Checking Up On Health: March 18, 2014

Health Care Policy News and Views
ompiled by Benita M. Dodd



Why no Medicaid expansion for Georgia? Just the expansion of Medicaid would cost Georgia an additional $2.5 billion over 10 years, Gov. Nathan Deal pointed out in an interview with Georgia Health News that was released Tuesday. “We simply cannot afford the $2.5 billion in new spending that the expansion would require without a severe impact on public education. The federal administration needs to start acknowledging the Supreme Court ruling and look at other alternatives that don’t force new spending by the state. I have often discussed the advantages of a block grant. States need more flexibility in order to make their program work for their unique population rather than a one-size-fits-all Washington mandate.” Read the Georgia Public Policy Foundation’s argument against Medicaid expansion here:

5 million signed up: More than 5 million people have now signed up for health insurance on marketplaces created by President Obama’s health care law, thanks to a surge in enrollment over the last two weeks, the Obama administration announced Monday. That would still fall short of the goal of 7 million that administration officials had hoped to reach before the botched rollout of the new law last fall. How many people have actually paid for the health insurance plans they have selected remains uncertain. Source: Los Angeles Times

… Or not: The generally-accepted estimate of the nationwide non-payment rate is 20 percent — meaning that one-fifth of the “newly enrollment” are not, in fact, enrolled, according to Guy Benson,’s senior political editor.  Benson points out that the administration “counts” anyone who’s placed an Obamacare exchange plan in their virtual shopping cart as signed up. Kathleen Sebelius again testified last week that the Department of Health and Human Services is not keeping track of who checks out and pays their first month’s premium, which are necessary steps to becoming fully enrolled. As of a few weeks ago, payment delinquency rates were close to 50 percent in certain states. Nearly half of the few previously-uninsured Americans who have selected plans through Obamacare are not paid up. Also, the overwhelming majority of these “new” enrollees are not obtaining coverage for the first time. Most had insurance prior to Obamacare. According to estimate, fewer than 30 percent of those signing up are first-time enrollees. Two independent studies revealed that roughly 90 percent of eligible consumers who were uninsured before the law’s implementation have chosen not to purchase plans on Obamacare’s exchanges. The top reason cited was lack of affordability.

Premiums will rise slowly: Last week, Health and Human Services Secretary Kathleen Sebelius sought to downplay concerns about rising premiums in the healthcare sector. She told lawmakers rates would increase in 2015 but grow more slowly than in the past. “I think premiums are likely to go up, but go up at a smaller pace than what we’ve seen since 2010,” Sebelius said in response to a question from Rep. Erik Paulsen (R-Minn.). “The increases are far less significant than what they were prior to the Affordable Care Act,” she said during testimony to the House Ways and Means Committee. Source: The Hill

… Or premiums will skyrocket:  Insurance companies say health premiums are about to soar, thanks to ObamaCare, and they are baffled as to why the HHS Secretary would tell Congress otherwise, The Hill reported this week. “It’s pretty shortsighted because I think everybody knows that the way the exchange has rolled out … is going to lead to higher costs,” said one senior insurance executive who requested anonymity. The insurance official, who hails from a populous swing state, said his company expects to triple its rates next year on the ObamaCare exchange.

Mandate? What mandate? One in three Americans who lack health coverage plan to remain uninsured, citing cost as their chief obstacle, according to Bankrate’s latest Health Insurance Pulse survey. Fewer than a third (30 percent) of the uninsured realize that federal tax credits available through the new Obamacare health exchanges can make health insurance affordable to lower-income individuals and families.


Georgia Legislature:  Interesting — and disappointing — that, as the 2013-14 Georgia legislative session wound down this week (Thursday is sine die),  the Georgia Legislature could find it in our wallets to give $17 million to the Falcons for a new parking garage, but not in their hearts to give charitable clinics a tax break. Reminds me of the creative meme I generated today …Law

U.S. Senate: Did you know there are three physicians running for Georgia’s open U.S. Senate seat? What do all the candidates have to say on health care issues affecting Georgia? The Healthcare Georgia Foundation polled them. (The poll didn’t include candidates Derrick Grayson and Art Gardner.) Some highlights:


  • Paul Broun (physician) champions his own bill, the Patient OPTION Act.
  • Jack Kingston proposes, “Expanding access and affordability to high quality, patient-centered health care starts with repealing ObamaCare and enacting market-based reforms.”
  • Phil Gingrey (physician) makes an important point: Keeping seniors in their own homes longer will reduce Medicaid costs.
  • Karen Handel wants ObamaCare “repealed in its entirety and replaced with a commonsense, market driven, patient-centered reform approach,” specifically mentioning Georgia Congressman Tom Price’s Empowering Patients First Act.
  • Jack Kingston proposes, “Expanding access and affordability to high quality, patient-centered health care starts with repealing ObamaCare and enacting market-based reforms.”
  • David Perdue says, “We first need to determine the basis of the 48 million uninsured. … For the young and invincibles, we need to reduce the cost of health insur­ance by removing some of the regulatory burdens on providers and plans that make health care costs and premiums climb. … I support Health Retirement Accounts and Health Savings Accounts as a means of increas­ing individuals’ control over their health spending and creating real benefits for healthy living.


  • Michelle Nunn proposes that, “The law should be fixed to give families more affordable choices and expand tax credits available to small businesses so they can afford coverage.” And, she adds of increasing Medicaid and Medicare costs, “address the debt. Over the long-term, our debt threatens to increase interest rates, increase cost-of-living, slow wage growth, and kill jobs.” Nunn also notes that Georgia has several “initiatives under way to address disparities — training rural health care prac­titioners in preventive care, encouraging public/private collaborations that offer food and nutrition programs (and) classes, and programs that utilize telemedicine in inno­vative and effective ways.”
  • Branko Radulovacki says, “As a physician, I believe that health care is a right and not a privilege. The ACA rebooted the health care system. It made preventive care more accessible and affordable, which is likely to reduce the need for more expensive care for ill­ness or disease. It limited insurers’ profit margins, which directly impacts costs. … I became an outspoken proponent of Medicaid expansion in Georgia, calling on the Insurance Commissioner to stop ‘obstructing’ the ACA rollout, and the Governor to ‘step up or step aside.’ …  We cannot force good health on anyone, nor would I suggest we try. But making quality health care available to all our citi­zens is a wise investment in our collective future, and it is one I believe is worth the effort and the cost.”


Building a better mouse: Scientists in Britain and Australia  have created the world’s first “super mouse,” which expresses a fluorescing ‘biosensor’ in every cell of its body, allowing diseased cells and drugs to be tracked and evaluated in real time and in three dimensions, raising hope that it will give humans a peek into diseases like never before. Researchers are using the mouse to track a protein known to trigger cancer in cells as well as response to drug treatment, but they say the mouse can be used in other studies as well. Source: Times of India

Big data, big savings: Did you know that 15 percent of Netflix’s 44.4 million global subscribers watched the second season of “House of Cards” the day it went live? Netflix had anticipated that, using
“big data.” Predictions based on big data analysis are being made in the stock market, the auto market, at the box office and in political elections. Drugmakers, too, can benefit from big data to cut their research and development costs by $40 billion to $70 billion, according to a McKinsey and Co. study. Large drugmakers can tap into various data sources, including thousands of online patient communities, more than 200 cancer support groups and more than 2,000 condition groups. But finding scientists who understand both pharmaceuticals and data mining is a major challenge, according to the study. Source: Medill Reports

Quotes of Note

“The best way to reform and make changes in your organization is to move very quickly, but incrementally. You implement change where you can predict the outcome, and then move to the next stage. The PPACA dreamed about a global solution to healthcare coverage with no clue about how to get from A to B. My problem with the PPACA is that it was not incremental reform. The consequences were not anticipated, and even those that could have been anticipated were not identified.” – Anthony Spezia, president and CEO of Knoxville, Tenn.-based Covenant Health

“I have the body of an eighteen-year-old. I keep it in the fridge.” – Spike Milligan


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