S.C. Does Good, Uncle Sam Rewards Us With Money

Posted on January 3, 2012 by scjustice

According to The Business Journal of Greenville, Spartanburg & Anderson, Uncle Sam has awarded S.C. $2.38 million in Medicaid bonus money for doing the right thing, making it simpler for low-income families to enroll their kids in the Children’s Health Insurance Program.

The performance bonus payments are funded under the Children’s Health Insurance Program Reauthorization Act. To qualify, states must surpass a specified Medicaid enrollment target. They also must adopt procedures that improve access to Medicaid and the Children’s Health Insurance Program, making it easier for eligible children to enroll and retain coverage.

Performance bonuses help offset the costs states incur when enrolling lower-income children in Medicaid. By ensuring that states streamline their enrollment and renewal procedures, the bonuses also give states the incentive to adopt long-term improvements in their children’s health insurance programs.

Of course, this is the first time South Carolina has qualified for the federal bonus program, given our long and hallowed tradition of scorning the poor. S.C. Appleseed has fought for years to get the S.C. Department of Health and Human Services to implement the bureaucratic efficiencies that only now have qualified us for this much needed federal funding. Unfortunately, the Sanford administration always was for ideology over individuals, even if that meant adhering to a policy that contradicted another of its closely held principles. In this case, that meant having separate state agencies duplicate each others’ work, thereby slowing and complicating the Medicaid enrollment process.

You read that correctly: The Sanford administration – that full-throated champion of drowning government in the bathtub – insisted that a bloated, redundant and wasteful state bureaucracy was preferable to helping low-income children access quality health care through Medicaid.

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Seniors Save Big Thanks To ObamaCare

Posted on December 27, 2011 by scjustice

From USA Today:

By Kelly Kennedy

12/6/2011

WASHINGTON – More than 2.65 million Medicare recipients have saved more than $1.5 billion on their prescriptions this year, a $569-per-person average, while premiums have remained stable, the government plans to announce today.

That’s because of the provision of the health care law that put a 50% discount on prescription drugs in the “doughnut hole,” the gap between traditional and catastrophic coverage in the drug benefit, also known as Part D.

And, as of the end of November, more than 24 million people, or about half of those with traditional Medicare, have gone in for a free annual physical or other screening exam since the rules changed this year because of the health care law.

“We’re very pleased with the numbers,” Jonathan Blum, director of the Center for Medicare, told USA TODAY. “We found the Part D premiums have also stayed constant, despite predictions that they would go up in 2012.”

The Department of Health and Human Services announced in August that 2012 Medicare prescription drug plan premiums would average about $30 a month, compared to $30.76 in 2011.

Starting this year, seniors who reach the doughnut hole in prescription benefits receive a 50% discount on name brand prescription drugs. Drug companies must provide the discount to participate in the prescription plan. Before the health care law took effect, Medicare patients had to pay full price for their prescriptions once they reached the gap in coverage.

The prescription data are through the end of October.

Seniors are becoming more engaged in their care, Blum said, citing the hundreds of forums Medicare has conducted about the changes. “The sentiment is that Medicare is trying to keep them healthy and out of the hospital,” Blum said. Read more »

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SCOTUS Sets Date For Obamacare Showdown

Posted on December 20, 2011 by scjustice

From Politico:

The Supreme Court will hear three days of oral arguments. | NIKO DUFFY/POLITICO

By JENNIFER HABERKORN

The health care showdown of 2012 has been scheduled.

The Supreme Court announced Monday that it will hear three days of oral arguments on various pieces of the health reform law on March 26, 27 and 28 — just days after the law’s two-year anniversary.

On Monday, March 26, the justices will hear one hour of debate on whether the Anti-Injunction Act prevents the court from ruling on the constitutionality of the law.

On Tuesday, March 27, the justices will hear two hours of argument on the constitutionality of the mandate, the centerpiece issue of the case.

On Wednesday, March 28, 90 minutes of argument will be held on which pieces of the law should fall if the mandate is ruled unconstitutional, and an hour of argument will be held on whether the law’s Medicaid expansion is constitutional.

In November, the court indicated it would spread the arguments on the health law’s four issues over just two days. The suit was brought by 26 states and the National Federation of Independent Business.

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Meet The New 1%: Healthcare CEOs Beat Out Bankers

Posted on December 15, 2011 by scjustice

From The Guardian:

Joel Gemunder, CEO Omnicare, had a total pay package in 2010 worth $98m.

No bankers in top 10 of America’s best-paid executives, but those in charge of healthcare and drugs firms are in the money.

By Dominic Rushe

Wednesday 14 December 2011

Pity Wall Street’s bankers. Once the highest-paid bosses in the land, they are now also-rans. The real money is in healthcare and drugs, according to the latest survey of executive pay.

There are no bankers in the top 10 of this year’s GMI survey of CEO pay. In fact, they have been out since 2007, when Goldman Sachs boss Lloyd Blankfein competed for the top slot with Richard Fuld, boss of soon-to-be-bust Lehman Brothers, and Angelo Morzillo, head of Countrywide, once the largest sub-prime home loan firm.

With the bankers still recovering from their tussle with hubris, old age and infirmity were 2010′s boom businesses – at least in terms of pay. Leading the pack was John Hammergren, chief executive of McKesson Corporation. The firm’s 52-year-old chairman, chief executive and president took home $145,266,971 in 2010.

McKeeson is probably the biggest company you’ve never heard of. Headquartered in San Francisco, the company is the largest pharmaceutical distributor in North America, distributing a third of the medicines used in the US. McKeeson’s sales topped $112bn last year.

Hammergren’s next closest rival was Joel Gemunder, outgoing boss of Omnicare, where he had been president since 1981. Omnicare is a pharmacy company that dispenses drugs in nursing homes – among other services – and had sales of $6.15bn last year. When Gemunder started at the firm it had sales of $150m. His 2010 total pay package was worth $98,283,242.

CVS Caremark, which operates 7,000 pharmacies across the US, awarded chief executive Thomas Ryan $68,079,823 in 2010. Caremark’s share price was $71.70 on 1 May 1998, when Ryan joined the firm, and ended 2010 at $34.29. Read more »

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2.5M Young Adults Gain Health Insurance Via Obamacare – Huzzah!

Posted on December 14, 2011 by scjustice

 From The Associated Press:

President Obama talks about the Affordable Care Act in Virginia earlier this week. He highlighted provisions, including requirements to let young adults stay on their parents’ insurance plans. (By Dennis Brack, Getty Images)

By RICARDO ALONSO-ZALDIVAR

December 14, 2011

Washington – The number of young adults lacking medical coverage has shrunk by 2.5 million since the new health care overhaul law took effect, according to a new analysis the Obama administration is to release Wednesday.

That drop is 2½ times as large as the drop indicated by previous government and private estimates from earlier this year, which showed about 1 million Americans ages 19-25 had gained coverage.

Administration officials said they now have more data. They say they’re also slicing the numbers more precisely than the government usually does, trying to pinpoint the impact of a popular provision in an otherwise politically divisive law.

Under the health overhaul, children can remain on their parents’ health insurance plans until they turn 26, and families have flocked to sign up young adults making the transition to work in a challenging economic environment. But the fate of President Barack Obama’s signature domestic accomplishment remains uncertain, with the Supreme Court scheduled to hear a constitutional challenge next year, and Republican presidential candidates vowing to repeal it.

“The increase in coverage among 19- to 25-year-olds can be directly attributed to the Affordable Care Act’s new dependent coverage provision,” said a draft report from the Health and Human Services Department. “Initial gains from this policy have continued to grow as … students graduate from high school and college.” Read more »

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And Here We Thought Gov. Haley Was Acting In Good Faith

Posted on December 14, 2011 by scjustice

From The Post & Courier:

Haley dictated panel finding

Outcome ordered before health committee met

By Renee “Little Girl” Dudley

rdudley@postandcourier.com

Wednesday, December 14, 2011

Gov. Nikki Haley dictated the conclusions of a committee charged with deciding how the state should implement federal health care reform before the group ever held its first meeting, public documents show.

Now, some of those involved in the dozens of meetings are calling the entire planning process a sham that wasted their time and part of a $1 million federal grant.

In a March 31 email thread that included Haley, her top advisers and the committee member who eventually wrote the report, Haley wrote, “The whole point of this commission should be to figure out how to opt out and how to avoid a federal takeover, NOT create a state exchange,” which is eventually what happened.

A central part of the federal health care overhaul, an exchange is a marketplace where various insurance plans eventually will be sold.

The emails were released to the newspaper Friday afternoon in response to a Nov. 16 public records request to the S.C. Department of Health and Human Services.

The newspaper had made a nearly identical request of the governor’s office in May, but the office did not include the emails in its response.

The documents show a first-term Republican administration focused on public perception of its handling of the Democratic health care reform law. They also reveal the tight control Haley and her top aides exercise over other state agencies, requiring media inquiries to various state departments to pass through the governor’s office for inspection.

“Oh my God, we just threw $1 million away here,” said Frank Knapp, who participated in the meetings as president of the S.C. Small Business Chamber of Commerce. “This confirms this whole thing was an effort to justify the million-dollar grant, but the reality is they had no intention of even exploring whether the state should establish an exchange — which is exactly what the grant called for.” Read more »

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The Individual Mandate’s Shameless Flip-Floppers

Posted on December 8, 2011 by scjustice

From The Hill:

GOPers Who Were For It Before They Were Against It

By Juan Williams

12/05/11 05:15 AM ET

What do Newt Gingrich and Mitt Romney, the leading contenders for the Republican presidential nomination, have in common?

Long before President Obama, both supported an idea they now pretend to spurn — the idea of requiring people to buy health insurance.

As recently as 2009, Romney publicly supported, the “individual mandate” for buying health insurance. And as recently as last month one of Gingrich’s websites still endorsed the “mandate” for all Americans earning more than $50,000 annually.

Romney and Gingrich are not alone in their history of supporting the idea of a government requirement that everyone buy health insurance. As governor of Utah in 2007, Jon Huntsman endorsed a healthcare reform plan from the United Way of Salt Lake City that called for a mandate.

“I think if you’re going to get it done and get it done right, the mandate has to be part of it in some way, shape or form,” he said at the time.

Gingrich, Romney and Huntsman are wide open to charges of political hypocrisy.

They apparently feel the need to fake their outrage over the individual mandate to win the GOP nomination. In an age of outrageous political posturing — telling lies and daring anyone to call you on it — this is the strongest indicator of the current lack of leadership and honest political debate about major national problems.

And it is not even good politics. Read more »

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

Posted on November 30, 2011 by scjustice

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.

Filed under: Children's Health Insurance Program, Health Care For Children, Medicaid | Tagged: , , , , , , , , , , | Leave a Comment »

Seniors Realizing ACA’s Benefits, Doughnut-Hole Shrinkage

Posted on November 28, 2011 by scjustice

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. Read more »

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S.C. Health Insurance Bringing Up The Rear Again

Posted on November 23, 2011 by scjustice

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. Read more »

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