Medicaid

People in the Deep South support expanding Medicaid under President Obama's healthcare law, though they oppose the law itself, according to a new poll.

The survey, released by the liberal advocacy group Families USA, found that 62 percent of respondents had a favorable view of the healthcare law's Medicaid expansion.

The survey polled adults in Alabama, Georgia, Louisiana, Mississippi and South Carolina — deeply conservative states, but places where the Medicaid expansion would cover millions of uninsured people.

The average Medicaid beneficiary is only covered for part of the year, leading to costly and harmful disruptions in his or her healthcare, according to a recent study.

Researchers at George Washington University looked at Medicaid "churn" — when beneficiaries move on and off the rolls because of small variations in income — and found that it leads to more hospitalizations and higher costs for patients.

According to the study, a Medicaid beneficiary enrolled consistently for 12 months pays $333 in medical bills per month, on average. Patients enrolled for six months paid $469, and those enrolled for one month paid $625.

Kentucky Gov. Steve Beshear said Thursday he supports the Medicaid expansion in President Obama's healthcare law — the last Democratic governor to sign on.

Republican-controlled legislatures have killed the Medicaid expansion in some states where the governor has embraced it, and the same could happen in Kentucky. But Beshear's endorsement at least sews up support from all of the country's Democratic governors, in addition to several high-profile Republicans.

Beshear said the Medicaid expansion would cover 308,000 Kentuckians — about half of the uninsured population in the state.

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Two prominent Republicans outlined a plan Wednesday to limit federal Medicaid spending and give states more control over the program.

Rep. Fred Upton (R-Mich.), who chairs the Energy and Commerce Committee, and Sen. Orrin Hatch (R-Utah), the top Republican on the Finance Committee, proposed a "per capita cap" on Medicaid benefits.

The idea of a per capita cap has its origins in the Clinton administration, and Rep. Bill Cassidy (R-La.) has proposed something similar.

The Obama administration wants to increase the amount it pays hospitals under Medicare.

In a 1,424-page proposal, set to be published in the Federal Register on May 10, the Center for Medicare and Medicaid Services (CMS) is proposing to increase the operating rates for long-term and short-term acute care at inpatient hospitals that treat patients covered by the government healthcare program, and is laying out some new features of the Affordable Care Act.

The CMS proposes increasing payments for acute care, which include short stays for non-chronic conditions like severe injuries or brief illnesses, by 0.8 percent, or about $27 million.

The agency also wants to increase payment rates for long-term care by 1.1 percent in 2014, estimated to come out to $62 million.

The agency's proposed increases account for offsets and reductions in spending, and would take effect starting in October.

The White House is conducting a final review of a proposal from the healthcare reform law that would cut federal grants for hospitals that serve poor patients.

The facilities, known as Medicaid Disproportionate Share Hospitals (DSH), are eligible for state and federal funding to balance out the amount they spend caring for patients who are unable to pay their bills.

The Department of Health and Human Services (HHS) spent more than $17 billion on payments to DSHs in 2011, according to a Government Accountability Office study. The Affordable Care Act aimed to slash those grants exponentially from 2014-2020, starting with a $500 million cut next year.

Lawmakers in Arkansas on Monday rejected a controversial approach to the Medicaid expansion in President Obama's healthcare law. 

Arkansas Gov. Mike Beebe, a Democrat, has proposed a version of the Medicaid expansion that GOP-led states might follow. Rather than directly expanding Medicaid, Beebe wants to move the newly eligible Medicaid population into his state's insurance exchange, where they could shop for private coverage.

But the Arkansas House voted down the proposal on Monday. The bill needed 75 votes to pass; it failed 69-28. The House is expected to try again tomorrow, as party leaders try to wrangle a few more votes for a proposal that could catch on in other states — if it can pass in the state that thought of it.

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Medicaid is quickly abandoning the traditional fee-for-service model when it comes to handling patient prescriptions, according to a new study.

The IMS Institute for Healthcare Informatics reported Thursday that Medicaid managed care plans handled 19 percent of the program's prescriptions in September 2011.

That share more than doubled by June 2012, less than one year later, the researchers found. 

Expanding Medicaid is the healthcare law's single best tool for reducing out-of-pocket healthcare costs, the Robert Wood Johnson Foundation said in a research paper Wednesday.

The study said other provisions of the Affordable Care Act will have an "uneven impact" on healthcare costs for low-income families, because of state-by-state variations in cost.

But the Medicaid expansion would apply uniformly in every state that decides to accept it, and therefore is more likely to make a dent in out-of-pocket spending, the report said.