Health

5 Challenges Facing Medicaid At 50

Jul 28, 2015
LBJ Library photo by Unknown

A “sleeper” provision when Congress created Medicare in 1965 to cover health care for seniors, Medicaid now provides coverage to nearly 1 in 4 Americans, at an annual cost of more than $500 billion. Today, it is the workhorse of the U.S. health system, covering nearly half of all births, one-third of children and two-thirds of people in nursing homes.

Medicare Turns 50 But Big Challenges Await

Jul 27, 2015
Harry S. Truman Library and Museum

Medicare, the federal health insurance program for the elderly and disabled, has come a long way since its creation in 1965 when nearly half of all seniors were uninsured. Now the program covers 55 million people, providing insurance to one in six Americans. With that in mind, Medicare faces a host of challenges in the decades to come. Here’s a look at some of them.

Michael Tomsic

Roughly half a million North Carolinians could soon lose money they depend on for health insurance. The U.S. Supreme Court will rule as soon as next week on a key part of the Affordable Care Act. It governs federal subsidies for states like North Carolina that did not set up their own exchange or marketplace. It may sound wonky, but the result could be disastrous for many low-income Americans and insurance markets.

Leaders on health policy in the North Carolina House are pushing their version of a bill to overhaul the state's most expensive health care program: Medicaid. The lawmakers rolled out the bill in committee Wednesday.

House leaders want to overhaul Medicaid by putting groups of doctors and hospitals in charge of managing the program. The state would give them a set amount of money based on who they treat, and the doctors would face financial penalties or rewards based on how they do. 

Republican Representative Nelson Dollar is one of the bill's sponsors. 

Alan Cleaver/Flickr
Alan Cleaver / Flickr/https://creativecommons.org/licenses/by/2.0/

In North Carolina, health insurance companies are planning to raise average premiums between 11 and 26 percent next year on the Affordable Care Act exchange or marketplace.

The state's dominant insurance company, BlueCross BlueShield, wants to raise average premiums about 26 percent – almost twice as much as last year's increase.   

Kaiser Health News

On Monday morning, a mayor in eastern North Carolina will begin walking to Washington, D.C, to highlight the challenges facing rural hospitals. Adam O'Neal is mayor of the small town of Belhaven, where the only hospital closed about a year ago.

After a heart attack or other health care emergency, the time it takes to get to a hospital can mean the difference between life and death.

Mayor Adam O'Neal says for the roughly 1,600 residents of Belhaven, "you have to go 30 miles on country roads for emergency care."

North Carolina leaders are calling out several cancer charities that barely used any of the money they raised to actually benefit cancer victims. Attorney General Roy Cooper and Secretary of State Elaine Marshall announced Tuesday they're part of a lawsuit against what they call "phony" charities. 

Secretary Marshall says government leaders "are sending the message to those trying to rip-off the giving public that we can find you, shut you down, and take you to court."

Michael Tomsic

In Charlotte and across the country, there’s a growing need at community health centers. They treat patients regardless of their ability to pay. And the increased need is a surprising result to some clinic leaders, who thought the Affordable Care Act would mean fewer people needing charity care.

kff.org

North Carolina has some of the worst rated nursing homes in the country. A report from the Kaiser Family Foundation released Thursday shows the federal government gave more than 40 percent of the state's nursing homes one or two star ratings.

Nine nursing homes in the Charlotte area received the lowest possible rating, one star:

Carolinas Healthcare System and UnitedHealthcare have come to terms on a new contract. The agreement means that most UnitedHealthcare customers in the Charlotte metro area will continue to receive “in-network” coverage for services provided at CHS facilities.

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