Word: medicaid
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Helping states by extending the Nebraska deal nationwide or by upping federal contributions to future Medicaid costs would certainly relieve some unwelcome pressure. Along with Schwarzenegger, who had previously been a reliable Republican proponent of Democratic health care reform, many other governors - including New York's David Paterson, a Democrat - have publicly protested the legislation on the basis of the Medicaid expansion, saying it amounts to an unfunded mandate. In addition, at least 13 state attorneys general have said Nelson's special deal is unconstitutional. But extending the Cornhusker Kickback to all 50 states would be a lot more than...
Although the proposal to widely expand the Medicaid program has not garnered nearly as much attention as the public option or sweeping new insurance regulations, it's critical to the Democrats' reform strategy. The plan called for under the House and Senate bills would cover about 15 million new people - half of those currently without health insurance who would enter the system under reform. This plan terrifies most states but especially those like California and New York, where Medicaid benefits are already far more generous than most states in the South. That's because under the formula called...
...current Medicaid-expansion proposal would cost the Federal Government about $395 billion from 2010 to 2019 under the Senate bill or about $425 billion under the House bill. The state share of the expansion, in contrast, would be $26 billion or $34 billion. Moving the state costs into the federal column, as Nelson is now suggesting, would increase the cost of legislation, which is already close to the $900 billion limit set by President Obama. Then again, House and Senate leaders are currently negotiating all sorts of adjustments for a merged bill, and any new Medicaid costs could be part...
...from the financial feasibility of extending the Nebraska deal to all states, there could be far-reaching policy implications of such a move. In contrast to Medicare, the other massive public insurance program, which is funded and run by the Department of Health and Human Services (HHS), administration of Medicaid has historically fallen to states. This has given governors and legislatures the flexibility to structure their Medicaid programs based on their populations and budgets. States now determine who qualifies for Medicaid, what's covered by the program and how much doctors and hospitals get paid for taking care of Medicaid...
...Federal Government currently pays about 57% of all Medicaid costs, with the rest shouldered by states. But under reform, the Federal Government would eventually pay 82% to 95% of Medicaid costs for the 15 million people who would become newly eligible. At that point, the result would be a huge public insurance program funded mostly by the Federal Government. By contrast, the public option - which exists in the current House bill but seems headed for a quiet death because of moderate Democrats' concerns that it would lead to socialized medicine - would have included no federal funding of benefits. Some health...