RikyRah asked a good question yesterday:
Will you do an analysis of the bill from the Senators from Georgia, who want to find a way to get healthcare to those in states that refuse to expand Medicaid?
Senators Warnock and Ossoff, among others, are lead sponsors on a Medicaid Expansion backstop bill. There are two primary components:
The first component is a federal back-stop of Medicaid for the population that earns less than 138% Federal Poverty Level and lives in a non-expansion state. The Department of Health and Human Services would set up a plan that meets minimal essential health benefits (EHBs) with no premiums and minimal co-pays. This would be paid for out of a permanent appropriation.
The second component is increasing the size and length of the bribe to get hold-out states to expand. Right now the ARP gives new expansion states an extra 5% of the federal match for Legacy Medicaid for 2 years. Warnock/Ossoff would give an extra 10% for 10 years. The ARP makes expanding Medicaid a profit center for a state budget for two years. W-O makes it a fire hose of federal money for multiple terms of any hold-out state governor.
Baud
Here’s where we should have a serious discussion of moral hazard.
Ohio Mom
I know I’ve said so before, Ohio Son has Medicaid and it’s the best health insurance any of us in Ohio Family has ever had.
I suspect it is a PR problem — Medicaid” translates to many as “poor people” and they find that insulting — but I’d much rather the goal be Medicaid For All rather than Medicare.
Omnes Omnibus
@Baud: The Euro Cup is over. Why are you talking about Belgian players?
Barbara
@Ohio Mom: There is no doubt that Medicaid is the better insurance/benefit design. The benefit structure of the Medicare program is basically insane. It reflects the way Blue Cross plans were structured in 1965 and it has never been updated. Part D (drug coverage) extended the dysfunctional nature of the program so that if you are in the fee for service cohort you will likely have four insurance buckets: Part A, Part B, Part D, and your own private supplemental plan. It’s up to you and/or your provider to figure out how these are supposed to work together.
The only exception here is that managed care plans contracting with CMS are able to offer something that looks and feels like more normal insurance, but the “background” assumptions for their bids reflect the relative idiocy of the original program. Anyway, that’s one reason why Medicare Advantage plans have become so popular and I find it more than a little amusing that the “Medicare for All” contingent seem to be completely clueless about the extent to which Medicare is being penetrated by private insurers (albeit ones that have their feet held to the fire by an extremely protective federal agency).
The issue with Medicaid is that it lacks strong political support and is always a target for budget cutting by states. Basically, CMS is always putting the beneficiary first, whereas, state agencies often prioritize budgets over people in the program. Having Medicaid’s benefit design with Medicare’s infrastructure would be the best of both worlds.
Ohio Mom
Barbara:
I’ve been on Medicare for a year and a half now so I have some appreciation of what a kluge it is — though I didn’t know the part about Blue Cross being the model. That explains a lot.
I long thought the best thing about Medicare was that you’re always guaranteed coverage, no matter what preexisting conditions you accumulate, but as I learn more, it looks to me that both options, Traditional and Advantage, have booby traps for the unlucky and unsuspecting.
rikyrah
Thank you so much for this??