Indiana Governor Pence seeking help from Congress in Medicaid dispute

[eridani]

http://www.indystar.com/story/news/2016/02/20/pence-seeking-help-congress-medicaid-dispute/80663058/

For example, Indiana is testing whether requiring participants to make monthly contributions to a health account that can be rolled over if not used for health care reduces the use of unnecessary care.

That feature is based on high-deductible insurance plans with health savings accounts that are becoming increasingly common in private insurance coverage.

Pence argues that the Urban Institute, one of the evaluators chosen by the federal government to assess Indiana’s plan, has previously been skeptical of using the health savings account model for Medicaid recipients.

Pence wrote Health and Human Services Secretary Sylvia Burwell in December, asking that the federal review be dropped as the Healthy Indiana Plan has already been evaluated by a state-hired contractor.

http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2015/rwjf420603

The RWJF/Urban Institute report that Pence argues shows a bias against using healthy savings accounts in Medicaid:

Comment by Don McCanne of PNHP: Gov. Mike Pence of Indiana wants to select his own facts for a report to CMS confirming that their consumer-directed health program for Medicaid, authorized by a Sec. 1115 waiver, is meeting Medicaid requirements for the patients.

They have already independently contracted with the Lewin Group to provide a report to CMS, but numerous organizations have expressed the concern that this report could be biased because of the conflict of interest. CMS has contracted with the Urban Institute, but Gov. Pence objects because Urban has produced a previous report expressing some concerns about the option to charge premiums for individuals living in poverty and about the administrative costs and inefficiencies of health savings accounts that are used in Indiana’s program. Also there is concern about Medicaid patients being locked out of care if they are in arrears with their premium payments.

Indiana’s program is driven by ideology rather than by objective application of health policy principles. Pence touts their success at “applying consumer-health care principles to the Medicaid population.” It is more important for him to require patients to demonstrate individual responsibility through sharing in the costs of care than it is to ensure that they do receive the care that they need. It has been demonstrated that requiring payments creates barriers to care, particularly for low-income individuals.

Imagine instead having one national standard program that automatically includes everyone, gives them free choice of their health care professionals, and removes financial barriers to care. We could have that with a single payer national health program, as long as we keep ideologues like Pence out of the way.

[Vinca]

1. What lobe are Republicans missing?

If you're in a spot that qualifies you for Medicaid, chances are you don't have piles of cash sitting around ready to be deposited in a Health Savings Account. They need to go back to their handbook, the Bible, and read about how you treat those in need. You don't feed them to your bankster cronies.

[eridani]

2. Repubs have turned into amoral sociopaths and whores for the 0.01% n/t

[kas125]

3. The last thing on earth I want to do is defend that idiot, Pence, but

it isn't as bad as they make it sound. I know someone on Medicaid here in Indiana who has to pay $1 per month into the health savings account. That's all she's required to pay and everything is covered, from rides to the doctors office to vision and dental. Her hospital bills for 2015 were over $77,000 and she paid nothing more than that $12. I don't know if people actually making money have to pay a lot more, but for her, Indiana finally letting people without dependent children join the medicaid program saved her life for $12.

[Vinca]

4. I imagine the cost of processing that $1 payment is way more than $1.

Republicans are like that. They'll also fight to keep GITMO open even though the cost is ridiculously high for the number of prisoners there. The only thing they care about is how it's going to play to their numb nuts base in the next election.

[kas125]

5. I wasn't going to say so, but that "person I know" is me, lol. And I know, the paperwork

they go through just for that $12 is utterly ridiculous. I paid the $12 at the beginning of the year. And every single month they send me a statement that says I don't owe anything that month, but includes about ten pages of instructions and forms in case I want to pay by mail, in case I want to pay online, in case I want to pay by phone, forms to submit if I want automatic payments from a bank account, envelopes, etc. It's insane. I've also received the exact same letter about ten times, telling me that the state has determined that I'm "medically frail" which I assume is because when I was in the hospital for something else I had kidney failure and my liver stopped working. But they were working again by the time I went home and I feel better now than I have in years. Everything they send, they send numerous times. They even send letters telling me that they're going to send forms. It's just crazy.

[Vinca]

7. I'm so glad you're getting decent medical care and feeling better (and not going bankrupt).

And I'm also glad you agree that the paper pushing associated with that $1 payment is idiotic. They could drop the $1 payment and save hundreds of dollars in paperwork processing and postage. Oh, well. That's the government for you. They've got to make things complicated to justify their jobs.

[kas125]

8. Thank you!! The paper pushing is really insane. They even send a form

to give to the employer I don't have in case I want the money taken out of the paychecks from my non-existent job. I spent years taking care of my parents who both died from cancer. With him I had to stop working because he was becoming a danger to himself and needed to be watched. In the meantime, my teeth got so bad that after he died I rarely left the house. But now I've been to the dentist and he told me last week that in seven or eight weeks I'll have a whole new smile. I am so looking forward to not being embarrassed to be seen in public again! And every time I make an appointment to see a doctor or the dentist I laugh and say screw you Pence.

[Vinca]

9. Good for you. That's amazing. I didn't realize dental was included.

I credit Obamacare and the pre-existing condition pool with giving me my life back, so I know how grateful you are. We've got to fight so everyone, to a person, has access to good medical care.

[kas125]

10. There are two kinds of medicaid here and I got lucky and got the one that has

dental and vision. I got new glasses, too. And since I'm "medically frail" mine includes other things that some people don't have, but that I've never had to use. When I was at the dentist last week he said that I was lucky that I got the one that covers what I need because not everyone does. I just said, yep, that's why we need Bernie so everyone can be covered for everything they need. I had no idea what he'd think about that, I'd never met the guy before, but he said, "Yeah, it's too bad they didn't just do that in the 40's."

[KamaAina]

6. I read that as "Hunter Pence"

outfielder for the SF Giants.

edit: come to think of it, Hunter Pence would be a better governor. He's widely known out here for his clubhouse leadership.