Posts Tagged ‘medicaid program’
Insurer Fee – Reasonable Idea… Unintended Consequences
Author : Chris Whistler
Dec 10th, 2009 | by
Whenever a new concept is proposed, those at the deliberation table automatically ask “what would happen if?” before they decide to act. With health care reform for example, the driving questions are more like: “Are the changes going to result in more Americans getting coverage? Are the proposed changes budget neutral?” Given the broad scope of the proposed health care legislation, it’s easy to see how details can get overlooked. And when time is ticking, unintended consequences have a higher chance at prevailing.
One concern that should be brought to light is the $6.7B annual fee proposed on insurers. While conceptually this might make sense given the number of Americans who will be required to obtain coverage and the new revenue that insurers stand to gain, a portion of this fee would not be limited exclusively to commercial health insurance companies. Health plans that contract with federal and state governments to serve Medicaid, Medicare, and beneficiaries of the Children’s Health Insurance Plan (also known as CHIP) would also get taxed too.
Well, the challenge is that a significant portion of this fee will fall on state budgets because of the way states are required to reimburse health plans that serve its most vulnerable residents. The new fee will unintentionally require states and the federal government to ultimately come up with additional public dollars to pay for this added fee.
Also, this fee would unfortunately raise the overall costs of these government programs and place additional strains on programs that are already in extreme financial distress. For example, Ohio’s Medicaid program would have to potentially come up with an estimated $65 million annually. Subsequently, the burden of this fee will be paid for by taxpayer-funded government programs and beneficiaries that use these health plans.
Easy solution to the problem? Just exempt health plans administering government entitlement programs from the application of this fee. Problem solved; Unintentional consequence diverted.
Article Tags
Children's Health Care • Children’s Health Insurance Plans • CHIP • health care plan • health care reform • health insurance • health insurance plan • insurer fee • Medicaid • medicaid ohio eligibility • medicaid program • Ohio medicaid • Ohio medicaid program • ohio medicaid providers • SCHIP • taxes
The Holidays are a Time for Reflection
Author : Toni Bigby
Nov 24th, 2009 | by
The holiday season is now upon us. And while this time of year is supposed to be a joyous time spent with family and friends, I find myself reflecting on the lives of people that find the holiday season to be just another reminder of their economic circumstance. The underserved – particularly those at or below the poverty level – will experience the holidays in a much different way. With more and more families facing job loss as a result of the recession, many will not have Thanksgiving feasts…many will be struggling to find ways to “make the season bright” for their children. Many are turning to the social services available within their community just to make it through another month.
Throughout my time at CareSource and with Ohio’s Medicaid program, I’ve learned to have a deep appreciation for the challenges faced by the underserved. Sure, we can try to conceptualize what a day in the life of someone living in poverty is like, but CareSource has exposed me to a much more profound way to think about the priorities of the underserved…and they did this by proactively organizing an interactive event for CareSource employees called the “Poverty Simulator.”
Because our company prides itself on helping the underserved better their lives by improving their health care, our organization does some pretty unique things to help us appreciate the challenges our members face each day – and how they prioritize getting their most basic needs met. This Poverty Simulator – organized by Think Tank, a non-profit organization that strives to build communities where all people can thrive – does just that…it allowed us to put ourselves in the shoes of our members through role-play, to gain a fuller appreciation of barriers that often preclude them from accessing health care services responsibly. It’s all done in an effort to teach us why our members make the decisions they make; ask the question they ask; need the support services they need; and where their health care fits in to the grand scheme of things they consider vital… Why? All so we can better serve them.
We’ve held this event four times this year for our employees who have described the event as “heart-wrenching,” “mind-blowing” and “eye-opening.” The simulator has been so enlightening that we included it as part of an event we hosted on Capitol Hill that allowed health care experts and interested parties to experience it firsthand. The purpose was for those following and influencing the health care debate to gain a better understanding of how poverty impacts the way people prioritize and access health care – even if it is made available to them at no cost.
It’s so easy to make general assumptions about why people make the decisions they make. But quite frankly, until you actually walk in the shoes of the underserved, it is very difficult to appreciate the complexities of living in poverty. Please take a few minutes to see what the Poverty Simulator is all about. I think you’ll find it offers a unique and profound approach for helping organizations understand the needs of its customers, and how CareSource excels at building a culture of compassion, dignity and excellence.
