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ObamaCare Discuss Report: Medicaid enrollment, costs swell under ObamaCare expansion at the General Forum; Originally Posted by AZRWinger Medicare dictates reimbursement rates to healthcare providers whereas private insurance providers don't have the power to ...

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Old 12-27-2017, 11:01 AM
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Default Re: Report: Medicaid enrollment, costs swell under ObamaCare expansion

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Originally Posted by AZRWinger View Post
Medicare dictates reimbursement rates to healthcare providers whereas private insurance providers don't have the power to dictate cut rate reimbursement. It is likely part of the cost of private care offsets the loss from low Medicare rates.
Mmmmm.... private insurance negotiates payment rates (reimbursement) with medical providers based on groupings called Reasonable & Customary, sometimes based on zip codes, because not all areas have the same cost factors for procedures. Networks also have negotiations for doctors and hospitals.

Ever read your EOB?
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Old 12-28-2017, 03:00 PM
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Default Re: Report: Medicaid enrollment, costs swell under ObamaCare expansion

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Mmmmm.... private insurance negotiates payment rates (reimbursement) with medical providers based on groupings called Reasonable & Customary, sometimes based on zip codes, because not all areas have the same cost factors for procedures. Networks also have negotiations for doctors and hospitals.

Ever read your EOB?
Private insurance negotiates, Medicare dictates, see the difference? The former is voluntary, the latter mandatory.

Yes, I have reviewed my EOB, everyone should so they can reconcile them with the bills from medical providers.
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Old 12-28-2017, 03:35 PM
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Default Re: Report: Medicaid enrollment, costs swell under ObamaCare expansion

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Originally Posted by AZRWinger View Post
Private insurance negotiates, Medicare dictates, see the difference? The former is voluntary, the latter mandatory.

Yes, I have reviewed my EOB, everyone should so they can reconcile them with the bills from medical providers.
I agree on the negotiates/dictates, but I won't stretch so far as to use the words voluntary/mandatory. A doctor or facility can decline to accept either one.
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Old 12-29-2017, 04:28 AM
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Default Re: Report: Medicaid enrollment, costs swell under ObamaCare expansion

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Originally Posted by AZRWinger View Post
Medicare dictates reimbursement rates to healthcare providers whereas private insurance providers don't have the power to dictate cut rate reimbursement. It is likely part of the cost of private care offsets the loss from low Medicare rates.
oh bullowney. all insurance pays what they pay. none pay everything unless you have a cadillac plan and even then they do dictate which drugs they will pay for and sometimes not the drug needed and generic but a whole different drug. I know this because I had that situation when my son was sick as a teenager.
And the doctors around here are quite happy with my husband's medicare. though he has almost entirely switched to the VA now. But when he did use medicare they rolled the carpet out for him. Also he gets his vaccines w/o co pay through medicare.
but I think the thread is about medicaid, which is also good. handled by states it is better some places than others. For a low populated state and rater poor, Idaho has excellent service and cost.
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Old 01-02-2018, 08:01 AM
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Default Re: Report: Medicaid enrollment, costs swell under ObamaCare expansion

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oh bullowney. all insurance pays what they pay. none pay everything unless you have a cadillac plan and even then they do dictate which drugs they will pay for and sometimes not the drug needed and generic but a whole different drug. I know this because I had that situation when my son was sick as a teenager.
And the doctors around here are quite happy with my husband's medicare. though he has almost entirely switched to the VA now. But when he did use medicare they rolled the carpet out for him. Also he gets his vaccines w/o co pay through medicare.
but I think the thread is about medicaid, which is also good. handled by states it is better some places than others. For a low populated state and rater poor, Idaho has excellent service and cost.
That is true, but the difference between private insurance and a one size fits all government coverage is that one has the ability to shop around for different providers of private insurance. With a government plan, you are stuck with what you get while unelected bureaucrats decide what you do and do not need.
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Old 01-02-2018, 11:01 AM
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Default Re: Report: Medicaid enrollment, costs swell under ObamaCare expansion

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Originally Posted by GottaGo View Post
I agree on the negotiates/dictates, but I won't stretch so far as to use the words voluntary/mandatory. A doctor or facility can decline to accept either one.
Negotiated prices with private insurance companies are voluntary. There is no negotiating with government reimbursement rates. Healthcare providers can elect to accept or reject either.
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Old 03-27-2018, 10:01 AM
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Default Re: Report: Medicaid enrollment, costs swell under ObamaCare expansion

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Originally Posted by Hairy Jello View Post
“A lot of folks on the left will say that this is a huge sign of success -- look at all of these people who need coverage and help,” Nicholas Horton, senior research fellow at FGA and co-author of the report, told FoxNews.com. “My response is that it is not success when you have able-bodied adults who are being trapped in welfare and reducing their incentive to work.”

The swelling enrollment also points to potential budget problems for the states.

Starting in January 2017, states’ share of Medicaid expansion costs will increase to 5 percent and, as noted in the FGA’s report, those costs gradually will rise to 10 percent by 2020. With costs rising more quickly than ObamaCare advocates projected, the FGA expects state budgets to take a hit.

“We’ve used deficit spending to pay for these people in federal dollars, and come January, states are going to have to use state dollars to pay for the program,” FGA senior fellow Josh Archambault said. “The one caveat in this is that every state dollar spent on able-bodied adults in a Medicaid program is one less dollar that can be spent on other programs. This is essentially eating up tons of funds at the state level.”

The FGA report also claims that Medicaid expansion makes welfare for able-bodied adults a higher priority than services for the nearly 600,000 seniors and children with developmental disabilities, individuals with brain injuries and others on waiting lists for additional Medicaid services.

But according to the Centers for Medicare & Medicaid Services, a division under the federal Department of Health and Human Services, these waiting lists are unrelated to the Medicaid expansion and pre-date ObamaCare, formally known as the Affordable Care Act.

Before ObamaCare, Medicaid eligibility extended mostly to low-income, disabled adults and some pregnant women and children. Under the Affordable Care Act, the program now allows coverage for most low-income Americans under age 65 in states that OK’d the expansion -- while other families not qualifying for Medicaid can still receive premium subsidies on the ObamaCare exchanges.
A lot of right-wing BS pretending to be an argument.

The lions share of the costs for Medicaid expansion are funded by the federal government and are not paid for with deficit spending.

Quote:
Beginning with tax year 2013 , single taxpayers who earn more than $200,000 and married taxpayers with combined income of more than $250,000 will face a new 3.8 percent Medicare tax on their investment gains. The tax will apply to investment income including interest, dividends, capital gains, rents, royalties and the taxable portion of an annuity payout.
https://www.shrm.org/ResourcesAndToo...reTaxHike.aspx

Instead of being required to fund 50% of the Medicaid costs the states initially funded none of the expansion. In 2017 the states had to fund 5% and in 2020 they will have to fund 10% or only 20% of the costs that they should be paying under the original Medicaid program where the costs were co-funded equally by the federal and state governments.

One of the great mistakes of Obamacare was that it called for any state funding at all for the Medicaid expansion. Had it not been for the state funding requirements in 2017 and 2020, that will only account for 10% of the costs, the Medicaid expansion would have been mandated in all of the states providing necessary health insurance to households that simply can't afford to pay any medical costs typically because of low wages.

The fix is relatively easy if we address this logically. Because the states contribute such a small amount even after 2020 why not just revise the expansion so that the federal government picks up all of the costs and raise the 3.8 percent Medicare tax on high annual investment incomes to fund the additional costs. That allows the Medicaid expansion to be implemented in all of the states providing health insurance and medical services to needy households and it doesn't create any deficit spending.

We can also remember that the households that pay the increased tax are wealthy households that won't have their lifestyles diminished by the additional tax and they're not paying any of the Social Security taxes at all on their investments income that working Americans have to pay. They're still being taxed less than you and I, average Americans, are paying while they can afford to live in million dollar homes, drive their new Mercedes Benz, and spend their days lounging on the beach instead of going to work.

BTW - The if the Republicans don't want to fund health insurance for "able-bodied" people then it's real easy. Require employers to provide health insurance and pay a living wage where the workers won't qualify for Medicaid. Those added under the expansion of Medicaid were virtually all working American households because those that are "able-bodied" and couldn't work for numerous financial reasons (e,g, a single woman with two children where childcare would cost more than she would earn in wages if working) were already covered by Medicaid prior to the expansion.

Republicans love to whine about welfare when the answer to eliminating most welfare is simply a living wage. If employers pay a living wage then their employees don't qualify for welfare benefits.
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Old 03-27-2018, 10:15 AM
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Default Re: Report: Medicaid enrollment, costs swell under ObamaCare expansion

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Originally Posted by AZRWinger View Post
Negotiated prices with private insurance companies are voluntary. There is no negotiating with government reimbursement rates. Healthcare providers can elect to accept or reject either.
Hospitals that receive huge federal and state subsidies are required, as a condition of the subsidies, to accept Medicare and Medicaid patients. Private clinics that don't receive the subsidies are not required to accept the Medicare and Medicaid patents. Because Medicare and Medicaid both pay less than the costs of the actual services most private clinics will not accept new Medicare/Medicaid patients. Private clinics do typically continue providing services to patients they have that eventually become Medicare patents at retirement age.

Private clinics don't worry too much about those with private insurance because the patient is simply billed for any shortfall in the scheduled benefit payments by the private insurance company (that aren't open to negotiation with the private clinic). Medicare/Medicaid patients can't typically be billed for costs in excess of the Medicare/Medicaid payment (except when it's related to private insurance tied to Medicare/Medicaid).
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Old 03-27-2018, 11:05 AM
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Default Re: Report: Medicaid enrollment, costs swell under ObamaCare expansion

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A lot of right-wing BS
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Old 04-04-2018, 10:06 AM
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Default Re: Report: Medicaid enrollment, costs swell under ObamaCare expansion

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A messenger is expected to provide the truth but in this case all we have are Republican liars.

The Republicans are lying about Medicaid when they claim the expansion is paid for with deficit spending because a tax was imposed to specifically pay for the expansion. Is the tax enough? I'm not sure but if it's not then it needs to be raised. Simple solution.
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