Reflex: October 28, 2011

Health reform’s popularity is waning, reports Jason Millman (POLITICO). “Just 34 percent of those surveyed said they have a favorable view of the Affordable Care Act, the lowest ranking in Kaiser Family Foundation’s monthly Health Tracking Poll since the law passed in March 2010.” Austin’s comment: I do not find this surprising. Health reform is a hard sell. Long ago, I noted that the benefits of health reform are likely opaque to most voters. The fact that most workers and retirees have insurance they find acceptable creates Paul Starr’s policy trap. In a presentation I made with Mark Pauly this week, he made the point that the moral case for reform has not been made. (See his related paper.) 

North Carolina addressing a $139 Million Medicaid shortfall, writes Lynn Bonner. Projections show that the State will not save as much as anticipated from increased use of managed care among other things during the current fiscal year. Don’s comment: The total cost of the state’s Medicaid budget is $12 Billion, so the shortfall is relatively small. However, if the savings targets for Medicaid are not met, automatic provider payment cuts will take place that may exacerbate access problems for the 1.5 Million beneficiaries. There are no easy answers for states seeking to deal with a counter cyclical program like Medicaid whose costs rise when the economy is poor.

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