Friday News Dump: Wonkbites

by Karan Chhabra

Another whirlwind week of wonkery! Here’s what you might’ve missed:

  1. Breaking: What’s Michigan doing to Medicaid? Hot off the press, there’s a new proposal from Michigan lawmakers to expand Medicaid, but with some major strings attached. Michigan House Republicans are okay with expansion if it limits “able-bodied adults” to only four years of coverage. I’m not the blog’s correspondent on all things Michigan (that’s Adrianna), and details are scant, but at the moment this smells fishy. Aside from the dubious ethics and economic implications, how much do “able-bodied adults” cost Medicaid anyway?
  2. Skepticism on the chargemaster data: Wonks went wild Wednesday, when the feds released gobs of data on hospitals’ charges to Medicare for their 100 most common procedures. Among other things, they revealed massive variation in the charges for the same procedures at hospitals just miles apart (anyone surprised?). And they signal that the feds are making efforts toward transparency. But this smart post by Paul Levy steps back from the fuss, highlighting how little those charges reflect actual payments and concluding that “the release of bad data is worse than having no data at all.”
  3. Kids, get inIn this editorial, Ezekiel Emanuel (who advised the President’s healthcare reform effort) voices his fear that “young invincible” millennials, especially us males, may turn their noses at Obamacare’s individual mandate to buy health insurance. He explains why health insurance exchanges need young and healthy enrollees, and offers some ideas to support the cause.
  4. Scratch that: You probably don’t remember when I told you, just a few weeks ago, that the healthcare cost growth slowdown was largely the result of the recession. I’m glad you don’t remember, because new reports say the recession played a smaller role than once thought—welcome news for those hoping that the system is moving toward more efficient and cost-effective care.
  5. Oh no you didn’t: Time‘s cover story this week courts us millennials with the charming title “The Me Me Me Generation: Millennials are lazy narcissists who still live with their parents.” Any other day we’d fire back on the offensive, but this The New Republic post does it better, so read it. Time did get one thing right, though—how to spell millennial. Two Ls and two Ns, people!

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Karan is a first-year student at Robert Wood Johnson Medical School and Duke graduate who previously worked in strategic research for hospital executives.

Follow him on Twitter @KRChhabra or subscribe to the blog.

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3 thoughts on “Friday News Dump: Wonkbites

  1. Ben says:

    I assume that there will eventually be a post specific to the Michigan Medicaid expansion but until then, I will comment here. The description here as well as Adrianna’s tweets on the subject lead me to believe the millennials think that HHS will never allow this to happen. I find that surprising. This doesn’t sound all that different from what Rick Scott of Florida proposed, i.e. approving Medicaid expansion for three years until the federal contribution starts to dip. The provision about the able-bodied adults may make this different but given that the administration obviously wants to make Medicaid expansion work for the state, I would expect they would plug their nose and take the Michigan House Republicans up on this offer.

    • With all due respect, I don’t think my age has skewed my perception of the Michigan proposal—I’ve discussed it with older colleagues. I think that HHS could be swayed to the HSAs, and to the “reevaluation” of the expansion decision after the 100% match declines. I expect all reluctant states to make that part of their proposals.

      What I think will be the sticking point—based on my reading of FAQ memos released by CMS—is this four-year limit on coverage for the able-bodied adults (the bill itself refers to “nondisabled” individuals). The agency has proven flexible on a number of points, but who receives coverage has not been one of them. Michigan is asking for the authority to change “who” after four years, in a way that would undermine the ACA’s objective of near-universal coverage. I think they could finagle this easily enough without enhanced (expansion) match funds, but not with them.

      • Ben says:

        I don’t think your age has anything to do with it either. (I don’t even know how old you are!) I assume by my referring to “millennials” you interpreted my meaning as being people of a certain age, but I really just meant people who blog on this site. Sorry if that was offensive.

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