Thousands of people in 5 states are not paying monthly premiums towards their Medicaid benefits; the House GOP is considering a complicated, multistep budget maneuver regarding Affordable Care Act cost-sharing reductions; a report says it's time to reimagine what healthcare could look like in rural America.
In Arkansas, few Medicaid enrollees are paying new $13 monthly premiums, which apply only to recipients whose earnings surpass the poverty level, according to Kaiser Health News. Tens of thousands of Medicaid enrollees in 4 other states that added premiums during the past 4 years—Indiana, Michigan, Iowa, and Montana—are also not paying, according to state records. Republicans in favor of the premiums say it will incentivize healthy living, and in surveys beneficiaries agree with the concept of paying towards their care, although advocates opposed to the premium payments said findings are not surprising and call the payments a barrier to care.
House Republican leaders are weighing a controversial, multistep plan that would have the Budget Committee direct the Congressional Budget Office (CBO) to take Affordable Care Act cost-sharing reductions (CSRs) out of its baseline for projecting federal spending, The Hill reported. The CBO would stop assuming that the CSRs payments would be made. But if they subsequently proposed making the CSR payments, the CBO would then score the proposal as saving money. Those savings could then be used to pay for reinsurance to bring down premiums.
More rural hospitals are closing, and some health policy analysts say it's time communities start thinking about changing healthcare structure in small towns, NPR reported. Citing a recent report by the Bipartisan Policy Center, some communities should consider what kind of primary care and more specialized care they could offer at a smaller facility instead, instead of having a full-service hospital. But losing rural hospitals would also mean the loss of jobs and hurt local economies, NPR noted.