Tax Credit, Not Advanced

[AllenChicago]

Don't count on it, TX is slashing funding to Medicaid for children with disabilities for therapy. No one cares or is calling for an Obamacare replacement

That is sad to hear KGMom. Sounds so callous! Parents don't care if their disabled children are punished by the state of Texas, and too apathetic to demand that something replace the coverage that was taken away?

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You nailed it AC.

It's hard to get an accurate count since the definition of who is covered and who isn't is a moving target. The current administration redefines stats to fit their narrative. Doesn't matter if it is covered lives, uninsured, unemployed or what.

The latest figures from KFF are for 2014 when 6% of the population had individual health insurance.

That translates to roughly 20M people.

In that same time period over 3x as many people (19% of the population) were covered by Medicaid.

I suspect that the percentages of people covered by individual insurance may have dropped while the percent of people covered by Medicaid has increased.

To your point, the collapse of Obamacare will potentially impact more people who currently have IFP than any other group.

My suspicion is that Medicaid will expand via more federal dollars flowing in to the states. If the Treasury is no longer funding hc.gov or paying subsidies then those dollars can be reallocated to Medicaid.

Those of us who (used to) make our living in the IFP world will have to find another way to pay the bills.

I envision Medicaid expansion more quickly than Medicare expansion. Medicare for all will more likely be Medicaid for all and IFP will go away.

It isn't illogical to expect the IFP market to be replaced with Medicaid and probably at a lower cost to the taxpayer than the current system.

JMO

Right you are, JMO Somarco. This pie-chart reflects the latest estimates, as of March 28, 2016.

REF: Where America gets its health coverage: everything you wanted to know in one handy chart - LA Times

3% on ACA / 7.6% on Medicaid

Merging the 3% in with the 7.6% would cause one of the ACA wheels to "squeal", but not too loudly, and not too long.

I've had parents who complained about their children being put on Medicaid, but accepted it after seeing the $215 per month per child cost (Health + Dental) of an individual plan for each child. Interestingly, none of those parents move the children to IFP plans the next Open Enrollment. I give them the opportunity, but they say that Medicaid isn't that bad. Just longer waits.

The potential for ACA insureds (just 3% of the population)being allowed to enter either a Medicaid program becomes more likely with each IFP company withdrawal, and PPO/HMO coverage reduction. That's a short-term fix for these folks that could become a longer-term solution... depending on who's elected President.

 

[somarco]

If the numbers in your link are correct, the % on Medicaid has jumped from 19% in 2004 to 22.5% now.

So it appears the 3% decline in IFP has moved over to Medicaid, which is not surprising.

Medicaid isn't that bad. Just longer waits.

And fewer provider options.

Those two probably go hand in hand. In GA less than half the docs take Medicaid so fewer choices = longer waits.

As for the next election, I really don't know what Trump will do if elected. Hillary will want to expand everything, including Obamacare, but not necessarily include carriers.

The Congressional make up could really be interested. Seems there are disenchanted voters in both parties and in large numbers. Might be a record number of incumbents (both parties) out off work.

 

[Ann H]

Yep, they are touting a better uninsured rate, but most of those just went to Medicaid.

It is destined to collapse, but collapse in what direction?

From the beginning, I thought this could collapse into MedicaidPlus, meaning free Medicaid up to 200% of FPL, low cost for certain levels of FPL, high risk pool for the sick, with the remaining population getting group, or full-pay IFP. But, it could fall in another direction. Which direction depends on who is in power. Even if there were no upcoming election, this would collapse.

Yes, most Americans are not in IFP. Out of that 3% IFP number, about 50% are on exchange. Out of that 50% of 3%, about 80% are subsidized, and a percentage of them have some or all of the subsidy taken away.

However, this still affects all Americans. If your doctor goes out of business... If costs rise due to cost shifting... If more employees go back on their employer's plan, raising costs for that business... If taxes rise... All of these things affect every American.

 

[kgmom219]

That is sad to hear KGMom. Sounds so callous! Parents don't care if their disabled children are punished by the state of Texas, and too apathetic to demand that something replace the coverage that was taken away?

Seriously AC? You think our extreme right wing legislators care about poor, disabled kids?

Our legislators don't care about that.

What they DO care about?

Going after Ft Worth ISD for some stupid trangender bathroom rule that affects less than .01% of the population.

 

[AllenChicago]

Seriously AC? You think our extreme right wing legislators care about poor, disabled kids?

Our legislators don't care about that.

What they DO care about?

Going after Ft Worth ISD for some stupid trangender bathroom rule that affects less than .01% of the population.

Well... I suppose since we're talking about a program that the parents of these disabled children don't pay for, their ability to get the Therapy benefits reinstated is pretty weak. They have no leverage. People who pay for their own insurance don't really care what happens to Medicaid families.

The Texas legislature may have a different mindset than the majority of states, but the lack of Medicaid recipient leverage, and empathy from the non-Medicaid population, is probably the same nationwide.