Health Reform Hub Issues

Issues :: Medicare, Medicaid and SCHIP

House of Representatives Committee on the Judiciary: The Enforcement of Criminal Laws Against Medicare and Medicaid Fraud
James Frogue
Center for Health Transformation, 03/04/10

The problem of healthcare fraud is far bigger than most Americans can imagine. But fortunately leaders from both political parties have started speaking up on this critical topic. That is the first step toward creating a climate where real solutions can be offered and implemented...Across the political spectrum there is emerging consensus that the amount of fraud in our healthcare system is very significant and totally unacceptable. Yet efforts thus far have failed to make a major dent in the problem. Read more...

Obama's Special Health Treatment
Mark E. Klein
Wall Street Journal, 03/03/10

On Sunday President Barack Obama underwent a complete medical examination, which included a screening for pre-cancerous polyps in his colon. If detected, such polyps would be removed before they became dangerous. The screening the president and his doctors chose was a virtual colonoscopy—a relatively new, high-tech exam that uses a CT scan to visualize the entire colon. Last May, the Centers for Medicare and Medicaid Services (CMS) decided virtual colonoscopies would not be covered by Medicare. Read more...

Medicare Advantage Confusion
James C. Capretta
National Review Online: Critical Condition, 02/25/10

The president is trying to make it seem like the only cuts in the Medicare program he is advocating are for Medicare Advantage (MA) plans. That’s demonstrably not true. The chief actuary has raised concerns about the payment-rate reductions that the Democrats are pushing for hospitals in the traditional program. He believes those cuts will harm access to care. That’s one of the points Rep. Paul Ryan made earlier. Regarding Medicare Advantage, there were several assertions made by the president that also are not true. Read more...

The President's Health Proposal: Taxing Investments Undermines Economic Recovery
Karen Campbell, Ph.D. and Guinevere Nell
Heritage Foundation, 02/25/10

The new White House proposal to impose a Medicare tax on investment income would reduce demand for investment, which is the last thing that the economy needs right now. It would slow recovery, reduce employment opportunities, and hinder wage growth. A dynamic macroeconomic analysis helps one see how this policy negatively affects all individuals in the economy, including the low-income individuals that the White House plan was designed to help. Read more...

State Abuse of the Medicaid Program
Dr. Roger Stark
Washignton Policy Center, 02/2010

The Medicaid program to provide health coverage for low-income people began in 1965 with the passage of title XIX of the Social Security Act. It has always been an entitlement, with no defined limit on the number of beneficiaries or the cost of the program. As long as a person meets the legal criteria for participation in the program, that person receives Medicaid benefits, regardless of total cost to taxpayers...This paper discusses state-federal Medicaid financing since the 1980s and how state officials have manipulated the federal program to receive extra matching money. Washington state’s proposed provider tax and the proposed “bed tax” on nursing homes are examples of how state officials adopt policies in an effort to leverage more federal funding from the Medicaid program. Since Medicaid is an entitlement with no statutory limit on spending, there is no limit to how much state officials can try to gain from the program. Read more...

Medicare Doctor Shortage Endangers Seniors' Access to Care
Matt Patterson
National Policy Analysis, 02/2010

2009-2010 has seen a great national debate over the role of government in health care.  But few Americans realize just what a expansive role the government already plays in our health care system: In 2008, government spending on health care constituted 36 percent of federal outlays, up eight percent from the previous year. And public financing of health care, aggregating federal, state and local programs, makes up 46 percent of U.S. health spending. Medicare alone represents 19 percent of those health care dollars. It is therefore wise, as the nation's legislators consider an expanded federal role in health insurance, to examine the viability of existing programs such as Medicare to determine whether the government is capable of meeting its existing health care obligations. Read more...

Obama's New Investment Tax 
Wall Street Journal, 02/24/10

The White House's new health-care proposal promises the "largest middle class tax cut for health care in history," which is a creative way of describing a vast taxpayer-subsidized insurance entitlement. Naturally, the fine print goes on to describe one of the largest tax increases for health care in history, too. Read more...

Medicaid's Continuing Crunch In a Recession: A Mid-Year Update for State FY 2010 and Preview for FY 2011
Kaiser Family Foundation, 02/18/10

This report finds that 44 states and the District of Columbia are experiencing higher than expected program enrollment and spending for fiscal year 2010. At least 29 states say they are considering additional mid-year cuts in provider rates and program benefits. The recession and the scheduled end on Dec. 31, 2010 of enhanced federal matching money for Medicaid that was provided through the American Recovery and Reinvestment Act of 2009 will have a significant impact on state fiscal year 2011 budgets, Medicaid directors reported. Read more...

Two Fatal Flaws in Health Reform Resuscitation
Bernadine Healy, M.D.
U.S. News and World Report, 02/16/10

 The Obama­care puzzle, a centrally driven plan that requires at least a trillion dollars to succeed, counts on a combination of taxation, fines, penalties, and cost savings; a reallocation of major resources within the current health system; and a willingness among doctors and patients to accede to substantial new government controls. Regardless of how workable the administration's grand design appears to be on paper—about 4,000 pages of paper—it will fail if all of these big puzzle pieces are not in place. Most obviously, are the needed resources there for the tapping? There are at least two giant reasons that I think the puzzle is now imploding on its own, and neither has anything to do with political partisanship. And no televised show of hand-holding will make one whit of difference. Read more... 

Unhealthy Spending, Unhealthy Economy 
Joseph Antos
American Enterprise Institute, 02/16/10

The U.S. economy is ailing, and more spending on health care will not heal the patient. Left to its current trend, federal health spending will take an ever-growing chunk out of the budget, crowding out other policy priorities. Unfortunately, the health reform debate has focused more on creating a new health entitlement program and less on responsible actions to make the current spending paths of Medicare and Medicaid sustainable in the long term. Read more...