Obamacare vs. children's health

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Article Highlights

  • If you’re a poor child, and you like your health plan, you can’t keep it @ScottGottliebMD

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  • Obamacare will force tens of millions of Americans to accept inferior health coverage to what they have now.

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  • Seniors who qualify for Medicaid and Medicare and kids enrolled in CHIP are threatened by Obamacare.

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Editor's note: for more information on why Obamacare forces poor children out of their current plans, read Gottlieb's blog post here.  

If you’re a poor child, and you like your health plan, you can’t keep it.

In fact, it’s now clear that ObamaCare will force tens of millions of Americans to accept inferior health coverage to what they have now. The most-threatened groups include: people who now get their policies from a job at a small business, those who buy individual coverage direct from an insurer, seniors who qualify for Medicaid as well as Medicare and kids enrolled in the Children’s Health Insurance Program, or CHIP.

The undermining of CHIP is particularly shocking: This is a bipartisan program that liberals spent much of the last two decades expanding.

CHIP provides health coverage to nearly 8 million children of families with incomes too high to qualify for Medicaid. The program has plenty of flaws, but often gets kids enrolled in plans that are a lot better than traditional Medicaid — the equivalent of a Blue Cross plan in some states, of the insurance state employees get in others. Yet ObamaCare will force many into Medicaid networks.

At risk are CHIPS kids whose parents earn between 100 percent and 133 percent of the Federal Poverty Level — which comes out to $23,000 to $31,000 a year for a family of four.

Here’s how it works: An obscure provision buried the ObamaCare law’s Section 2001(a)(5)(B) automatically enrolls in Medicaid any child whose parents earn between 100 percent and 133 percent of the Federal Poverty Line — even if the kids are now getting better coverage from CHIP.

The provision makes these kids a “mandatory Medicaid population,” so it applies toall states. As long as the parents are in that income zone, the kids are on Medicaid (even if the parents aren’t). Goodbye, CHIP.

And many Americans will soon learn that ObamaCare means their present insurance will get switched, cheapened or hollowed out.

In the individual market, where people buy coverage directly from insurers, most folks are going to end up in the new ObamaCare exchanges, regardless of income. Once the full brunt of the law’s regulations of this market starts hitting this fall, the individual plans they now buy just won’t be offered outside the exchanges. (This is true even in states that refuse to set up their own exchanges.)

Worse, many of these folks are going to find that the exchange-based coverage is a lot skimpier than what they now enjoy, with narrow lists of allowed doctors and hospitals and heavy coinsurance payments for using “out of network” health-care providers.

Wall Street analysts predict that 25 percent of folks who get their health coverage from small businesses will quickly end up in the exchanges, as well. They will also find that their new plans are far more meager than the coverage they now carry.

Poor seniors are in a similar jam. Under “demonstration” programs being rolled out nationally by Medicare, “dual eligibles” — seniors who also qualify for Medicaid — are involuntarily losing their standard Medicare benefit.

Their coverage is being turned over to the states, which get federal cash to manage the medical needs of these less-well-off, and often sickly, seniors. And some states are dumping these folks straight into their existing Medicaid networks.

These are just some of the dislocations unfolding, and ObamaCare isn’t even in full swing.

In his State of the Union Address, the president said he’s simply updating America’s founding vision to help everyone have a better life.How does imposing worse medical coverage for some of our most vulnerable citizens do that?

Dr. Scott Gottlieb is a physician and resident fellow at the American Enterprise Institute.

 

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About the Author

 

Scott
Gottlieb
  • Scott Gottlieb, M.D., a practicing physician, has served in various capacities at the Food and Drug Administration, including senior adviser for medical technology; director of medical policy development; and, most recently, deputy commissioner for medical and scientific affairs. Dr. Gottlieb has also served as a senior policy adviser at the Centers for Medicare & Medicaid Services. 

    Click here to read Scott’s Medical Innovation blog.


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