By Carol Gentry
09/13/12 © Health News Florida
In the onslaught of information we all received this week, two reports stand out as worth your attention:
--The number and rate of uninsured both went down this year nationwide, mostly because of two provisions in "Obamacare."
--Lots of health care jobs will be lost starting Jan. 1 if Congress sits on its hands.
Taking those in order, the good news on the uninsured came from U.S. Census data. As Phil Galewitz's article at Kaiser Health News reports, health economists cite two provisions in the Affordable Care Act that likely reversed the long and sad erosion in health-insurance coverage.
While most of the ACA is delayed until 2014 -- such as the requirement that all citizens sign up for health insurance or pay a penalty -- some parts of the law have already taken effect.
One is the law's requirement that health insurers allow young adults to remain on their parents' policy until age 26. This accounts for 40 percent of the improvement, according to the report.
The other part of the law they credited for the turnaround is one that bars states from making it harder to qualify for Medicaid -- the so-called "maintenance of effort" provision. During the recession, so many more families qualified for the low-income insurance program that it grew by 2 million, to over 50-million in the country.
Because of the recession, Florida's Medicaid program grew from 2.1 million to 3.2 million over the past five years. It now accounts for $21.5 billion of the just-under-$70 billion budget. State taxpayers pay just under half of the cost of Medicaid, or $9.7 billion, as the Palm Beach Post reported last month.
The Affordable Care Act would have required states to admit more low-income uninsured people into Medicaid, but Florida challenged that provision and the Supreme Court decided earlier this summer that it would be optional. Gov. Rick Scott has said he will oppose any expansion of Medicaid; the matter will come before the Legislature next session.
As Health News Florida reported last month, there are life-and-death consequences associated with this decision. Based on a study that quantified it in other states, there is a likelihood that a failure to expand Medicaid in Florida would mean 5,680 early deaths each year.
By the way, the drop in uninsured wasn't uniform, as this map shows. Florida's uninsured rate remained about the same, which isn't good.
As these data show, Florida's uninsured rate among working-age adults is second-worst in the country, at just under 30 percent.
Now, on to the other report worth your attention. If you're in the health-care field, you probably have already heard about it. It's the Budget Control Act of 2011, which mandates an automatic cut of 2 percent in payments to Medicare providers on Jan. 1 under an arcane provision called "sequestration."
Kaiser Health News reported today that a report commissioned by national organizations representing hospitals, doctors and nurses estimate the job losses at almost half a million the first year, and 766,000 over a decade.
Florida would obviously take a punch, given its Medicare demographics. The Florida Hospital Association sent out estimates that Florida will be second-hardest-hit, losing more than 55,000 health-care-sector jobs by 2021.
Of course, anyone who has followed Congress closely knows that it is unlikely its members could withstand the combined fury of all those well-heeled lobbies for one year, much less a decade. On the other hand, Congress hasn't been a beacon of cooperation lately, and forestalling the automatic cuts would require group action.
So it's anyone's guess what will happen.
--Health News Florida, which covers health policy in the public interest, is part of WUSF Public Media. Contact Editor Carol Gentry at 727-410-3266 or by e-mail.