Quote of the day

Well, I’m always a little annoyed with bloggers who post a quote of the day even when they don’t post one every single day. But I won’t let that stop me:

Originally designed as a kind of safety-­net,  . . . [Medicaid and CHIP] will soon become the largest single source of mandatory health coverage, and the largest single payer for health care services in the United States.

This from the executive summary of a report that actuarial firm schramm-raleigh sent to the Kansas Health Policy Authority board. The board wanted to know the impact of health care reform on the state of Kansas.

It said overall health costs to Kansans – whether by federal, state, or local governments, by private companies or individuals – will grow by about $150 million (1%) from 2014 to 2019. (Obamacare takes hold fully in 2014.) The number of uninsured Kansans will fall to about 145,000 from 330,000. Here’s how:

  • 87,000 Kansans will get insurance from Medicaid/CHIP because Obamacare expands eligibility for Medicaid and CHIP.
  • 33,000 will get insurance from Medicaid/CHIP because they are required to buy insurance.
  • 96,000 persons will get insurance from large employers, mainly from the employer mandate.
  • 108,000 will lose insurance because small employers will cut their rolls.
  • 73,000 will get insurance from state-based exchanges because they don’t fall into any of the buckets above.
  • Yeah, I know; there’s another 4,000 people the exec summary didn’t account for. But I don’t think that absence confounds the analysis.

So spending will increase by $150 million, $30 million a year, and 185,000 people, by my count, will get coverage. That’s less than $1,000 per person over five years – sweet deal for Kansas.

But as the Medicaid/CHIP juggernaut emerges, I think the program’s success will depend on how well the federal subsidies fare in the next few Congressional sessions. If people can be persuaded that Medicaid isn’t a “welfare program” anymore and Congress doesn’t make it harder to qualify for Medicaid, health care reform stands a decent chance.

The executive summary and more detail can be downloaded here.

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