CRFB: Senate Bill Cuts Medicaid $2.6 Trillion in Second Decade

https://goo.gl/JaAapf

The Congressional Budget Office (CBO) estimates that the Senate Republican health bill’s Medicaid cuts would deepen significantly in the second decade, with the cuts growing from 26 percent in 2026 to 35 percent in 2036, relative to current law. Now, based on CBO estimates and data, the Committee for a Responsible Federal Budget (CRFB) estimatesthat the Senate bill would cut Medicaid by roughly $2.6 trillion over the second decade (2027-36), on top of Medicaid cuts of $772 billion in the first decade.

That’s because the Senate bill, like the House-passed health bill, would: (1) effectively end the Medicaid expansion, and (2) convert Medicaid to a per capita cap. Rather than continue to pay a set share of state Medicaid costs each year, the per capita cap would limit annual federal funding for each state’s Medicaid program to a set amount per beneficiary, which would rise each year at a rate slower than health care costs generally and the expected growth in Medicaid costs per beneficiary.


Why Americans With Disabilities Fear Medicaid Cuts

https://goo.gl/focVdN

On a recent Thursday afternoon, 43 demonstrators were arrested outside of Senate Majority Leader Mitch McConnell’s office. They shouted “No cuts to Medicaid!” as Capitol Police lifted some from wheelchairs and removed them from the building. The activists were quick to point out that the vans used to transport them were wheelchair accessible, which they attributed to decades of similar direct action.

“We’re here to fight for our freedom,” said Erik von Schmetterling, a demonstrator from Philadelphia, as he waited outside the police station for the others to emerge. It was humid and late in the afternoon. Schmetterling looked weary under his Philadelphia Eagles baseball cap. He had a blurry amateur tattoo of a person in a wheelchair on his forearm. It looked like the typical handicapped parking sign, but the figure’s arms were raised in victory above its head. “It’s us in the wheelchair, breaking the chains,” Schmetterling explained.

the proposed changes to Medicaid go well beyond a budgetary trim. Right now, more than 80 percent of Medicaid’s budget funds health care for the disabled, elderly, and children. The plan “fundamentally changes Medicaid in a way that hasn’t been done before,” said MaryBeth Musumeci, a Medicaid expert at Kaiser Family Foundation. The Senate bill would reduce Medicaid’s budget by a projected 35 percent over the next two decades, compared to current policy, and because so much of its budget already goes to the neediest Americans, Musumeci said it would have “profound implications for all beneficiaries.”

That’s because such a large reduction leaves states little option but to raise taxes, pay doctors less, limit who gets coverage, cut back on services—or perhaps do all at once.

Some services, like hospital care and nursing homes, are mandated under federal law and can’t be cut. But advocates warn that because other services that are essential to disabled people are technically optional, they could be the first on the chopping block.

Chief among those optional benefits are the Medicaid-funded attendants who help about 3 million disabled Americans get out of bed, bathe, eat breakfast, drive to work, and go to sleep at night.

“When states are squeezed for money they are going to reduce those services or end them all together,” said Mary Lou Breslin, a policy analyst at the Disability Rights Education and Defense Fund, “and without that help they face institutionalization.”


Will House Avert Cuts in Rental Aid?

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When a House subcommittee considers the 2018 funding bill for the departments of Transportation and Housing and Urban Development (HUD) tomorrow evening, a key question will be: will it sustain the rental aid that now enables 4.8 million low-income households — nearly all of which include seniors, people with disabilities, or children — to afford decent, stable homes?

To its credit, the House appears poised to reject President Trump’s proposed deep cuts in non-defense discretionary (NDD) programs for 2018, including his draconian HUD cuts. Still, the House apparently has agreed to cut NDD funding below the level required under the 2011 Budget Control Act, which has already forced deep cuts in housing and other programs over the past seven years.

In addition, the cost of renewing HUD rental aid will rise in 2018, even as House policymakers have fewer dollars to allocate across NDD programs. To renew all of the Housing Choice Vouchers that 2.2 million families are now using, for example, would require an estimated $19.9 billion in 2018, or $1.6 billion more than policymakers provided to renew those vouchers in 2017. Total voucher program funding, including administrative expenses, would have to grow to $21.8 billion.

The reasons for these higher costs are straightforward. Housing vouchers are effective in helping families afford rent only if they keep pace with rental costs in the private market. To meet this goal, we estimate that voucher subsidies must rise 3.5 percent in 2018, slightly less than the 4 percent that HUD says will be required in 2017.

In addition, the number of vouchers to be renewed will grow modestly next year as some vouchers authorized in the past several years — including those aimed at helping homeless veterans or preserving public housing units under the successful Rental Assistance Demonstration — will need renewal funding for the first time in 2018. These added vouchers will increase renewal costs by another 1.4 percent, we estimate.

At the aforementioned $21.8 billion, funding for 2018 would still be 3 percent below the 2010 level, adjusted for rent and utility cost inflation.


Drug companies spent $287 million in four years on 'educational' events for doctors

https://goo.gl/WUd4fy

The drug industry is spending $72 million a year "educating" doctors, with one company splashing $750,000 on a weekend conference.

A new database of pharmaceutical company-funded events created by Sydney University researchers shows 42 companies shelled out $286 million on 117,000 events for doctors and nurses over a four-year period. The average cost of an event was $2500.

Swiss giant Roche organised the most expensive event each year, spending an average $750,000 on the two-day event (plus welcome dinner), the "Annual Haematology & Oncology Targeted (HOTT) symposium" for about 300 doctors.

The data shows about half the money covered meals, five-star accommodation, airfares and transfers. How the rest was spent (apart from speaking fees and general event costs) is a mystery.

Dr Quinn Grundy, one of the researchers, said the sheer scale of generosity was worrying because it could lead to doctors prescribing more expensive medicines.


I shared my toddler's hospital bill on Twitter. First came supporters — then death threats.

https://goo.gl/dCGu1e 

Not all hearts are this expensive, but my son, Ethan, was born with heterotaxy syndrome, a rare condition that can cause any of the internal organs to be malformed, misplaced, multiplied, or missing altogether. Ethan’s insides are a math all their own: two left lungs, five spleens, and nine congenital heart defects. It was his heart that had brought him to the operating room to have his chest opened four times in his short life, and the bill I was holding was for the latest of these surgeries.

I snapped a picture of the bill and opened Twitter on my phone, absentmindedly imagining that someone might be interested in knowing why we medical mamas care so much about laws that ensure our access to affordable health care, why Obamacare has been a lifeline to our children, banning lifetime limits and ensuring that no one would deny them coverage simply because they’d been born with preexisting conditions like heterotaxy. Maybe someone would listen when I explained how terrified I was now that these protections were under siege due to the Trumpcare bill that stood before the Senate.

The tweets came easily; I’ve always been an external processor. I told our story the same way I always do, softening the hard edges of Ethan’s struggle with photos of the tender-hearted little boy who’s fought so hard to make it this far. I wrote about his medical team, about the surgeries and procedures and medications that he will rely on for the rest of his life, and also I wrote about his love for sticks and fireflies and his mama. I begged the people in power to look him in his big brown eyes and tell him to his face that his life was too expensive to be worth saving.