Sunday, March 17, 2019

Real health care academics find WisGOP study against Medicaid expansion to be "garbage work"

You know that "study" that WisGOP politicians used to say Medicaid expansion in Wisconsin would raise costs for most other people? Guy Boulton of the Journal-Sentinel talked to actual academics, and it was found to be the BS we suspected it to be.
“My real concern is they are trying to affect policy with such garbage work,” said Tim Classen, a professor of economics at Loyola University in Chicago.
Why is it garbage? Well, it goes beyond the fact that it was created by Will Flanders of the Bradley Foundation front group WILL, and right-wing hack Noah Williams of the Koch-Bradley-funded CROWE Institute at UW-Madison.

One of the reasons the right-wing study is absurd is that it conveniently ignores what has happened since the Medicaid expansion and ACA insurance exchanges have been in full effect in America.
The expanded eligibility for Medicaid programs under the Affordable Care Act didn’t begin until Jan. 1, 2014. Health systems would begin to see any purported shortfalls from more patients’ being covered by Medicaid during that year.

Insurers typically negotiate three- to five-year contracts with health systems and other providers. Even assuming that health systems could raise prices for every heath insurer if there was a shortfall, the price increases would not have been set until the following year, 2015.

Insurers and employers who self insure, in turn, set premiums for their health plans for the following year in September or October.

This means that any costs shifted to private insurers wouldn’t have appeared in the cost of health plans until 2016 at the earliest.
.Anyone with a clue about how insurance's many interacting parts would have known that. And I'll give Flanders and Williams "credit" in the sense that I think they know that too, but they're paid to come up with a certain conclusion, so they manipulated the numbers to say what they wanted to say, and left this important context out.

Naturally, WisGOP politicians use these cherry-picked "facts" as a reason to ignore the hundreds of millions of dollars of savings from Medicaid expansion, and the will of the public.

It's almost like Robbin' and the Bradley's are working together, isn't it?

Another bit of context the Bradley Boys ignored was that it didn't look at Wisconsin's particular circumstance, even though the policy paper allegedly was supposed to analyze whether Wisconsin should make this move.
Critics of the study done by Flanders and Williams also contend that it did not account for the fact that Wisconsin already partially expanded Medicaid.

“The issue that really is not addressed for me is Wisconsin’s expansion has sort of already happened,” said Laura Dague, an economist and associate professor of health policy at Texas A&M University. “The application of these numbers to the Wisconsin context is pretty questionable.”

Basically, the study comes up with a national average of the purported cost shift to private health plans from a broad group — adults with incomes up to 138 percent of the poverty threshold. It then applies that average to a subset of that group — those with incomes between 100 percent and 138 percent of the threshold.
Needless to say, that's not the only people that a private insurance group pays for. In fact, one of the concerns about ACA is that the exchanges and expanded Medicaid pick up the sickest and most economic vulnerable individuals, which is a boon to private insurance companies since they don't need to pay for those individuals as much anymore.

The article ends with this great passage and comment.
Whether to accept the federal money is a key issue in the debate. And the position of the Republican lawmakers frustrates Robert Laszewski of Health Policy & Strategy Associates, a health care consultant and Wisconsin native who has been a sharp critic of flaws in the Affordable Care Act.

“Why are we even having this discussion? The data is there. The studies are there. The practical information is there,” Laszewski said. “When are these people going to give up and finally admit that forcing Wisconsin taxpayers to pay something the federal government has been begging to pay for is not smart policy?”
That answer's easy.

1. When the Koch/Bradley money dries up and there are no more donations to be made by trying to sabotage Obamacare (I wouldn't expect that to happen for a while).

2. When voters in their districts toss their asses out of office for deliberately hurting Wisconsinites.

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