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The Governor Blocked Medicaid Expansion. Now Maine Voters Could Overrule Him.

Kari Medeiros, 40, of Eastport, a tiny town in the state’s poorest county, earns less than $5,000 a year cleaning houses and pet sitting, and has back pain that has worsened to the point where she can barely mop and sweep.“With MaineCare I believe I’d be able to find a provider who would see me,” she said, referring to the state’s Medicaid program. “But a lot of people here don’t vote. So many families here are having addiction problems with their loved ones, and they’re not focused on going to vote — even though those are the people that need it the most.”Under the Affordable Care Act, the federal government picked up the entire cost of new enrollees under Medicaid expansion for the first three years and will continue to pay at least 90 percent. […]

Medicare for All or State Control: Health Care Plans Go to Extremes

Their proposal was the last gasp of Republican efforts to undo the Affordable Care Act. Those efforts, which seemed sure of success in January, appeared to meet a dead end on the Senate floor in late July, when Republicans could not muster even a simple majority for a repeal bill.But Mr. Graham and Mr. Cassidy have persisted, and they said they had encouragement from the White House and some Republican governors.Under their proposal, money would be distributed based on a complex formula, and the regional cost of living would be one factor, but the sponsors acknowledge that higher-spending states like Massachusetts would receive less than under current law.The block grant would replace federal money now being spent under the Affordable Care Act for the expansion of Medicaid, for premium tax credits and for subsidies that reimburse insurers for reducing out-of-pocket costs for low-income people.The Graham-Cassidy bill includes many features of earlier Republican bills. It would repeal the Affordable Care Act’s requirements for most Americans to have coverage and for larger employers to offer it, and would also eliminate a tax on medical devices.In addition, the Graham-Cassidy bill would make deep cuts in Medicaid, putting the entire program on a budget and ending the open-ended entitlement that now exists. States would receive a per-beneficiary allotment of federal money.A goal of the Graham-Cassidy bill is eventually to equalize the amount of federal money states receive for the health care of each person with annual income from 50 percent to 138 percent of the poverty level (from roughly $6,000 to $16,650 for an individual).Continue reading the main storyBut time is running out on the bill. […]

New Health Bill Is Forecast to Leave 15 Million More Uninsured Next Year

Mr. Cruz’s proposal was included in a version of the bill released last week, but it has been assailed by the insurance industry. While the provision was omitted from the latest version of the bill that was released on Thursday, it remains under consideration to be part of the repeal legislation, a Republican congressional aide said.The budget office released its analysis as Senate Republicans are struggling to keep alive their longtime goal of repealing the Affordable Care Act — and to settle on a strategy for achieving that aim. But its conclusions are not likely to help.The budget office did have good news about the latest version’s fiscal impact: it would reduce federal budget deficits by a total of $420 billion over 10 years, about $100 billion more than an earlier version of the legislation. The change resulted mainly from the fact that Senate leaders decided to keep two taxes on high-income people that would have been eliminated by the previous version of the Senate bill.How the Number of Uninsured Would ChangeThe increase in the number of uninsured is virtually the same under the initial and the revised versions of the proposed Senate Republican health plans.Senate repeal plan60 millionuninsuredInitial House billFinal House billRevised Senate plan50Initial Senate plan40Under theAffordableCare Act30201020172026Senate repeal plan60 millionuninsuredInitial House billFinal House billRevised Senate plan50Initial Senate plan40Under theAffordableCare Act30201020172026The latest version of the Senate bill would increase average insurance premiums by 20 percent next year, the budget office estimate, but it would reduce premiums after 2019, so that in 2026 premiums for a typical “benchmark plan” would be 25 percent lower than under current law.That is not all positive. One of the main reasons for the lower premiums is that the typical insurance plan would, according to the budget office, “pay for a smaller share of the total cost of covered benefits.” In other words, out-of-pocket expenses from deductibles and co-payments would grow.Moreover, the budget office said, even though average premiums for a standard benchmark plan would decline after 2019, many older people would face substantial increases in premiums.Newsletter Sign UpContinue reading the main storyThank you for subscribing.An error has occurred. Please try again later.You are already subscribed to this email.View all New York Times newsletters.For example, it said, the net premium — after tax credits — for a midlevel “silver plan” for a 64-year-old person with annual income of $26,500 would be $5,500 a year in 2026, or more than three times the amount projected under current law.The analysis detailed huge changes that the bill would impose on Medicaid, the health care program for low-income people and the disabled. […]

In Clash Over Health Bill, a Growing Fear of ‘Junk Insurance’

State insurance regulators say the proposal harks back to the days when insurance companies, even household names like Aetna and Blue Cross, sold policies so skimpy they could hardly be called coverage at all. Derided as “junk insurance,” the plans had very low premiums but often came with five-figure deductibles. Many failed to pay for medical care that is now deemed essential.Continue reading the main storyOne Aetna plan, for example, defined hospitalization coverage as mainly for room and board. It capped coverage at $10,000 for “other hospital services,” a category that included such routine care as medication and operating room expenses.The Affordable Care Act drastically changed the health insurance landscape by requiring insurers to offer a set of comprehensive benefits — including hospitalization, doctor visits, prescription drugs, maternity care and mental health and substance abuse treatment — in order to formally qualify as insurance. “The new bill opens the door to junk insurance,” said Dave Jones, the California insurance commissioner.Ned Scott, 34, who lives in Tucson, said the health plan he had before the Affordable Care Act left him with $40,000 to $50,000 in unpaid medical bills after he learned he had testicular cancer when he was in his late 20s.“I thought it would cover things,” Mr. Scott said […]

Governors From Both Parties Denounce Senate Obamacare Repeal Bill

Conservative governors were not much more supportive. Gov. Scott Walker of Wisconsin suggested that Congress consider a better-funded version of the measure proposed this year by two Republican senators, Susan Collins of Maine and Bill Cassidy of Louisiana, that would offer states more flexibility over how to run their health care programs.Continue reading the main storyPursuing that approach, Mr. […]

The Right and Left React to Medicaid Cuts, the Travel Ban and More

Mr. Benson points out that under the Republican plan, states would once again be able to concentrate government dollars to the poorest people and make Medicaid “fiscally sustainable.” He goes on to say that, under the Affordable Care Act, life expectancy has decreased. If Republicans trafficked in the “same brand of ugly, motive-impugning hysteria” as the Democrats, he argues, they would try to establish a causal relationship between the Affordable Care Act and rising mortality rates. Read more »Continue reading the main story_____• Robert Holland in American Spectator:“With federal vouchers for homeschooling, Washington, D.C. soon would be registering and tracking homeschooled children, as well as deciding how much could (or should) be spent on their instruction.”Mr […]

$45 Billion to Fight Opioid Abuse? That’s Much Too Little, Experts Say

The Affordable Care Act vastly expanded access to addiction treatment by designating those services as “essential benefits.” That means they had to be covered through both an expansion of Medicaid to far more low-income adults and the marketplaces set up under the law for people to buy private plans. Both the House and Senate health bills would effectively end the expansion and cap federal Medicaid spending, resulting in the loss of coverage for millions of people, according to the Congressional Budget Office.Continue reading the main storyAccording to the National Household Survey on Drug Use and Health, there were roughly 1.35 million low-income Americans in 2015 with an opioid use disorder. Only 25 percent of those people get treated in a year, although the Affordable Care Act’s expansion of health insurance coverage has provided more resources for closing the treatment gap.Richard G. Frank, a health economics professor at Harvard Medical School, has estimated that last year, people who enrolled in expanded Medicaid incurred about $4.5 billion in costs for mental health and addiction treatment […]