Empire State madness:  Medicaid blob keeps growing.  Created in the 1960s to serve the truly poor, the state-federal Medicaid program has gradually expanded to cover those with somewhat higher incomes; with its Essential Plan, New York aims to enroll anyone up to 250% of the poverty line.  But the state's been beyond careless in policing enrollment.  As of this September, 44% of the Empire State's population is covered — 20 points above the national average and seven points above the closest state.  That includes 60% of New York City residents.  The mismatch has been building over the years, Hammond finds:  Over-enrollment reached 1.6 million in 2019, then zoomed to 3.6 million, thanks to Democrats' ban on checking eligibility during the pandemic.  Yet the state's failure to check since that rule expired still has the excess at about 3.4 million.

Biden and Harris Raided Medicare to Fund Green New Deal:  Premiums Are Now Set to Spike.  When Democrats rammed through the Inflation Reduction Act during the days they controlled all of Washington, D.C., it ignited a chain reaction that led to higher Medicare costs for America's senior citizens.  "Nearly two years after its passage, the IRA has diverted nearly $260 billion from the projected Medicare 'savings' to pay for special interest handouts like large tax credits for costly electric vehicles, enormous subsidies paid to big health insurer-PBM corporations, and funding health care programs for illegal immigrants," Ron Fitzwater, Chief Executive Officer of the Missouri Pharmacy Association, wrote in an Op-Ed in the Missouri Times.  "The Biden-Harris administration is not protecting Medicare; they're stealing from it," he wrote.

CBO: Medicaid Spending on Illegal Aliens Has Cost Taxpayers over $16.2 Billion Under Open Border Czar Harris.  Last week, the nonpartisan Congressional Budget Office (CBO) released its analysis of the cost to taxpayers of Vice President Kamala Harris' open border agenda on the Medicaid program.  CBO estimates that the Biden-Harris Administration's open border agenda cost federal and state taxpayers more than $16.2 billion to provide Medicaid-funded emergency services to illegal aliens since taking office.  This is a staggering increase of 124% compared to the same period under the Trump Administration.  This analysis responds to a request from House Budget Committee Chairman Jodey Arrington (R-TX) calling on CBO to produce an analysis of Medicaid spending on emergency services for illegal aliens.

To 'Empower Patients' — First Dispel Seven Myths.  [#1]  Cost is not spending.  A recent headline proclaimed, "healthcare costs are expected to jump by 9% in 2025."  But this isn't about costs — it's about spending.  The distinction is crucial as we evaluate Harris's Medicare for All initiative, which, while well-intentioned, risks inflating spending without addressing the underlying inefficiencies that drive these numbers.  The U.S. spent $4.8 trillion on healthcare in 2023, but about half of that wasn't on actual care — it was on the bloated bureaucracy that Harris's plan would likely expand rather than streamline.  The resources needed to produce health care services — the true cost — vastly differ from the inflated spending figures driven by administrative bloat.  Real reform requires understanding and addressing this difference, not conflating the two.

Biden-Harris administration using taxpayer money to mask Medicare premium hikes before election: critics.  In a move critics say is designed to shield the Biden-Harris administration from election fallout, the administration has leveraged taxpayer funds to mask upcoming increases in Medicare premiums.  Under the Inflation Reduction Act (IRA), which was intended to cap out-of-pocket drug costs for Medicare beneficiaries, insurers are poised to significantly hike monthly premiums, with average bids for Part D plans expected to triple by 2025.  In response to potential voter backlash, the Centers for Medicare and Medicaid Services (CMS) rolled out a three-year "demonstration project" to subsidize these premiums, aiming to keep them artificially low.  However, despite the appearance of relief, some critics are saying that taxpayers will fund a dramatic increase in subsidies — from $30 per recipient per month in 2024 to $142.70 in 2025 — raising concerns about the long-term impact on government spending and debt.

We're in an Election Year, and Joe Biden Has Decided to Cut Medicare Advantage Benefits.  The Biden administration somewhat quietly announced cuts to next year's base payments to Medicare Advantage plans, adding concerns to an already unstable economic environment.  According to multiple reports, the administration will be decreasing that base pay by 0.16 percent, which may not seem like much, but it can have a big impact on enrollees. [...] It's not the first time his administration has made the call to do it, and we've known for a while another round was coming.  But now they've made it official.

GOP House Members Push Back on Biden Administration's Continued Efforts to Force 'Medicare for All'.  Radicals within the Biden administration's bureaucratic state are out of control.  We've got Lina Khan at the Federal Trade Commission harassing businesses with frivolous and poorly-thought-out lawsuits, Rohit Chopra at the Consumer Financial Protection Bureau worrying about "junk fees" and overstepping his authority, Julie Su at the Department of Labor pushing through a rule that will outlaw independent contracting nationwide, and Chiquita Brooks-Lasure at the Centers for Medicare and Medicaid Services gutting the popular Medicare Advantage program as part of an attempt to drive the country toward "Medicare for All."

A Proposal to Fix Medicaid.  In 1965, President Lyndon Johnson signed into law legislation that officially brought the United States government into the business of providing health care. [...] Medicaid is often referred to as health care insurance for the poor, but that is a misnomer. [...] Medicaid is a welfare program, where underprivileged individuals pay no premium and receive "free" government-subsidized health care. [...] Total Medicaid spending in 2023 was $910 billion and is projected to be $1.2 trillion by 2031.  The federal share is around 69%, or $840 billion.  At the federal and state levels, this amount of spending is not sustainable.

Shut It Down!  [Scroll down]  Get rid of the Centers for Medicare & Medicaid Services.  I know, Medicare is popular.  "Free" stuff always is.  But government's current health promises are unsustainable.  As we live longer and want the newest and best medicines, Medicare is on track to go broke.  I'm on Medicare.  I get everything my doctor suggests.  I never even ask about price.  That's insane.  Medicare and Social Security take money from the young and give it to those of us who had decades to invest and save.  That's just unfair.  Let people shop for free-market plans.  Let the market work.  Once people pay their own bills, competition will drive prices down.  Health care would be less confusing and bureaucratic.

Christie: Social Security, Medicare cuts are a necessary 'political risk' in today's economy.  Former New Jersey Gov. Chris Christie (R) said it's time to take a "political risk" and consider changes to Social Security and Medicare benefits for young people.  Changes to the programs are necessary, otherwise they could run out of money for everyone in about a decade as the country faces a rising national debt, the presidential candidate said.  "The most disgusting part of Joe Biden's State of the Union address this year was when he stood up, and he said, 'We'll all agree, right?  We're not going to do anything to Social Security?' And both sides got up and cheered," Christie said at conservative radio host Erick Erickson's conference in Atlanta on Saturday.  "[They're] a group of liars and cowards, because they know that in 10 years, Medicare will be bankrupt.  And in 11 years, Social Security will be bankrupt."

How to brazenly steal $100 billion from Medicare and Medicaid.  A nondescript suite of offices in a bland building tucked in a quiet Miami suburb seemed as good a place as any for a medical supply company to rent some office space.  But this company rented space two floors above a regional office of the U.S. Department of Health and Human Services' criminal investigative unit.  It also tried billing Medicare more than $500,000 for various medical equipment — such as braces, orthotics and wheelchairs — for patients who didn't exist.  During a routine check by HHS' Office of Inspector General, which investigates Medicare and Medicaid fraud, special agents in Florida noticed that a local company had recently changed owners and had another address in their building.  But that location didn't have any actual employees.

Becerra threatens states and medical providers with loss of Medicare dollars if they don't provide genital mutilation surgeries.  Despite two circuit courts ruling against HHS regulations seeking to compel genital mutilation surgeries by health care providers, HHS Secretary Javier Becerra threatens to find ways around the judicial restraints.  [Tweet with video clip]  Is there any other life-altering, irreversible change that the federal government wants children to be able to decide on by themselves?  Is there any other such life-altering, irreversible decision that the federal government wants to compel medical providers to carry out, in penalty of losing Medicare funding?

Medicare-for-All: Resurrection of a Terrible Idea.  Avowed socialist Bernie Sanders along with Representatives Pramila Jayapal (D-Washington) and Debbie Dingell (D-Michigan), as well as 14 senators and 110 members of the House of Representatives are seeking to resurrect H.R. 1384, the disastrous Medicare for All National Health Insurance Bill.  They claim CoViD deaths showed the need to bring it back.  Further, they assert 15 million Americans otherwise will lose Medicare coverage, that the bill would save $650 billion, lower drug costs, reduce administrative cost and hassle, and improve access to care.  Every claim is false.  It is now clear the number of deaths directly attributable to CoViD was greatly inflated, but whatever the number, lack of insurance coverage played no role.  National health insurance, viz., H.R. 1384, would thus have no impact.  There is absolutely no basis for the claim that 15 million will lose Medicare coverage.  If not, why would patients need H.R. 1384?  The claim that Medicare-for-All will save money is falsehood, propaganda, or to use favored progressive phraseology, disinformation.

Medicare For All: This Idea Has To End.  Sen. Bernie Sanders is still promoting Medicare for All to "solve" several problems with the current health care system.  What are those problems?  Cost and access are the top two.  Advocates for socialized medicine schemes like Medicare for All get both wrong.  Typical framing of the cost issue shows U.S. healthcare spending relative to gross domestic product (GDP).  But, health care spending should be divided by household disposable income, which is the amount of income available to spend after taxes.  The U.S. ranks no. 1 in household disposable income in the world, and leads 2nd place by more than 20%.  Gross domestic product, in contrast, is a measure of the productivity of the economy rather than of income.  On a per-capita basis, the U.S. typically ranks between 10th and 15th place in the world, and trails countries like Luxembourg, Ireland, and Monaco (which has a per-capita GDP that is more than three times the U.S.)  Clearly, GDP is an antiquated measure developed shortly after WWII that doesn't reflect reality.

The 340B Program Is America's Safety Net Multiplier.  Without substantive changes, Medicaid and Medicare are on the path to fiscal insolvency.  Just look at the prescription drug benefit portions of each program: The ACA mandated Medicaid expansion in 2014.  In its first year, with millions of new enrollees, Medicaid Part B spent $43.2 billion on drugs.  With rebates, net spending dropped to $23.2 billion.  By 2021, gross spending ballooned to $80.6 billion, while rebates lowered net spending to $38.1 billion.  Based on prior expenditures, the 2022 Medicare Trustees Report offers a bleak picture for future Part D expenses.  In 2006, the prescription benefit plan for seniors cost the federal government $33.9 billion.  By 2014, costs more than doubled to $72.6 billion.  In 2021, expenditures reached $110.1 billion.  Estimates for 2031 outlays now come in at a whopping $198.5 billion.

Joe Biden Moves to Cut Medicare Advantage.  President Joe Biden's administration announced that it would cut Medicare Advantage, after the president has frequently claimed that Republicans want to slash Medicare and Social Security.  The Centers for Medicare and Medicaid Services (CMS) announced this week that they would cut Medicare Advantage by 1.12 percent in 2024, which is not as significant a cut as what the administration proposed two months ago. [...] Biden has proposed these cuts to Medicare Advantage as he has frequently accused Republicans of wanting to slash Social Security and Medicare as part of a potential compromise to address the coming debt ceiling deadline.

Cuts Are Coming to Social Security and Medicare Whether the Politicians Want Them or Not.  Social Security and Medicare are on an "unsustainable course" and will run out of funds by 2037. That's the conclusion reached by the General Accountability Office (GAO) and the Social Security Administration.  There is no saving these programs without massive changes.  And demagoguing the issue, as Joe Biden and the Democrats are doing, only delays the day of reckoning.  To pretend these programs don't need intervention now — right now — is to play with dynamite.  The sooner we can get started, the less pain will be inflicted on senior citizens.  Pain there will be.  In order to put these programs on the path to long-term viability, it will take political courage absent from today's politicians.

Biden's Big Lie About Social Security and Medicare.  emocrats and the corporate media have often accused former President Donald Trump of using a propaganda strategy called the "Big Lie" to convince Americans that the 2020 election was stolen. [...] Essentially, it involves relentlessly repeating a colossal lie until the public eventually comes to believe it.  It is little wonder that the Democrats and the Fourth Estate are so familiar with this strategy — they employ it themselves every election cycle.  Their Big Lie of choice is the perennial claim that the Republicans are plotting to gut Social Security and Medicare.  President Joe Biden repeated that yarn during last week's State of the Union address:  "Republicans say if we don't cut Social Security and Medicare, they'll let America default on its debt for the first time in our history."  After being loudly booed for that whopper, he went on to say, "If anyone tries to cut Social Security ... and if anyone tries to cut Medicare, I'll stop them."  This is an ironic assertion coming from a man who, as a U.S. senator, once bragged about his own attempts to cut both programs.

Report: Biden Administration Allowing Medicaid Funds to Pay for Groceries.  President Joe Biden's (D) administration is reportedly allowing states to use Medicaid for food and nutritional counseling, according to the Wall Street Journal.  The Journal reported Sunday that policy makers are trying to determine whether "food as medicine" programs can enhance health and also save money, the outlet said:  ["]A growing body of research suggests that addressing food insecurity can improve health as well as deliver savings by reducing medical visits, the need for medication, or by helping control serious illness.  The programs have also appealed to some GOP lawmakers who believe states should have more control over their Medicaid programs. ...["]

Biden's Drug Price Controls Will Kill More Patients in the Long Run.  Federal government interference has massively distorted American health care costs for decades.  In his State of the Union address on Tuesday, President Joe Biden touted how the misnamed Inflation Adjustment Act (IRA) will further warp medical care costs by "finally giving Medicare the power to negotiate drug prices."  The result is essentially putting price controls on prescription drugs.  And price controls will do for prescription drugs what they do for all other products upon which they are imposed: create shortages, queues, black markets, and rationing.  Even worse, drug price controls will have the additional baleful effect of increasing disease, disability, and deaths while simultaneously raising the total costs of health care.  How?  Because price controls substantially reduce the incentives for pharmaceutical and biotechnology companies to research, develop, and deploy innovative new medicines that would prevent and cure illnesses and cut overall costs.

Here's The Real 'Long COVID' Crisis — The One Nobody Is Talking About.  Take Medicaid.  From March 2020 through October 2022, enrollment in this program exploded by more than 20 million, according to the Kaiser Family Foundation.  That's an almost 29% increase, and it came after Medicaid enrollment had been on the decline thanks to the booming economy under President Donald Trump.  The reason for the massive increase was simple: As part of its panicked COVID response, Congress essentially banned states from kicking anyone off Medicaid, even if they were no longer eligible.  This provision lasted as long as there was an officially declared public health emergency.  The feds gave states extra money to help cover the cost.  Not surprisingly, President Joe Biden kept extending the public health emergency, which he now claims will be lifted on May 11.  The result is that more than 90 million Americans are currently getting "free" health insurance, with the costs paid for with borrowed money.  If you think the surge in Medicaid enrollment was a surprise, or an accident, you need a history lesson.

New York's swelling Medicaid rolls are helping bankrupt Brooklyn's biggest hospital.  Life, death, newborns entering the world, a CEO raking in millions, politicians calling for an investigation: all part of the drama swirling around Maimonides Medical Center, which lost a staggering $145 million last year.  It's Brooklyn's largest hospital, and newly released financials show it barely has the cash to make it through another year.  The Maimonides calamity could be seen as a soap opera, if so many patients weren't affected.  Worse, the same basic story is being repeated at hospitals everywhere that treat the poor.  Safety-net hospitals are bleeding red ink because Medicaid, the government health-insurance program, shortchanges hospitals, paying them only 67 cents for every dollar of care.  Most hospitals shift the 33% in unmet costs to the privately insured patient down the hall.  But at safety-net hospitals like Maimonides, fewer than one in five patients has commercial insurance.  These hospitals have nowhere to shift their unmet costs.  They lose money year after year.  It's also happening at Atlanta Medical Center, closing in November.

Senate panel exploring loosening tele-health rules for Medicare recipients.  Two years after the outbreak of COVID-19, healthcare continues to re-imagine new methods to deliver service to patients.  Legislators across the nation are beginning to take notice by actively working to pass legislation to provide more care at a lower cost for various patients.  On May 26, the Senate Finance Committee introduced a discussion draft addressing new mental healthcare initiative policies.  Notably, a new feature includes a "Bill of Rights" that focuses on mental health service delivery.  In addition, the draft's Bill of Rights seeks to address the requirement of an in-person visit before tele-health services may begin for Medicare patients.  However, the law has been temporarily halted due to COVID-19.

Erroneous Payments In New York Medicaid Program Just Shy Of $1 Billion.  An audit released Tuesday [4/19/2022] by New York State Comptroller Thomas DiNapoli found that the state's Medicaid program paid $965.1 million in claims over a five-year span to medical professionals not enrolled in the health insurance program.  The audit claimed that most of those errors took place during the first three years of the review.  The errors were tied to eMedNY, the claims processing system utilized by the state Department of Health to handle Medicaid payments to providers.  The system continued to pay claims to providers not certified to care for Medicaid enrollees.  Auditors found nearly $6 million in claims processed for providers that had been debarred from New York's Medicaid program.

Congress is about to rob Medicare to 'save' the Postal Service.  In the business world, low-performance departments are often audited, reformed, and — if they continue to under-perform — eliminated.  It's one of the many ways companies stay competitive — by eliminating dead weight to stay profitable and keep customers happy with high-quality service and competitive prices.  This week, the House is set to do the exact opposite.  In typical "kick the can down the road" action by our elected officials, a bipartisan group of politicians are shifting billions of dollars in retirement costs from the U.S. Postal Service to Medicare.  Supporters celebrate that USPS will remove unaffordable retirement costs from its balance sheet, thus keeping itself solvent.  What they've tried to hide is Congress's sleight of hand, which will accelerate Medicare's projected 2026 bankruptcy.

The Medicare 'free' at-home COVID virus test boondoggle.  Medicare recipients at first were left out of the "free" Covid tests that private insurers were required to provide.  Well, now us old folks are included among those able to grab 8 free tests per month. [...] With 8 tests per month x 12 months x 60 million people on Medicare, that's up to 6 billion tests per year.  At, say, $5 wholesale per test, that could be a cool $30 billion in annual revenue for the companies making them. [...] Medicare will need to pay a higher amount per test based on whatever markup it negotiates with the retail pharmacies.  How much earlier will the program go broke?

How the Feds Handcuff States to Medicaid.  During the pandemic, the number of Americans enrolled in Medicaid skyrocketed from 75 million to 90 million.  The issue?  Not everyone currently enrolled in Medicaid is eligible.  And the federal government is trying to prevent states from removing ineligible Americans from their rolls.  This costs the taxpayer serious money, explains Hayden DuBlois, deputy research director at the Foundation for Government Accountability.  "The reality is very, very disastrous for state and federal taxpayers alike, for the truly needy who are kept waiting, for other budget priorities, which are now getting more and more crowded out by Medicaid as it's just consuming so much of state budgets," DuBlois says.  "So it's really snowballed into this crisis that is quickly falling out of control."

Medicare Part B premiums for 2022 jump by 14.5% from this year, far above the estimated rise in cost.  The standard premium for Medicare's outpatient care coverage will jump by 14.5% for 2022, far outpacing an earlier estimate of 6.7%, according to the government.  The standard premium for Part B, which covers outpatient care and durable equipment, will be $170.10 next year, up $21.60 from $148.50 this year, said a senior official for the Centers for Medicare & Medicaid Services on Friday.  The program's trustees had estimated this summer that the premium would rise to $158.50. The deductible for Part B will be $233, up $30 (14.8%) from this year.

Democrat plan to bankrupt Medicare in a year.  Democrats now plan to ruin Medicare to get us all on Medicaid as part of their $3.5 trillion 'human infrastructure' bill.  The plan is for Medicare to completely cover dental, vision, hearing services, and more.  They plan to give Medicare to younger people of age 60.  Illegal aliens will receive it.  Democrats want to give it to people with lower incomes.  Medicare is a program for the elderly and disabled.  Democrats will turn it into full-on welfare.  It's part of their plan to make more people dependent on the central government.  "Democrats are ramming through a reckless new expansion of Medicare — just as it's a few years from bankruptcy," said Rep. Kevin Brady, R-Texas, in prepared remarks at a House Ways and Means Committee session on Thursday as debate began on portions of Democrats' massive legislative package.  Economic illiterate Bernie Sanders has come up with the plan.  The plan to cover the cost is to tax the rich, who already pay most of the taxes.  Everything will be at the expense of the rich and there just aren't enough of them.  The middle class will pay for it.

Why Do Doctors Go Along with COVID Panic Porn and CDC Prescriptions?  [Scroll down]  My group cared for patients of all descriptions, with roughly half of them on Medicare and another batch on Medicaid.  Both programs are ultimately managed by the feds, one of the most humorless groups on the planet.  They write a whole bunch of rules on how you have to document everything you do.  If you didn't document it correctly, it didn't happen, and you won't get paid.  But that's not the half of it.  Suppose you have one of those patients brought in by the ambulance from under the bridge.  His only clothes are the ones he's wearing, and he doesn't have two nickels to rub together.  It's more than obvious that this surgery for bowel obstruction will be a charity case.  Before Medicare, you'd simply write it off as your good neighbor duty.  Now you don't get a choice.  CMMS (the actual administrative agency) requires you to send a bill.  Twice.  Or maybe three times.  Whatever it takes to turn the bill into bad debt.  Then you have to send it to a collection agency.  Your only alternative is for your group to bring it up in its Board meeting and declare it a write-off that gets noted in the minutes.

Health firm that donated big to Biden, Dems pays $90 million for allegedly bilking Medicare.  A California health care firm whose executives and employees donated big to Joe Biden and other Democrats has agreed to pay a $90 million civil penalty to settle allegations it bilked Medicare by filing paperwork to make patients look sicker than they were.  The penalty was one of the largest ever reached in a case involving Medicare Part C fraud, government officials said.  Sutter Health, headquartered in Sacramento, Calif., agreed to pay the fine and enter into a corporate integrity monitoring agreement with the government for five years to resolve allegations it violated the False Claims Act by knowingly submitting inaccurate diagnosis codes for Medicare Advantage patients, the Justice Department announced Tuesday.

House GOP demands answers over $87B in improper spending on entitlements.  House Oversight and Reform Committee Republicans sounded the alarm Tuesday about hundreds of billions of taxpayer dollars that have been improperly spent on one of the government's largest and fastest-growing entitlement programs.  Rep. James Comer, the top Republican on the committee, sent a letter to the Centers for Medicare and Medicaid Services, which oversees Medicare and Medicaid, demanding answers about "rampant [and] improper" Medicaid payments.  Mr. Comer and the committee's other Republicans are concerned that CMS' own data shows that more than $57 billion was spent on improper Medicaid payments in fiscal 2019 and nearly $87 billion in fiscal 2020, accounting for one of every five Medicaid payments.

Libertarian group sues government over information on $143 billion in improper Medicaid payments.  The libertarian organization Americans for Prosperity Foundation is suing the Centers for Medicare and Medicaid Services to find out what it is doing about $143 billion in improper payments made by Medicaid.  The complaint asks for records on CMS's efforts to recover improper Medicaid payments and for data showing improper payment rates by states.  According to CMS, improper Medicaid payments totaled $143 billion in 2019 and 2020, rising from 14.9% of all payments in 2019 to 21.4% in 2020.  Medicaid is a joint federal-state healthcare program for the poor.  "Failing to recover $143 billion in improper Medicaid payments is an affront to hardworking American taxpayers and a threat to Medicaid's long-term fiscal stability," said Dean Clancy, a senior health fellow at Americans for Prosperity Foundation.  "More transparency and accountability is needed to ensure that CMS manages Medicaid responsibly."

California taxpayers to pay $1.3 billion to enroll more illegal immigrants in Medicaid.  California taxpayers will soon pay more in taxes to enroll more illegal immigrants in Medicaid, a plan that was part of a recently approved state budget.  Younger illegal immigrants are already enrolled in Medicaid, SNAP and other federally funded programs.  The plan proposed by California Democrats guarantees that low-income illegal immigrants older than age 50 will receive health insurance.  Coverage would take effect in 2022 and cost taxpayers $1.3 billion per year.  It follows a $213 billion taxpayer-funded plan proposed in 2019 to allow low-income illegal immigrants between the ages of 19 and 25 to enroll in Medicaid.  Democrats then estimated that adding 90,000 people to Medicaid would cost taxpayers $98 million per year.

Medicaid enrollment swells during the pandemic, reaching a new high.  The number of Americans relying on Medicaid swelled to an apparent all-time high during the coronavirus pandemic with nearly 74 million Americans covered through the safety-net health insurance, new federal figures show.  From February 2020 through January, Medicaid enrollment climbed nationwide by 9.7 million, according to a report, based on the most recent available data, released Monday by the Centers for Medicare and Medicaid Services.  Some people signed up last year as the pandemic's economic fallout took away their jobs, income and health benefits.  But according to federal health officials and other Medicaid experts, much of the increase is because of a rule change that was part of the first coronavirus relief law adopted by Congress last year.

Biden's Plan To Raid Medicare Shows His Callous Disregard For Math And Voters.  [Scroll down]  We've seen this gimmick before.  Obamacare raided Medicare, to the tune of $716 billion over a decade, to pay for that law's new entitlements.  Kathleen Sebelius, then the Secretary of Health and Human Services, infamously testified before Congress that this $716 billion could "both" save Medicare while funding Obamacare.  Only Washington politicians could claim with a straight face to spend the same money twice.  President Biden, who has spent the last half-century in Washington, wants to do just that.  His budget takes a page out of the Obama playbook, raising Medicare taxes while raiding those additional funds from Medicare to pay for his Obamacare expansion.

Doctor accused making $800k-plus from health care fraud.  The federal government is suing a local doctor to recover more than $800,000 it says he was paid after fraudulently billing Medicare and Medicaid.  In a civil complaint filed in U.S. District Court in Greenbelt, the Department of Health and Human Services says it wants to recover $814,315 that Dr. Abdul Fadul allegedly collected from the two programs through fraud.  The complaint, which also names one of his clinics, the Cardio Vascular Center in La Plata, as a defendant, says Fadul billed Medicare and Medicaid for procedures that weren't performed thousands of times between 2004 and 2005.  Fadul ran the scheme, the complaint says, by setting up billing systems at the center that automatically rendered bills for more tests than a physician performed.

H.R. 3 Ignores What Mature Adults Want from Their Healthcare System.  Congress is once again tossing around a piece of legislation that will do more for big government than for Americans.  While intended to lower out-of-pocket costs for prescription drugs and treatments, H.R. 3 could take away mature adults' ability to make their own healthcare decisions and put it in the hands of the federal government.  Government interference not only imposes on the patient-provider relationship, but it also puts mature adults' health at risk by restricting what treatments should be at their finger tips.  Millions of retirees rely on the Medicare program because it provides access to various treatments for chronic conditions, such as cancer, Rheumatoid Arthritis, and other serious illnesses, and the flexibility to personalize these treatments based off their individual needs.  However, by referencing foreign countries' prices and healthcare systems, policymakers could import the same access issues patients abroad face, leaving Americans with fewer treatments to choose from.

Texas Sues To Block 'Biden's Power Grab' To Strip State Of Medicaid Waiver.  The Biden administration was slapped with a lawsuit on Friday after Texas Attorney General Ken Paxton launched a suit countering changes to the state's federally funded portion of Medicaid last month.  In April, the administration rescinded a Trump-era eight-year extension to provide billions of dollars in federal funds annually for Texas' uninsured residents, which was set to expire next year.  While the move does not revoke healthcare funding through 2022, Paxton called it an "unlawful abuse of power aimed at sovereign states."  "The Biden Administration cannot simply breach a contract and topple Texas's Medicaid system without warning," he said in a Friday statement.

Most Medicare enrollees could get insulin for $35 a month.  Many Medicare recipients could pay less for insulin next year under a deal President Donald Trump announced Tuesday [5/26/2020] in a pivot to pocketbook issues important in November's election.  "I hope the seniors are going to remember it," Trump said at a Rose Garden ceremony, joined by executives from insurance and drug companies, along with seniors and advocates for people with diabetes.

Justice Department sues Anthem for alleged diagnosis fraud scheme totaling millions of dollars.  The Justice Department sued Anthem, one of the nation's largest health insurance providers, over an alleged fraudulent scheme to inflate diagnosis numbers to scam Medicare out of millions of dollars a year.  It is among the largest Medicare fraud lawsuits yet.  Investigators said that they filed this civil lawsuit because Anthem "falsely certified the accuracy of the diagnosis data it submitted to the Centers for Medicare and Medicaid Services for risk-adjustment purposes under Medicare Part C and knowingly failed to delete inaccurate diagnosis codes" between 2014 and 2018.

The federal government issued $175 billion in 'improper payments' in 2019.  Roughly $121 billion (69 percent) of the waste was concentrated in just three programs:  Medicaid ($57.4 billion), Medicare ($46.2 billion), and Earned Income Tax Credit (EITC) ($17.4 billion).  In other words, Medicaid accounted for more waste than all of the other government programs (aside from Medicare and EITC) combined.  This is another reason why it would be better to convert Medicaid into a direct subsidy to those in need, much like food stamps, rather than funneling it through corrupt managed care.  The rate of improper payments for Medicaid accounts for a whopping 13.5 percent of the entire cost of the program, as compared to a 6 percent improper payment rate for the food stamp program.  The same principle applies to the Children's Health Insurance Program (CHIP), which is also funneled through the managed care cartel and racked up improper payments ($2.7 billion) composing 15 percent of the program's budget.

Why Canadian-Style Health Care Would Not Cut Costs in America.  One common claim by supporters of single-payer health care is that it would ultimately save money while providing universal health coverage for all.  Having one centralized bureaucracy, they say, would eliminate complicated administrative inefficiencies that waste enormous sums of money each year.  As reported by Time, researchers behind a new study believe that by adopting Canada's single-payer health care system, the United States would be able to save enough money to more than pay for universal coverage.  This is a bold claim, considering that the United States wastes so much money on health care administration despite, or perhaps because of, Medicare being the largest single payer of national health expenditures.

Improper Medicaid payments top $75B: More than entire food stamp program.  $75 billion.  That is not the cost of Medicaid.  That is merely the cost of improper payments from the Medicaid program, accounting for roughly 20 percent of the total program tab, according Brian Blaze and Aaron Yelowitz writing in the Wall Street Journal.  Prior to the Obamacare expansion of Medicaid incentivizing states to flood their rolls with Medicaid recipients, the improper payments accounted for roughly six percent.  Now, just the official fraud and waste of Medicaid amount to more than the entire cost of the food stamp program!  In many ways, the entire Medicaid program is one big fraud perpetrated on the American taxpayer, designed to serve as a cash cow for the insurance cartel and major hospital and health care administrator networks.

Has Elizabeth Warren Really Thought about Her Tax Plan?  I have a friend with a chronic back problem that needed an operation.  She got a run-around from her Medicare program for years and finally paid $13,000 to have the operation done privately.  My parents were briefly resident in a Medicare nursing home.  It was terrible, with demented people wandering around screaming, etc.  When they moved to a non-Medicare nursing home, the difference was between a zoo and a 4-star hotel.  The cost was only marginally higher.  However, doctors declined to visit the patients in the nursing home because the reimbursement was extremely low under Medicare.  If you go to a medical facility that mostly deals with seniors, such as an eye clinic, you will find assembly-line medicine:  long waits and brief visits to the doctor.  If you have a problem with a private insurance company, it is feasible to sue it, and the company fears that.  If you have a problem with Medicare, forget about it.

Biden:  Warren's A Liar.  Democratic presidential candidate Joe Biden on Friday [11/1/2019] accused Sen. Elizabeth Warren (D., Mass.) of making up the numbers for her recent Medicare for All cost estimate.  Biden went on the attack after PBS host Judy Woodruff repeated the Warren campaign's estimate that government run health care would only cost about $20 trillion.  "She's making it up," Biden said.  "She's making it up.  Look, nobody thinks it's $20 trillion.  It's between $30 and 40 trillion dollars.  Every major independent study that's gone out there — that's taken a look at this, there's no way — even Bernie, who talks about the need to raise middle class taxes — he can't even meet the cost of it."

11 people charged with defrauding Minnesota Medicaid program.  Minnesota's attorney general's office says it has charged 11 people with defrauding the state's Medicaid program of more than $800,000.  Attorney General Keith Ellison said in a statement Friday that the charges involve nine different cases.  The announcement comes on the heels of an investigation into a northern Minnesota care center that bilked Medicaid out of nearly $2.2 million.  Among those charged Friday were 33-year-old Kaldeq Yusuf, of Hopkins, and 39-year-old Abdifatah Ali, of Eagan, who owned and managed Diversity Home Health Care, Inc.

Feds Bust Huge ($258 million!) California Medicare/Medicaid Fraud Networks.  Perhaps even worse than the millions of taxpayer dollars lost to these alleged cheats — medical doctors and other medical professionals — is the fact that they diagnosed people with major illnesses that the patients didn't have!

Obama Judge:  Medicaid Must Pay for "Sex Change".  If you're on Medicaid, the program won't cover your root canal or a nose job that could make you feel better about yourself.  But if you want the body alteration known as "gender-reassignment surgery" so you can feel better about yourself, taxpayers must now foot the bill — according to an Obama-appointed judge.

One Federal Department [is] Now Spending $100 Billion Per Month.  For the first time in our nation's history, there is now a federal department spending an average of more than $100 billion per month.  No, it is not the Department of Defense, which is charged with the core federal responsibility of defending us from foreign enemies.  It is the Department of Health and Human Services, which, if Democratic Sen. Bernie Sanders of Vermont has his way, will run the "Medicare for All" program.  As it now stands, HHS runs Medicare for many and Medicaid for more.

Why Are Democrats So Incredibly Ignorant About 'Medicare for All'?  Ask Democrats whether they support "Medicare for All" and the vast majority will say yes.  Ask them what's actually in it, and most don't have a clue.  That, at least, is what a new survey shows.  The Kaiser Family Foundation asked multiple questions about Medicare for All, and broke down the findings by partisan affiliation.  You'd expect that Democrats, who have been calling for single-payer for decades, and now have two bills in Congress that would achieve it, would be the most well-informed of anyone.  It turns out, they are the worst informed.

Single-Payer Health Care Will Increase Fraud, Corruption.  It seems fitting that the Democratic National Committee chose Miami to host the first debates of the 2020 presidential campaign.  Given that many of the candidates appearing on stage have endorsed a single-payer health care plan, the debates' location epitomizes how government-run care will lead to a massive increase in fraud and corruption.  In South Florida, defrauding government health care programs doesn't just qualify as a cottage industry — it's big business.  In 2009, "60 Minutes" noted that Medicare fraud "has pushed aside cocaine as the major criminal enterprise."  One former fraudster admitted that likely thousands of businesses in the Miami area alone were defrauding Medicare.

Requiring People To Work To Get Medicaid Went Really Well In Arkansas Until A Judge Stopped It.  Since 2000, the number of able-bodied adults using Medicaid quadrupled nationwide.  The program is one of the chief costs for state governments, squeezing other priorities.  When last summer Arkansas became the first state to require Medicaid recipients to work in exchange for taxpayer-provided health care, welfare advocates would have had you believing the world was ending:  health coverage for the needy was being slashed, the reporting process was too complex, and those who lost coverage didn't even know about the requirement.  On and on the hysteria went.  But those apoplectic claims were far from reality.  Arkansas' work requirement was a big step towards restoring the state Medicaid program to its objective.  It was saving taxpayers money, freeing up resources for the truly needy, and — notably — changing people's lives for the better.

The Stupid Party.  [Scroll down]  Take, for example, their support for Alexandria Ocasio-Cortez' Green New Deal and its promise of Medicare For All.  Yes, as I've written previously, it's true that Medicare's trust fund for hospital care will run out of money in 2026.  And yes, according to the Medicare 2018 Annual Report, the trust fund is already in the red for $4.5 trillion of unfunded obligations.  And yes, that means Medicare is effectively bankrupt even under the current situation in which it only covers senior citizens.  And yes, yes, that means it's beyond stupid to promise Medicare For All without even talking about how to fix Medicare For Seniors.

Unexpectedly: Medicare and Social Security Circling the Drain.  Seven years, at most, is all we have.  Remember the last time Republicans tried to address the looming entitlement crisis?  Do you recall how the Democrats responded?  Did they propose common-sense reforms?  Raising the eligibility ages of recipients?  Something, anything to attack the imminent crisis?  Uhm, no.  You got it.  They aired nonstop commericals of Paul Ryan — then a key Republican helping George W. Bush try to reform these programs — pushing Granny off a cliff.  Here's the bottom line.  This crisis is entirely on the Democrats' hands.

Why Medicare for All is a rotten deal for most.  President Barack Obama made a stunning policy shift Friday, endorsing Medicare for All — a single-payer health system for the nation.  Most Democrats contending for the 2020 presidential nomination and many Dems vying for congressional seats this fall are backing it, too.  Beware:  They're pulling a bait-and-switch.  The phrase Medicare for All sounds as American as apple pie.  A new Reuters poll shows 70 percent of Americans respond to it favorably.  Yet the public isn't getting the truth about what it means.  The actual plan these Democrats are pushing doesn't look anything like Medicare.  They're slapping the Medicare label on what will be dangerously inadequate health care.

Judge's Meddling in Kentucky Medicaid Causes Benefit Cuts.  Before federal Judge James Boasberg vacated Kentucky HEALTH, a Medicaid demonstration project approved by HHS in January and due to be launched on July 1, he should have taken the time to learn about its benefits.  State officials tried to tell him that non-medical vision and dental coverage were available only through that project, and that these benefits would have to be cut if he struck it down.  But the Obama-appointed judicial hack was so intent on killing its "community engagement" provision that nearly half a million Kentucky residents became collateral damage in the Democratic war against work.

The bad news on entitlements piles up.  The trustees for the Social Security and Medicare trust funds released their annual reports last week.  And the takeaway?  Despite a strong economy, both programs have large and growing financial deficits.  Unfortunately, the gap between spending and revenue for these programs is likely even larger than the official projections show because of assumed but unrealistic cuts in medical care payment rates and the persistently low birth rates of recent years.

Medicare Is Broke But the Dems Want to Expand It.  On Tuesday [6/5/2018] the Democrats received an unpleasant reality check.  The California primaries, which they believed would provide the impetus for a nationwide "blue wave" destined to drown the GOP's congressional majorities, left them pathetically grateful not to be locked out of key races in November.  One of the rocks upon which their electoral fantasies foundered was their irresponsible support of Medicare-for-All, a single-payer health care plan that would dramatically expand a government program that is already on the verge of bankruptcy.  The just-released Medicare Trustees report indicates that the traditional program for the elderly will go broke in less than ten years.

Medicare Is On Death's Door ... After ObamaCare Supposedly Saved It.  The latest official report on Medicare's financial status says it will be insolvent in 2026 — just eight years from now.  So much for the promise that ObamaCare had fixed that program for the long term.

Medicaid Expansion Will Harm the Poor.  Like all Democratic programs, it's about power and money.  Obamacare incentivizes expansion states to shift Medicaid's focus to able-bodied adults by paying over 90 percent of their coverage costs, while the federal share of costs for traditional Medicaid patients remains below 60 percent.  This does not mean, however, that doctors and hospitals will receive more money.  Providers will continue to be paid less by Medicaid than the cost of treatment whether the patients are expansion or traditional enrollees.  The extra money will go to political slush funds and insurance companies.

New Hampshire Becomes Fourth State to Require Work for Medicaid.  New Hampshire became the fourth state to implement work requirements — behind Arkansas, Indiana, and Kentucky.  Under New Hampshire's waiver, able-bodied adults without dependents aged 19 to 64 will have to complete 100 hours a month of employment, education, job skill training, or community service to obtain Medicaid.

Trump Action Will Reduce Immigrant Medicaid Enrollment.  Many Americans are angry about the large percentage of their tax dollars being doled out to immigrants in the form of public assistance, particularly at a time when federal budget deficits are skyrocketing. [...] Medicaid, for example, costs the taxpayers $565 billion annually and, according to a widely cited 2017 report by the National Academies of Sciences, Engineering and Medicine, 46 percent of immigrant households receive Medicaid benefits.  The Trump administration is therefore taking action to reduce the number of non-citizens who enroll in Medicaid.

California Commits Massive Medicaid Fraud.  California is indeed the Golden State where Medicaid is concerned.  The HHS Office of Inspector General (OIG) has found that, by exploiting Obamacare's expansion of the program, California has enrolled hundreds of thousands of ineligible adults in Medicaid.  Consequently, the state has bilked the federal government out of more than $1 billion in funding to which the state was not entitled.  Indeed, these figures probably understate the amount of money that California officials have fraudulently extracted from the taxpayers.

'Medicare Extra' Delivers Socialized Medicine In Slow Motion.  The Center for American Progress, one of the nation's most influential left-wing think tanks, just released a plan to repeal Obamacare.  Unfortunately, the proposal would replace the law with something even worse — single-payer health care.

Medicaid recipients find $1 premiums too confusing to pay.  Imagine if you were poor and you got Medicaid, heavily subsidized by the taxpayer, but you had to pay between $1 and $15 a month in premiums.  Wouldn't that be confusing?  For many people, it is so confusing that they don't understand how to pay and end up being kicked off Medicaid.

New York to guarantee Medicaid for 'Dreamers' no matter what happens in D.C..  New York will continue to provide some illegal immigrant "Dreamers" with access to government-run Medicaid insurance no matter what happens in Washington, Gov. Andrew Cuomo announced Tuesday [1/23/2018].  There are 42,000 people living in New York who are currently protected by the Obama-era DACA deportation amnesty, which makes them eligible for Medicaid in the state.  Mr. Cuomo said given the uncertainty over the program in Washington, he wanted to guarantee the migrants health coverage.

Nine more states ready to require jobs for Medicaid enrollees.  Last week, Kentucky became the first state to require work for some Medicaid beneficiaries.  The Trump administration approved a proposal from Kentucky that would require Medicaid beneficiaries to work, volunteer or take classes as a condition of being enrolled in the program.  But the state is unlikely to be the last.  Arizona, Arkansas, Indiana, Kansas, Maine, New Hampshire, North Carolina, Utah, and Wisconsin have submitted their own proposals, though some will have to work with federal officials to make sure their requests fit the guidelines laid out Thursday [1/11/2018] by the Trump administration.  States have varying requests, according to a Washington Examiner review of Medicaid waiver applications filed to CMS.

No, Medicaid Work Requirements Aren't Racist or Cruel.  When the Centers for Medicare & Medicaid Services (CMS) announced that states could experiment with work requirements and volunteer community service as prerequisites for Medicaid eligibility, the melodramatic response from the Democrats and their media allies was as predictable as it was mendacious.  House Democratic Leader Nancy Pelosi summed up the position of her congressional accomplices by vehemently denouncing the new CMS policy as "mean-spirited," "cynical," and "spiteful."  And USA Today captured the gist of the "news" coverage with a work of fiction titled, "Medicaid work requirements are a throwback to rejected racial stereotypes."

Kentucky to add Medicaid work requirement; first state to follow Trump plan.  Kentucky received the green light Friday [1/12/2018] to require many of its Medicaid recipients to work in order to receive coverage.  The Bluegrass State thus becomes the first state to act on the Trump administration's unprecedented change that could affect millions of low-income people receiving benefits.  Under the new rule, adults age 19 to 64 must complete 80 hours of "community engagement" per month to keep their care.  That includes working a job, going to school, taking a job-training course or volunteering.

Illinois' home health care industry rife with fraud, tainted by unscrupulous physicians.  For adults hobbled by disability or disease who want to stay out of nursing homes or hospitals, home health care services can be a godsend.  For criminals who want to tap into federal Medicare dollars, it can represent a loosely guarded bank vault.  A Tribune investigation reveals that Illinois public health regulators proved unprepared for a surge in new home health care companies, doling out too many home health licenses too fast and failing to provide meaningful oversight.  Even today, most anyone can own a home health care business for a $25 license fee — no criminal background check required.

Nurse sentenced to prison for $17.1 million in Medicare fraud.  A Fort Bend nurse was sentenced Wednesday [11/27/2017] to 10 years in prison for his role in a Medicare fraud scheme that deprived the government of $17.1 million over seven years.  Eric Ugorji, a registered nurse who relocated to the U.S. from Nigeria 25 years ago, made a lengthy statement to U.S. District Judge David Hittner expressing remorse for his actions and begging the court's mercy.  "I was a good nurse and I made terrible, bad business mistakes," said Ugorji, who is 48.  "Your honor, I didn't intend to defraud Medicare."

The Editor says...
How does someone end up with $17 million unintentionally?

Maine, Medicaid, and the Gruber Principle.  Maine experimented with Medicaid expansion 15 years ago, and it took the state a decade to recover from the hangover.  Nonetheless, a majority of Maine's voters approved another Medicaid expansion last Tuesday.  And it is no exaggeration to say that it took Maine 10 years to recover from its last Medicaid expansion.  That debacle, initiated in 2002 by former Governor Angus King — who has since fled to D.C. where he now "serves" as a U.S. Senator — damaged Maine's finances so badly that there was no money to pay hospitals for services rendered to Medicaid patients.  It wasn't until 2013 that the state was able to pay off that debt, whereupon Obamacare advocates began pimping expansion again.

Medicaid Innovation Should Be Based On Competition And Choice.  The negative human impact and economic costs of unchecked expansion of Medicaid is becoming clear, and state leaders are now left grappling with increased costs, finite resources and hard decisions.  One such state is Massachusetts, where the state's previous governor, Deval Patrick, greatly expanded Medicaid eligibility, seemingly without regard to what future elected officials, like current Gov. Charlie Baker, would now be forced to confront.  Gov. Baker is right to try to fix the problem, but increasing competition and choice for patients is the only approach that will work.  In Massachusetts, enrollment for Medicaid and the Children's Health Insurance Program has increased by more than 350,000 people since Gov. Patrick ushered in expansion of the programs following the passage of ObamaCare, and the state is now forced to cover 1.6 million individuals.  As the number of covered individuals and benefits afforded them have increased, obviously so have the costs.

Medicaid for All Would 'Bankrupt the Nation,' Warns Bernie Sanders — In 1987.  Sen. Bernie Sanders (I-Vt.) introduced new legislation yesterday [9/13/2017] to expand Medicare to everyone in the United States.  The bill, which came with 15 Democratic co-sponsors, envisions universal coverage, paid for by tax increases, that would be far more generous than what is offered by any other first-world government-run health care system offers.  Notably absent from Sanders' proposed single-payer system was a detailed plan to pay for it.  The senator said he would lay out the tax hikes necessary to fund his new system in separate legislation.  That may be because enthusiasm for single payer tends to die down pretty quickly once people get a sense of what sort of tax increases would be necessary to fund it.  An Urban Institute analysis of a previous version of Sanders' plan estimated that it would cost $32 trillion over a decade.

Are You Sure You Want Medicare for All?  In 2001, the Congressional Budget Office warned that spending on retirees — specifically Social Security and Medicare — "will consume... almost as much of the economic output in 2030 as does the entire federal government today."  "Notwithstanding recent favorable developments," the Medicare Trustees conceded in their report this year, "current-law projections indicate that Medicare still faces a substantial financial shortfall that will need to be addressed with further legislation."  The report foresees that "the trust fund becomes depleted in 2029."  In actual dollar amounts, says Michael D. Tanner of the Cato Institute, "Medicare faces unfunded liabilities approaching $48 trillion.  And, if we return to double digit health care inflation, we could see Medicare's liabilities swell to more than $88 trillion."  This is the regular Medicare system that we have now, targeted at the growing but limited population of retirees.  Medicare for All would take this existing system's promises, costs, and unfunded liabilities, and apply them to the whole country.

Social Security And Medicare Are In Worse Shape Than You Think.  The Social Security report finds that the "trust fund" will run out of money in just 17 years.  The news only gets worse from there.  The program's unfunded liability over the next 75 years is now $12.5 trillion, which is up from $11.4 trillion last year and $4.7 trillion a decade ago.  In other words, Social Security's long-term unfunded liability has increased by 166% in the span of 10 years.

The Great American Rip-Off.  Ask a politician how he wants to balance the budget and, nine times out of ten, he'll give you a politician's answer:  cutting "waste, fraud, and abuse."  Normally, the correct response to this is contempt and mockery:  What drives federal spending isn't office supplies walking out the back door with a rogue secretary at the Merit Systems Protection Board — what drives federal spending is Social Security, Medicare, and Medicaid.  And you know where there's a lot of waste, fraud, and abuse?  Social Security, Medicare, and Medicaid.  Identifying small-ball efficiencies at obscure federal agencies would not do very much to get federal spending under control, but getting a grip on the shenanigans that plague the major entitlements — especially the health-care entitlements — could mean substantial savings, "substantial" here meaning hundreds of billions of dollars.

Obamacare Is Killing People.  Opiate deaths have been on the steady increase, with fatal drug overdoses tripling since 1999.  Much of that growth has come in the last few years.  From 2010 to 2015, the opiate death rate in the U.S. increased from 12.3 per 100,000 population in 2010 to 16.3 in 2015, according to a study by the Centers for Disease Control.  Of the 52,404 fatal US drug overdoses in 2015, 63 percent of them involved an opioid.  Obamacare's Medicaid expansion and individual insurance exchanges both went into effect in 2014.  In just the next year, the fatal opioid overdose rate increased by 15.6 percent, CDC found.  Correlation, of course, is not causation, but the pattern is persistent.  The increase isn't uniform.  It's clearly happening in 30 states, most of which accepted the Medicaid expansion.  But overdose deaths have remained steady in 19 other states, according to the CDC.

Obamacare Robs Medicare of $716 Billion to Fund Itself.  [Scroll down]  In total, Obamacare raids Medicare by $716 billion from 2013 to 2022.  Despite Medicare facing a 75-year unfunded obligation of $37 trillion, Obamacare uses the savings from the cuts to pay for other provisions in Obamacare, not to help shore up Medicare's finances.  The impact of these cuts will be detrimental to seniors' access to care.  The Medicare trustees 2012 report concludes that these lower Medicare payment rates will cause an estimated 15 percent of hospitals, skilled nursing facilities, and home health agencies to operate at a loss by 2019, 25 percent to operate at a loss in 2030, and 40 percent by 2050.  Operating at a loss means these facilities are likely to cut back their services to Medicare patients or close their doors, making it more difficult for seniors to access these services.

74,531,002 Enrolled in Medicaid/CHIP.  As of April, there were 74,531,002 people enrolled in Medicaid and the Children's Health Insurance Program as of April, according to the latest data released by the Centers for Medicare and Medicaid Services.  That is up 16,705,235 in the 49 states that reported their Medicaid/CHIP enrollment numbers for both the July-to-September period of 2013 (the last quarter before the Obamacare exchanges opened) and this April.  The 74,531,002 enrolled in Medicaid/CHIP as of April includes the numbers for all 50 states and the District of Columbia.

Democrats Can't Stop These Medicaid Reforms From Happening.  Trump's budget called for reforms of Medicaid, food stamps and other entitlement programs with a goal of moving as many as possible out of these government programs and toward jobs and self-reliance.  Chief among the changes is a push to add work requirements to able-bodied adults as a condition of getting benefits.

Medicaid Blows $109 Billion on Promotional "Demonstrations".  Medicaid is administered by states and is jointly funded by the federal government and states.  Millions of low-income adults, children, pregnant women and people with disabilities are covered under the program, which cost American taxpayers an eye-popping $545.1 billion in 2015, according to government figures.  A little-known section of the Social Security Act gives the Secretary of Health and Human Services (HHS) authority to approve experimental, pilot or demonstration projects that promote the objectives of Medicaid and its counterpart, the Children's Health Insurance Program (CHIP), as if they really need to be further publicized.  The purpose of the demonstrations, according to the Social Security Act, is to expand eligibility to individuals who are not otherwise Medicaid or CHIP eligible, provide services not typically covered by Medicaid and use innovative service delivery systems that improve care, increase efficiency and reduce costs.  Ultimately, the goal is to increase and strengthen states' overall coverage of low-income individuals, enhance access to provider networks that serve low-income populations and boost the efficiency and quality of medical care through "initiatives" that "transform service delivery networks."  This could mean anything.

Hard Truths about Health Care.  Medicare is not a success. [...] Medicare is undoubtedly popular, especially with its beneficiaries.  It should be.  The average two-earner couple pays about $150,000 over their lifetime in Medicare taxes and premiums, while collecting almost $450,000 in benefits.  Jackpot!  But that disparity is one of the reasons why Medicare is running some $58 trillion in the red, after totaling all projected future liabilities.  A program facing more long-term debt than most countries probably isn't begging to be expanded.

In 24 States, 50% or More of Babies Born on Medicaid; New Mexico Leads Nation With 72%.  In 24 of the nation's 50 states at least half of the babies born during the latest year on record had their births paid for by Medicaid, according to the Kaiser Family Foundation.  New Mexico led all states with 72 percent of the babies born there in 2015 having their births covered by Medicaid.  Arkansas ranked second with 67 percent; Louisiana ranked third with 65 percent; and three states — Mississippi, Nevada and Wisconsin — tied for fourth place with 64 percent of babies born there covered by Medicaid.  New Hampshire earned the distinction of having the smallest percentage of babies born on Medicaid.  In that state, Medicaid paid for the births of only 27 percent of the babies born in 2015.

Seniors: Take Obamacare repeal/replace one step further.  With many people today wanting Republicans to keep their promise to repeal and replace Obamacare, one seniors group is making an additional request.  Besides pushing for end of the so-called "Affordable Care Act," 60 Plus Association also wants Republicans to keep their promise and restore money cut from Medicare.  "They took funds out of the Medicare program to pay for Obamacare," 60 Plus Association Chairman Jim Martin asserts.  "Who got hurt by that? ... Senior citizens."  Martin pointed out that many hospitals in rural America have closed in recent years — due, in part, to the cuts to Medicare.

Federal judge blocks Texas' move to kick Planned Parenthood out of Medicaid.  A federal judge on Tuesday [2/21/2017] said Texas can't remove Planned Parenthood from Medicaid, issuing a temporary block of the state's ouster that will allow the provider to continue to care for patients through the program.  U.S. District Court Judge Sam Sparks issued a preliminary injunction and said the state didn't have grounds to conclude that Planned Parenthood "warranted termination from the Medicaid program as unqualified."  His temporary block will stay in place until a full trial is scheduled, argued and decided.

Study Finds Medicaid Has No Effect on Measured Health Outcomes.  A randomized-controlled study published in the New England Journal of Medicine by a group of the nation's top health policy scholars has found that Medicaid has no measurable effect on any of the objectively measured physical health outcomes the study examined.  In its second-year results, the Oregon Health Insurance Experiment, which randomly selected 10,000 people in Oregon to get Medicaid (only about 6,300 actually got the benefit), and then compared them with a randomly selected control group, found that those who got Medicaid did not on average have healthier blood pressure, cholesterol levels, or diabetic blood pressure control than those who did not get Medicaid.

Medicare failed to recover up to $125 million in overpayments, records show.  Six years ago, federal health officials were confident they could save taxpayers hundreds of millions of dollars annually by auditing private Medicare Advantage insurance plans that allegedly overcharged the government for medical services.  An initial round of audits found that Medicare had potentially overpaid five of the health plans $128 million in 2007 alone, according to confidential government documents released recently in response to a public records request and lawsuit.  But officials never recovered most of that money.  Under intense pressure from the health insurance industry, the Centers for Medicare and Medicaid Services quietly backed off their repayment demands and settled the audits in 2012 for just under $3.4 million — shortchanging taxpayers by up to $125 million in possible overcharges just for 2007.  The centers are part of the Department of Health and Human Services.

Why Medicare isn't actually going bankrupt. New medical findings give plenty of reason for optimism about the cost of caring for the elderly.  Medicare spending on end-of-life care is dropping rapidly, down from 19 percent to 13 percent of the Medicare budget since 2000.  Living to a ripe old age shouldn't be treated like it's a problem.  It's a bargain.  Someone who lives to 97 consumes only about half as much end-of-life care as someone who dies at 68.

Obamacare firm fined over taxpayer-funded birth care for illegals.  A major Obamacare provider has been fined more than a half billion dollars for using bribes to cash in on illegal immigrant mothers who get taxpayer-funded Medicaid birth services, according to the Justice Department.  Dallas-based Tenet Healthcare agreed to pay $513 million in the bribery scandal.  According to Justice, Tenet and two subsidiaries paid Hispanic health care providers to refer pregnancy cases to their hospitals, where they could run up the Medicaid tab by calling the maternity cases emergencies

ObamaCare's Nasty Surprise for Seniors.  On March 23, 2010, when President Obama signed the Affordable Care Act he signed into law a bill that wiped out more than $50 trillion in Medicare's unfunded liability.  That's not a misprint.  That's trillion with a "t".  The savings are almost three times the size of our entire economy.  But ObamaCare is supposed to be about insuring the uninsured.  It's about health insurance exchanges and the expansion of Medicaid.  What has that got to [do] with the elderly and the disabled?  A lot, it turns out.  One of the most important sources of funds that are being used to pay for ObamaCare comes from cuts in future Medicare spending.

DoJ busts largest Medicare fraud in history.  Using "data driven" law enforcement techniques, the Department of Justice has busted the largest Medicare fraud case in history.  More than a billion dollars in fraudulent Medicare claims over a decade were filed by a Miami-based health care provider.

Clinton Destroys Medicare.  Hillary Clinton is taking a sledgehammer to Medicare.  In a move calculated to fire up the extreme left wing of the Democratic Party, presidential candidate Hillary Clinton pledges to open Medicare to people 55 to 64, and make a "public option" insurance plan for all ages.  The 65-and-overs are already having a hard time finding a doctor willing to accept Medicare's stingy payments.  Clinton's proposals will suddenly invite in millions more patients competing for the same doctors.  Seniors, brace yourselves for long waits to see a doctor.

Planned Parenthood Caught Engaging in $28 Million in Medicaid Fraud Loses Bid to Stop Lawsuit.  Just one Planned Parenthood affiliate in Iowa allegedly committed $28 million in medicaid fraud.  And now a federal appeals court has ruled that it can't stop the lawsuit a former Planned Parenthood clinic director filed against it.  Former Planned Parenthood clinic director Sue Thayer filed the lawsuit against the abortion giant's Iowa affiliate accusing it of submitting "repeated false, fraudulent, and/or ineligible claims for reimbursements" to Medicaid and failing to meet acceptable standards of medical practice.  Alliance Defending Freedom filed the suit for Thayer in March 2011.  The lawsuit claims that Planned Parenthood's Iowa affiliate submitted "repeated false, fraudulent, and/or ineligible claims for reimbursements" to Medicaid and failed to meet acceptable standards of medical practice.

Hundreds arrested for $900 million worth of health care fraud.  The Justice Department announced Wednesday [6/22/2016] it's charging hundreds of individuals across the country with committing Medicare fraud worth hundreds of millions of dollars.  It's the largest takedown in history — both in terms of the number of people charged and the loss amount, according to the Justice Department.  The majority of the cases being prosecuted involve separate fraudulent billings to Medicare, Medicaid or both for treatments that were never provided.

Justice Dept unveils 'largest takedown ever' to combat Medicare fraud.  U.S. law enforcement officials have charged 301 suspects with trying to defraud Medicare and other federal insurance programs in 2016, marking the "largest takedown" involving health care fraud allegations, the Justice Department said on Wednesday [6/22/2016].  The national sweep resulted in charges against doctors, nurses, pharmacists and physical therapists accused of fraud that cost the government $900 million, the department said.  The cases involved an array of charges, including conspiracy to commit health care fraud, money laundering and violations of an anti-kickback law.

Obama is gutting Medicare.  The American Journal of Public Health reports that a man turning 65 can expect to live almost five years longer than he would have in 1970 — and almost all of it in good health.  What a priceless gift.  A gift Obama is snatching away.  The president's Medicare reforms make it harder for seniors to get joint replacements.  His new payment rules shortchange doctors, discouraging them from accepting Medicare in the first place.  New ER rules clobber seniors with bills for "observation care." Under ObamaCare, hospitals get bonuses for spending less per senior, despite having higher death rates and infection rates.

The fast lane to rationed care.  When the Obama administration first proposed its massive overhaul of the nation's healthcare system, opponents raised concerns that government officials would be making decisions about healthcare not on the basis of a patient's needs, but based on bureaucratic spending limits and one-size-fits all political decrees.  Critics were especially alarmed over a provision in the Affordable Care Act that creates an agency called the Independent Payment Advisory Board and charges it with limiting the growth of Medicare spending.  The board will set the payment rates healthcare providers will receive for treatments and services of Medicaid patients.

Obama to hospitals:  Perform 'sex-change' operations or lose federal funding.  President Obama's Department of Health and Human Services implemented a rule change to the Affordable Care Act (a.k.a.  Obamacare) last week mandating that all health providers receiving taxpayer dollars must perform sex-change operations or lose their federal funding.  The final rule states that, under Title IX, any hospital receiving funding from HHS must "treat individuals consistent with their gender identity."  The rule provides no religious exemption.  In other words, religious hospitals that receive taxpayer dollars via Medicaid or Medicare will be required to perform sex-change operations or get cut off financially.  The rule change is not the only directive from the Obama administration forcing individuals to embrace the transgender agenda.

Obama's Latest Executive Overreach Is in Medicare.  The Obama administration has proposed regulatory changes in payment for Medicare Part B drugs.  They're looking to impose a broad, multi-year change through a demonstration project.  Medicare demonstrations routinely test payment or delivery models in pilot programs, make a report to Congress, and the lawmakers either enact or reject the model as a statutory basis for Medicare payment.  But Obama's proposal goes well beyond a normal pilot program, testing to see what does and doesn't work among a relatively small, randomly selected, group of providers.

Medicare Cuts Killing Seniors.  President Obama's Medicare cuts are killing seniors.  His health law changed Medicare, adding bonuses for hospitals that spend the least per senior.  The result?  Hundreds of hospitals are skimping on care to win bonuses.  Seniors at these hospitals aren't getting the right antibiotic or other treatments they need.  They're dying from pneumonia, heart attacks and heart failure at higher rates than patients in other hospitals that provide more care.

Obama Health Care Regulators Are In A Last-Minute Frenzy To Do More Damage.  [Scroll down]  As the article explains, ObamaCare created a little-known agency called the Center for Medicare and Medicaid Innovation with the mission of testing "innovative payment and service delivery models to reduce program expenditures." [...] Just last month, the center ordered almost 800 hospitals in 67 regions to accept bundled payments for knee and hip replacements.  If the total cost of a procedure — including follow-up physical therapy outside the hospital — exceeds a certain cap, these hospitals face a penalty.  If the bill comes in below the cap, they get a bonus.  But these bundled payment schemes have a very checkered history, and the new one is likely to force hospitals to scrimp on follow-up treatments, since doing anything more than sending patients home will likely push costs over the cap.

Ohio Medicaid expansion costs top $7.5 billion.  Ohio Medicaid expansion costs sailed farther past Gov.  John Kasich's projections in March, as total spending on the program topped the $7.5 billion mark.  Expansion cost $411 million last month, making March the most expensive month yet.  For the past six months, expansion costs reported by the Ohio Department of Medicaid averaged $394 million — dwarfing other state programs.  Kasich's budget office reported $312 million in primary and secondary education expenditures, $186 million in higher education expenditures, and $170 million in justice and public protection expenditures in March.

Dem Donors Plead Guilty to $33 Million Medicare Fraud Scheme.  Five individuals who have donated to Democratic politicians pleaded guilty to a scheme that drained Medicare out of $33 million dollars.  Two physicians and three owners of hospice and home care companies based out of Detroit, Mich., were charged on June 18, 2015 as part of the largest Medicare fraud case in history for submitting fraudulent claims for home health care and hospice services that were either not provided or deemed medically unnecessary.  The elaborate operation revolved around Muhammad Tariq, Shahid Tahir, and Manawar Javed — the owners of the home health care and hospice companies — paying kickbacks and bribes to physicians for referrals to their companies that included A Plus Hospice and Palliative Care, At Home Hospice, and At Home Network Inc.

71,777,758 Enrolled in Medicaid and CHIP; Up 14,478,342 Since Obamacare Exchanges Opened; 1 for Every 2 Americans With a Job.  As of the end of 2015, there were 71,777,758 individual in the United States enrolled in Medicaid or the Children's Health Insurance Program (CHIP), according to data published by the federal Centers for Medicare and Medicaid Services.  The 71,777,758 people enrolled in Medicaid and CHIP as of December, according to CMS, was an increase of 14,478,342 from the average monthly enrollment of 56,274,369 in the period of July through September 2013, just before the "State-Based Marketplaces" opened in October 2013 under the terms of the Affordable Care Act (AKA Obamacare).  That means overall Medicaid and CHIP enrollment has increased 25.7 percent since the Obamacare marketplaces opened.

The Obama Republican: John Kasich's Medicaid expansion is a $7 billion disaster.  Ohio Gov. John Kasich's expansion of Medicaid under the 2010 federal health law has cost taxpayers $7 billion in a little more than two years.  The federal government — which is $19 trillion in debt — paid $390 million for Ohio Medicaid expansion benefits in February, bringing the program's total cost since January 2014 to $7.1 billion.  Kasich frames his Obamacare expansion as a fiscally responsible way to keep drug addicts and the mentally ill out of prison, even as costs zoom past his projections.  The expansion was $1.5 billion over budget after 18 months.

Bernie Sanders' Medicare-For-All Plan Has Even Liberals Crying Foul.  [As Bernie] Sanders has gained traction with an increasingly out-of-the-mainstream Democratic Party, more grounded liberals among them have started to publicly denounce his plans, particularly his "Medicare for all" plan, as wildly unrealistic.  How unrealistic?  Just look at the details of his health plan.  First, he would abolish all private health insurance, forcing everyone into a government-run health system.  And the government would pay for everything, from dental work to annual checkups to brain surgery, with no deductibles or co-pays.  It would, he says, be entirely free.  Well, not free.  By Sanders' own admission his health plan is massively expensive — its $1.4 trillion price tag would increase an already out-of-control federal budget by more than a third.

I don't like Bernie because his "Medicare For All" plan will destroy our health and economy.  My college-age child introduced me to a website called I Like Bernie, But... which is particularly appealing to young voters.  The website offers short answers to concerns pro-Bernie voters might still be harboring about his policies and his ability to win.  With few exceptions, these answers are just plain wrong.  You can see my rebuttals at a website I set up as a counterweight (I Don't Like Bernie, Because...).  I've republished those same articles here, at my own blog, addressing Bernie's socialism, his tax plans, and his Second Amendment stance.  Today I'm tackling everything that's wrong with Bernie's plan to socialize American medicine.

Here are 5 of Bernie Sanders' Most Ridiculous Ideas.  [#1] "Medicare for All."  As one of the sections on Sanders' website explains, the presidential candidate is calling for a single-payer healthcare system.  Medicare is an example of a single-payer system, which is why Sander calls for "Medicare for All."  The problem is that Medicare already faces $43 trillion in unfunded liabilities and denies healthcare claims at a higher rate than any private insurer.  "Medicare for all" would drive the country into bankruptcy.

Taxpayers Billed $27 Million for Hoveround Wheelchairs That Weren't Medically Necessary.  Taxpayers were billed $27 million for thousands of power wheelchairs that were not medically necessary for their users.  Hoveround was the subject of an audit released last week by the Department of Health and Human Services inspector general, which faulted the company for failing to meet Medicare requirements before it charged the government for its electric wheelchairs.  In 2010, Hoveround provided 13,025 power wheelchairs to Medicare beneficiaries.  Eighty-five percent of those who received the wheelchairs did not meet the necessary medical requirements, according to the audit.  The findings were based on a sample of 200 individuals who received a power wheelchair from Hoveround.

Millions could see their Medicare costs soar.  The Social Security Administration told nearly 65 million retirees on Monday [10/12/2015] they will not be getting a raise next year, because inflation is too low to trigger one.  And the bad news gets worse.  Unless Congress acts, many of the more than 55 million on Medicare could see premiums rise as much as 50 percent — and higher deductibles, as well.

Mystery ambulance rides cost Medicare $30M: auditors.  Medicare paid $30 million for ambulance rides for which no record exists that patients got medical care at their destination, the place where they were picked up or other critical information.

Health Group Run by Dem Donor to Pay $118M to Settle Fraud Allegations.  The Department of Justice announced on Monday [9/21/2015] that the Florida-based Adventist Health System, a nonprofit health care organization that operates 44 hospitals in 10 different cities, has agreed to pay $118 million to settle claims that the group had arranged an improper compensation system that paid physicians for referrals to their hospitals.  The organization provided compensation that included leasing a BMW and Mustang for one surgeon, offering a $366,000 base salary for a family practitioner — nearly double that of the average salary of similar practitioners in the area — and providing a bonus of $368,000 and a total salary of $710,000 to a dermatologist who worked three days a week.  Additionally, the group was accused of submitting false claims to Medicare and Medicaid for services rendered to the patients who were referred to their system.

An Obamacare Change to Medicare Is Backfiring.  A provision in the Affordable Care Act requires Medicare to reduce payments to hospitals that have high readmission rates.  The goal was to improve patient care and cut the costs of avoidable hospitalizations.  Instead, the new study finds that the Obamacare change unfairly affects hospitals based on the patients they treat.  The current Medicare readmissions rate is high, with close to one in five elderly patients returning to the hospital within 30 days of leaving, and it's also costly — readmissions cost Medicare $26 billion annually, $17 billion of which is spent on return trips that might not have been necessary if proper care was received in the first place.

Medicare unfairly penalizes hospitals treating sickest, poorest patients, study finds.  For the last four years, Medicare has wielded a big stick:  It has fined hospitals if too many of their patients returned to any hospital within weeks of being released.  But many safety-net hospitals, including academic teaching hospitals, say this is unfair because they take care of sicker, poorer patients.  Now data released Monday [9/14/2015] shows they may be right.  Researchers at Harvard Medical School found that hospitals are being penalized to a large extent based on the patients they serve.

Obama Justice Dept. backs Planned Parenthood against La. Gov. Jindal.  The Obama administration has sided with Planned Parenthood in its effort to keep its contract with Louisiana, arguing in a court filing that the state's decision to defund the organization may be in violation of the federal Medicaid Act.  The Justice Department filed a "statement of interest" late Monday in favor of Planned Parenthood Gulf Coast, arguing that "thus far, Louisiana has not proffered sufficient reasons to terminate Planned Parenthood Gulf Coast Inc. ("PPGC") from its Medicaid program."

The Union That Rules New York.  One of the many crises that overwhelmed David Paterson's brief, hapless term as governor of New York was a surge in Medicaid costs.  Every recent New York governor has tried but failed to rein in Medicaid.  Yet Paterson's opportunity to address the problem appeared promising.  Government spending had to be cut during the 2009 budget cycle because of that year's historic collapse in revenues.  Accordingly, Paterson proposed $3.5 billion in cuts to the state's Medicaid program — the second-greatest burden on New York taxpayers, after K-12 education — and sought to shift monies away from inpatient hospitals to less expensive outpatient clinics.  Hospitals would have seen a revenue reduction of less than 2 percent.  But Medicaid is one of the primary sources of funding for the hospitals employing workers from 1199 SEIU, the powerful hospital and nursing-home employees' union.

Unchecked Medicare Fraud is Government Run Amok.  In today's world, federal agencies in the Obama era are the spending equivalent to Genghis Khan.  So why is the administration dragging its to stop Medicare fraud and save the taxpayer billions?  Two words:  Hospital.  Lobby.

Medicaid: A Fifty-Year-Old Flimflam.  [T]he poor medical outcomes endured by Medicaid patients is one of the best documented yet least known aspects of the program.  The most comprehensive study of this phenomenon was the "Oregon Experiment."  The state of Oregon chose enrollees for its Medicaid program by lottery, which gave researchers an unprecedented opportunity to compare the outcomes of Medicaid patients to those who remained without insurance.  The results, published by the New England Journal of Medicine, were startling:  "This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured physical health outcomes."

Obama: There is no entitlement crisis.  [Quoting Barack H. Obama:]  Today, we're often told that Medicare and Medicaid are in crisis.  But that's usually a political excuse to cut their funding, privatize them, or phase them out entirely — all of which would undermine their core guarantee.  The truth is, these programs aren't in crisis.  Nor have they kept us from cutting our deficits by two-thirds since I took office.

The Editor says...
If you triple the budget deficit and then reduce it by two thirds, you have accomplished nothing.  Nevertheless, you can fool some of the people all of the time.

Medicare and Medicaid At 50: One Is Going Bankrupt, the Other Is Bankrupting States.  When President Johnson signed Medicare into law on June 30, 1965, he said, "If it has a few defects, I am confident those can be quickly remedied."  Fifty years later, a Government Accountability Office report found that an eye-popping $60 billion — fully 10% of Medicare's budget — was lost to waste, fraud, abuse or improper payments last year.  Among the glaring defects, the GAO found 23,400 fake or bad addresses on Medicare's list of providers.  Between those two events, Medicare has repeatedly suffered vast cost overruns, has been "reformed" countless times and has imposed a seemingly endless serious of price controls on doctors and hospitals.

Medicare's funding well to dry up in 2030.  The fund Medicare uses to pay hospitals will run out in the next 15 years, and experts say there are no easy answers to solve it.  The independent Board of Trustees for Medicare found the trust fund used for Medicare payments to hospitals would become insolvent in 2030 unless something is done.  The board issued its annual report to Congress on the entitlement program's finances on Wednesday [7/22/2015].

Medicare's Prognosis Is Far Worse Than Dr. Obama Says.  Medicare is still a fiscal time bomb.  As the nearby chart shows, its hospital insurance deficits will hit $110 billion in 2031 — the first year after its trust fund runs out of money.  Annual deficits will eventually top $1 trillion a year.  Even that is a fantasy, since it assumes ObamaCare's steep Medicare provider payment cuts actually happen.  Even Medicare's trustees are skeptical.  Buried in an appendix, the report admits that "there is substantial uncertainty" regarding the likelihood that those cuts will be feasible.

ObamaCare's Medicaid Expansion Is Blowing Up.  Two dozen states immediately took the bait, lured by the promise the federal government would pay 100% of costs in the first three years and 90% for the newly eligible on into the future.  Several more have joined since.  An analysis by the Associated Press finds that this was short-sighted folly.  At least 14 of these states have seen enrollment surge unexpectedly, forcing at least half to increase their cost estimates.  And we're not talking about a few percentage points.

Medicare's midlife crisis: Catastrophic finances pit doctors against patients.  July 30 marks the 50th anniversary of President Lyndon Johnson signing Medicare into law.  At the time it was signed, government actuaries had predicted that the portion of the program that covers hospital insurance would cost $9 billion by 1990.  In reality, it ended up costing $67 billion by that point — or more than 7 times the original estimate.  Since its inception, the program has been dramatically expanded by both parties — even when President George W. Bush had a Republican Congress, he twisted arms to add a prescription drug benefit in 2003.  This year, the government will spend $626 billion on the Medicare program as a whole — more than is spent on national defense.  In fact, more is spent on Medicare than any government program other than Social Security.  A combination of the aging of the population and rising healthcare costs will cause Medicare costs to explode even further in the coming decades.

Medicaid enrollment surges, stirs worry about state budgets.  More than a dozen states that opted to expand Medicaid under the Affordable Care Act have seen enrollments surge way beyond projections, raising concerns that the added costs will strain their budgets when federal aid is scaled back starting in two years.

Obama: 'Medicare and Social Security Are Not In Crisis'.  In a White House speech directed at seniors, President Obama re-assured them that Social Security and Medicare were not in crisis, contrary to the message signaled by Republicans.  "Now, we're often told that Medicare and Social Security are in crisis," said Obama pointing out that it was used as an "excuse" by Republicans to cut spending.  "But here's the truth.  Medicare and Social Security are not in crisis, nor have they kept us from cutting our deficits by two-thirds since I took office."

House Dems want Medicaid to cover abortion.  House Democrats are renewing their attack on the Hyde Amendment, the controversial budget provision that bars federal funds from paying for abortions.  Reps. Barbara Lee (D-Calif.), Diana DeGette (D-Col.) and Jan Schakowsky (D-Ill.) introduced a bill Wednesday [7/8/2015] that would require Medicaid to cover abortion services — currently banned under the Hyde Amendment.

Patients confront doctor who falsely diagnosed them with cancer.  The government says a man who took an oath to do no harm instead turned more than 500 of his patients into victims in a shocking case of medical fraud. [...] Courtroom sketches could not adequately capture the anguish of the victims Tuesday [7/7/2015] as one by one, they confronted the cancer doctor who prescribed aggressive chemotherapy for patients he knew were not ill, and for those who were, ordering treatments that were excessive while billing medicare $34 million.

The Editor says...
Chemotherapy is miserable enough without finding out later that it wasn't necessary.

Medicare's Victims.  Despite the Supreme Court's repeated attempts to prop it up, Obamacare is collapsing.  This is obvious not merely to the majority of Americans who have always disapproved of the law, but also to an increasing number of progressives.  Consequently, we are once again hearing calls for single-payer health care.  Most advocates of this system, including Hillary Clinton's main competitor for the 2016 Democrat presidential nomination, favor Medicare-for-All.  They want, in other words, to put all Americans on the government program that covers the elderly and disabled.

Doctor Accused of Medicare Fraud Donated $450K to Democrats.  A cardiologist in Florida who has donated more than $450,000 to Democrats has been suspended from receiving Medicare reimbursement payments over "credible allegations of fraud" after reimbursements as far back as 2012 came under scrutiny.  Dr. Asad Qamar, a cardiologist based out of Ocala, Fla., was officially suspended from participating in the program in March, though the suspension was only recently made public.  In January, the government intervened in a lawsuit against Qamar filed by whistleblowers who alleged the doctor had defrauded the government.

America's Coming Transfer of Wealth.  According to the CBO's annual Long-Term Budget Outlook, if current laws were to remain unchanged, government spending as a share of gross domestic product would reach 22.2 percent in fiscal 2025, up from 20.5 percent today.  By then, even under a very rosy GDP growth scenario, the debt would amount to 78 percent of the economy. [...] The deterioration comes fully from the explosion of major health care programs, Social Security and escalating interest on debt costs.  More precisely, Medicare, Medicaid, Affordable Care Act subsidies, and Social Security are the drivers of our future debt.  Spending on these programs alone could reach 11.8 percent of GDP in fiscal 2025 and 14.2 percent of GDP in 2040, up from 10.1 percent today.

However the Supreme Court Rules, ObamaCare Is In Deep Financial Trouble.  By 2025, the CBO says, ObamaCare will cut Medicare spending by $153 billion.  That's equal to 73% of what the CBO expects the exchange subsidies and the Medicaid expansion will cost in that year.  By comparison, planned Medicare spending cuts will cover only 24% of ObamaCare's subsidy costs in 2016.  No one believes these Medicare cuts — which involve mainly payment cuts to doctors and hospitals — will happen.  Medicare's board of trustees, the Government Accountability Office and Medicare's chief actuary have all warned they are unrealistic and unsustainable over the long term.

Feds announce nationwide health care fraud sweeps.  Health care fraud sweeps across the country have led to charges against 243 people, including doctors, nurses and pharmacy owners accused of bilking Medicare and Medicaid, the government announced Thursday [6/18/2015].

Obama Sued for Attempted Blackmail, Other States Join In.  The state of Florida has now filed a lawsuit against Barack Obama who attempted to force Florida to bend to his will using blackmail.  Florida had refused to accept Obama's demand to expand their Medicaid program to include able bodied adults with no children. [...] Florida's program is called LIP and Obama has informed Florida that contrary to the ruling by SCOTUS, that he will be cutting them off.  That would force Florida to either fund LIP exclusively by themselves or end the program for millions who depend on it for their healthcare coverage.  The expansion of Medicaid in Florida comes at a steep price.  The leftwing Urban Institute in 2012 estimated that the expansion of Medicaid would cost Florida 82 billion dollars over the next 10 years, but Lip will only cost them 22 billion over the same period.  All this so shiftless bums can get free medical from the government.

Ohio Gov. Kasich on Medicaid Expansion: 'It's my money'.  Anytime Gov. Kasich opens his mouth to talk about Medicaid expansions, you can be sure either an absurd canard or an outright falsehood will spew forth.  Ohio's governor, who is positioning himself to run for president, brags incessantly about his history as a budget hawk during his time in Congress in the '90s, but apparently sees no contradiction between claiming to be a fiscal conservative and expanding Medicaid to hundreds of thousands of able-bodied working, childless adults.  Nevermind that he did so by circumventing the state legislature, adding to the federal debt and imperiling the benefits of the most vulnerable Ohioans — because it's his money.

Lawsuit: AIDS foundation scammed feds for millions.  The nation's largest supplier of HIV and AIDS medical care is accused of bilking Medicare and Medicaid in an elaborate $20 million scam that spanned 12 states, according to a lawsuit filed in South Florida federal court.

23 arrested in massive Medicare-Medicaid fraud scheme.  A 199-count indictment against 23 doctors, nurses, and medical supply companies was unsealed in Brooklyn, NY yesterday, revealing a massive scheme to defraud Medicare and Medicaid of millions of dollars.  Hundreds of poor people were recruited with the promise of new sneakers to visit a couple of clinics in the Bronx, where bogus tests and procedures were performed.  The criminals would then bill government insurance programs for millions.

AARP opposes Medicare bill which reduces its profits.  A major player in health insurance is resisting a bipartisan Medicare bill that would hurt the company's bottom line.  That's to be expected.  Here's the odd part:  The insurance giant is AARP.

Medicare Is Doomed — Save the Patients.  Medicare "as we know it" is doomed.  It never had a chance.  What was originally intended as a vital safety net for seniors has become a massive boondoggle that is collapsing under its own weight.  In 1965, Medicare started as a medical savings program for retirees.  The government would take a small amount out of your paycheck each month for forty years.  This would be placed in a virtual lockbox with your name on it, and would grow at some nominal but safe rate, say three percent.  At retirement, the average American would have well over $100,000 in today's dollars in a virtual individual Health Savings Account to cover old age medical costs.  Things did not work out that way at all.

Feds shelled out $125B in bogus payments last year.  The government paid out $124.7 billion in potentially bogus payments last year, the government's chief watchdog said Monday [3/16/2015], blaming a controversial tax credit for the poor as well as increased bad payments in Medicare and Medicaid.  One major problem is tracking when Americans die — the Social Security Administration admitted last week that its rolls are filled with names of more than 6 million folks who are listed as 112 years of age or older.

Lisa Crinel, former Zulu queen, charged in alleged $30 million Medicare fraud scheme.  Prominent New Orleans businesswoman Lisa Crinel, the 2004 Zulu Queen, faces federal charges in a scheme prosecutors say defrauded Medicaid for $30 million for bogus home health care fees, according to an indictment announced Thursday (March 12) by U.S. Attorney Kenneth Polite.  Crinel, 51, the owner of Abide Home Health Services, was one of 20 people named in the 26-count indictment alleging that from 2008 until charges were filed Thursday [3/12/2015], her company was the centerpiece of a scam that charged Medicaid program for services clients either didn't need or were never performed.

Report: Rural Hospitals Get Billions in Extra Medicare Funds.  A law that allows rural hospitals to bill Medicare for rehabilitation services for seniors at higher rates than nursing homes and other facilities has led to billions of dollars in extra government spending, federal investigators say.

Baker budget: Slash Medicaid to help close massive $1.8B gap.  The state is staring down a $1.8 billion budget gap entering next fiscal year, Gov. Charlie Baker will announce today [3/4/2015] when he unveils his first budget — a $38 billion proposal that includes deep cuts to the state's Medicaid program but keeps his vow not to raise taxes.  The deficit, which Baker is expected to detail at an afternoon press conference, is driven in part by nearly a $1 billion in new net spending at MassHealth and exceeds even the projections of the Massachusetts Taxpayers Foundation, which had pegged the total gap at $1.5 billion in recent weeks.

New York, Louisiana, Texas top Medicaid fraud recoveries in 2014 ranking.  Law enforcement nationwide recovered more than $2 billion through Medicaid fraud investigations in 2014, with New York state representing almost one-fifth of the money.  The Department of Health and Human Services inspector general released a state-by-state breakdown of money recovered by Medicaid Fraud Control Units, law enforcement tasked to act against individuals or entities taking advantage of Medicaid.  New York had the most success with more than 100 convictions.  It also recovered $378 million, one and a half times more than Louisiana, which compiled the second highest total of recoveries.

States find out why Medicaid expansion is bad idea.  I hate to say "I told you so," but in this case I actually did.  Back in August, I wrote a column for this paper calling on governors to say no to the massive boondoggle that is Obamacare's expansion of Medicaid.  It traps people in yet another government program and does nothing to help improve the health outcomes of the people it claims to serve.  But for some reason, governors in states like Illinois and Ohio jumped at the possibility of more "free" money from Washington.

Colorado hospitals to be penalized for Medicare readmissions.  More than half of Colorado hospitals that treat Medicare patients will be penalized for having high readmission rates under the federal health care law.

Medicaid is broken and expansion won't fix it.  Medicaid is administered jointly by the state and federal government, offering health coverage to Americans earning up to about $16,000 in the states participating in Obamacare's expansion of the program and up to roughly $12,000 in the states that do not.  Providing these benefits comes at a great cost to taxpayers.  In fiscal 2013 (even before the program expanded) federal and state governments spent nearly $460 billion combined on Medicaid.  Nearly a quarter of money spent by states went to finance the program in 2013, putting it ahead of elementary and secondary education as the biggest component of state budgets, according to the National Association of State Budget Officers.

Expanding Medicaid hinders growth costs jobs.  Expanding Medicaid through President Obama's healthcare law hinders economic growth and costs jobs, according to a study from the American Action Forum released on Thursday [12/11/2014].  The finding runs counter to the argument that the Medicaid expansion is an economic stimulus, one that many supporters of the law's expansion have been making to convince states to participate in it.  "[W]e find that Medicaid expansion, if adopted by all states, would result in a direct net loss of up to $174 billion in economic growth nationwide over ten years, and would result in the loss of over 206,000 full-year-equivalent jobs for the years 2014 to 2017," wrote economist Robert A. Book, the report's author.

Federal Spending by the Numbers, 2014 (Including 51 Examples of Government Waste).  Where Does All The Money Go?  Forty-nine percent, or almost half of all spending, paid for Social Security and health care entitlements (primarily Medicare and Medicaid).  In 2002, the entitlement share of the budget was 25 percent, about half of what it is today.  Without reform of these massive and growing programs, Washington will have to borrow increasing amounts of money, piling debt onto younger generations and putting the nation on a dangerous economic course.  Social Security is the largest federal spending program and has held this position since surpassing defense spending in 1993.  Medicare is one of the largest and fastest-growing programs in the entire federal budget.

Medicaid Is Destroying Public Education.  One of the truly unheralded disasters caused by Obamacare is the sharp reduction in spending on public education as Medicaid costs eat up an ever-larger share of state budgets.  When Obama took office, the proportion of state spending that went to Medicaid was smaller than that for public education (K-12).  In 2008, states spent 22.0 percent of their funds on education and only 20.5 percent on Medicaid.  But now the situation has reversed and health care has vaulted ahead of education spending in the states.  This year, only 20.0 percent of state funds will go to K-12 schools while almost a quarter — 24.5 percent — will go to Medicaid.

HHS still doing business with firm that twice defrauded Medicare.  A Tennessee home healthcare company was forced to pay $25 million to settle its second fraud case in two years.  CareAll, a collection of home nursing and rehabilitation companies, defrauded both Medicare and Medicaid by billing inflated and falsified costs to the federal programs for home healthcare services, the Department of Justice said.  From 2006 to 2013, CareAll exaggerated the severity of patient illnesses to pad its billings and sought reimbursements for medically unnecessary services that were administered to patients who weren't even homebound, according to the Justice Department.

Report: 42 percent of new Medicaid signups are immigrants, their children.  Immigrants and their U.S.-born children make up more than 40 percent of new Medicaid recipients at a cost of $4.6 billion, according to an analysis of government data.  The Center for Immigration Studies, a low-immigration advocacy group, released a report early Thursday [11/13/2014] that found both legal and illegal immigrants and their minor children made up 42 percent of Medicaid growth from 2011 to last year.

Study: 42 Percent of New Medicaid Recipients in the Last Two Years Were Immigrants.  Almost half of the low-income Americans who have enrolled in Medicaid in the past two years are immigrants to the United States, according to a new report, suggesting that Obamacare's large expansion in the program will disproportionately benefit immigrants as well.  "The data show that immigrants and their children accounted for 42 percent of the growth in Medicaid enrollment from 2011 to 2013," the CIS report says.  Because immigrants are more likely to have low incomes or lack insurance from their jobs, they're much more likely to be eligible for the existing Medicaid program — and Obamacare's expansion of it, which began this year.

Medicare Bought Meds For Dead People.  A report released Friday [10/31/2014] by the Health and Human Services Department's inspector general said the Medicare rule allows payment for prescriptions filled up to 32 days after a patient's death — at odds with the program's basic principles, not to mention common sense.

TLC — the Washington Version.  The Medicare Act was signed into Law by President Lyndon Johnson in January, 1965.  It was intended as a national Health Savings Account with individual accounts called lockboxes. [...] Sometime between 1965 and 1970 (I could not discover precisely when), Congress broke open all those tens of millions of lockboxes, confiscated tens of billions of dollars, and dumped them into the General Account, to spend on anything Congress wanted.  They replaced all the cash with government-issued IOUs.

The Secret Committee Behind Our Soaring Health Care Costs.  In 2012, national health care spending in the United States reached $2.8 trillion, or more than 17 percent of the country's gross domestic product — more than any other industrialized country. [...] Another explanation, debated by experts in health policy circles but less known to the public, lies with a secretive committee run by the American Medical Association (AMA) which, with the assent of the government, has enormous power to determine Medicare prices by assessing the relative value of the services that physicians perform.

Medicare Star Ratings Allow Nursing Homes to Game the System.  The lobby of Rosewood Post-Acute Rehab, a nursing home in this Sacramento suburb, bears all the touches of a luxury hotel, including high ceilings, leather club chairs and paintings of bucolic landscapes.  What really sets Rosewood apart, however, is its five-star rating from Medicare, which has been assigning hotel-style ratings to nearly every nursing home in the country for the last five years.

A Medicare scam that just kept rolling.  The government has paid billions to buy power wheelchairs.  It has no idea how many of the claims are bogus.

Medical Transportation Company Owner Pleads Guilty to Billing Medicaid for Dead People's Rides.  Unfortunately for Cynthia Keegan, dead men do tell tales.  Keegan, 51, owns a van company that provided nonemergency rides for wheelchair-bound MassHealth patients.  Some of the patients she billed MassHealth for, it turned out, had not used the service.  Because they were dead.  In September, Keegan was indicted on seven counts of larceny and seven counts of making false claims to Medicaid for billing MassHealth for nearly 10,000 rides that never happened, using the names of a dozen nursing home patients and 47 people who had previously ceased to be.  Those rides never actually happened because Keegan's Cross Roads Trolley is a wheelchair van company, not a hearse company.

The Obscure Drug With a Growing Medicare Tab.  An obscure injectable medication made from pigs' pituitary glands has surged up the list of drugs that cost Medicare the most money, taking a growing bite out of the program's resources.  Medicare's tab for the medication, H.P. Acthar Gel, jumped twentyfold from 2008 to 2012, reaching $141.5 million, according to Medicare prescribing data requested by ProPublica.  The bill for 2013 is likely to be even higher, exceeding $220 million.

Report shows $6.7 billion in improper Medicare payments.  Medicare paid out $6.7 billion in 2010 for health care visits that were improperly coded or lacked documentation, a report released Thursday [5/29/2014] found.  That's 21% of Medicare's total budget for diagnostic and assessment visits, according to the Department of Health and Human Services inspector general.  They found that 42% of diagnostic and assessment claims were improperly coded and 19% were improperly documented.  This comes after a 2010 report found that 1,669 physicians consistently billed for the two highest-paying codes.  In the new report, 56% of claims for those high-coding physicians physicians were incorrect, with 99% being up-coded in the provider's favor, and with 1% of the "errors" being down-coded.  Those providers cost $26 million in 2010 in incorrect coding.

Medicare Ban on Sex Reassignment Surgery Lifted.  Medicare can no longer automatically deny coverage requests for sex reassignment surgeries, a federal board ruled Friday [5/30/2014] in a groundbreaking decision that recognizes the procedures are medically necessary for some people who don't identify with their biological sex.

Lung Cancer Screening Could Cost Medicare Billions.  Every person covered by Medicare would shell out an additional $3 a month if the government agreed to pay to screen certain current and former smokers for lung cancer, a new study estimates.

Medicaid paid $12 million for deceased people in Illinois, documents show.  The Illinois Medicaid program paid an estimated $12 million for medical services for people listed as deceased in other state records, according to an internal state government memo.

Feds Begin Fingerprinting 'High Risk' Medicare Providers and Suppliers.  Four years after Obamacare became law, the Department of Health and Human Services (HHS) is notifying Medicare providers and suppliers of new fingerprint-based background checks. [...] The provision is part of the Medicare, Medicaid, and CHIP Program Integrity Provisions (Title E) of the Affordable Care Act, and gives the HHS secretary broad discretion in applying the background check requirements depending on the potential for abuse, fraud, and/or waste.

Americans on Medicaid Exceed Population of UK.  The number of Americans who were enrolled in Medicaid at any time during fiscal 2013 exceeded the entire population of the United Kingdom, according to new data published by the federal government's Medicaid and CHIP Payment Access Commission (MACPAC).  Were Medicaid a nation instead of a U.S. entitlement program it would be the 20th most populous country on earth.

Sliver of Medicare Doctors Get Big Share of Payouts.  A tiny fraction of the 880,000 doctors and other health care providers who take Medicare accounted for nearly a quarter of the roughly $77 billion paid out to them under the federal program, receiving millions of dollars each in some cases in a single year, according to the most detailed data ever released in Medicare's nearly 50-year history.

Data trove shows U.S. doctors reap millions from Medicare.  In 2012, an enterprising ophthalmologist in south Florida received $20.8 million in Medicare payments, the highest amount the government health plan for the elderly paid an individual provider that year, according to a preliminary analysis of federal data.

Data uncover nation's top Medicare billers.  The Medicare program is the source of a small fortune for many U.S. doctors, according to a trove of government records that reveal unprecedented details about physician billing practices nationwide.  The government insurance program for older people paid nearly 4,000 physicians in excess of $1 million each in 2012, according to the new data.  Those figures do not include what the doctors billed private insurance firms.

Obamacare's Medicaid Trap.  The technology behind a huge part of Obamacare's efforts to expand insurance coverage — the part aimed at low-income Americans — remains far from fixed, and the glitches are keeping some of the nation's most vulnerable patients from getting insured.  The administration launched a "tech surge" to improve the HealthCare.gov experience for those shopping for private insurance, but the website's process for enrolling in Medicaid remained mired in glitches.  And for President Obama's efforts to expand health coverage that's a major problem.

Political Ties of Top Billers for Medicare.  Two Florida doctors who received the nation's highest Medicare reimbursements in 2012 are both major contributors to Democratic Party causes, and they have turned to the political system in recent years to defend themselves against suspicions that they may have submitted fraudulent or excessive charges to the federal government.  The pattern of large Medicare payments and six-figure political donations shows up among several of the doctors whose payment records were released for the first time this week by the Department of Health and Human Services.

Healthcare cuts canceled after Dem complaints.  The Obama administration announced Monday [4/7/2014] that planned cuts to Medicare Advantage would not go through as anticipated amid election-year opposition from congressional Democrats.  The cuts would have reduced benefits that seniors receive from health plans in the program, which is intended as an alternative to Medicare.  Under cuts planned by the administration, insurers offering the plans were to see their federal payments reduced by 1.9 percent, which likely would have necessitated cuts for customers.  Instead, the administration said the federal payments to insurers will increase next year by .40 percent.

HHS updates Medicare enrollment rules for same-sex couples.  The Obama administration on Thursday [4/3/2014] announced that it was updating Medicare rules to allow partners in same-sex marriages to apply for benefits during special enrollment periods.  The Department of Health and Human Services said that the Social Security Administration would now be able to take applications for special enrollment periods for Medicare Part A and Part B and reduce late penalties for some eligible same-sex couples.  The move is the latest step taken by HHS after the Supreme Court in 2013 struck down a key part of the federal Defense of Marriage Act, which defined marriage as a union between one man and one woman.

So you want single payer? Medicare has 375,000 case appeals backlog.  And that sort of a backlog has Democrats worried. [...] This sort of a problem is also visible in another government run health care system.  VA currently has almost 400,000 disability claims pending.  It claims to be on track to erase that in 2015, but observers are skeptical of that claim.  While it claims to have shed 200,000 previously backloged claims, new claim backlog numbers continue to rise.

The Obama Administration's About-Face on Medicare.  The Obama administration seems determined not to rock the boat before the midterm congressional election this fall.  It's already delayed Obamacare mandates that could cause outrage.  Now it has stopped proposed Medicare changes that weren't even part of Obamacare — and with good reason.  The administration had proposed new rules for seniors' prescription drug plans in Medicare Part D.  This is significant because Part D is unusual for a government program:  People love it.

House subcommittee chairman: Obama administration policy would eliminate half of all existing Medicare Part D plans.  The Obama administration's new proposed rule for Medicare Part D would eliminate half of all Medicare Part D plans and raise prescription drug premiums for millions of seniors by up to 20 percent, according to a U.S. House subcommittee chairman.  "Today, the average senior has 35 different [Medicare Part D] plans to choose from this year.  This rule would reduce that choice to two plans.  50% of the plans offered today will be gone, and the health care that seniors like may go with it," House Energy and Commerce Health Subcommittee chairman Rep. Joe Pitts said in a statement at a Feb. 26 hearing attended by a top administration health official.

Update:
Administration drops controversial proposed Medicare changes.  The Obama administration says it's pulling the plug on proposed changes to the Medicare prescription program that ran into strong opposition on Capitol Hill.  Among other changes, the regulation proposed to remove three classes of drugs from a special protected list that guarantees seniors access to a wide selection of critical medications.

Drug rule is ditched by Obama.  Medicare chief Marilyn Tavenner alerted lawmakers Monday that her agency would not go forward with a proposal to give insurers more leeway to limit the number of drugs they cover for Medicare beneficiaries.  Critics argued that making the change, which was designed to save money, would have hampered seniors' access to necessary drugs.  Democrats worried the issue would hurt them in the midterm elections, and House Republicans had scheduled a vote this week on a bill blocking the regulation from going forward.

Obama's Not-So-Secret War On Private Medicare Plans.  To say that President Obama is not an enthusiastic backer of the two Medicare programs that offer seniors private insurance options would be something of an understatement.  Over the years, Obama has repeatedly derided Medicare Advantage — the program that lets seniors enroll in subsidized, private insurance.  He once called it "wasteful," and said it amounted to "giveaways that boost insurance company profits but don't make (seniors) any healthier."  Obama has been equally harsh when it comes to Medicare Part D — the drug benefit President Bush signed into law that relies on privately run plans.

Insurers: Medicare Advantage cuts cost seniors $900 per year.  The health insurance industry fighting proposed cuts to Medicare Advantage payments argued they will raise seniors' out-of-pocket costs next year.  America's Health Insurance Plans (AHIP), a trade group, blasted the reductions with a report Thursday finding that beneficiaries could pay as much as $900 more in 2015 if the cuts take effect.

Medicaid Fraud: Who's in on the Act and How They're Getting Away With It.  A single mom with five kids living in Brooklyn with no income on record and struggling to make ends meet sounds like an eligible candidate for government subsidy programs.  She signs up for the SNAP (Supplemental Nutrition Assistance Program) and Medicaid for herself and her children and gets government assistance to help cover her rent.  But in reality, she's married, her husband has an all-cash business, which allows her to rake in thousands of dollars a month via welfare programs and remain undetected by the government.

Feds to fine state over limit on Medicaid patients' ER visits.  Florida has been limiting Medicaid patients to six emergency room visits a year even though federal officials consider such a cap illegal.  As a result, the federal government intends to penalize the state by withholding a portion of Medicaid funding.  "We hope the state will realign their Medicaid program with federal standards to avoid this penalty," said Emma Sandoe, a spokeswoman for the Centers for Medicare and Medicaid Services.

The Editor says...
Mr. Obama apparently wants Medicaid "clients" to continue to use hospital emergency room physicians as their family doctors — without any limits.

Major flaw in Maryland health site may mean $30 million in unnecessary Medicaid payments.  The cost to taxpayers of flaws in Maryland's online health insurance exchange is coming into focus, with officials estimating at least $30.5 million in unnecessary Medicaid spending and conceding that they have no idea how much it will take to get a system that works.  The state has paid $65.4 million to the contractor hired to build the system and fired this week because of the protracted problems.  Costs are likely to keep rising as Maryland figures out how to fix or replace the system.

25 Charged in Largest Medicaid Fraud Bust in D.C. History.  Federal authorities say 25 people have been charged in a wide-ranging scheme to obtain millions of dollars in fraudulent Medicaid payments from the District of Columbia government.

Medicaid Overpays Millions for Diapers.  A lack of competitive bidding processes among state Medicaid agencies caused the program to overpay for diapers by about $62 million in 2012, according to a report released by federal auditors on Monday.  Only five state Medicaid agencies have implemented competitive bidding programs for "disposable incontinence supplies," according to the inspector general for the department of Health and Human Services.  Those states reported saving up to of 50 percent on those supplies, the IG report found.

ObamaCare death debt? States can seize assets to recoup Medicaid costs.  Though many may not realize it, states are allowed to recover the cost of health care after someone's death by seizing their assets.  It applies to Medicaid recipients who are between the ages of 55 and 64.  The law has been in place since 1993, when Congress realized states were going broke over rising Medicaid expenses.  But under ObamaCare, Medicaid eligibility has expanded dramatically along with the promise that the federal government will pick up the cost of the higher tab — at least for the first few years, after which states will be on the hook for a portion of the increase.  Millions more are entering the system, perhaps without knowing that their assets could be at risk.

How Obamacare will hurt doctors.  A study just published in the prestigious journal Science reveals that new Medicaid patients in Oregon were 40% more likely to use the emergency room than the uninsured were.  This finding is not a surprise to me or most physicians — we have known that truth for years.  But it does undermine one of the basic philosophical and practical underpinnings of Obamacare:  the notion that expanding insurance will invariably unclog ERs, improve primary and preventive care, prevent diseases and lower costs.

Single Payer: We've Been There, Done That.  Medicare is a single payer health care system for seniors, and it is Exhibit A in the case against government-run health care.  "Medicare-for-All" is what single payer advocates usually mean when they refer to universal health care.  Most of these people naïvely believe that such a system could be paid for with a few modest tax increases.

Surprise! Medicaid isn't free — it's a poorly advertised predatory loan.  It's called "estate recovery" and although it's been around for 20 years, most Americans have never heard of it.  Sadly, this arcane bit of Medicaid fine print is about to become much more familiar.  Basically, what it says is this:  If you're over 55 and are on Medicaid, when you die the state can seize your assets in an effort to repay the cost of your care.

Study: Expanding Medicaid doesn't reduce ER trips, it increases them.  As the health-care law expands Medicaid to cover millions more Americans, a new Harvard University study finds that enrollment in public program significantly increases enrollees' use of emergency departments.  The research, published Thursday in the journal Science, showed a 40 percent increase in emergency department visits among those low-income adults in Oregon who gained Medicaid coverage in 2008 through a state lottery.  This runs counter to some health-care law supporters' hope that Medicaid coverage would decrease this type of costly medical care, by making it easier for low income adults to see primary care providers.

Emergency Visits Seen Increasing With Health Law.  Supporters of President Obama's health care law had predicted that expanding insurance coverage for the poor would reduce costly emergency room visits because people would go to primary care doctors instead.  But a rigorous new experiment in Oregon has raised questions about that assumption, finding that newly insured people actually went to the emergency room a good deal more often.

Hospice firms draining billions from Medicare.  Hospice patients are expected to die:  The treatment focuses on providing comfort to the terminally ill, not finding a cure.  To enroll a patient, two doctors certify a life expectancy of six months or less.  But over the past decade, the number of "hospice survivors" in the United States has risen dramatically, in part because hospice companies earn more by recruiting patients who aren't actually dying, a Washington Post investigation has found.  Healthier patients are more profitable because they require fewer visits and stay enrolled longer.

Russian Diplomats' Medicaid Fraud Raises Questions About Foreign Officers Accessing Taxpayer Benefits.  According to the U.S. Attorney for the Southern District of New York, 25 current and former Russian diplomats and 24 of their spouses allegedly participated in a scheme to illegally obtain Medicaid benefits for prenatal care and related costs by underreporting their income or falsely claiming that their children were citizens of the United States, [Congressman Ed] Royce noted.  Over the course of nearly a decade, they milked the system of $1.5 million in benefits.

Surprise! Obamacare Includes A Medicaid Death Tax.  Before Obamacare there was a Medicaid provision allowing the state to recuperate funds spent on a Medicaid patient over 55 years old from his/her estate.  The end result of that policy, for those on Medicaid dying with assets, would see the government seizing the assets of an estate forcing family members to purchase back any items they'd want to keep.  It's called estate recovery, and it's not exactly advertised as one of the terms for Medicaid enrollment.  But pre-Obamacare there weren't many people who were a) on Medicaid and b) had many assets of value for seizing.

Expanded Medicaid's fine print holds surprise: payback' from estate after death.  As thousands of state residents enroll in Washington's expanded Medicaid program, many will be surprised at fine print:  After you're dead, your estate can be billed for ordinary health-care expenses.

Obamacare's expanded Medicaid asset seizure bonanza.  Basically, the problem is that the Democrats, in their infinite wisdom, decided to drastically expand the Medicaid rolls without considering the consequences — one of which being, state governments have been long in the habit of trying to get at the remnants of Medicaid recipients' estates in order to cut costs. [...] You see, in order to get a subsidy for an Obamacare plan people have to be making neither too much, nor too little.  People who make too little are expected to go onto Medicaid by the federal government; they certainly aren't going to get any kind of subsidy for their new health care plan.

ObamaCare created a Medicaid time bomb.  The good news, if you want to call it that, is that roughly 1.6 million Americans have enrolled in ObamaCare so far.  The not-so-good news is that 1.46 million of them actually signed up for Medicaid.  If that trend continues, it could bankrupt both federal and state governments.

Dozens of Russian diplomats have been ripping off Medicare for years.  Almost 50 Russian diplomats and members of their families have been charged in a massive health care fraud scheme, officials announced Thursday [12/5/2013].  Federal officials allege that 58 of the 63 births to Russian officials living in New York between 2004 and 2013 were fraudulently paid for by Medicare at a cost of roughly $1.5 million to US taxpayers.  The Russians were applying for these benefits while emptying their pockets at famed stores such as Bloomingdale's, Jimmy Choo's, Prada and Tiffany & Co, officials said.

Medicaid Fraud: Obamacare promise of free quality healthcare.  It may be the biggest Obamacare lie of all.  Not that you can keep your health care plan if you like your plan.  Not that you can keep your doctor if you like your doctor.  Not all of the phony cost estimates and supposed efficiencies.  The biggest lie of all is that 15-30 million additional people who will be enticed or shoved onto Medicaid will receive quality health care.  In reality, they will receive health care "insurance," but there will be few doctors willing to see them because the reimbursement rates are so low.

Obama Trashes America to Save ObamaCare.  The U.S. is hugely generous to those who can't afford to pay for health care.  Hospitals spend more than $40 billion a year doing so.  Doctors generously provide billions of dollars worth of free or discounted care to those who need help.  There are various philanthropies that raise billions each year for charity care.  And that's to say nothing of the existing government programs.  Taxpayers fork over $415 billion a year so Medicaid can provide health care for the poor, and another $500 billion for Medicare.  There's the VA for veterans and various state-run programs as well.  So, no, the health care system isn't now and never has been the cold, cruel, heartless disaster that the Obamas make it out to be.

ObamaCare Forced Mom Into Medicaid.  Countless individually insured Americans have received such letters; many are seeing more radical increases in premiums and deductibles.

White House attempts to shame Republican governors into Medicaid expansion.  The White House stepped up its effort Thursday night to shame more Republican governors into accepting an expansion of Medicaid rolls, calling on Florida and Louisiana to add more than 1 million uninsured residents under Obamacare.  "We should be about putting people over politics," said presidential adviser David Simas.  "It is reckless that some governors are so determined to see that the health care law not succeed, that they have even refused to expand Medicaid coverage for millions upon millions of working families."

Audit reveals half of people enrolled in IL Medicaid program not eligible.  [A] review of the Illinois Medicaid program confirms massive waste and fraud.  A review was ordered more than a year ago — because of concerns about waste and abuse.  So far, the state says reviewers have examined roughly 712-thousand people enrolled in Medicaid, and found that 357-thousand, or about half of them shouldn't have received benefits.  After further review, the state decided that the percentage of people who didn't qualify was actually about one out of four.

Watchdogs: Government Paid Millions in Medicare to Deceased, Illegal Immigrants.  The Department of Health and Human Services' Centers for Medicare and Medicaid Services paid out $23 million to beneficiaries after their deaths in 2011, according to one report from HHS' inspector general.  Another report tallied more than $28 million in payments from 2009 to 2011 to individuals who were in the country illegally.  In all, CMS paid Medicare benefits to 4,139 illegal immigrants and 17,403 deceased people, according to the two reports.

Medicare paid millions to dead patients, illegal immigrants, probe finds.  Medicare paid $23 million for dead patients in 2011 and $29 million for drug benefits for illegal immigrants from 2009 to 2011, according to a report Thursday [10/31/2013] from the Health and Human Services inspector general.  The investigators said Medicare has safeguards to try to stop payments to dead patients, but it still ended up sending out the $23 million anyway.  The Centers for Medicare and Medicaid Services (CMS) — the same agency that is struggling to fix the broken Obamacare website — acknowledged the problems and said it will try to take steps to fix them.

CMS Spent More Than $1 Trillion in Less Than 1 Year.  The Centers for Medicare and Medicaid Services (CMS), which runs the federal government's major health-care programs, and which was responsible for developing the Obamacare health-insurance exchange website, spent more than $1 trillion in just the first eleven months of fiscal 2013, according to the Treasury.  From October 2012 through August 2013, according to the Treasury, this one federal agency spent $1,036,561,000,000.

Medicaid Overview.  Medicaid covers pregnant women, individuals with disabilities, children of low-income households, some of the poorest elderly, and parents meeting specific income thresholds, generally those at or below the federal poverty level — $958 gross income per month for one person, or $1,963 gross income per month for a family of four.  (Children above the threshold for Medicaid can qualify for a separate program, the Children's Health Insurance Program; North Dakota's CHIP program covers children up to 160 percent of the poverty level, and New York's goes up to 400 percent of the poverty level.)

The Great Medicaid Swindle.  On Monday [10/21/2013], the same day President Obama gave a poorly received speech defending the glitchy Obamacare rollout, there was another unfortunate development in health-care reform:  Ohio expanded Medicaid.  In a controversial (and possibly illegal) move, Ohio's Controlling Board voted to expand Medicaid coverage in the state to adults that were not previously eligible by way of accepting billions in federal funds.  That means 25 states, plus the District of Columbia, have now signed on to take part in an aspect of the Affordable Care Act that is both optional and ill-considered.

Are they signing up for Obamacare, or for Medicaid?  How many people have tried to sign up for Obamacare?  How many have completed the process?  Those numbers are important, but let's keep something else in mind here — there's another important number that a lot of publications are failing to separate out.  That is, how many people are enrolling in the private insurance plans within the Obamacare exchanges — as opposed to those applying who report very low incomes and get steered into the Medicaid program?

Obamacaid.  Democrats do have one lament about [Obamacare's] implementation:  Some states are opting out of the Medicaid expansion.  Medicaid, the joint state-federal safety net intended for the poor, already covers more than one of five Americans and pays for two of five U.S. births.  And that's before ObamaCare dumps up to 20 million new dependents onto its rolls.

'Death doctor' accused of misdiagnosing cancer patients.  A Michigan oncologist charged with intentionally misdiagnosing patients with cancer as part of a major Medicare fraud operation will remain in prison until trial, with court officials scared he will flee to the Middle East.  Dr Farid Fata — who is accused of ordering unnecessary treatments for his patients, such as chemotherapy, to enrich himself through insurance programs — made an application in the federal court to have his bond reduced from $9 million to $500,000 so he could leave prison, where he has been held since August 6.

Almost Half of U.S. Births Covered by Medicaid.  According to researchers from the George Washington University (GWU) School of Public Health, in 2010, almost half of all births in the United States were paid for by Medicaid, and that rate is only going to go up.  Medicaid was responsible for 48% of the 3.8 million births in 2010, an increase of 90,000 births from 2008, which was an 8% increase during that period.

Detroit doctor charged in $35M Medicare scam gave fake diagnoses, feds say.  A Detroit-area doctor has been charged with bilking the government of tens of millions of dollars by deliberately misdiagnosing patients with cancer and illegally billing Medicare for the treatment.  Dr. Farid Fata [...] was arrested last week on charges he ripped off Medicare for millions of dollars by giving chemotherapy to patients who didn't need it and diagnosing cancer when the illness wasn't apparent, MyFoxDetroit.com reported.

Medicare by the Scary Numbers.  The trustees report's predicted expenditures are based on the assumption built into the law that next Jan. 1 there will be a 25 percent decrease in the fees that Medicare pays doctors.  The reason has nothing to do with ObamaCare.  In the Balanced Budget Act of 1997, Congress declared that Medicare physician fees could grow no faster than the economy as a whole.  Since then, though, Congress has postponed the cuts on 14 occasions, not allowing them to take place.  Why assume things will be different now?  A second problem does stem from ObamaCare.  In order to pay for the expansion of health insurance for the young, the new health law calls for steep cuts in the growth of health care spending on the elderly.

Obamacare's Insurance "Solution": Medicaid for All.  Even as the Left celebrates Obamacare's expansion of health coverage, a Reuters story highlighted what kind of "insurance" people will receive under the law.

This Thing Called ObamaCare.  It's instructive to witness the inability of politicians to accurately predict their own legislative outcomes.  In 1967, Congress predicted that Medicare spending would equal only $12 billion per year by 1990 — a paltry sum.  Actual spending for that year was $110 billion, so they were slightly off the mark.  But of course, by that point, Medicare was fully entrenched in the American political system, and the notion of even modestly reforming it was off the table (it evidently continues to be off the table today).  Thus stands the ossified character of American government, and thus will likely stand ObamaCare twenty-five years from now, too.

Feds let Medicare provider give away $20 grocery cards to lure patients.  The Department of Health and Human Services has given qualified approval for a Medicare provider to give away $20 grocery gift cards to induce seniors to get more taxpayer-funded health screenings, despite concerns the promotion could run afoul of federal anti-kickback laws.

FBI raids headquarters of The Scooter Store as part of $100 million Medicare fraud investigation.  More than 150 FBI agents and local cops have raided the Texas headquarters of The Scooter Store, the nation's largest supplier of mobility vehicles, after the company allegedly defrauded Medicare by $100 million.  The company is accused of harassing doctors with constant phone calls and surgery visits in order to wear them down to prescribe their vehicles to patients who do not need them.

Report: $2 billion spent annually for Medicaid emergencies, largely for illegal immigrant baby deliveries.  Even though federal law largely bars illegal immigrants from obtaining Medicaid coverage, the program annually pays out more than $2 billion in free emergency coverage that mostly goes to illegal immigrants, according to Kaiser Health News.  The vast majority of the total emergency care reimbursements cover delivering babies, Kaiser reports.

Medicare improperly paid $120M to ineligibles.  Illegal immigrants and prison inmates received more than $120 million in Medicare services from 2009-2011 despite federal law that makes them ineligible for the program, according to two new reports from the HHS inspector general.  The issue, according to the reports, is timing.  When Medicare is alerted that someone is incarcerated or undocumented, its contractors help prevent payments from going out the door.  But often, Medicare's databases aren't up to date, and improper payments go out.

The Real Country-Killer in 2013.  Every week, the U.S. Treasury borrows money to keep operating, by holding auctions of "T-Bills."  Institutional investors, foreign and domestic, show up to bid on these government bonds (Treasury Bills).  What if investors decide that it just isn't worth risking any more of their money?  There won't be any money.  Even when the country still looks strong, investors could sit on the sidelines, worrying:  "Let someone else take the risk."  If the lending stops, can the country survive when the Ponzi scheme collapses?  What if there is no money to cut social security or Medicare checks, or operate the government?

Sheila Jackson Lee: Entitlements Off The Table, They Are "Earned".  Rep. Sheila Jackson Lee (D-TX):  "There is no way, Mr. Speaker, that we should raise the eligibility age for Medicare, that we should not think carefully about how we approach the reform of Medicaid.  And that we don't the American people that Social Security is solvent. [..."]

The Editor asks...
If you are entitled to receive something, it isn't necessary to earn it.

This Is Your Life under Obamacare.  We couldn't afford Medicare or Medicaid.  They're unfunded liabilities by trillions of dollars, when projected into the future.  And the solution is — what?  To impose a third government insurance program that we can't afford — ObamaCare?  That's like a working-class family not being able to afford their two cars, so their solution is to buy a third one.

Dems' Medicare lie.  Attention, New York's 3 million seniors:  Don't be fooled.  It's the Obama health law that destroyed Medicare, though the impact will not be felt for another year or more.

This is an original compilation, Copyright © 2024 by Andrew K. Dart