Saturday, January 11, 2014

Gov's Rejection of ACA Funds Like The Religious Couple Refusing Medical Care For Their Ill Child

 NPR (and others) reported in April 2013:
A faith-healing Philadelphia couple on probation after they refused to seek medical care for a son who later died has now lost a second child.
Instead of taking $2.9 billion in federal aid to expand medicaid (with a cost of about $250 million to the state over seven years) and taking about 20,000 Alaskans off the uninsured list, our governor instead relies on the "Invisible Hand" of the free market to take care of these people.

To me that's very similar to not taking your sick kid to a doctor because you believe in God's will.

How many Alaskans will suffer and die because of his refusal to take the ACA funding?

This is not to say that the free market doesn't make a very significant contribution to US prosperity, but unregulated, it also makes a huge contribution to the massive transfer of wealth to what's been popularly called the 1% from the rest. 

I've already posted about the study that the Governor himself commissioned that said expanding medicaid would cost the state  $240 million from 2014-2020
and gain the state $2.9 billion from the Feds.    And about 20,000 fewer Alaskans would be uninsured.

Instead the Governor's ideological beliefs in the miracles of the free market, apparently, have led him to not accept the Federal ACA funding to expand Medicaid in Alaska.

I have no doubt that many people will become unnecessarily ill, miss work, even lose their jobs, and many will die prematurely because of the governor's decision.  Just like this child in Pennsylvania died because of his parent's decision to let God, not modern medicine, save their child. 

I'm reminded of this because of  a new study by Chuck Burnham, Legislative Analyst from the Alaska Legislative Research Services  requested by Sen. Senator Bill Wielechowski.  It adds to the previous studies already showing the overwhelming benefits to the state of expanding Medicaid.   Here's the summary:


Among the provisions of  the federal Patient Protection and Affordable Care Act (P.L. 111 ‐ 148), or ACA, when it was enacted is a requirement that states expand Medicaid programs to cover individuals with incomes of up to 138 percent of the federal poverty level. 1 Pursuant to the June 2012 U.S. Supreme Court decision in National Federation of Independent Business v. Sebelius , Medicaid expansion under the ACA became optional for the states. As you know, on November 15, 2013, Governor Parnell announced his intention to reject Medicaid expansion. Although this decision will have far ‐ reaching and, to some degree, unknown impacts, we confine this report to the specific questions you raised.


Although we located no Alaska ‐ specific research on the possible impact on mortality of rejecting Medicaid expansion, a significant body of research shows that health insurance improves access to medical care and outcomes related to a wide range of serious illnesses and disease. Recently published research specifically on Medicaid expansion in other states suggests that rates of mortality decrease among those who are enrolled in the program as compared to the uninsured. Due to differences among populations and Medicaid eligibility thresholds, we believe applying specific numerical finding to Alaska’s uninsured population based on these results would be improper and problematic; however, it is reasonable to conclude that some of the specific benefits found elsewhere would generally accrue to newly enrolled Medicaid participants in Alaska.

Impacts on Healthcare Facilities

The ACA requires reductions in certain payments and reimbursement rates to hospitals. These reductions are more than offset, however, by the reductions in uncompensated care and increased revenues that are projected to occur through expansion of Medicaid. Nationwide, the net effect is estimated at $2.59 in revenues for every $1 in reductions. In Alaska, hospitals expect additional revenues of roughly $60 million per year and a reduction in uncompensated care of over 85 1 Text of the ACA can be accessed at dsys/granule/PLAW ‐ 111publ148/PLAW ‐ 111publ148/content ‐ detail.html . Portions of the federal healthcare overhaul are also contained in the Health Care and Education Reconciliation Act of 2010 (P.L. 111 ‐ 152), http://www.gpo.go v/fdsys/pkg/PLAW ‐ 111publ152/pdf/PLAW ‐ 111publ152.pdf .  L EGISLATIVE R ESEARCH S ERVICES , LRS 14.117 J ANUARY 8, 2014 — P AGE 2 S ELECTED I MPACTS OF R EJECTING M EDICAID E XPANSION percent. However, because Alaska declined to expand Medicaid, hospitals will absorb the reductions implemented by the ACA without the offsetting benefits.

Effects on Health Insurance Premiums

Research suggests that in 2009 uncompensated care added roughly $257 to premiums per privately insured individual Alaskan, or about eight percent of total private insurance premiums. We are unable to isolate the impact of rejecting Medicaid expansion on insurance premiums; however, implementation of the ACA’s health insurance exchanges coupled with Medicaid expansion in Alaska has been projected to result in savings that could reduce the premium increases associated with cost shifting from $301 in 2014 without the ACA / Medicaid expansion to $45 with the healthcare act fully implemented.

Job Creation

One study estimates that additional Medicaid spending under the ACA would result in the creation of over 1,500 jobs in 2014 with annual increases through 2020 when 4,000 new positions are expected. In that year, these jobs could provide approximately $220 million in wages.

Federal Funding

Three studies on Medicaid expansion projected resultant additional federal funding in “mid ‐ case” enrollment scenarios at between roughly $1.1 billion and $2.9 billion in aggregate for the years 2014 to 2020. Increases in state spending in the same projections ranges from $79 million to $240 million. All three reports estimated federal to state spending ratios under expansion would be over $12 to $1

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