideas will reach across the aisle,\u201d said Republican economist Gail Wilensky, also a former Medicare and Medicaid administrator.<\/p>\n

The push for Medicaid changes will now shift to the states. Some on the political right are seeking federal approval for work requirements and drug testing. But activists in the 19 states that have not yet expanded their programs are contemplating revived campaigns.<\/p>\n

An area that could find bipartisan support is\u00a0health\u00a0promotion, since Medicaid beneficiaries tend to have higher rates of smoking and other harmful lifestyle factors.<\/p>\n

Katherine Hempstead, who directs\u00a0health\u00a0insurance research for the nonpartisan Robert Wood Johnson Foundation says Medicaid has come out a \u201cwinner\u201d in the debate.<\/p>\n

\u201cMedicaid has shown itself to be very much appreciated by a broader constituency than we might have originally thought,\u201d she said. \u201cAnd that is an important takeaway.\u201d<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

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