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Legislation and Policy
HHS Faces Uphill Battle In Marketing ACA.
The AP   (4/1) reports, "With the
nation still split over President Barack Obama's health care law, the
administration has turned to the science of mass marketing for help in
understanding the lives of uninsured people, hoping to craft winning pitches
for a surprisingly varied group in society." As "it turns out,
America's more than 48 million uninsured people are no monolithic mass. A
marketing analysis posted online by the federal Health and Human Services
Department reveals six distinct groups, three of which appear critical to the
success or failure of the program." These are the "Healthy &
Young," the "Sick, Active & Worried," and the
"Passive & Unengaged."
Similarly, the Washington Post (3/31, Galewitz) reported that a
Palm Beach County, Florida program that offered subsidized health insurance
coverage for $52 a month to residents who didn't qualify for Medicaid
attracted "fewer than 500 people" after a year. The program's outcome
has created "worry that similar problems could bedevil the new online
health insurance marketplaces that open for enrollment Oct. 1 under the
Affordable Care Act." The Post also said that "persuading millions
of people to buy insurance...is still expected to be a tough sell,"
while the Obama Administration "has yet to release any details of its
marketing campaign" for ACA options.
ACOs Increasingly Working
Behind The Scenes To Benefit Patients.
The
print edition of Modern Healthcare (3/29, Carlson, Subscription
Publication) reported that Medicare and private health plans are backing
Accountable Care Organizations, while doctors and hospitals see the approach
"as potentially becoming the long-awaited bridge from inefficient fee-for-service
medicine to a healthcare system that provides higher quality care at lower
cost for large groups of similarly situated patients." Proponents also
believe ACOs can close some of the gaps in how "advances in medical
knowledge have not been evenly distributed among healthcare providers."
Nonetheless, "the types of ACO models being tried today are so varied
and complex that it's difficult to draw conclusions about their ultimate
success," and "major questions...still linger," including
"which patients are right for ACOs and how much hospitals and doctors
should be rewarded for coordinating patient care."
ACOs Look To Insurance Benefits To Promote Value-Based
Decisions. The print edition of Modern Healthcare (3/30, Evans, Subscription
Publication) reported, "More hospitals and doctors are signing
accountable care contracts that tie payouts and sometimes penalties to
delivering better results at lower costs." Towards that end,
"insurance is increasingly seen as a vehicle to encourage patients not
only to embrace healthy behavior and manage chronic conditions, but also to
consider less expensive treatment options, especially when a more expensive
path promises limited benefits." In addition, "a growing number of
employers are shifting incentives away from efforts that encourage
self-awareness and health education and toward results, such as lower body
mass index."
South Said To Remain Solidly
Opposed To ACA.
The AP (3/30, Barrow) reports that
"an opposition bloc remains" to the ACA "across the South,
including from governors who lead some of the nation's poorest and
unhealthiest states." The AP says politics are mostly responsible,
although "the hospital industry and other advocacy groups continue to
tell GOP governors that expansion would be a good arrangement, and there are signs
that some Republicans are trying to find ways to expand insurance coverage
under the law."
GOP Capitalizing On Sebelius'
ACA Premium Hike Concession.
The Hill (4/1, Viebeck)
"Healthwatch" blog reported that following last week's
"surprise concession from Health secretary Kathleen Sebelius,"
Republican campaign officials "are claiming new momentum for 2014."
Sebelius' remark, that "some consumers could see their health insurance
premiums rise under healthcare reform," has "triggered a rush of
campaign messaging against vulnerable Democrats who supported healthcare
reform." According to the blog, "The controversy points to the challenge
facing the Obama administration as it implements a cumbersome and politically
volatile reform whose full impact may not be understood for decades."
LATimes: ACA Premium Hike Studies A "Bump In The
Road." In an editorial, the Los Angeles Times (3/30) called the recent study
predicting a 30.1% increase in premiums for Californians buying individual
health insurance a "bump in the road" for the Affordable Care Act.
To sum the argument up, the paper wrote, "The bill's title is not ironic
- its provisions will slow the growth of healthcare costs and lead over time
to a more rational and efficient system. But the transition will have some
rough patches, and we're about to hit one."
NYTimes Blog Points To High
Healthcare Costs As Driver Of Debt.
Uwe
Reinhardt wrote in the New York Times (3/29) "Economix" blog
that "traditionally, the theory driving discussions on the high
cost" of US healthcare "has been that there is enormous waste in
the system, taking the form of excess utilization of care." But
"largely overlooked in these discussions has been the elephant in the
room: the extraordinarily high prices Americans pay for healthcare." He
cited a 2004 paper that concludes "it is higher health spending coupled
with lower - not higher - use of health services that adds up to much higher
prices in the United States than in any other member nation of the
Organization for Economic Cooperation and Development."
AMA Calls For Health Insurance
Exchange Network Standards.
American Medical News (3/29, Lubell) reported,
"Standards ensuring that consumers have access to sufficient networks of
health care professionals on federally operated health insurance exchanges
need to be tightened, the American Medical Association wrote in a March 15
letter to the Obama administration." The Association's Executive Vice
President and CEO James L. Madara, MD, "in his correspondence to acting
Centers for Medicare & Medicaid Services Administrator Marilyn
Tavenner...specified what information qualified health plans on these
marketplaces should be providing."
ACA Repeal Push At Odds With
GOP Courting Of Latinos.
On its
front page, the Los Angeles Times (4/1, A1, Levey) reports, "As
Republican leaders try to woo Latino voters with a new openness to legal
status for the nation's illegal immigrants, the party remains at odds with
America's fastest-growing ethnic community on another key issue:
healthcare." As the article explains, "Latinos, who have the lowest
rates of health coverage in the country, are among the strongest backers of
President Obama's healthcare law." And yet, "Yet congressional
Republicans continue to make repeal of the 2010 Affordable Care Act a top
agenda item and have renewed calls for deep cuts in health programs such as
Medicaid, which are very popular with Latinos."
NPR Addresses Misinformation
About ACA.
On
Friday, NPR (3/30) ran an eleven minute segment
on "All Things Considered" that questioned, upon the third
anniversary of the Affordable Care Act: "Is it actually possible
Americans know less about Obamacare now than they did three years ago?"
The piece looked into "misinformation and disinformation" about the
law, before attempting to clear up some of these misconceptions.
North Carolina Senators Call
For Transparency In Hospital Billing.
The Winston-Salem (NC) Journal (4/1) reports that "North
Carolina hospitals don't publicly post the cost of their medical
procedures," which "makes it all but impossible for patients to
comparison shop or to effectively question prices, and experts say it allows
hospitals to make more money from patients and insurers." In response,
Sens. Bob Rucho (R-NC) and Harry Brown (R-NC) "have introduced
legislation addressing the hospital-billing system that would begin to
provide transparency and more ability for consumers to shop for services."
Under the bill, "hospitals would be required to publicly disclose their
prices on the most common medical procedures." The bill also outlines
how Hospitals with low Medicaid costs would be rewarded.
Charlotte Paper Lauds Effort To Make North Carolina Hospitals
More Transparent. In an editorial, the Charlotte (NC) Observer (3/31) lauds the effort of Sens.
Bob Rucho (R-NC) and Harry Brown (R-NC) to make the hospital billing system
in North Carolina more transparent. The Observer claims that the bill
"offers some promise in taking the mystery out of medical pricing – and
perhaps putting us on the path toward having more control over our health
care costs." The Observer concludes: "Such transparency, on a wider
scale, can benefit both patients and providers."
Maryland Working Toward ACA
Implementation.
The Baltimore Sun (3/30, Dance) reported that
Maryland officials "face a long to-do list" to implement the ACA,
while "a dramatic proposed change in the way state hospitals can charge
for services could add to the upheaval. On Tuesday, state hospital regulators
submitted an application to change the state's Medicare waiver, which allows
them to set hospital rates." The plan "would create incentives for
Maryland hospitals to reduce the cost of care, ending compensation based on
inpatient admissions and thus removing an incentive to fill more hospital
beds." Maryland officials said they worked with the state's healthcare
industry to devise the "complex new system."
Public Health and Private
Healthcare Systems
Medicaid Expansion Decision Progress Across
Country.
Over
the weekend and through Monday, states continue to make news for moving
toward Medicaid expansion decisions. Coverage is scattered across the
country, with especially heavy focus on Texas, Montana, and Mississippi.
High Profile Texas Lawmakers To Push For, Against Medicaid
Expansion. The Texas Tribune (4/1, Ramshaw) reports, "On
the heels of Monday's press conference by Gov. Rick Perry and US Sens. Ted
Cruz and John Cornyn to reassert their opposition to expanding Medicaid, US
Rep. Joaquin Castro, D-San Antonio, and his identical twin, San Antonio Mayor
Julián Castro, will hold their own event to promote the key provision of
federal health reform." The Castro brothers "will be joined by the
Texas Hospital Association, supportive lawmakers and community and
faith-based groups."
The San Antonio Express-News (4/1, Fikac) asks, "Could the
Texas House debate Medicaid expansion?" The paper notes that "more
than halfway through the legislative session, a conversation on the House
floor would itself be a start. Devising and implementing a plan would take
much more."
In an article titled, "Perry Under Pressure To Accept Obamacare,"
the Financial Times (4/1, Kirchgaessner, Subscription
Publication) also covers the story. ***[HHS ONLY]***
Debate Over Medicaid Expansion Continues In Montana. The AP (3/30, Gouras) reported, "Gov.
Steve Bullock made sure Friday that it will be a little harder for
Republicans to oppose votes expected next week on Medicaid expansion,
pointing out that now even the conservative-leaning Montana Chamber of
Commerce endorses the program." He told reporters, "The Legislature
still has the opportunity, and Montanans want to see it. Other than those few
Republican legislators, you have to ask yourself: 'who is against
this?'"
The Missoulian (3/31, Dennison) reported,
"The biggest supporters of Medicaid expansion in Montana – besides those
who might get the coverage – are Montana's medical community, including
hospitals, clinics, physicians, nurses and other providers." This is because
"they'd benefit financially, as hundreds of millions of federal funds
would pour into the state, to pay medical bills for some 70,000 Montanans now
without insurance."
The Helena (MT) Independent Record (4/1, Dennison) reports further on
the debate over expansion, explaining that "Republicans say expanding
Medicaid will blow up the state budget, as the state pays a larger share of
the program in future years, overload an already 'broken' Medicaid program with
more people than it can handle, and hand out 'free' health care to thousands
of adults who should be buying private health insurance instead."
However, "Democrats argue the multibillion-dollar influx of federal
Medicaid money from expansion not only will provide coverage for 70,000
adults who can't afford it otherwise, but also give a huge boost to the
economy, creating jobs and a healthier workforce."
Mississippi Democrats Block Medicaid Funding To Push Expansion. The AP (4/1, Tillman) reports, "The
Mississippi House voted down a bill to fund the state's Medicaid program on
Sunday, creating the likelihood of a special session." Though the vote,
on Easter, was 58-49 in favor, a few more votes were needed to pass.
Disagreement over the bill stems from whether the state should expand the
program under the Affordable Care Act. Governor Phil Bryant responded Sunday
in a statement, saying, "It is unfortunate that the Democrats in the
Mississippi House are choosing political posturing to expand Obamacare at the
expense of vulnerable citizens in nursing homes, aged, blind and disabled
adults from losing services by not funding Medicaid."
The Jackson (MS) Clarion Ledger (4/1, Pender) reports that with the
block, Democrats are trying "to force a vote on expanding the program
and to block Gov. Phil Bryant from running it by executive order." As
Rep. Steve Holland, a Democrat, explained, "The federal government is
offering venture capital to expand the largest industry we've got in this
state, and we can't even get a vote and debate on it. So we're doing what we
have to do. We are going to have an up-or-down vote on Medicaid expansion -
it may be in a special session - or we are not going to have Medicaid."
The Memphis (TN) Commercial Appeal (4/1, West) adds that "stunned
Republicans asked the bill be held for one day as they decide how to pick up
the three votes needed for passage of the Medicaid spending bill."
Arkansas Moving Toward "Private Option" For Medicaid
Expansion. The AP (4/1, DeMillo) reports, "As
Arkansas lawmakers approach what could be the final weeks of this year's
session, it's becoming clearer that proposals to expand health insurance to
low-income workers and to cut $100 million in taxes are colliding." The
article explains, "Lawmakers are mulling a proposal that would allow
Arkansas to use federal Medicaid funds to purchase private insurance for
low-income citizens - those who make up to 138 percent of the poverty line,
which amounts to $15,415 per year. The insurance would be purchased through
the exchange created under the federal health care law." This move
"comes as Beebe is showing an openness to tax cuts that he once said the
state couldn't afford."
In an analysis piece, David Ramsey of the Arkansas Times (3/30) wrote that while "no
Republican lawmaker has endorsed the new 'private option' framework for
Medicaid expansion," many "are speaking, writing and tweeting about
it positively." For example, "earlier this week Rep. Charlie
Collins sounded downright excited about the new framework (maybe partly
because of all the revenue expansion brings in)."
However, noting that "the Arkansas plan to expand Medicaid" is
"getting attention from Republican leaders in Florida and Ohio, among
other states," the Kaiser Health News (3/29, Galewitz)
"Capsules" blog reported that "the strategy is not new,"
as "Oregon has been using this model for more than a decade - with mixed
results." Reports "paint a mixed picture" about the Oregon
Family Health Insurance Assistance Program. While "enrollees have a
wider choice of providers than in traditional Medicaid," the program
resulted in "higher deductibles and co-pays than traditional Medicaid,
which means beneficiaries have larger out-of-pocket costs. As a result, some
people report going without necessary health care, or delaying care until
they could afford the cost-sharing."
Sebelius, Pennsylvania Governor To Discuss Medicaid Expansion
Tuesday. The Allentown (PA) Morning Call (3/29, Darragh) reported that Gov.
Tom Corbett will meet Tuesday with HHS Secretary Sebelius to discuss Medicaid
expansion and will "be feeling the tug of hundreds of thousands of working
poor, political leaders, healthcare providers and advocates from all sides in
one of the last big political battles over Obamacare." The Morning Call
said HHS "has shown some willingness to allow other balky states
latitude in how they expand their Medicaid programs," and "that
gives supporters of the expanded program hope and opponents a bit of
concern."
In continuing coverage of related news from Pennsylvania, the Huffington Post (3/29) reported on a new study that
found that "expanding Medicaid in Pennsylvania would have increased the
annual amount of money the state receives from the federal government by
around $2 billion, adding about $200 million in state revenue every year, according
to a new study by the RAND Corporation, the nation's largest independent
health policy research program." Further, the study showed that
"the increase in funding would have added 35,000 jobs and provided a $3
billion boost in economic activity."
Indiana Governor Pushes Controversial Medicaid Expansion Plan. In the
Indianapolis Star (4/1), columnist Chris Sikich
writes that Indiana "Gov. Mike Pence and state lawmakers are moving
forward with an unconventional - and controversial - plan to expand Medicaid,
which would offer health insurance to about 400,000 more Hoosiers."
While the "unconventional part" is that officials "want to do
it through the state's Healthy Indiana Plan," Sikich reveals that the
"controversial part" concerns whether Indiana will be allowed "to
alter Medicaid to fit the Healthy Indiana Plan." Although, if Washington
fails to give Indiana approval, "Medicaid would not be expanded" in
the state, Sikich notes that "it's a gamble that legislative leaders and
Pence, a strong opponent of the Affordable Care Act, appear ready to
take."
The Munster (IN) Times (4/1, Carden) reports that "it
was always a long-shot that Indiana would expand eligibility for its Medicaid
program... given the distrust of the federal government by the state's
Republican-controlled Legislature and Republican Gov. Mike Pence." Now,
however, "it appears increasingly likely the General Assembly will
adjourn April 29 without taking any steps to prepare Hoosiers for the 2014
mandate that all Americans have health insurance." Noting that the House
Public Health Committee is scheduled to "take up Senate Bill 551
today," the Times adds that Debra Minott, secretary of the Family and
Social Services Administration (FSSA), told the committee "last week
that Pence believes state law already allows FSSA to negotiate" Healthy
Indiana Plan (HIP) "matters with the federal government and nothing more
is needed from the General Assembly, a claim that could potentially scuttle
the pending legislation."
"Tense" Medicaid Expansion Debate In Missouri
Continues. The AP (3/31, Lieb) reported that "in
the tense Medicaid debate at the Missouri Capitol," opponents have
raised concerns that Medicaid expansion would "create a crisis for
public schools," while supporters warn the failure to expand Medicaid
could "result in millions of Missourians' tax dollars going to health
care in other states." Noting that the arguments "might best be
labeled as hyperbole" because "states set some of their own
eligibility criteria," the AP revealed that, "in Missouri, coverage
is available to children whose families earn three times the poverty level,
about $58,600 annually for a single mother of two. Yet that mom cannot get
Medicaid coverage for herself unless her income is less than about $3,700
annually."
The Missourian (4/1, Johnson) reports that
"the Washington Chamber of Commerce board of directors has given a
letter of support to urge legislators in Jefferson City to approve Medicaid
expansion," despite rejection by the Missouri House. Mike Peters, Mercy
Health Systems' vice president of advocacy, "appeared before the chamber
board Thursday morning to ask it to sign a resolution supporting Medicaid
expansion, which is vital to Mercy Hospital Washington's financial operations
because of huge spending cuts in the Medicare sector due to
sequestration." Peters said that "looming payment cuts from
Medicare and Medicaid from 2013 to 2019 threaten health care's future
stability."
Battle Over Medicaid Expansion Mounts In Ohio. The Lima (OH) News (4/1, Malongowski) reports that,
"on the same day that two powerful state legislators - Senate President
Keith Faber and state Rep. Matt Huffman - laid out a case why the state needs
to move cautiously before accepting federal funds for Medicaid, Ohio Gov.
John Kasich was in Ohio's Appalachian foothills extolling his proposal to
expand the coverage." Noting that the battle over Medicaid expansion
"continues to play out among fellow Republicans," the News adds
that the fight is expected to "come to a head" as "it pits
lawmakers who are trying to rein in government spending against the leader of
their party who is on a crusade to help the poor with money provided under
President Barack Obama's health care overhaul."
The Cincinnati Enquirer (3/31, Bernard) reported that,
"as the debate over Medicaid expansion in Ohio heats up, a new report
details the impact the move could have across the state's 88 counties."
The report, which was released by a partnership of the Health Policy Institute
of Ohio, Ohio State University, the Urban Institute and Regional Economic
Models Inc., "offers the first look at what each county stands to lose
or gain as Ohio's legislature wrestles with whether to expand the joint
federal-state health care program to hundreds of thousands of low-income
residents." However, "whether this latest study can sway the minds
of Republican legislators remains to be seen."
Florida Businesses Could Benefit From Medicaid Expansion. The Tampa Bay (FL) Times (3/30, Tillman) reported,
"Service industries like restaurants, retailers and hotels all might
benefit [from Medicaid expansion], both by avoiding financial penalties and
by having employees who can get regular health care." According to the
article, "It's a case made by two recent research reports, and one
widely discussed in health policy circles. But Florida companies aren't
talking it up."
Similarly, WFOR-TV Miami (3/31) reported, "In
addition to providing insurance for those in need, an expansion of Medicaid
in Florida would create more than 100,000 new jobs, according to one
study." In a report "by the University of Florida Food and Resource
Economics Department if the state used the $51 billion in federal money to
expand Medicaid, it would boost Florida's economy by 121,945 permanent
jobs."
The Fort Myers (FL) News-Press (3/29, Gluck) reported that the
Florida Hospital Association, citing this study, "on Friday called on
state lawmakers to change course and endorse an expansion of Medicaid
insurance coverage as outlined in the 2010 Patient Protection and Affordable
Care Act."
McDonnell's Amendments Include "Tweaks" To Medicaid
Compromise. The Washington Post (4/1, Whack) reports that the
amendments Virginia Governor Bob McDonnell made to the state Legislature's
"landmark transportation deal" are unlikely to derail the bill. The
article notes that McDonnell's amendments "included tweaks to a compromise
reached on Medicaid expansion that assured support from some Democrats on his
marquee issue of transportation. Under the agreement, the legislature will
form a 10-member commission to oversee Medicaid expansion if certain goals
are achieved. McDonnell said his proposed changes are aimed at further
defining what reform will look like in Virginia."
Brownback Leaves Medicaid Expansion Question To Kansas
Legislature. The AP (3/31, Hanna) reported that Kansas
Gov. Sam Brownback is leaving Medicaid expansion up to the legislature, and
lawmakers "haven't formally rejected an expansion." That
"gives advocates of an expansion hope that they eventually can change
enough minds to bring tens of thousands of uninsured Kansans into
Medicaid." The AP says Brownback also is studying the Arkansas model
that has "received permission from the Obama Administration to use funds
for a Medicaid expansion to subsidize private insurance for poor
residents."
New York's Medicaid Plan
Receives High Marks For Handling Common, Costly Diseases.
On its
website, NY1 (4/1, Billups) reports that the
National Committee for Quality Assurance (NCQA) "analyzed New York
State's Medicaid health care plan against 76 different quality measures and
found that when it comes to offering the right type of care for common,
costly diseases like diabetes, childhood obesity, smoking cessation and
follow-up care for the mentally ill, New York is a national leader, second
only to Massachusetts." NY1 notes that "the good grades from the
national health care watchdog group left New York's state and city health
commissioners beaming." New York State Health Commissioner Dr. Nirav
Shah "points to work done by the state's Medicaid Redesign Team that
helped cut $4 billion out of delivery costs in the last year."
NYPost Concerned About Medicaid Misuse. In an
editorial, the New York Post (3/31) expressed concerns about
Medicaid waste and fraud. The Post note a recent audit from HHS that
"identified an "extremely high" incidence of error in billing
in the Family-Based Treatment Rehabilitation Services program for mentally ill
young people. As a result, the state has overcharged the federal government,
so the latter is now demanding New York return $27.4 million in reimbursement
fees." Even though $27.4 million is a "drop in the bucket given the
billions the state spends on Medicaid," a bipartisan report by the US
House Oversight and Government Reform Committee released last month "was
particularly scathing about putting the state's spending practices into
depressing perspective," noting the "the worst abuses of the
program consistently occurred in New York." The Post then advocates
reducing Medicaid.
Colorado Group, Lawmaker
Pushing For Single-Payer System.
The Denver Post (4/1, Booth) reports on an effort
in Colorado to put a single-payer system initiative on the ballot in 2014.
The group pushing for the vote, Health Care for All Colorado, argues that
healthcare is a right, not a privilege. The article notes that the initiative
has found little support among Republicans or Democrats.
The Durango Herald (3/30) reported on another push in
Colorado for universal healthcare, this one from state Senator Irene Aguilar.
Specifically, "Aguilar's bill would ask voters to create a statewide
health insurance co-op, owned by all Coloradans, which would replace health-insurance
companies. It would offer one wide-ranging policy for all residents. It would
be funded by a tax, which would replace the insurance premiums that companies
and people now pay."
Editorials Look Ahead To Possible Single-Payer Healthcare System.
In an editorial, the Salt Lake (UT) Tribune (3/30) wrote that the Affordable
Care Act is simply "one last opportunity for the private health
insurance market to prove that it can offer a service that covers the
millions of Americans who were previously left out, at a cost that we - as
individuals, employers and taxpayers - can afford." However, the paper
said it does not believe that this will bear out, and advocated instead for
"a single-payer plan - Medicare for all."
Similarly, but from a more negative perspective, in an editorial, the Augusta (GA) Chronicle (3/29) wrote that HHS Secretary
Kathleen Sebelius was "not just wrong but is off by a galaxy or
two" when she "cited a slowdown in Medicare expenses and conclude
that American health-care costs were going down." The paper continued, "In
a 2009 article, political watchdog Politifact.com noted fears among some
Americans that 'private insurance will wither in the face of a public option
and Obama will get the single-payer system he secretly wants.' So far, no
signs have emerged to point in another direction."
Local Health-Insurance Marketplaces Struggle To
Get People Enrolled.
The Washington Post (3/31, Galewitz) reports from
Florida that a Palm Beach County program that offered subsidized health
insurance coverage for $52 a month to residents who didn't qualify for
Medicaid attracted "fewer than 500 people" after a year. The
program's outcome has created "worry that similar problems could bedevil
the new online health insurance marketplaces that open for enrollment Oct. 1
under the Affordable Care Act." The Post also says that "persuading
millions of people to buy insurance...is still expected to be a tough
sell," while the Obama Administration "has yet to release any
details of its marketing campaign" for ACA options.
NY Post Concerned About Medicaid Misuse.
In an
editorial, the New York Post (3/31) expressed concerns about
Medicaid waste and fraud. The Post note a recent audit from HHS that
"identified an "extremely high" incidence of error in billing
in the Family-Based Treatment Rehabilitation Services program for mentally
ill young people. As a result, the state has overcharged the federal government,
so the latter is now demanding New York return $27.4 million in reimbursement
fees." Even though $27.4 million is a "drop in the bucket given the
billions the state spends on Medicaid," a bipartisan report by the US
House Oversight and Government Reform Committee released last month "was
particularly scathing about putting the state's spending practices into
depressing perspective," noting the "the worst abuses of the
program consistently occurred in New York." The Post then advocates
reducing Medicaid.
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