Civitas Review

Obamacare: The Grinch That Stole Healthcare


You know Obamacare has become a nightmare when even the President's hometown paper is slamming the law as a disaster. Some excerpts from the Chicago Tribune's stinging article: (click the link to read the whole article, its well worth it)

For weeks, the government's website repelled customers with the brutal efficiency of a nightclub bouncer. Even if you thought you completed the process, chances were good that your application information wasn't accurately sent to insurers.

Last week, federal officials piled on more confusion when they urged insurers to relax coverage rules. The feds asked companies to cover people even if they miss the Jan. 1 deadline to pay their premium. On Wednesday, most insurers agreed to grant customers a grace period until Jan. 10 to pay premiums. The feds also pushed insurers to refill prescriptions in January, even if those pills aren't covered under the new plan. And they prodded insurers to treat out-of-network doctors as in-network under some emergency circumstances. Our analysis: Huh?

You think the Obamacare run-up to Jan. 1 has been a train wreck? Now it gets worse.

You'll soon be hearing more stories of people who thought they'd signed up for coverage, only to find that their paperwork was gobbled by computer gremlins …. One thing is certain: Most states lag behind in their Obamacare sign-up goals. The National Review Online reported this week that 45 states haven't yet hit 10 percent — 10! — of their enrollment goals. In Illinois, a paltry 7,043 people have signed up, hardly a dent in the state's goal of 300,000 by the end of March.

New Gallup Poll: 72% Say Big Government Biggest Threat


Politico reports on news from a recent Gallup poll showing that an overwhelming majority of Americans agree with the Civitas Institute that the biggest threat to the country's future is big government.

Nearly three-quarters of Americans identify big government as the greatest threat to the country’s future, according to a new poll.

The 72 percent that named big government over big business and big labor in the survey released Wednesday by Gallup is a record high in Gallup’s polling. The previous high was 65 percent in 1999 and 2000.

Today's Obamacare Trap: Dunning the Estates of Medicaid Patients


mousetrapWe hear a lot about how Medicaid is free — but it may not be as free as you think. And Obamacare seems set to leave more grieving survivors with a nasty surprise.

The Seattle Times found buried in that state's Medicaid rules a provision that mandates "estate recovery"  — allowing the  government to dun the estates of some deceased Medicaid recipients. And by federal law North Carolina and every state must (under various circumstances) do so.

Washington state had just expanded its Medicaid program, as North Carolina is being urged to do. Washington resident Sofia Prins, 62, was stunned to look over all the regulations and discover:

If you’re 55 or over, Medicaid can come back after you’re dead and bill your estate for ordinary health-care expenses. The way Prins saw it, that meant health insurance via Medicaid is hardly “free” for Washington residents 55 or older. It’s a loan, one whose payback requirements aren’t well advertised. And it penalizes people who, despite having a low income, have managed to keep a home or some savings they hope to pass to heirs ….

That's right, it's kind of a balloon loan, and not a good one. Washington residents could get into Medicaid, which all too often provides mediocre care, if they can find a doctor who will take them — and then the government will plunder their estates when they pass on.

As, as this proviso is buried in the typical mountain of red tape, most patients don't know about it. As pundit Mary Katharine Ham writes:

For no one else in the world is it a-okay to give low-income people a loan that might endanger their family’s assets and not even clearly inform them they’re getting a loan.

To give credit where credit is due, the Daily Kos notes:

So here's the deal: since 1993 there has been a federal law requiring states to recover at least some of the costs of Medicaid-covered medical care for anyone 55 years old and up,  from the estates of those covered. …. States enforce this law, with their own laws and policies added in ….

The Kos writer adds that, under the Affordable Care Act, if you apply for Obamacare, and your fnances indicate you are eligible for Medicaid — you will automatically be enrolled in Medicaid. Remember, under federal law, your estate could be hit up for Medicaid costs. Plus … "if you go on Medicaid, you owe the entire amount that Medicaid spends on you from the day you turn 55."

This includes not only doctor bills, but also a so-called "capitation charge," a sum paid to the organization that runs the program.

Could that happen in North Carolina? Here's what the NC Medicaid regulations say:

The estates of Medicaid recipients may be subject to estate recovery if the recipient applied or re-applied on or after October 1, 1994, and

1. Is under age 55 and an inpatient in a nursing facility, intermediate care facility for the mental retarded, or other medical institution, and cannot reasonably be discharged to return home, or
2. Is 55 years of age or older and is living in medical facility and receiving medical care services, or home and community-based services, or Personal Care Services (PCS).

Update as of Dec. 19: DHHS says that NC limits estate recovery to the amount required by federal law:

  • It applies for: Medical care services paid for by the North Carolina Medicaid Program on behalf of the recipient: If the recipient of any age is receiving medical care services as an inpatient in a nursing facility, intermediate care facility for the mentally retarded, or other medical institution, and cannot reasonably be expected to be discharged to return home; or if the recipient is 55 years of age or older and is receiving one or more of the following medical care services:
  1. Nursing facility services.
  2. Home and community-based services.
  3. Hospital care.

3a.  Prescription drugs.

  1. Personal care services.

So let's say you are one of the fortunate few who can actually sign up for Obamacare. But if your income is low, you may be automatically be slotted in Medicaid. I would guess it would be common for people to at some time receive some of the services listed in the law.  And after age 55, everything Medicare spends on you could be billed to your children or loved ones when you pass on.

At least, that's how I understand it. I am seeking more information on this subject.

For the moment, this trap looks like one more reason to avoid Medicaid. Liberals are aghast that NC hasn't roped more people into the program. I'd imagine, however, the above problem is just one of the many hazards scattered through Medicaid and Obamacare. We should stay clear of these programs until better opportunities are offered.

Examining Common Core: Better Late Than Never


The North Carolina legislature adopted Common Core standards for math and English in 2010 with little discussion. More than three years later, legislators have finally formed a committee to take a closer look at the controversial standards.

Today the N&O printed an oped by Civitas Education analyst Bob Luebke discussing the new committee.

What will the committee review? Enabling legislation says the committee “shall comprehensively study both current and suggested curriculum standards in K-12 education in the state.” The committee will specifically focus “on the question of cost and benefits of any existing or proposed curriculum standards and whether these standards will directly and positively affect educational outcomes in the state.”

What questions need to be addressed? The committee would do well to review the letter Lt. Gov. Dan Forest sent to Superintendent of Public Instruction June Atkinson in July. Forest has taken the lead in asking pertinent questions on how the standards were developed, on their costs and on what steps North Carolina is taking to ensure that the problems occurring in states like Kentucky and New York won’t occur here. Unfortunately, the response Forest received from 67 probing questions was nothing more than a data dump. The confusion is telling.

For those interested, the committee meets today at 1pm in room 643 of the Legislative Office Building in downtown Raleigh.