LTE on health care access - Mark Martin: More health coverage options needed

More health coverage options needed 3/29/23 "Minnesota Care is a state-supported income-limited health insurance program that is set up to act as a bridge between medical assistance and private health insurance. Isn’t it time that all Minnesotans have all options available to them in choosing health insurance? Most of our health insurance is covered by employers (think private insurance companies) or government-backed programs (think medical assistance, Medicare, and MinnesotaCare). I reside in Wabasha County and have maintained a private medical practice in Winona since 1999. Almost daily I see patients that struggle to pay for co-pays, deductibles, premiums, and just basic care. Patients that have employer-based insurance complain that it is becoming more expensive with increases almost yearly in premiums, deductibles, and co-pays – with a corresponding decrease in covered services. I see many patients whose spouse works a job just for health insurance, which is especially hard on farmers and other self-employed people. There are also people who only work at a certain level because if they make over a set income limit, they will lose their MinnesotaCare insurance and they will be financially unable to afford health care, even with subsidies."

The quiet privatization of government health insurance programs

Article: https://www.axios.com/2023/03/28/medicare-medicaid-privatization-health-insurance

"The biggest public health insurance programs have become increasingly privatized over the last decade, even while politicians sparred over whether government-run health care should be expanded to cover more Americans. Why it matters: Although privately run Medicare and Medicaid plans are still highly regulated and funded by the government, the commercialization has complicated efforts to rein in medical spending and unleashed fierce partisan fights like the ongoing one over Medicare Advantage. Driving the news: The insurers that administer Medicare benefits and their allies are running an enormous lobbying blitz against proposed regulations by the Biden administration that they say will cut their government funding and, in turn, harm enrollees. Supporters of the cuts say that the proposal corrects overpayment, which plans obtain by manipulating the billing system. The potency of the lobbying is a sign of just how ingrained Medicare Advantage has become among seniors over the years — and how important it is to some insurers' business mix. The big picture: Medicare for All rose to prominence during Democrats' 2016 presidential primary, championed by Sen. Bernie Sanders. Four years later, it returned as a key litmus test for Democratic presidential hopefuls. More moderate candidates, including President Biden, instead embraced a public option, which would extend eligibility for government-run insurance to more Americans. But as Democrats aired out whether or not to abolish private insurance, existing public programs became increasingly commercialized. Meanwhile, attempts to expand Medicare eligibility or benefits as part of Democrats' domestic policy agenda during Biden's first two years in office fizzled largely over the cost. By the numbers: Medicare Advantage enrollment has grown from 22% of eligible Medicare beneficiaries in 2008 to 48% of beneficiaries in 2022, per KFF. This year's enrollment numbers, when they're released, will likely reveal that the majority of seniors are now enrolled in a Medicare Advantage plan. Private plans are even more ubiquitous in state Medicaid programs. In 2020, 72% of Medicaid beneficiaries were enrolled in a Medicaid managed care plan, also per KFF. In fiscal year 2021, more than half of state and federal Medicaid spending went to managed care organizations. Although Medicaid managed care organizations can be private for-profit, private non-profit or government plans, as of 2020 half of the market was covered by plans owned by one of five companies: Centene, Molina, Elevance, UnitedHealth Group and CVS. Between the lines: Administering entitlement benefits is an increasingly lucerative line of work for insurers. Another KFF analysis found that in 2021, plans had gross margins of $1,730 per enrollee — more than double those of other markets. The second highest were in Medicaid managed care, which had gross margins of $768 per enrollee — higher than both the group and individual market. The analysis cautions that gross margins aren't equivalent to profitability but are indicative of trends. A clear one presented in the analysis is that the employer-sponsored and individual markets were significantly less profitable in 2021 than they were in 2018, while managed care plans did better."

WI Spring Election will impact health issues

Up North News Article on WI Abortion issue that will be impacted by the Spring Election "OB/GYN: Wisconsin's Current Abortion Ban Isn't Just Dangerous, It's Deadly Right now, Wisconsin is facing a health crisis on multiple fronts. Students who want to become OB-GYNs are forced to leave the state to finish their training because they're unable to learn basic, standard care for cases of ectopic pregnancy or miscarriage under current Wisconsin law. Dr. Kristin Lyerly knows just how difficult this will be for her industry and the future of women's health. Today, she's answering a few of our questions. UpNorthNews: How has your job changed since Wisconsin's 1849 abortion ban went back into effect? Dr. Kristin Lyerly: There is a lot more fear and uncertainty related to women's health care now for both patients and providers. Women have become more afraid to ask questions about their reproductive health, and doctors are often unsure whether they can offer basic services like contraception and management of miscarriages, which are technically spontaneous abortions. What hasn't changed? Our desire to ensure that our patients have access to quality, affordable, comprehensive, compassionate health care. It's just so much harder to deliver that in the post-Dobbs era. What do you believe is the biggest lie anti-choice activists are currently spreading about abortion? Their goal is to tie issues like abortion to a political side in order to win votes, so they use hyperbolic language that plays on people's emotions. The one that infuriates me the most is the "abortion up until the time of birth" trope that conservative radio hosts love because it sounds so terrible. It is terrible because abortions that happen after viability, when a baby has a reasonable chance of survival outside of the mother, are only offered when either the baby or the mother have a profound medical problem that threatens the health, well-being, and future reproductive potential of the mother. These are heartbreaking situations where families are already suffering in tragic ways that most of us will never understand. Politicians and activists who retraumatize these people for their own gain should be ashamed. What is one thing most people don't know about abortion, but you wish they did? Abortion is health care and it's common—one in four women in the US will have an abortion in her lifetime. How does this tie into next week's election? We all want the freedom to make our own decisions about our own bodies within the context of our own lives, whether we're talking about a new cancer diagnosis or a complicated pregnancy. The conservative [state Supreme Court] candidates have shown us that they don't trust women to make these decisions."

In WI-Advocates mark Affordable Care Act anniversary with success stories, warnings Evers renews Medicaid expansion push; White House adds up the cost of cutbacks

Article

Is Wisconsin the only Midwest state to not accept the federal Medicaid expansion?

Fact Brief : Is Wisconsin the only Midwest state to not accept the federal Medicaid expansion? | Gigafact NO Both Wisconsin and Kansas have not adopted the federal Medicaid expansion, which expanded Medicaid coverage to those with incomes up to 138% of the federal poverty level. Despite not adopting the expansion, Wisconsin allows all uninsured adults who fall below the federal poverty line to be eligible for Medicaid, according to the Kaiser Family Foundation. In his previous budgets and a special session, Democratic Gov. Tony Evers has proposed funding an expansion of Medicaid, but it has failed to make it into the final budget under the Republican-controlled Legislature. In his 2023-25 budget, Evers has again proposed accepting the expansion. The Evers administration estimates the move would save the state $850 million in its first year and add 897,000 low-income people to its Medicaid program, including 30,000 people who currently do not have insurance.

post to Great Northern States Health Care Initiative - question about racism

As a new blog participant, I am curious if the issue of American racism, specifically white supremacy, has been discussed here as the fundamental barrier preventing the U.S. from terminating its present health care chaos and switching over to the sanity of a health care system which is funded through a one-payer administrator?

 

Diane J. Peterson

St. Paul, Minnesota

oak7@centurylink.net

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