Extraordinarily creative!

When pondering how to keep low-level drug offenders out of jail, officials in Albany, New York, faced a challenge: How could they pay for a case manager to coax addicts onto the straight and narrow, sometimes by tracking them down on the streets?

The money turned up in a previously untapped source: President Barack Obama's health care law, which by expanding Medicaid in some states has made repeat drug offenders eligible for coverage, including many who are homeless or...read on here.

 

Expand Medicaid, Governor Abbott!

 

 

 

Texas should expand Medicaid

Texas political leaders prove themselves irresponsible for not expanding Medicaid. 

Take a look right here at the gains made by other states that decided to expand the health benefit to poorer folks. 

Why do voters tolerate shortsighted public policy against their own self-interest?

Medicaid and groceries

According to a new study from the Robert Wood Johnson Foundation and Urban Institute, Texas stands to lose $100 billion over the next decade if it sticks to Governor Perry's promise not to expand Medicaid with federal funds made available to the state.  Expanding Medicaid would cost the state something under $6 million, a comparatively meagre investment. 

Refusing the expansion makes no sense whatsoever in economic terms. 

All the talk about Medicaid got me to thinking.  Expanding the low-income health insurance product in Texas faces another fundamental challenge:  even if expanded, there aren't nearly enough doctors in the state who will accept Medicaid patients due to the low reimbursement rates defined by the program, among other reservations associated with treating the very poor. 

Given the stalemate, I'm wondering if Medicaid expansion funds could be used for other efforts to improve community health outcomes among the poor and marginalized?  Already, some states are using these funds to invest in decent, affordable housing for the homeless.  Housing has been identified as a determinant of health, and therefore worthy of use of these funds.  Reports on this innovative approach have been written by our friends at the Corporation for Supportive Housing (www.csh.org).

Today, I'm imagining using Medicaid funds to incentivize grocery stores to move into low-income, marginalized communities.  Why couldn't Medicaid funding be used to wipe out "food deserts" so prevalent in our inner cities in this nation? 

I haven't figured out the business model yet, but it would include several factors. 

• Advance funds to grocery store chains for development of the stores
• On-going reimbursement or "value added" supplemental income, if needed, that could be indexed to the pounds of produce sold in the stores. 
• Company marketing would produce ad campaigns for fresh foods to drive these on-going income supplements. 

Ultimately, the benefit and cost savings would be realized via better public health outcomes in neighborhoods that today are "hot spots" for chronic disease sets like hypertension, diabetes and obesity. 

Just thinking out loud while billions of Texas funds remain on the shelf  in D. C.!

An NPR report you must hear!

You've got to listen to this report! 

A definition of insanity for sure! 

Listen here.

Medical experts differ with Gov. Perry on Medicaid policy

Last week's edition of the Dallas Business Journal published a front page article explaining why Dallas area hospital leaders disagree with Texas Governor Rick Perry's opposition to expanding Medicaid care with increased federal funding.  Here's what they had to say:

Hospitals say Medicaid expansion is critical

by Bill Hethcock, Staff Writer and Matt Joyce, Staff Writer

Date: Friday, August 3, 2012, 5:00am CDT - Last Modified: Thursday, August 2, 2012, 1:16pm CDT 

Gov. Rick Perry’s rejection of Medicaid expansion in Texas will shift costs to the privately insured, increase uncompensated care expenses and raise mortality rates, all while more uninsured patients crowd North Texas emergency rooms.

That’s the consensus of hospital industry leaders in the Dallas-Fort Worth area about the impact of Perry’s decision to spurn $70 billion from the federal government to expand Medicaid in a way that would make more Texans eligible for the program.

Click here to read the entire report.

More on Medicaid refusal: Questions for Governor Perry

Texans Need Real Solutions to Our Health Care

(AUSTIN, Texas)─The Center for Public Policy Priorities’ Associate Director Anne Dunkelberg released the following statement regarding the Governor’s announcement about Medicaid expansion and establishment of an insurance exchange as part of the Affordable Care Act.

“Expanding Medicaid is a great deal for Texas and refusing to do so is not something the Governor should decide by himself before Texans have had a full and thoughtful conversation about what's at stake for our state, and then the Legislature needs to decide on a course of action. Our state has an opportunity to help millions of Texans xget the quality, affordable health care they need, and we should not pass it up.

“Under the Medicaid expansion, the federal government will pick up the vast majority of the costs of helping as many as 2 million Texans who don’t have insurance get the health coverage they need. The federal government will cover 100 percent of the costs for the first three years of Texas’ expansion, and no less than 90 percent every year after that. The Texas Health and Human Services Commission has projected that even with a large enrollment increase in Medicaid for poor adults, our Medicaid costs would only increase by $5.8 billion from 2014-2019, and the state would receive $76.3 billion in federal matching funds—a net gain of $70 billion.

“Expanding Medicaid will save Texas money in other ways, especially by reducing the money it spends providing health care in emergency rooms and health clinics to people without insurance. Texas could even end up saving more on these costs than it spends on the expansion, easing the strain on property taxes.

“Failing to expand Medicaid would squander the opportunity to pump tens of billions of dollars into our state economy and leave as many as 1.5 to 2 million of struggling Texans out in the cold without insurance coverage. The last thing Texans want is to see our federal tax dollars pay for health care for people in New York or California rather than to cover people right here at home.

“Texas should also move forward with setting up a state-based health insurance marketplace, called an exchange, that will allow millions of Texans to use tax credits to purchase quality, affordable health coverage. As recently as 2011, a broad-based group of organizations including businesses, conservatives, and advocates all agreed that a state-based insurance exchange was a good idea for Texas. And the exchanges are where many of the Affordable Care Act’s most popular consumer protections are found, including the rule that insurers may not deny coverage to anyone with a pre-existing health condition like cancer, autism, or diabetes.

“Because one of every four Texans is uninsured, Texas has the most to gain from health care reform. Now more than ever, we need real solutions from our leaders that meet the health needs of all Texans.”

Texas Governor rejects Medicaid Expansion

Poor people don't do very well in Texas in any category.

Now comes the news that Texas Governor Rick Perry will reject federal funds to expand Medicaid to the very poor who remain uninsured.

Even more amazing is the fact that the federal government would pay 100% of the expansion costs for thre first three years and then 90% of the cost after that!

You'll be interested to hear the following report from NPR on the Governor's action. And, be sure and watch a FOX News interview with Mr. Perry here.

Amazing!