Tag Archives: health care

Hogan’s Point Man on Health Care Wants to Destroy the Affordable Care Act

By Adam Pagnucco.

Governor Larry Hogan may be silent on the efforts by President Donald Trump and congressional Republicans to gut health care, but his newly appointed Chair of the Maryland Health Care Commission has been anything but silent.  To the contrary, Hogan’s new point man on health care has openly advocated for the destruction of the Affordable Care Act.

Robert E. Moffit, whom Hogan appointed Chair of the Maryland Health Care Commission on May 9, will now be playing a critical role in administering Maryland’s health care system.  The commission is an independent agency with broad regulatory powers over health care providers in areas including IT, data reporting, performance evaluations, certificates of need authorizing new hospitals and expansions and much more.  Moffit’s appointment would normally be confirmed by the Maryland State Senate, but since they do not return to Annapolis until next year, Moffit will have plenty of time to make his mark on the state’s health care system.

And that could be quite a mark.  During his tenure as Senior Fellow at the Heritage Foundation, Moffit was a leading critic of the ACA, which provides health coverage to more than 400,000 Marylanders, and called for it to be repealed as soon as possible.  Consider his views.

1.  In one of many screeds against the ACA, Moffit said it was experiencing “multi-organ failure” and that “central planning is the disease.”  One wonders what he thinks about other “centrally planned” health care systems like Medicare and the Veterans Health Administration.

2.  Moffit wrote that Congress “should kill the employer mandate entirely,” thus leaving employees to fend for themselves in health care as they did before the ACA was passed.

3.  Moffit enthusiastically endorsed the GOP’s plan to issue waivers to states so that they could excuse insurers from having to cover pre-existing conditions.  In an article entitled “House Health Care Bill Moving in the Right Direction,” he wrote, “President Barack Obama and his allies in Congress should never have imposed centralized federal control over diverse state health insurance markets in the first place.  While the best solution would be to repeal that federal overreach, the proposed waiver is a significant improvement over current law. Its practical effect is to achieve a devolution of health insurance rulemaking back to the states.”

4.  Just weeks after Hogan appointed him, Moffit cheered on Trump’s budget, which called for $800 billion in cuts to Medicaid and converting it into a block grant program.  Moffit wrote: “By putting Medicaid on a budget—either through a fixed allotment to the states in the form of a block grant or a per capita cap—the Trump budget would give state officials much needed flexibility in managing the program and better target services to the poorest and most vulnerable of our citizens.”

5.  Last November, when criticizing the ACA’s poll numbers, Moffit wrote, “What ‘progressive’ politicians want, and their academic and media cheerleaders like, most Americans don’t want or like.”  According to Gallup, the ACA’s approval rating went from 42% at the time Moffit wrote his article to 55% in April.  Apparently, Americans want to have health care after all.

6.  Moffit called the Republican House bill replacing the ACA “a major improvement over current law.”  Yesterday, the Congressional Budget Office found that the House bill would increase the number of Americans without health coverage by 23 million by 2026.  The office said, “Premiums would vary significantly according to health status and the types of benefits provided, and less healthy people would face extremely high premiums.”

In selecting Moffit, Governor Hogan has broken his silence on the Affordable Care Act.  Moffit’s views are longstanding, well developed and very public.  If Hogan had major disagreements with him on the ACA, why would he appoint him to one of the most powerful health care positions in Maryland?  Actions speak louder than words, and this action speaks volumes.

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Will Hogan Stand By as Republicans Destroy Health Care in Maryland?

By Adam Pagnucco.

President-Elect Donald Trump and the new Republican-controlled Congress are proceeding rapidly to dismantle the Affordable Care Act (ACA).  The law, a complicated amalgam of policy and funding requirements, has helped 20 million Americans gain health care coverage and has cut uninsured rates dramatically across many racial and ethnic groups.  Its repeal threatens to throw millions of Americans out of health care coverage, including hundreds of thousands of Marylanders.  And so far, Governor Larry Hogan is standing by silently and letting it happen.

The ACA has expanded health insurance coverage in two primary ways: setting up government-run health care exchanges and expanding Medicaid, the federal/state health insurance program for low-income people.  In Maryland, 146,808 people are currently enrolled for coverage through the state’s exchange, Maryland Health Connection.  The latter entity reports that roughly 278,000 more people are covered by the ACA’s expansion of Medicaid.  All told, more than 420,000 Marylanders have obtained health coverage through the ACA and two more weeks remain in the enrollment period.

Marylanders in every county are enrolled in the state’s health exchange.

Maryland Health Connection Enrollment 2017

Under the ACA, the federal government has invested a lot of money in increasing enrollment.  Maryland Health Connection reports that Maryland health care exchange participants receive about $225 million in annual federal tax credits to subsidize their individual health insurance premiums.  The Kaiser Family Foundation estimates that the federal government spent $5.7 billion on Medicaid in Maryland in Fiscal Year 2015.  These funding sources are now at risk.

Since it is a federal law, some changes to the ACA must pass a 60-vote hurdle to overcome filibusters in the U.S. Senate, where the GOP has just 52 seats.  But budget items are not subject to filibusters.  That means part or all of the above federal funding to support ACA enrollment could be eliminated in a budget passed solely with Republican votes and signed by President Trump.  If that happens, millions of Americans and possibly hundreds of thousands of Marylanders could lose their health coverage.

That’s not all.  The federal tax credits and Medicaid funding under the ACA support lots of jobs and income in the health care industry, and through the multiplier effect, the broader economy as well.  A new study from George Washington University estimates that if the ACA’s tax credits and Medicaid funding are repealed, Maryland will lose 52,000 jobs by 2019.  The study projects that Maryland will also lose $49 billion in business output and $982 million in state and local tax revenues from 2019 to 2023.  All of this would be on top of any federal agency cuts that Trump and the Republican Congress might include in their next budget.

Any Governor would be expected to jump up and down about the prospect of losing tens of thousands of jobs and hundreds of millions in tax revenues as well as having hundreds of thousands of constituents lose health care coverage.  But not Larry Hogan.  He has stayed silent as Donald Trump and his Republican colleagues in Washington plan to destroy health care in Maryland.  Hogan bristles at questions from reporters about anything going on in Washington, telling one of them that he was tired of “stupid questions about the Trump administration.”  And yet, the Trump administration’s actions will have gigantic negative impacts on his state that he declines to oppose.

All of this begs the question.  Is Larry Hogan with Donald Trump and anti-health care zealots in the Republican Party?  Or is he with the rest of us?

 

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