Medicaid expansion is needed for NC says this retired benefits professional

As North Carolina continues its stalemate on Medicaid expansion, it might be interesting to heed the words of former Ohio Republican governor John Kasich. When Ohio moved forward with the Medicaid expansion, he called it a “no brainer.”

Now why would he say that? Kasich noted Medicaid expansion would not only help people, it would bring $13 billion to his state over several years. George Washington University did a study that said Medicaid expansion would help a state’s economy, help a state’s rural hospitals and help people. We should also remember NC Republican Mayor Adam O’Neal of Belhaven walking to Washington seeking the expansion of Medicaid after his colleagues in Raleigh turned him down as he tried to save his town’s hospital.

Rather than offer stale arguments, it would be nice if the Senate and House leaders figure out a way to get this done. Let me add the voices of The Commonwealth Fund, RAND Corporation and Economic Policy Institute that echo the results of the GWU study. NC is already in the minority on this. Please let’s find a way to help people.

Let me close with a truism about health coverage to think about. Those with coverage will see doctors earlier and will have access to prescription drugs to avoid future train wrecks. Preventive care and health maintenance are better paths forward for people and healthcare financing.

Note: The author of this post is a retired benefits professional who is a former actuary, former benefits consultant and benefits manager for a Fortune 500 company

Note to Democrat Senators running for President – stabilize the ACA

The following note was posted on the website for the seven Democrat Senators running for President, with a copy to select others.

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I am an Independent voter and retired, but my career included being an actuary, benefits consultant and benefits manager for a Fortune 500 company. I have shared with Senators and Congress people a few thoughts on stabilizing the ACA, something Democrats campaigned on last fall and won.

Medicare for All deserves debate, but will require a more elongated and data-driven discussion. We need to have Congress take steps to stabilize the ACA now. To do otherwise, is a disservice to Americans.

Here are my thoughts.

– the GOP sabotaged the ACA in two specific steps which increased premiums even more. They defunded 89% of the risk corridors (for initial adverse selection) driving some insurers out of the market. The other is Trump reneged on reimbursing insurers for copays/ deductibles for people making less than 2 1/2 times the poverty level. My suggestion is to pay insurers what we promised in writing and invite those who left back into the exchanges.*

– I suggest the lowering of the eligibility age for Medicare to age 62 (the age when retirees can first draw Social Security). This could be viewed as a pilot for Medicare for All. This action would lower the Medicare premium rate for all and lower the ACA exchange premiums due to the age of those leaving the ACA and joining Medicare. In other words, both the average age of Medicare and the exchanges would be lower, so the actuarial cost per person is less in both.

– Actively encourage the expansion of Medicaid in the remaining states – this will help the economies, healthcare providers and people in those markets. There are now 36 states who have done so. GOP Ohio Governor John Kasich calls Medicaid expansion a “no brainer.”

– Finally, where only one option exists in a rural county, offer a Medicare option, again as a pilot. People should have choices.

There are other changes that would help, but this needs a data-driven analysis and not whatever the GOP did in 2017, which was a horrible approach to legislation that resulted in horrible legislation. Had any of the GOP legislation passed to kill the ACA, the GOP would have lost even more seats and we would be talking about a recession coming our way.

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* Please feel free to Google these topics: “Marco Rubio and risk corridors” and Donald “Trump and ACA subsidy decision”. The former caused insurance premiums to increase more than they otherwise would have and some insurance companies left the exchanges with the US government owing them money.  The risk corridors were designed to tie insurers over until the initial adverse selection flushed out of the system.

The latter was frustrating because the subsidy helped people in need. Trump untruthfully claimed it will only affect insurer profits, but the carriers committed to the customers to do this under contract. The CBO said this action raised the deficit by $10 billion, since premium subsidies went up to pay for the increased premiums. In my home state of NC, BCBS said before the Trump decision premiums were NOT going to increase. After the decision, the premiums increased 8%.

Saying this in a more succinct way, the GOP screwed American people to win a political argument. Sadly, that is the truth, but very few people know of this. This also is an exemplar of the President’s lying affecting hard-working people. Lying is one thing, but setting policy off lying is another matter altogether.

Note, the ACA is imperfect and complex. But, it still has not been fully implemented in all the states with those who did not expand Medicaid. But, people need to be fully aware of the sabotaging of the ACA undertaken by the GOP, which I find interesting, as the ACA is largely based on a GOP idea. That is politics for you – you did it, so I must be against it.

Thursday’s little bit of this and that

Having been away at the funeral for my friend’s mother, I have been a little out of sorts as well as out-of-pocket. The elections and next two days of affairs have my mind spinning, so please forgive me as I comment on a little bit of this and that.

The election results are encouraging from a number of fronts, but most of all from the number of diverse candidates that led to the Democrats retaking the House of Representatives. I am proud to see more newcomers and many women getting elected. These folks felt the need to get involved to focus on issues and decorum, which has been kicked to the curb. I wish for them to have the wisdom of Solomon, the patience of Job and the collaborative bipartisan bent of former Speaker Tip O’Neill and President Ronald Reagan.

I was also pleased to see a number of ballot initiatives pass in various states. Several so-called red states voted on the expansion of Medicaid, which is telling. Florida passed an initiative that would overturn the highly restrictive limitations on former felons regaining the right to vote after they get out. And, in North Carolina, every former governor advocated for the successful defeat of a power grabbing measures by the GOP led legislature to limit the powers of appointment of the governor.

While the Senate result was a little displeasing given the election of a couple of folks who should not hold public office (Former Florida Governor Rick Scott and Texas Senator Ted Cruz), the GOP maintaining the majority was not news. My greatest disappointment is two races benefitted racist efforts to likely win, although one is still not certain. The fact Brian Kemp may win the Georgia governor’s race after his blatant unethical and untruthful efforts to channel Jim Crow-like voter restriction is disheartening. Should he win, the state of Georgia deserves much better than him, as if he cheated to win, he will cheat while serving. The other is in Florida, where the new governor Ron DeSantis has a racist past and benefitted from racists robo calls and dog whistle statements, one he made. Florida deserves better, especially following Scott.

What has not changed is the US President continuing to channel his inner child heightening his lack of truthfulness, bullying and denigration of the media. At his tempestuous news conference yesterday, I kept thinking that a leader needed to step up and put him in time-out. I am still amazed at how he can sell his followers that he is the one telling the truth and that everyone who is against him is lying. But, per his five biographers, that has been his schtick over time. His firing of AG Jeff Sessions was expected, but at the heart of this, is the US President thinks the AG represents him, not the country. It is not a puzzle that Trump cannot fathom that the recusal was the ethical thing to do. He asked, “what kind of man would do that?” An ethical one.

Finally, we have one more mass shooting in America. How can we stop them? It is simply quite difficult to stop a motivated lone gunman (and it is almost always a man). Our police and FBI are terrific, but with our freedoms of less-inhibited gun ownership and the focus more on the lesser problem of foreign terrorists taking money from preventing the far worse domestic terrorists and hate groups, we are making it easier not harder to kill many at one time. Our leaders have lacked the courage to do more and too many are paid to avoid doing so. So, I just pray that my family, friends and others are just not in the wrong place at the wrong time. And, I pray that those leaders find that conscience they misplaced.