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ObamaCare Clusterfuck: Because Medicaid is so privatized, Medicaid expansion enriches heath insurances companies too

Alert! Neoliberal rentier infestation! Bruce Japsen in Forbes (via PNHP):

As the Obama administration touts the need for uninsured Americans to sign up for private coverage via exchanges under the Affordable Care Act, the insurance industry sees growth in an expanded Medicaid program for the poor under the health law.

This week, the chief executive of the nation’s largest health insurance company and a new analysis indicate major growth ahead for health plans that have contracts with state Medicaid programs thanks in large part to President Obama’s signature legislative achievement.

As state budgets have been hurt by the stagnant economy [that's not a bug. It's a feature], lawmakers have turned more patients eligible for Medicaid over to privately-contracted insurance companies. Now, the health law provides a cash infusion of more than $900 billion in federal dollars from 2014 to 2022 to expand Medicaid programs for states interested in the proposition.

Enrollment in health plans that have contracts with Medicaid will rise by 20 percent this year and by nearly 40 percent from last year to 2016, according to a report this week from Avalere Health, a research and advisory services firm on health policy issues tracking the Affordable Care Act.

Other major players in the Medicaid managed care market include Aetna, Centen, Humana, Wellpoint [Hi, Liz! (waves)] ) and Americagroup, as well as a host of Blue Cross and Blue Shield plans.

“The continuing shift toward Medicaid managed care presents a significant growth opportunity for health plans that specialize in managing these low-income populations,” said Avalere executive vice president Matt Eyles said in a statement accompanying the analysis. “Plans that currently operate in Medicaid could see significant membership growth, and those outside of the Medicaid market until now could gain market share by moving into this space.”

This Medicaid funding under the Affordable Care Act is unlike past efforts to expand Medicaid in that the federal government will pick up the full tab for the first three years. The state gradually has to pick up some costs in 2017 but by 2020 the federal government is still picking up 90 percent or more of the Medicaid tab.

Avalere said 38 states and Washington, D.C. contract with private managed care plans “to provide care to some or all of their Medicaid beneficiaries.”

I keep thinking of both Medicare and Medicaid as nation state programs, as part of a compact between citizen and government. They're not. They're market state programs, and the role of the State is to allocate rental streams. Ugh.

Average: 5 (1 vote)


Submitted by lambert on

All the "Medicaid is the BESTEST" people are screwing the 55+ people big time.

Submitted by weldon on

The managed care company in San Diego refused to cover one of my medications unless it was prescribed by a specialist, and there were no such specialists in the "network" so I couldn't get a referral to anybody who could write the prescription. Back in Honolulu, I've been waiting more than three months to get an appointment for one of those preventive screenings we hear so much about. Not to get in; just to get an appointment.

I had a colloquy with a friend after I wrote the Krugman thing. He was insisting I recognize the expanded Medicaid coverage as better than nothing. I said sure, but it's horribly inequitable and often demeaning. He wouldn't put up with the shit Medicaid recipients have to do, but he's okay with millions of others forced to put up with it just because they're desperate. The underlying sentiment is "Health care is a right and you should be grateful to get any." It's infuriating.

Rainbow Girl's picture
Submitted by Rainbow Girl on

That's where the money stream action is now.

QED this post - 20% growth Medicaid industry this year; 40% by 2016 - too bad none of that "growth" translates into more health for citizens.