Tag: Medicaid
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Two Medicaid Updates: Work Requirement, PBMs
By Steve Haner Medicaid Work – Training Requirement Dead Disappointing many, thrilling many, and surprising nobody, the Governor of Virginia has openly broken his 2018 promise to couple expanded Medicaid coverage with a work or job training requirement for able-bodied recipients. Moving people out of poverty is no longer the goal. Governor Ralph Northam was…
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JLARC: Medicaid Jumps 19% In Expansion Year
By Steve Haner Every year, the Joint Legislative Audit and Review Commission issues a report looking at ten years of state spending, sliced and diced various ways. In recent years, the headline results have largely been surprisingly consistent and the 2019 report issued Monday fit the pattern. As seen before: Medicaid program costs lead the…
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Don’t Abandon Medicaid Work Requirement
By Steve Haner To Republicans who supported the 2018 decision to expand Medicaid services to more Virginians – and encouraged yes votes from reluctant colleagues — the promise to couple those benefits with pathways toward gainful employment was a key reason. The compromise has worked in other states as well.
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Medicaid Expansion Cost Still Off-Budget, Elusive
By Steve Haner All the signs point to trouble. The next state budget, a two-year plan to be proposed in December, adopted by March and implemented in July, may be caught between stagnant revenue and soaring spending. The spending charge will be led once again by Medicaid. Just how much the decision to expand Medicaid…
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Oops, We Did It Again
What a shock! Virginia’s Medicaid expansion isn’t working out as planned. Today we learn that Virginia’s private hospitals, which are paying a tax to defray the state’s 10% share of expansion (Uncle Sam pays the rest), is on track to receive only 78% of the Medicaid revenue they expected, reports the Richmond Times-Dispatch. The big…
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Are PBMs Killing Pharmacies, Hiking Medicaid?
A form letter mailed this month announced the death of another local independent pharmacy, this one in the bustling community of Nellysford. Residents of Nelson County’s Rockfish Valley, including those in the large Wintergreen community, will join plenty of other rural areas in the U.S. without a pharmacy close by.
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Shock! More “Surprise” Medicaid Cost Expenditures
Gee, who could have foreseen this? Virginia’s Medicaid expansion will cost more than expected. From the Richmond Times-Dispatch: A hospital tax designed to pay for Medicaid expansion might not cover the expense of administering a key provision of the legislation: a work requirement for people receiving benefits. The Senate Finance Committee was “taken aback” earlier…
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Does Virginia Do Income-Verification for Medicaid Recipients?
Last month a Louisiana state audit of 100 randomly selected Medicaid beneficiaries found that 82 did not qualify for the benefits they received. Most under-reported their income, some shamefully. Two recipients were getting Medicaid despite having incomes above $300,000. Now, Louisiana is Louisiana, not exactly known for squeaky clean governance. But there is accumulating evidence…
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Medicaid Expansion’s Achilles Heel: the Doctor Shortage
The Northam administration sold Medicaid expansion to the public in part by claiming that the net cost to Virginia taxpayers would be minimal. Uncle Sam would pay for 90% of the cost of extending medical coverage to up to 400,000 Virginians, and the state’s 10% share would be offset by savings in prisons, mental health,…
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Medicaid, the Blob that Ate the Budget
Details on that runaway Medicaid budget… Spending per Medicaid enrollee has been relatively flat the past five years, having increased less than 0.4% annually (adjusted for inflation) between FY 2011 and FY 2015. The cost driver has been enrollment, which increased 16.5% over the same period, according to a Joint Legislative Audit and Review Commission…
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Medicaid Expansion an Inefficient Way to Prop up Rural Hospitals
by James A. Bacon One commonly cited argument in support of expanding Virginia’s Medicaid program in concert with the Affordable Care Act is that enrolling more poor Virginians would help prop up financially shaky rural hospitals. Rural hospitals tend to serve disproportionately poor populations, which means they tend to provide disproportionate amounts of uncompensated care. Expanding Medicaid coverage to…
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A Timely Reminder: Virginia Hospitals, Even the Non-Profits, Are Very Profitable
One of the justifications given for expanding Virginia’s Medicaid program as part of the implementation of Obamacare is to shore up the financial condition of Virginia’s hospitals. On the assumption that Medicaid expansion would reduce the number of indigent (non-paying patients), Obamacare will cut back funds to hospitals under the established Disproportionate Share Hospital (DSH) program to help…
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Virginians Skeptical of Medicaid Expansion
by James A. Bacon The biggest story in Virginia right now (even bigger than the U.S. 460 fiasco) is Medicaid expansion, and the latest wrinkle is that Republican skeptics are winning the debate. Frankly, I am amazed. I thought that the siren call of recouping billions of dollars in federal money that Virginians were paying already…
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Who Is Being Intransigent Now?
by James A. Bacon Let me get this straight. Virginia Democrats in the General Assembly are saying that they will not pass a state budget until they get Medicaid expansion? “We won’t vote for a budget — and I can’t be emphatic enough — we will not vote for a budget, nor will the governor…
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Medicaid Expansion and the Trust Issue
by James A. Bacon Do you trust the federal government to make good on its promises to uphold entitlement spending? Or do you fear that, as the federal funding crisis intensifies, the feds will renege? That is the question at the heart of the debate over Medicaid expansion in Virginia. Bart Hinkle, a columnist for…