Tuesday, 10 December 2013

The Medicaid Woes

The New York Post put up an interesting article over the weekend.  Basically, it laid out what has been noticed with a surge of folks signing up for health care....via the Affordable Healthcare Act website.  The mass of people?  Well....the bulk....well over ninety percent.....have gone onto Medicaid.

This statistic has generated some worry.  From the all the planning phases, there was some belief that folks would sign up for Medicaid, but in vary small numbers.  No one will say the precise guess.....but you get the impression it was supposed to be under twenty percent.

So, this gets a guy to pondering.

Medicaid is a state-run health service, with federal dollars attached.  Most doctors hate the option because there's a fairly limited budget, and service cost is always tied to limits.  You can charge X amount, and that's usually a third less than the regular service charges.  Profit-wise.....you the doctor, or the hospital....don't make much profit.

But there's this other nifty thing about picking Medicaid....the deductible for marginal wage earners (those folks under $20,000 a year).....is not much to worry about.  Most of these people weren't in a position to be happy over cheaper health insurance via a private company, but with a $6,000 yearly deductible.

It's hard to say if some dimwits with no real life experience or business background were ever in the planning process of the Affordable Healthcare Act.  If you had interviewed a hundred low-income folks and explained the options to them.....logically, all one hundred would have chosen the Medicaid option as the 'cheapest' deal.

Note, I didn't say it was the best deal....just the cheapest.

The issue now?  States are standing there in a bit of shock.  While the federal government is obligated to help in the beginning stages of this program.....you can sense that the states were supposed to invent ways to cover the added cost down the line (hint: more state taxes or local sales taxes).

Emergency meetings?  No.  You can sense the whole schedule to this.  By January, the final tally on new folks in Medicaid will come out.  It'll be a Friday afternoon announcement.....to avoid discussions on the weekend political chat shows.

For the first six months of 2014, most states will just stand there and note how much this is costing them.  By the end of 2014....the budget review will occur.  Shock will be a topic of discussion.  By the spring of 2015.....well into the election process for the next President.....this will be a major topic.  Most states will indicate that they can carry this for a year or two, but it's dissolving their financial situation.

 A mess?  Yeah, but the cows went exactly down the trail that you'd expect.  If you had virtually no real income and nothing left to spend on deductible costs.....Medicaid makes perfect sense.  If the dimwits in Washington had realized this.....they might have done this totally different, but they aren't exactly that smart on healthcare or how it works in the real world.

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