Texas is thinking of abandoning Medicaid, reports the New York Times, reprinting a story from the Texas Tribune, a colorful piece that omits one central fact about Medicaid expansion under the Affordable Care Act (ACA).

Apparently the state’s conservatives are unhappy that reform legislation will open Medicaid’s doors to millions of Texas. Today, in the Lone Star state, parents qualify for Medicaid only if their family income is below $5,720. The legislation would set a new national standard for Medicaid eligibility at about $28,000—or $33,000 for a family.

“Dropping out of Medicaid is worth considering,” State Senator Jane Nelson, who heads the state’s Senate Public Health Committee, told the Tribune. “Currently, the Texas program costs $40 billion for a period of two years, with the federal government paying 60 percent of the bill,” but “as a result of federal health care changes, millions of additional Texans will be eligible for Medicaid. I want to know whether our current Medicaid enrollees, and there certainly could be millions more by 2014, could be served more cost efficiently and see better outcomes in a state run program.” 

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This week The New Health Dialogue’s Meredith Hughes, Allison Levy and Sam Wainwright host a round-up of some of the best health care posts of the past two week.  Below, just a few highlights. (To read the entire review, click here )

On the Health Business Blog, David Williams asks New England Health Care Institute’s Valerie Fleishman to explain the definition of comparative effectiveness research, describe CER provisions contained in the ARRA and ACA and discuss the challenges in disseminating new information to be used at the point of care.  It’s an excellent interview which tells you everything you need to know about Comparative Effectiveness Research –and how the research will be used at point of care.

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                                      Rick Scott vs. Alex Sink
 

Source: FlaglerLive.com  

Summary: As regular HealthBeat readers know, Rick Scott, the former CEO of Columbia/HCA, a for-profit hospital chain that was raided by the FBI in 1997, is now in the running to become governor of Florida. (See links below to earlier HealthBeat posts.) As the election approaches, it appears that Scott might well win. Even the Florida Medical Association (FMA) is endorsing him.

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Summary: Those who oppose health care reform continue to assert that the legislation is unaffordable. The only way to dispute this claim is first, to spell out the specific provisions in the Affordable Care Act (ACA) that trim spending and raise new revenues—without rationing care. These planks in the legislation provide substantial funding for the subsidies, employer tax credits, and Medicaid expansion needed to cover some 32 million Americans who are now uninsured—while simultaneously putting Medicare on the road to fiscal stability.

Here are the highlights. The Affordable Care Act finances reform by:

• collecting  over $100 billion in new fees from the insurers, drug-makers and device-makers who will see their revenues grow as millions of new customers buy their products

•  raising Medicare taxes for the 2% of the population at the very top of the income ladder

•   cutting $132 billion in over-payments to Medicare Advantage insurers

•   collecting penalties from individuals  who choose not to purchase “essential minimal coverage” for themselves or their families

•   collecting fees from employers with at least 50 full-time employees who do not offer insurance to their workers 

•   taxing “Cadillac” insurance plans (costing more than $10,200 for an individual, or $27,600 for a family)

•   reducing government subsidies to hospitals that treat a large number of uninsured patients. (Because there will be fewer uninsured, hospitals will no longer need such large subsidies.)

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Summary:  Yesterday, a federal District Court judge in Michigan rejected a constitutional challenge to the Affordable Care Act (ACA)  .This is the first time that a court has gotten to the merits of the case against the ACA.  Below, excepts from analysis by Timothy Jost of the Washington and Lee University School of Law, explaining the decision. Jost’s piece, titled“A Victory for Health Reform and Good Law” appeared on the HealthAffairs blog today.

I’ve added some comments in italics.

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You probably have heard about the new Swedish study of mammograms that appeared in the journal Cancer last week. It seemed to suggest that an average-risk woman in her 40s would benefit from routine mammograms—contrary to the U.S. Preventive Service Task Force’s latest recommendation.
But over at the HealthNewsReviewBlog Gary Schwitzer points to some curious caveats in major news stories about the study. His team reviewed four stories and found that:

“Three of the four stories gave a pretty clear indication that there were methodological concerns about the Swedish research. (Only HealthDay – of the four we reviewed – offered no such hint.)

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The conference is sponsored by the Center on Budget and Policy Priorities, the Century Foundation, Demos and the Economic Policy Institute.

 Speakers and moderators include: Paul Krugman, Karen Davis, John Podesta, Larry Mishell, Robert Greenstein, Robert Reischauer, Robert Kuttner and Ezra Klein.

 The conference is being streamed live from the Newseum; You can also return to this page and view it below the following press release with details

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As regular readers know, I began questioning prostate cancer screening when I launched HealthBeat, back in 2007.  Since then, skepticism about the effectiveness of PSA testing has snowballed.

Over at his HealthNewsReviewBlog  Gary Schwitzer quotes Dr. Otis Brawley, chief medical officer of the American Cancer Society  (ACS)  “taking the gloves off” on prostate cancer screening:

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Harvard Pilgrim Health Care, one of the nation’s leading private health plans, has announced that it will drop its Medicare Advantage health insurance program at the end of the year.  The headlines, bashing Obama and blaming health care reform legislation, were predictable.

• “Obamacare victims” ( Boston Herald.com, Sept. 30, 2010)
• “No, You Can’t Keep Your Current Health Coverage” (The American Spectator, Sept. 30, 2010)
• “The Obamacare Nightmare Begins: 22,000 Seniors Lose Their Current Coverage,” (Las Vegas ReviewJounral.com, September 28, 2010)
• “22,000 lose their health insurance due to Obamacare,” (examiner .com, September 29, 2010) 
• “The Heavy Hand of Kathleen Sebelius,” (Forbes, September 30)

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But the headlines were not just predictable–they were dead wrong.

Pilgrim did not decide to “cancel its Medicare Advantage coverage specifically because of new regulations imposed by Obama's health care law,” as the American Spectator, like so many others, suggested.
Another law, the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), passed two years before health reform legislation,  drove Harvard Pilgrim’s decision to shut down its “First Seniority Freedom Plan” says Harvard Pilgrim CEO Eric Schultz. 

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