Have we Seen the Last Round of ObamaCare Waivers?
Last Friday, per their normal Friday dumping of health care information, the Obama Administration released its latest list of granted health care waivers. Since our last report four weeks ago, an additional 117,000 people have received exemptions under 62 plans.
As pointed out in many Locke blog and newsletter posts, the use of waivers leads to many questions about the need to exempt people and organizations from a health plan that is supposed to be beneficial for all. Of course, we all know the reason. Despite claims from the Obama Administration that health reform will save money, these exemptions are merely the manifestation of the projected and actual cost increases associated with the plan. Additionally, the recently granted waivers have gone largely to union-associated plans, calling into question the legitimacy and transparency of the exemption granting process.
Interestingly, something else happened on Friday related to health care waivers. The Administration made an unexpected and vague announcement that it will stop accepting waiver applications in September of this year. This unpredicted move raises all kinds of new questions about the need for, use of, and granting of exemptions. For example, given that it seems the administration has been unfairly granting waivers to union-affiliated plans, who is supposed to benefit from this change? Moreover, is the waiver program being closed completely, and if so, why?
It isn’t news to anyone that states are having trouble paying for their current Medicaid programs, even with large Federal contributions. However, state expectations of how severely they will suffer under Federal Health Reform are surprising.
A new National Governor’s Association Fiscal Survey of States, released a couple of weeks ago, indicates that for fiscal year 2012, a majority of states are facing tough decisions and are strongly considering cuts in state Medicaid programs. For example, the survey showed that 30 states are proposing limits on prescription drug spending and 28 are proposing limits, or even elimination, on certain benefits. Another 37 states have considered freezing or reducing provider payments, which everyone knows will significantly and negatively impact the access and quality of Medicaid.
Even more concerning than direct cuts to state Medicaid are the inevitable reductions in funding for other public goods (e.g. public safety and education), as state monies will have to be shifted. To make room for more health-related expenses in 2014, as Health Reform is fully implemented, cuts will have to come from other state funded sources. Thus as a result of the Federal regulations in place for health reform, state legislators will be forced to prioritize spending and place health care above other public goods.
Although North Carolina recently passed a tough, but thoughtful and efficient, state budget, we must be fully aware of the large additional costs coming our way as we approach the next budget cycle.
Articles of Interest:
Emergency Medical Care: Three Myths Debunked
Here We Go Again: ObamaCare Preventive Care Subsidies Aren’t Free
