EDITORIAL: Health care measure [The Gazette, Cedar Rapids, Iowa]
By The Gazette, Cedar Rapids, Iowa | |
McClatchy-Tribune Information Services |
What looked like a gap too far to bridge in the final frantic days of the 2013 session, suddenly became a done deal. Gov.
And now that the confetti has settled, and we've had some time to examine that complex legislative work product more closely, it looks like -- for the most part -- those accolades were appropriate.
HOW IT WORKS
If all goes according to plan, on
Under the new
With those carrots, there are some sticks. After the first year of the program, recipients from 50-138 percent of poverty will be expected to meet preventive care and wellness objectives. If they meet those objectives, they'll continue to receive premium subsidies. If they fail, they'll be required to pay some share of monthly premiums.
"It's the most significant increase in health care coverage in
Details are still being worked out as the state seeks a federal waiver it needs to move ahead with Health and Wellness. The exchange is also still in the planning stages.
CAP PROBLEM
But between now and
On
Local public health officials were notified of the change on
"It was a big surprise," said
Hatch admits that lawmakers failed to mind the gap.
"We did not object to that, apparently. We were so consumed with getting
Iowa Medicaid Director
"For all of those reasons, capacity issues, logistical issues, transition of care issues, continuity of care issues, we felt it was just better to not enroll new members for the period of six months," Vermeer said, adding that the governor and lawmakers provided no dollars for new enrollees.
Hatch also blamed inadequate staffing within the department to handle the transition. He contends
FIX THIS MISTAKE
Whatever the reason, we think this gap was a big mistake. Although we understand the challenges of turning a vast bureaucracy in a new direction, those issues pale in comparison to the needs of sick Iowans seeking help. It's not a large number of people in the big scheme of government entitlements, but if a small
And evidence shows that those seeking Iowa Care are often sick -- in some cases, very sick.
According to a survey of Iowa Care recipients by the Public Policy Center at the
"Among the uninsured, these are going to be among the sicker ones," said
We commend county officials for responding as quickly as possible to the coverage gap. And we urge state human services leaders to provide emergency resources to help that effort. Hatch says lawmakers could pay for that emergency help when they return in January. That makes sense.
The good news in Damiano's survey is that the
PREVENTION AT RISK
Also, less than one half of respondents had received preventive care in the last six months.
Damiano said preventive care incentives included in the new Health and Wellness plan could have a positive impact in keeping some clients from developing chronic conditions. But he doubts it will lead to big cost savings.
"That's not to say prevention isn't a good thing and that we shouldn't be promoting it. But the real cost savings are in other ways of dealing with people with severe chronic illnesses," Damiano said.
The state will attempt to control those costs through the formation of Accountable Care Organizations, or ACOs, to corrdinate client care with an eye on outcomes and costs.
But it's doubtful that federal officials will allow the state to charge any premiums to Iowans below the poverty line.
"They didn't tell us that wouldn't be accepted. But we're all very clear they have not approved those in the past," Hatch said, adding that he thinks lawmakers will resist the idea of promoting preventive care if the feds balk.
"We may need to be a little more creative in how we get people to do that."
We hope the federal government leaves the prevention and wellness incentives in place as a strategy that may have long-term benefits. But we agree with Hatch that lawmakers should work on a new approach in case those requirements are rejected.
Comments: [email protected] or (319) 398-8262
___
(c)2013 The Gazette (Cedar Rapids, Iowa)
Visit The Gazette (Cedar Rapids, Iowa) at thegazette.com
Distributed by MCT Information Services
Wordcount: | 1268 |
Unsealed: Top administrator at Amos Cancer Center files federal court claim accusing the center of overbilling government insurers [Columbus Ledger-Enquirer]
Advisor News
Annuity News
Health/Employee Benefits News
Life Insurance News