As election races heat up across the nation, candidates are spending countless hours traveling throughout their districts and disseminating their targeted messages on key issues. Issues being debated in 2016 vary from the economy and taxes to criminal justice reform, but one of the most important issues taking center stage is the future of Medicaid expansion.
On August 24, Kentucky Gov. Matt Bevin (R) submitted his Medicaid waiver proposal, appropriately titled Kentucky HEALTH, to the U.S. Department of Health and Human Services (DHS) after receiving significant pressure to reform the program that provides health insurance for 1.32 million Kentuckians.
On August 17 in Tennessee, state lawmakers on the 3-Star Healthy Task Force met with TennCare Chief Dr. Wendy Long and Melinda Buntin, chair of the Department of Health Policy at Vanderbilt University’s School of Medicine. The Task Force discussed a number of changes they would like to make to the state’s current Medicaid expansion plan—including “circuit breakers,” or enrollment thresholds, and components, such as drug tests. According to a recent article in The Tennessean, reporter Joel Ebert mentioned one idea discussed would cap the pilot program if there are too many emergency room or hospital visits.
Georgia lawmakers are considering a form of Medicaid expansion that’s similar to the hybrid “private option” Arkansas adopted in September 2013. According to a recent Heartlander article, author Ben Johnson, “In 2015, 1.8 million Georgians were enrolled in state Medicaid programs, at a cost of $8.9 billion, according to the Georgia Department of Community Health’s annual report.” Johnson goes on to warn, “Medicaid expansion would enroll more people in a system already failing to provide Georgians with access to primary care.”
Associated Press correspondent Ricardo Alonso-Zaldivar argued in a recent PBS Newshour article the cost of expanding Medicaid to millions of additional low-income people is increasing faster than expected. Alonso-Zaldivar also says the cost of expansion nationally was about 49 percent higher than previously estimated. “The new estimates could be a warning light for Democrat Hillary Clinton, who has promised that if elected president she would work to expand Medicaid in the remaining 19 states that have not done so. Higher costs would make it harder for a President Clinton to sell Obama’s full-financing plan to Congress.”
In a recent Research & Commentary, Senior Policy Analyst Matthew Glans argues while health insurance has been made available to more people under the Affordable Care Act, the cost of health care continues to rise, making the new coverage unaffordable for many families. “The federal government has spent millions of dollars on state-based exchanges that give the federal government considerable control over health care policies, what they cover, and how much they cost. Instead of wasting millions of dollars propping up exchanges that do not work, legislators should focus on creating health care policies that lower costs and empower individuals to control their own health care.”
What We’re Working On
Budget & Tax
Research & Commentary: Nevada’s Need for Pension Reform Grows
The Nevada pension system’s debt is growing each year because it continues to miss its projected investment targets. Research from Robert Fellner, director of transparency research at the Nevada Policy Research Institute, shows the Public Employee Retirement System of Nevada (PERS) had only a 2.3 percent return on its investments in 2015. Fellner says the low return means PERS has now “missed its target over the past five, 10, 15, 20 and 25 years.” In this Research & Commentary, Senior Policy Analyst Matthew Glans examines Nevada’s pension system and discusses the need for reform. “The fiscal health of Nevada’s pension system may be far worse than most people recognize.” Read more
Education
Research & Commentary: New York City Public Schools’ Improvement on Standardized Tests Dwarfed by Charter Schools
New York City charter schools made larger gains on the New York State Common Core-aligned English language arts (ELA) and math assessments during the 2015–16 school year compared to all other Empire State schools, easily outpacing both state and New York City (NYC) district schools in each assessment. Math scores jumped by 4.5 percentage points, and their ELA scores increased by 13.7 percentage points. Over 48 percent of students in grades 3 through 8 in New York City charters now test proficient in mathematics, compared to just 39.1 percent of their peers statewide and 36.4 percent in NYC district schools. ELA proficiency follows the same pattern, with 43 percent of NYC charter students in grades 3–8 testing proficient, easily outpacing their statewide (37.9 percent) and district (38 percent) peers. Charter students outperformed district averages in math and ELA in 24 of the city’s 28 community school districts where charters are in operation, and charters now make up 38 percent of the list of the top 50 schools in the city. In this Research & Commentary, Policy Analyst Tim Benson analyzes the data and writes, “New York traditional public schools’ woeful performance on these tests underscores the desperate need for the state to expand school choice opportunities far beyond what is currently available in the current charter networks.” Read more
Energy & Environment
Research & Commentary: Rhode Island’s Renewable Power Mandates Are Too Costly
In this Research & Commentary, Policy Analyst Tim Benson writes about a new study from the Rhode Island Center for Prosperity and Freedom that argues Rhode Island’s renewable portfolio standards (RPS) have had a negative impact on state taxpayers and ratepayers, as well as on the entire state economy. The study finds the Ocean State’s renewable mandate will result in up to $190 million in total additional costs each year. Employment levels are expected to be reduced by between 4,000 and 5,000 jobs annually as a result of the RPS mandates. Further, the sustained increase in electricity costs due to new renewable capacities, chiefly wind and solar, will be between 49 percent and 73 percent, causing a 13–18 percent sustained increase in electricity rates for consumers and up to $893 million in higher electricity payments annually. By lowering electricity prices, Benson argues, “repealing renewable power mandates will raise living standards, stimulate long-term economic growth, and create a substantial increase in net jobs.” Read more
Health Care
Research & Commentary: State ACA Exchanges an Expensive Failure
Under the Affordable Care Act (ACA), states have been allowed to choose between creating their own health insurance exchanges or joining a federal exchange. Many of the marketplaces in these exchanges have not performed well, because they have failed to draw enough providers to create real competition, have been riddled with technical issues, and have resulted in increased health care costs. In this Research & Commentary, Senior Policy Analyst Matthew Glans argues while health insurance has been made available to more people under ACA, the cost of health care continues to rise, making the new coverage unaffordable for many families. “Instead of wasting millions of dollars propping up exchanges that do not work, legislators should focus on creating health care policies that lower costs and empower individuals to control their own health care.” Read more
From Our Free-Market Friends
Reason Foundation’s Annual Privatization Report
Reason Foundation recently released its 29th Annual Privatization Report, which claims to be the world’s longest-running and most comprehensive report on privatization news, developments, and trends. The 2016 Annual Privatization Report details the latest news and analysis on privatization and government reform initiatives at all levels of government. One of the most popular sections in this year’s edition focuses on criminal justice reform. Lauren Krisai, director of Reason’s Criminal Justice Project, argues in the report, “Criminal justice reform [is] necessary but eliminating private prisons is not the answer. We have been at the forefront of opposition to America’s unjust, counterproductive, and immoral drug prohibition, advocating for smarter laws on sentencing and bail that are designed to be more just and to reduce unproductive incarceration.” Read more
Nathan Makla is a former state government relations manager for the Government Relations Department at The Heartland Institute.
