{"id":1062,"date":"2019-07-10T08:47:41","date_gmt":"2019-07-10T15:47:41","guid":{"rendered":"http:\/\/danschmidtforsenate.com\/blog\/?p=1062"},"modified":"2019-07-07T20:56:34","modified_gmt":"2019-07-08T03:56:34","slug":"waiver-season","status":"publish","type":"post","link":"https:\/\/danschmidtforsenate.com\/blog\/?p=1062","title":{"rendered":"Waiver Season"},"content":{"rendered":"\n
\"\"\/
Not that kind of waver<\/figcaption><\/figure>\n\n\n\n

It\u2019s summer, so it\u2019s time for wilderness hikes, river floats, stream fishing and reading Medicaid waiver applications<\/a>. <\/p>\n\n\n\n

Many don\u2019t believe it, but the Federal government is our\npartner in Medicaid. It is a Federal law, but states have a say. Heck, if Idaho\nwanted to we could withdraw from the whole program. We could thumb our noses at\nthe $1.8 Billion Federal dollars we get every year to provide care for our\nseverely disabled, aged poor and pregnant women. Many legislators vote against\nthe budget. In fact, Idaho House Republicans split evenly this year on\napproving the Medicaid budget. If they really don\u2019t want to participate in the\nprogram I\u2019d like to see them come out and vote to end the partnership.  But they haven\u2019t been so bold. <\/p>\n\n\n\n

Instead, they asked our state agencies, the Department of\nInsurance and the Department of Health and Welfare to work to modify the plan\napproved by voters, simple Medicaid Expansion. These proposed modifications will\nneed approval of the Trump Administration, and they will need to be lawful,\nthat is, follow the law of the land. Of course, the Trump Administration could\napprove an unlawful waiver request. Then someone would need to sue to get a\njudge to interpret the legality. <\/p>\n\n\n\n

The first waiver application is \u201cIdaho Coverage Choice\u201d. The DOI has closed their comment period, but now the DHW has learned they must apply for a waiver <\/a>for this program also, so their comment period is open. This modification to Simple Medicaid Expansion<\/a> would allow folks between 100-138% of the Federal Poverty Level who currently have health insurance through the exchange to choose: either enroll in Medicaid or \u201ckeep your insurance\u201d on the Idaho Exchange. It is estimated this would affect about 18,000 Idahoans.<\/p>\n\n\n\n

I\u2019m all for giving people choices. But this program would be\nvery costly to our federal government. If you read the reports from DOI and DHW\nthey claim a \u201csavings\u201d for the budget. But the savings claimed are reduced tax\ncredits and subsidies when people go OFF the exchange and enroll in Medicaid.\nDoesn\u2019t it make sense that the more people we moved that direction, the more we\nwould save? <\/p>\n\n\n\n

Their own figures claim an average \u201ccost\u201d of tax credits and\nsubsidies for exchange enrollees Per Member Per Month between $430-$802. But\nthey also estimate the cost of enrollment in Medicaid PMPM would range\n$212-$496. It\u2019s pretty clear to me this proposed waiver would not be budget\nneutral for taxpayers.<\/p>\n\n\n\n

There is no mention of other costs to those who choose to \u201ckeep\ntheir insurance\u201d, like deductibles, copays, out of network fees that insurance\ncompanies use to try to keep their costs down and reduce \u201coveruse\u201d. I guess\nthat\u2019s because it comes out of their own pockets.<\/p>\n\n\n\n

Why would conservative Idaho Republicans want to offer\npeople the freedom of choice of more costly health insurance on the taxpayers\u2019\ndime? If the real reason for this \u201cIdaho Coverage Choice\u201d plan is to save some\nenrollees on the exchange, effort would be better placed to make plans more\naffordable for folks above 200% FPL who buy insurance on the exchange. They are\ngoing uninsured in droves. Can\u2019t blame them; the subsidy and tax credit tables\nneed a big adjustment. But that would take a congress that wants to fix the\nAffordable Care Act. Republicans won\u2019t go there and Democrats are too busy\nwanting to abolish private insurance or promote \u201cMedicare for All\u201d.<\/p>\n\n\n\n

It\u2019s no mystery why Medicaid health insurance is cheaper\nthan private plans. Medicaid and Medicare set what they pay. Providers either\ntake the low payment or refuse to participate. Private insurers are stuck\nnegotiating with providers. Moreover, reducing costs reduces their cash flow.<\/p>\n\n\n\n

I appreciate the Idaho legislature trying to make some\ninnovative changes to the health payment system. But choice, in this case, is\ntoo expensive.<\/p>\n\n\n\n

There are many more\nwaivers coming. Stay tuned.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

It\u2019s summer, so it\u2019s time for wilderness hikes, river floats, stream fishing and reading Medicaid waiver applications. Many don\u2019t believe it, but the Federal government is our partner in Medicaid. It is a Federal law, but states have a say. … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/1062"}],"collection":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1062"}],"version-history":[{"count":1,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/1062\/revisions"}],"predecessor-version":[{"id":1063,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/1062\/revisions\/1063"}],"wp:attachment":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1062"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1062"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1062"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}