Latest news with #MedicaidExpansion
Forbes
7 hours ago
- Business
- Forbes
Why Do We Care How Much We Spend On Medicaid?
The U.S. has fewer hospital beds per person than Europe does. In evaluating the success of Obamacare in general and Medicaid expansion in particular, reporters and commentators have tended to focus on only one measure: the increase in the number of people with health insurance. At the same time, in evaluating the health consequences of the House Republican reconciliation measure, almost all the focus has been on the number of people who will lose health insurance. The implicit premise in all of this is: more health insurance means more health care and less health insurance means less health care. That has been the premise behind virtually every important piece of health care legislation going all the way back to the creation of Medicare and Medicaid in1965. Yet the premise ignores a fundamental economic principle: no matter what happens to the demand for care, there won't be a change in health care delivered unless there is a change in supply. Under Obamacare, we are certainly spending more money. The annual cost of Medicaid expansion is $130 billion and the cost of exchange subsidies is more than $60 billion. What are we getting in return for all this extra spending? Although there has been a substantial increase in the number of people with health insurance, one study finds that there has been no overall increase in health care. In fact, the nation may be getting less care. In 2023, 13 years after the passage of the Affordable Care Act (Obamacare), the number of hospital admissions per capita was 19 percent lower and the number of hospital days was18 percent lower than the year the act was passed. In the 9 years following the passage of Obamacare, doctor visits per capita declined by 18%. Further, our health care resources appear to be quite skimpy in comparison to other developed countries. Today, the United States has 2.7 doctors per 1,000 people, while the European average is 4.1. The U.S. has fewer than three hospital beds per 1,000 residents. The EU has more than five. And our country doesn't seem to be getting any healthier. Life expectancy in 2024 was lower than it was ten years earlier. As for Medicaid, numerous studies through the years have produced conflicting results on what difference the program makes for enrollee health. Yet these studies suffer from all the problems that are inherent in making inferences from population statistics. One study was different. The Oregon Health Insurance Experiment was a randomized controlled trial (RCT) that examined the medical condition of real people. Medicaid enrollees were selected by lottery and after two years the investigators compared the medical condition of those who enrolled with those who didn't. The results: enrollees had less financial stress and were less likely to be depressed, but there was no difference in their physical health. One of the Oregon investigators, MIT economist Amy Finkelstein, helps us understand those results. People without health insurance, she notes, still get about 80 percent of the health care that Medicaid enrollees get. And when they are confronted with high medical bills, they actually pay only a small portion of them. You might suppose that Medicaid enrollees are less likely to rely on hospital emergency rooms. The reverse is true. Once they enroll, Medicaid patients increase their trips to the emergency room by 40 percent. This may explain why Medicaid enrollees place a very low value on enrollment. If you were to offer to buy their Medicaid insurance coverage, it appears that the average enrollee would sell her insurance for as little as 20 cents on the dollar. Moreover, among the lottery winners who were offered enrollment in Oregon, more than half turned the offer down! By implication, these folks placed no value on the opportunity to enroll. These findings have convinced Finkelstein (certainly no right-winger) that rather than giving low-income families more Medicaid, we should give them cash instead. Here is one way to do that. Private companies managing Medicaid (or the state itself) should be able to make deposits to Health Savings Accounts (HSAs) that would cover, say, all primary care. Enrollees would be restricted to using the money for health care during an insurance year. With these funds, they would be able to pay market prices (instead of Medicaid fees) at doctor's offices, walk-in clinics and urgent care centers – allowing them to buy medical care the way they buy food with food stamps. This would allow low-income families to have the same health care opportunities that middle-income families have. At the end of the insurance period, they could withdraw any unspent funds for any purpose. If there were no taxes or penalties for non-medical withdrawals, health care and non-health care would be trading against each other on a level playing field under the tax law. People wouldn't spend a dollar on health care unless they got a dollar's worth of value. An early study by the RAND Corporation suggests that these accounts could reduce Medicaid spending by 30 percent. Excluding payments for the disabled and nursing home care, the savings would amount to almost $1 trillion over ten years. This saving would be shared by the beneficiaries and the taxpayers who fund Medicaid. This is one way to resolve the impasse in the Senate over the House reconciliation bill. HSAs for Medicaid are a way to make the program better for enrollees and cut spending at the same time.
Yahoo
3 days ago
- Business
- Yahoo
Medicaid expansion would be a lifeline for Floridians; that's why we're suing
Let's not sugarcoat it: Florida's healthcare policies are failing us. They're failing the single mother in Ocala who earns $15,000 a year working part-time and was recently diagnosed with cancer — but can't afford the treatment she needs to survive. They're failing rural hospitals on the brink of collapse. And they're failing the hundreds of thousands of Floridians stuck in the 'coverage gap'— earning too much to qualify for Medicaid, but too little to afford private insurance. And now, to make matters worse, our state's lawmakers have passed a law that aims to take away one of the last tools Floridians have to fix it: the power of citizen-led constitutional amendments. That's why Florida Decides Healthcare filed a federal lawsuit challenging the dangerous new law known as House Bill 1205. This isn't just about getting Medicaid expansion on the ballot. This is about defending the very foundation of our democracy: the people's right to be heard and to shape their own future. This law, signed by the governor, isn't reform. It's repression. HB 1205 is a cynical effort to make it harder for everyday Floridians — teachers, nurses, veterans, parents — to participate in their own government. It buries citizens in red tape, threatens them with criminal penalties, and intimidates them for simply trying to collect signatures. It's designed to silence us, to shut down grassroots movements, and to keep power locked in Tallahassee's political elite. But we're not backing down. Because we know what's at stake. Medicaid expansion could transform lives in every corner of Florida—from the Panhandle to the Keys. It would bring billions of our own federal tax dollars back to our state — money we're already sending to Washington, only to fund healthcare in other states. It would help stabilize struggling hospitals, especially in rural areas where 135 hospitals have closed since 2010. It would let people see a doctor without risking bankruptcy. This isn't welfare — it's common sense. More than 60% of the people who would benefit from expansion are part of working families. Medicaid helps people stay healthy enough to work, care for loved ones, and contribute to their communities. And study after study has shown that expansion wouldn't raise taxes — it would grow Florida's economy. Floridians get it. Nearly 8 in 10 — Republicans, Democrats and independents — support Medicaid expansion. It's not a partisan issue. It's a people issue. And when our elected officials refuse to act, the people have not just the right, but the responsibility, to do it themselves. That's what Florida's citizen-led amendment process is for. It's how we raised the minimum wage, legalized medical marijuana, and protected our land and water. It's a tool for communities to drive change when politicians won't. HB 1205 is not about accountability or transparency. It's about fear of the people and the power they hold. This law hacks away at a process that may need refining, but not destruction. It puts up traps and hurdles to ensure only the wealthy and politically connected can get an idea on the ballot. It is a direct assault on the will of the people. And if it's allowed to stand here, you can bet it will spread across the country. This is how democracy erodes — not in one sweeping moment, but in a thousand paper cuts to participation, voice, and power. But we're not letting that happen. We filed this lawsuit because we believe in the power of the people. We believe the single mother in Miami, the bus driver in Fort Myers, and the veteran in Jacksonville deserve a voice in the laws that shape their lives. Floridians — not politicians afraid of accountability — should have the final say. This lawsuit is our declaration: We will not let them rig the rules. We will not be silenced. We're collecting signatures. We're building coalitions. We're taking this fight from the courtroom to the streets to the ballot box. Because Medicaid expansion isn't just smart policy — it's a moral imperative. And the citizen initiative process isn't just a political tool—it's a right we will defend. Mitch Emerson is executive director of Florida Decides Healthcare.
Fox News
20-05-2025
- Business
- Fox News
Former Atlanta Mayor Keisha Lance Bottoms announces Georgia governor bid, slams Trump in campaign video
Former Atlanta Mayor Keisha Lance Bottoms launched a Georgia gubernatorial bid on Tuesday, slamming President Donald Trump in a campaign video. "Donald Trump is a disaster for our economy and our country. From his failure to address rising prices to giving an un-elected billionaire the power to cut Medicare and Social Security. It's one terrible thing after another," she asserts in the video, later declaring, "Georgia families deserve far better than what Donald Trump and Republicans are giving us." Fox News Digital reached out to the White House for comment but did not immediately receive a response. Bottoms said in the video that "expanding Medicaid" would be her "top priority" as the state's governor, and that she would "work to eliminate state income taxes for teachers." She worked for President Joe Biden during a portion of his White House tenure. In 2022 she was announced as Senior Advisor to the President for Public Engagement, and then in 2023 Bottoms was selected to serve on the President's Export Council. Current Peach State Gov. Brian Kemp, a Republican who is now serving his second consecutive term, is not eligible to seek re-election in 2026. In addition to Bottoms, Republican state Attorney General Chris Carr and Democratic state Sen. Jason Esteves, are both also running for the job. Olu Brown — who previously "served as the Founding and Lead Pastor of Impact United Methodist Church," according to — is also seeking the governorship.
New York Times
20-05-2025
- Politics
- New York Times
Keisha Lance Bottoms, Former Atlanta Mayor, Enters Georgia Governor's Race
Keisha Lance Bottoms, a former mayor of Atlanta, entered the race for governor of Georgia on Tuesday, becoming the highest-profile Democrat in an election that will test the durability of Georgia's relatively new status as a swing state. Ms. Bottoms has immediately set her sights on President Trump, who won Georgia in 2024 but has had a strained history with the state, including with Gov. Brian Kemp and some of the state's other top Republicans. Ms. Bottoms said she was positioning herself as an antidote to the 'chaos in Washington,' citing her time leading Atlanta during Mr. Trump's first term as useful experience. 'This is a very uncertain and anxious time for people in Georgia,' she said in an interview on Monday, ahead of her announcement, 'and people are looking for a leader who is willing to fight for them.' Mr. Kemp will not run again because of term limits. Ms. Bottoms's tenure as mayor from 2018 to 2022 was defined largely by her handling of the turmoil that rattled Atlanta after the coronavirus pandemic began and George Floyd was killed by the police in Minneapolis. If elected, she would become the nation's first Black female governor, and the first Black person and first woman to lead Georgia. Her announcement, which came in a video released early Tuesday, makes official a campaign that has hardly been a secret in recent weeks. She said that one of her top aims as governor would be expanding Medicaid under the Affordable Care Act, a move that would support struggling rural hospitals and provide largely free government health insurance to most low-income adults. She also wants to eliminate the state income tax for teachers. Chris Carr, the state's Republican attorney general, is the only other well-known figure who has announced a run. Burt Jones, the Republican lieutenant governor, is a possible contender, as is Stacey Abrams, who was the Democratic nominee for governor in 2018 and 2022. Jason Esteves, a Democratic state senator and a former Atlanta school board member, entered the race in April. United States Representative Lucy McBath, a Democrat representing a swath of the Atlanta metro area, had been widely expected to join the race. But she announced in late March that she would not, at least for now, because her husband was ill. The governor's office has been the biggest target to elude Democrats as they have become more competitive in Georgia. The party harnessed the rapid growth and diversification of the state, as well as a deep aversion to Mr. Trump among many suburban voters, to help former President Joseph R. Biden Jr. win Georgia in 2020 and elect two Democratic senators months later. One of those senators, Raphael Warnock, eked out a re-election victory in a runoff in 2022. But in 2024, Georgia, like every swing state, went to Mr. Trump. Republicans still control both chambers of the state legislature and every state elected office. Ms. Bottoms, a former city councilwoman and judge in Atlanta before becoming mayor, joined the Biden administration in 2022 as a senior adviser, working primarily on strengthening its ties with community and business organizations. In 2023, Mr. Biden appointed her to the President's Export Council, an advisory commission on international trade. During the pandemic, she clashed as mayor with Republican leaders — particularly Governor Kemp — over their aggressive push to roll back Covid precautions and reopen businesses weeks into the pandemic. Mr. Kemp sued Ms. Bottoms and the Atlanta City Council after they defied him by enacting strict masking requirements. And as racial justice protests spurred by the murder of George Floyd in 2020 turned violent in Atlanta, she was recognized for a response that was regarded as tough yet empathetic. 'We are all angry,' she said in a message frequently replayed on social media and local television and radio. 'This hurts everybody in this room. But what are you changing by tearing up a city? You've lost all credibility now. This is not how we change America.' Suddenly, Ms. Bottoms had an unusually high profile, even for a big-city mayor. For a time, she was mentioned as a contender to be Mr. Biden's running mate in 2020. But her critics argued that the spotlight had become a distraction from the increasingly urgent needs of Atlanta. As in other American cities, violence exploded there during the pandemic. Her relationship with Atlanta's police rank-and-file eroded after her forceful response to a police killing in the city just weeks after Mr. Floyd's death: Rayshard Brooks, a 27-year-old Black man, was fatally shot by a white officer. The officer was fired almost immediately, and was later charged with murder. The police chief also quickly resigned. But the Wendy's parking lot where Mr. Brooks was killed became the site of renewed demonstrations. Arsonists burned down the restaurant, and then an armed group opened fire on a vehicle, killing an 8-year-old girl. Ms. Bottoms was criticized for not conducting a nationwide search to find a new police chief. The city's Civil Service Board reinstated the officer who shot Mr. Brooks, finding that his due process rights had been violated, and eventually, the criminal charges against him were dropped. In May 2021, Ms. Bottoms abruptly announced that she would not seek a second term as mayor. In an emotional news conference, she ran through a list of hurdles she had encountered since she was narrowly elected in 2017, including a cyberattack on the city government and the continuation of a federal investigation into high-ranking city officials accused of taking bribes and other corruption allegations that had started during the tenure of her predecessor, Kasim Reed. She said on Monday that she looked back at her mayoral tenure with pride. 'I have a track record," she said, 'of being a battle-tested leader in the toughest of times.'
CBS News
08-05-2025
- Business
- CBS News
Wisconsin Republicans kill marijuana legalization and tax increases for millionaires
Republicans who control the Wisconsin Legislature voted Thursday to kill most of the top spending priorities of Democratic Gov. Tony Evers, including legalizing marijuana, even as both sides negotiate a tax cut. The Legislature's Republican-controlled budget committee voted along party lines to kill more than 600 budget proposals put forward by Evers, including spending more state money on child care providers, expanding Medicaid and raising taxes on joint tax filers those who earn more than $1 million. Republicans did the same thing in each of Evers' previous three budgets and had said they were going to do it again. Some of the killed ideas, like allowing absentee ballots to be processed before polls open on Election Day, have had bipartisan support in the past and could return in another form. The cuts come amid uncertainty about how much federal money the state will get as President Donald Trump's administration moves to drastically reduce government spending. Evers' budget as introduced would have spent about $119 billion money over two years, a 20% increase in spending. Evers and Republicans have been talking about a tax cut plan they both could support but have not released details. Republicans argue that most of the state's roughly $4 billion surplus should be returned as tax cuts rather than used to support spending on K-12 schools, the University of Wisconsin and other state programs. Evers proposals stripped from the budget on Thursday include: eliminating the tax on tips; increasing funding to combat what some people call forever chemicals or PFAS; targeted property tax cuts for veterans, seniors and people with disabilities; spending $128 million on new financial aid targeting low-income college students and adding gender-neutral language such as "person inseminated" to state law. "Republicans talk a lot about what they're against, but not what they're for," Evers said in a statement. "There are pressing challenges facing our state. Wisconsinites are sick and tired of having a do-nothing Legislature. Republicans must get serious about getting things done." Republican Sen. Howard Marklein, co-chair of the budget committee, said "popular items" could return as separate bills. Co-chair Rep. Mark Born said just because the committee was rejecting Evers' approach to various issues facing the state doesn't mean they won't be addressed in other ways. The vote gutting the governor's spending plan marks the first step in what will be a weekslong process of slowly rebuilding the two-year budget to include more Republican priorities. Evers can make more changes with his broad veto power once the Legislature passes a budget, which typically happens in late June or early July. However, Republicans have talked about taking longer to pass a budget this year, or passing only certain top priority spending bills, in reaction to a Wisconsin Supreme Court ruling upholding a line-item budget veto Evers made in 2023 that extended a K-12 spending increase for 400 years. That ruling affirmed the governor's power to veto digits from a budget bill, allowing him to create new amounts and years not envisioned by lawmakers. The court noted in its ruling, however, that the Legislature could rein in the governor's veto powers in several ways. That includes passing a constitutional amendment that's under consideration curbing a governor's veto power and drafting budget bills in a way to prevent a governor from making such a sweeping veto.
