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Despite Bad Economy, S.C. Makes Progress In Enrolling Kids

Press Release:

New Analysis Shows State, National Progress in Extending Coverage

Columbia – South Carolina made significant progress in reducing the number of uninsured children from 2008 to 2010, according to a new report released by the South Carolina Appleseed Legal Justice Center and authored by the Georgetown University Health Policy Institute’s Center for Children and Families.  South Carolina’s rate of uninsured kids declined from 11.7% in 2008 to 9.4% in 2010, meaning more than 23,000 additional children had coverage in 2010, despite challenging unemployment and increases in child poverty.  Nationwide, the rate of uninsured children went from 9.0% in 2008 to 8.0% in 2010.

“The progress on children’s health insurance is due to the success of Medicaid and Healthy Connection Kids, which have continued to fill the void created by a decline in employer-based health insurance, high unemployment, and the increasing cost of private health insurance,” said Sue Berkowitz of the South Carolina Appleseed Legal Justice Center.

“Now we call on the General Assembly to build on this progress by granting the Department of Health and Human Services the additional $35 million it has requested, in order to provide coverage to another 70,000 children in South Carolina who are currently shut out of our healthcare system.”

Analyzing newly available data from the Census Bureau, the Georgetown researchers examined the changes in coverage rates for children from 2008 through 2010.

In 2008, South Carolina had about 124,900 uninsured children according the report, which uses data from the Census Bureau’s American Community Survey.  By 2010, that number had declined to 101,900.  South Carolina’s improvement in coverage for kids of 2.3 percentage points over three years was enough to put it into the top ten among states for improvement over that period.

While state-specific demographic data are not available, nationally there are some important differences worth noting among demographic groups.  Hispanic and Native American children remain disproportionately uninsured, older children are less likely to be covered than younger children, and uninsured rates are higher for children living in families earning below 50 percent of the poverty line.

“This report highlights a rare piece of good news at a challenging time for children. Poverty has gone up, but more kids are insured,” said Joan Alker, Co-executive Director of the Georgetown Center for Children and Families. “State leaders, with strong federal support through Medicaid and CHIP, have provided some much needed peace of mind to many families struggling to meet their children’s health care needs during perilous economic times.  These gains are fragile and could quickly be reversed if state or federal support erodes.”

See the full report here.

Seniors Realizing ACA’s Benefits, Doughnut-Hole Shrinkage

From The Associated Press:

By RICARDO ALONSO-ZALDIVAR

Sunday, 11.27.11

WASHINGTON — Medicare’s prescription coverage gap is getting noticeably smaller and easier to manage this year for millions of older and disabled people with high drug costs.

The “doughnut hole,” an anxiety-inducing catch in an otherwise popular benefit, will shrink about 40 percent for those unlucky enough to land in it, according to new Medicare figures provided in response to a request from The Associated Press.

The average beneficiary who falls into the coverage gap would have spent $1,504 this year on prescriptions. But thanks to discounts and other provisions in President Barack Obama’s health care overhaul law, that cost fell to $901, according to Medicare’s Office of the Actuary, which handles economic estimates.

A 50 percent discount that the law secured from pharmaceutical companies on brand name drugs yielded an average savings of $581. Medicare also picked up more of the cost of generic drugs, saving an additional $22.

The estimates are averages, so some Medicare recipients may do worse and others better. Also, it’s still unclear if the discounts will start to overcome seniors’ deep unease about the law. Continue reading

S.C. Health Insurance Bringing Up The Rear Again

From The Health Care Blog:

Still ringing true after all these years.

By Al Lewis

Nov 22, 2011

What makes a state’s health insurance successful for its citizens?   It should be affordable, it should cover a lot of people, and it should manage its members well, keeping people healthy as measured both by preventive care as well as actual health outcomes.

It turns out that, using those criteria, the state with the highest Health Insurance Success Score (HISS) is Massachusetts.   One would expect high quality, good outcomes and of course close to 100% coverage in the Bay State, but it also — quite surprisingly — ranks 5th in affordability, as described below.

Hawaii is a very close second.  (One could also argue that Hawaii’s circumstances are unique and non-comparable because that state differentially attracts and retains healthy residents, but the analysis eschewed all subjectivity and second-guessing of the data.)    Texas is last, one point behind Arkansas.   In both the best and worst listings, there is a noticeable gap between the two states at the extremes and their respective runner-up pelotons.

Out of a potential overall score of 4 to 204 (4 would be a #1 ranking in all 4 categories), the top ten states would be:

The bottom ten states would be:

The 51-state (including DC) ranking may be obtained gratis from the author. Continue reading

Healthcare Costs Driving Americans Into Poverty

From The Washington Post:

By Drew Altman and Larry Levitt

November 18, 2011

Policymakers in Washington are consumed with the federal budget deficit. The Congressional Budget Office serves as the official referee in budget debates, keeping score of how proposed legislation would make the deficit bigger or smaller. But Congress and the public could get a fuller picture of the implications of legislative changes if the CBO broadened its analysis. What if, in addition to assessing the effect of a proposed law on the budget deficit, the CBO also gauged the effect on people who are poor or on the precipice of poverty ?

In fact, a recent report from the U.S. Census Bureau has introduced a tool that could help do just that. This different way of calculating who is poor takes into consideration a broader range of living expenses and the help that people get from government programs. It found that 2.5 million more people are living in poverty than were classified as poor under the previous (and still official) method, bringing the not-so-grand total to 49 million Americans. The single biggest factor driving the increase? Out-of-pocket health-care costs.

Indeed, if the burden of health-care expenses were not taken into account, then 10 million fewer people would have been classified as poor. Continue reading

Haley’s Panel: No State Health Insurance ‘Exchange’ For S.C.

From The Post & Courier:

By Renee Dudley

rdudley@postandcourier.com

Friday, November 18, 2011

South Carolina should not manage its own “exchange” where health coverage will be sold once the new federal health care law takes full effect in 2014, a state panel is expected to recommend today.

The S.C. Health Planning Committee wants private companies to create their own exchanges to sell insurance, an option critics said will face resistance and likely lead to a federal takeover of the process.

If Gov. Nikki Haley approves the recommendations, South Carolina would join a handful of other states in declining to set up its own exchange — the website and hotline where health coverage will be sold to residents who qualify for subsidized insurance as part of federal health care reform.

Instead of a single state-managed website, members of the Health Planning Committee, who include state Health and Human Services Director Tony Keck, said private entities should set up their own sites to sell insurance.

Keck said small businesses or insurers could band together to build their own exchanges. The resulting sites would be similar to having a choice of Travelocity, Orbitz and Kayak for buying discounted airline tickets, he said.

Advocates for the uninsured, however, said buying health insurance is a complicated transaction. Allowing private companies to manage exchanges could open the door for insurers to take advantage of the poor, they said. Continue reading

The Medicaid Ambush

From Slate:

The Supreme Court’s unexpected and astounding reasons for wanting to hear a challenge to Obamacare.

By and

Monday, Nov. 14, 2011

The Supreme Court agreed Monday to hear a challenge to the Affordable Care Act, which means a five-and-a-half-hour oral argument before the court this spring, with a ruling likely by the end of June. It’s hardly surprising that the court agreed to hear this case: There was a deep split of opinion between several federal appellate courts, 26 states say they hate this law, and the Obama administration wanted the court to hear it quickly. The surprise is which issues the court has asked each side to address, and for how long. By this measure, the court’s announcement is precisely 64 percent expected, 18 percent unexpected, and 18 percent astounding.

The health care law, signed by President Obama in March 2010, extended insurance coverage to more than 30 million Americans, in part by requiring citizens to purchase health insurance by 2014 or face a tax penalty. That “individual mandate” provision was the one that launched a thousand Tea Parties, and it’s the issue to which most constitutional scrutiny has been devoted: Can the government, under the Constitution’s Commerce Clause, regulate “inactivity” (i.e., the decision not to purchase health insurance), and by what principle can we limit such unspeakable powers (i.e., how far can it go in forcing citizens to eat broccoli)?

The court will hear arguments on that issue for two hours. It will also entertain 90 minutes of argument on the mandate’s “severability”—that is, whether the entire law collapses if the individual mandate provision is deemed unconstitutional. (The 11th Circuit Court of Appeals, even as it struck down the mandate, believed that the law itself would stand.)

So that’s three-and-a-half hours of debate. What are they going to argue about for the remaining two hours? That’s where it gets interesting. Continue reading

Haley’s Waiting Game On S.C.’s Health Insurance Exchange

From Kaiser Health News:

S.C.’s top health official, Anthony Keck, and Gov. Nikki Haley, not fans of the 2010 health law, are likely to decide to let the federal government run the state’s exchange. (Haley photo by MaryAustinPhoto via Flickr)

By Christopher Weaver

Nov 15, 2011

South Carolina’s top health official will recommend this week that the state decline creating its own health insurance exchange, one of the central tenets of President Barack Obama’s health care law.

Instead, the state should let the federal government build the insurance marketplace in the state for now, Anthony Keck, the director of the state’s Department of Health and Human Services, said in an interview. That recommendation is expected to go to a committee appointed by the governor to study the issue on Friday.

South Carolina, a state dominated by health-law-averse Republicans who got a Tea Party boost in last year’s election, has been heading down this road for months. But the recommendation is the latest step in formalizing objections to the exchange — and it frames the move as pragmatism, even as the state hands over power to the federal government.

The No. 1 reason for the wait-and-see approach? The stakes are so low. If a state does nothing, Washington is required to step in and build an exchange by 2014. That thinking — as well as a list of technical and logistical problems — is swaying decision-makers in other states too, industry analysts say.

State officials say the 2014 deadline is too tight given that rules for the exchanges are not complete, which is one incentive to defer to Washington. Plus, if South Carolina officials don’t like the federally run exchange, they can always circle back and start their own later under rules issued by the federal health department in July.

“What is the first mover advantage for states to rush ahead and implement this, given all the uncertainty?” Keck asked. “States have the safety valve of being able to take it over when they want to.”

“Sometimes, the smartest thing when you’re doing something new like this is to wait,” he said. Continue reading

ACA Opponents Wine & Dine Justices Scalia, Thomas

From The Los Angeles Times:

Supreme Court Justice Antonin Scalia speaks to a policy forum in Washington last month. (Manuel Balce Ceneta/AP)

By James Oliphant

November 14, 2011

The day the Supreme Court gathered behind closed doors to consider the politically divisive question of whether it would hear a challenge to President Obama’s healthcare law, two of its justices, Antonin Scalia and Clarence Thomas, were feted at a dinner sponsored by the law firm that will argue the case before the high court.

The occasion was last Thursday, when all nine justices met for a conference to pore over the petitions for review. One of the cases at issue was a suit brought by 26 states challenging the sweeping healthcare overhaul passed by Congress last year, a law that has been a rallying cry for conservative activists nationwide.

The justices agreed to hear the suit; indeed, a landmark 5 1/2-hour argument is expected in March, and the outcome is likely to further roil the 2012 presidential race, which will be in full swing by the time the court’s decision is released.

The lawyer who will stand before the court and argue that the law should be thrown out is likely to be Paul Clement, who served as U.S. solicitor general during the George W. Bush administration.

Clement’s law firm, Bancroft PLLC, was one of almost two dozen firms that helped sponsor the annual dinner of the Federalist Society, a longstanding group dedicated to advocating conservative legal principles. Another firm that sponsored the dinner, Jones Day, represents one of the trade associations that challenged the law, the National Federation of Independent Business.

Another sponsor was pharmaceutical giant Pfizer Inc, which has an enormous financial stake in the outcome of the litigation. The dinner was held at a Washington hotel hours after the court’s conference over the case. In attendance was, among others, Mitch McConnell, the Senate’s top Republican and an avowed opponent of the healthcare law.

The featured guests at the dinner? Scalia and Thomas. Continue reading

Will Clarence Thomas Recuse Himself From ACA Case?

From The Nation:

Clarence and Ginni Thomas

By George Zornick

November 14, 2011

Today, the Supreme Court agreed to hear constitutional challenges brought on by twenty-six states and a business group to President Obama’s healthcare reform bill. There will likely be arguments in the spring and a ruling by July, right in the heat of the presidential election.

This is a good time to recall that seventy-four members of Congress have signed a letter asking Justice Clarence Thomas to recuse himself from any ruling on the Affordable Care Act because of his wife’s work as a conservative activist and lobbyist, where she specifically agitated for the repeal of “Obamacare.” The recusal effort was spearheaded by Representative Anthony Weiner, and his resignation in June slowed the momentum around this issue on Capitol Hill—but there’s still ample evidence for concern. Continue reading

CNN Poll: Support Rises For Health Insurance Mandate

From CNN:

Posted by

November 14th, 2011

Washington – The public is divided over the idea of requiring all Americans to have health insurance, according to a new national survey. But a CNN/ORC International Poll also indicates that support for the proposal, a cornerstone of the 2010 health care reform law, has risen since June.

The survey’s Monday release comes as the Supreme Court has agreed to decide the constitutionality of the sweeping health care reform law that was passed by a Democratic Congress and championed by President Barack Obama. The justices made their announcement in a brief order issued on Monday. Oral arguments would likely be held in late February or March, with a ruling by June, assuring the blockbuster issue will become a hot-button political issue in a presidential election year.

According to the poll, 52% of Americans favor mandatory health insurance, up from 44% in June. The survey indicates that 47% oppose the health insurance mandate, down from 54% in early summer.

“The health insurance mandate has gained most support since June among older Americans and among lower-income Americans,” says CNN Polling Director Keating Holland. “A majority of independents opposed the measure in June, but 52 percent of them now favor it.”

The poll was conducted for CNN by ORC International Poll from November 11-13, with 1,036 adult Americans questioned by telephone. The survey’s overall sampling error is plus or minus three percentage points.