Why are the states so hesitant about Medicaid expansion?

Policy Interns

Where the States Stand

Figure 1. States position on Medicaid Expansion under the ACA.

Via: The Advisory Board Company

To expand, or not to expand Medicaid, that is the question.

Why are some states skeptical about Medicaid expansion and making the assumption that the “plan is [too] costly?” If the states expand their Medicaid program, they would receive federal funds up to 100 percent until 2017 under the ACA. It seems silly that the states would reject the idea of expanding Medicaid programs if it could potentially benefit them financially as a result of the reduction in uncompensated health care costs as well as reducing the number of uninsured individuals.

The purpose of Medicaid expansion under the ACA is to provide broader health coverage to lower-income individuals. States are not required to implement the provisions, however, it is “the single largest source of coverage for nursing home and community-based long-term care.”

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Why is home health service important? It is becoming more prevalent to us as the generation gets older and the aging population continues to increase. It is crucial that policymakers and healthcare providers consider future healthcare alternatives in better improving long term health services to avoid hospital readmissions or to financially alleviate the costs of treating chronic illnesses.

Policy Interns

What does Medicare or home health services mean to you? Is it even relevant?

I’ll tell you why we should care. Not to be the bearer of bad news, but you will eventually grow older and hospital visits will become more frequent. Eventually we will be enrolling in Medicare programs or experiencing at first-hand, various healthcare options for our parents and grandparents. Looking at long-term healthcare plans is as relevant to us today as it will be to us later in life. There is also the fact that you’ve already experienced a new additional 0.9 percent Medicare tax on individual wages, which may potentially heighten your interest.

Home health services originated at the start of the 20th century. They were created to alleviate the burdens of health and social needs for neglected patients. One of the main incentives of home health care is that it reduces overall healthcare…

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My post about health information technology.

Policy Interns

Here’s a novel idea: Facebook co-founder Eduardo Saverin proposes an idea to enforce the use of real names and identity of Facebook users in order to provide accurate health related information to the right person.

Health information technology is an idea that has been discussed in the past, but more so now because of the buzz of healthcare resulting from the ACA. Last week, Bipartisan Policy Center hosted an event entitled “An Oversight Framework For Assuring Patient Safety in Health IT.” The BPC proposes a set of recommendation for an oversight framework to protect patient safety, provide flexibility to the patients, avoid regulatory duplication, and provide support to experts and stakeholders in every sector of healthcare.

According to a study from The Office of the National Coordinator for Health Information Technology, the Pennsylvania Patient Safety Authority finds that health information technology was used in only 3,900 of 1.7 million…

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Do you think this is necessary? Would this prevent future healthcare spendings and aid in preventing high healthcare costs?

Policy Interns

What are your thoughts about a federal tax on sugary drinks (ie. Soda, energy, and sports drinks)?

The Field Poll, a non-partisan media-sponsored public opinion news service, found an interesting result in their survey of Californians’ views on the tax on sugary drinks. Approximately 40 percent of California residents voted in support of a soda tax when first asked; the statistics increased to a drastic 68 percent when suggesting that the revenues made from taxes were going to be used to improve school nutrition standards and physical activity programs. Also, the survey finds that three in four California voter participants (75%) understand that those who consume sugary drinks regularly increase their chances of obesity and weight-gain problems.

According to the Dietary Guidelines for Americans (2010), 35.7% of added sugars in Americans’ diets come from sugary drinks such as soda, energy drinks, and sports drinks.

Awareness of the impact…

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By Ji Lee

(I am re-blogging from blog posts that I am writing for my current internship)

Policy Interns

Earlier last week, the American Action Forum released a survey analyzing the cost of individual premiums due to the ACA. The survey looks at the spectrum of rate changes across any geographic area rather than the average changes. The results are shocking and they paint a poor future outlook for the young and healthy individuals.

The study reveals new findings that “the ACA will dramatically increase the cost of insurance for the young and healthy individuals and small employers….” The average increase is up to 100 percent. The study also finds that older and sicker individuals will see an average 25 percent decrease in their premiums. Now, why is that?

Also, there is no guarantee that all healthy individuals will be willing to purchase a costly health insurance plan. Will enforcing the ACA with penalties for noncompliance make up the necessary revenue to subsidize older and sicker Americans?

Even large…

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Opinions and views are of my own.

Policy Interns

The big question in healthcare this week is what impact, if any, President Obama’s immigration proposal will have on the ACA. Will those immigrants benefit from the ACA if immigration reform is passed? And will they receive the same health coverage and benefits as the American people? It depends.

Currently, under the ACA, naturalized citizens and legal immigrants will have access to free or subsidized health coverage if have been living in the United States for more than five years. Those legal immigrants who have been residing in the country for five years or less with incomes below 400 percent of Federal Poverty Level also receive access to subsidized coverage.

However, unauthorized immigrants are not eligible to receive Medicaid, Children’s Health Insurance Program coverage, or subsidies. Also, they are not allowed to even purchase private coverage health insurance exchanges. Therefore, unauthorized immigrants are at risk of having no health coverage…

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As a healthcare policy intern at American Action Forum for the spring 2013, I’ve started to write for their healthcare part of the Policy Interns blog. I will start re-blogging from their posts! It is my original work; I update it once a week! The opinions and views are of my own. Blog posts are my own thoughts and perspectives.

Policy Interns

By Ji Lee

On Monday January 21, 2013, President Barack Obama delivered his second inaugural speech at the United States Capitol building.

Having viewed the inauguration, there are a few components related to the future of healthcare that I would like to highlight.

President Obama mentioned that “Together we discovered that a free market only thrives when there are rules to ensure competition and fair play. Together we resolve that a great nation must care for the vulnerable and protect its people from life’s worst hazards and misfortune.”

Few disagree with the ideas of ‘competition and fair play,’ but it raises questions when he implies that without these “rules to ensure [them],” a free market approach will fail.  A free market health care system, with limited government intervention can more efficiently allocate resources and provide the American people with better and more cost efficient options. An example would be the…

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Cough, Cough, and Sneeze.

(Photo credit – TIME magazine “Cartoons of the Week: January 5-11)

Be careful of the flu! Check out these websites I’ve listed below. They can tell you where to go for your flu shot. It’s better to get one now when you’re healthy rather than being miserable later.




Myths and Truths about sugar!


In 2009, an hour and a half lecture about sugar and obesity that I gave to the public was posted to YouTube. Given its scientific content, I wasn’t even sure if my family members would watch it. Three million views later, the video is still going strong, and my theories about sugar’s toxic effects on the body are gaining traction. I still believe that one particular form of sugar—fructose—is toxic in high dose. Yet there is still a lot of confusion about this dietary bogeyman. Here are five myths about sugar and some important distinctions about how our body processes its different forms.

(LIST: Top 10 Diet Discoveries of 2012)

Myth 1. A carbohydrate is a carbohydrate; they all have the same calories.

Half true. There are three molecules that make up all the various kinds of carbohydrate: glucose, galactose, and fructose. All three molecules have the…

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Have you seen a doctor recently? It’s very common to find yourself waiting in the doctor’s office for at least one to two hours. After filling out some basic information about yourself and about your previous health history, a nurse finally calls you in into a small, brightly lit room where you will sit and wait another minimum of thirty minutes. Once the doctor enters the room, you briefly chat and be examined under ten minutes, if even that. Then you’re out the door with a prescription in your hand.

  • Now imagine that scenario again but double the time you wait and shorten the actual examination period. With the new healthcare in full swing for 2014, you will slowly see changes in the new year of 2013. Even though we’re in our 20s and medicare does not apply to any of us, fortunately, as well as medicaid, it will somehow indirectly effect your next doctor’s visit. The purpose of President Obama’s Affordable Health Care Act is to provide health coverage to those who are uninsured. Those who are without a health insurance will soon be insured by 2014, unless they are willing to pay a fine. In a recent study in American Journal of Medical Quality,Characteristics of Primary Care Safety-Net Providers and Their Quality Improvement Attitudes and Activities: Results of a National Survey of Physician Professionalism,” researchers have found that doctors who willingly accepted uninsured and medicare patients, “safety-net” physicians, may have already reached their capacity of patients that they can see.

In a press release, Massachusetts General Hospital researchers have found that these so-called “safety net” physicians may no longer accept new patients or simply are unable to care for the increased number of patients.

“This study raises very serious concerns about the willingness and ability of primary care providers to cope with the increased demand for services that will result from the ACA. Even with insurance, it appears that many patients may find it challenging to find a physician to provide them with primary care services.” — Eric G. Campbell, PhD, of the Mongan Institute, senior author of published report in American Journal of Medical Quality.

You may think this does not apply to you just yet. However, what will you do if you need a doctor who is unable to see you because of the overwhelming number of patients flooding the office?

Whether you are self-employed or on a payroll, you will experience an increase in medicare taxes. Currently, employers deduct 7.65 percent of your wage to support the elderly and to those with permanent disabilities. And of that, 1.45 percent goes into Medicare’s hospital expenses. However, in the beginning of 2013, the Affordable Healthcare, Obamacare, will increase Medicare hospital tax by 0.9 percent for those who earn more than $200,000 (source: IRS). There is also a new 3.8 percent tax on investment income to the same provision as discussed earlier; for those who earn more than $200,000. Investment income is simply an unearned income; its what is left over after you have subtracted your investment expenses such as fees and commissions (source: financial dictionary).

Even though many of you still may be in college or are not worried about the future of healthcare, it is important to take note that it has the ability to effect the economy in which we are living in.

What are your thoughts?

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