In the video below, Rick Santorum says that he would allow insurers to deny coverage to individuals with pre-existing conditions because the problem of people being turned away from coverage is “fairly limited.” This, despite the fact that an estimated 50 to 129 million Americans likely suffer from some kind of pre-existing ailment and run the risk of being denied coverage. In the course of his remarks to the Des Moines Register on Friday, Santorum also inadvertently explained why the individual mandate is so crucial to maintaining the pre-existing condition clause:

SANTORUM: The reason for the pre-existing condition clause is that you don’t want to create a situation where you don’t get insurance until they get sick or have an accident and the reason why Barack Obama did not, you’ll notice, enforce the pre-existing condition clause is until the mandate as put it. Why? Because if you enforce it before, what you do is you encourage everyone to drop their insurance. Because if you don’t have to have insurance until you’re sick, then of course why pay the premiums and particularly if you’re young and you’re single and you don’t have to worry about children and the complications of that. So what the pre-existing condition clause would do without an individual mandate is lead to much higher rates of uninsurance and much higher premiums for everyone who is insured.

Watch it:

A new study from Avalere Health is predicting that newly-insured Medicaid beneficiaries — who will enroll in the program as a result of the Affordable Care Act — will be sicker and more expensive to treat than current beneficiaries, the Hill’s Sam Baker reports:

A new Avalere analysis found that roughly two-thirds of Medicaid beneficiaries report being in “excellent” or “very good” health — compared with only about half of the low-income uninsured population that will gain access to Medicaid in 2014.

“What it means is that this is a more expensive population to treat, at least initially,” Mendelson said.

He could not say whether the findings indicate that the Medicaid expansion will ultimately cost more than what the Congressional Budget Office projected in its estimates of the healthcare reform law. It’s normal for per-person costs to jump as new groups gain access to healthcare coverage, he said.

This isn’t exactly unexpected, since uninsured individuals often lack access to the preventive care necessary to catch a condition before it becomes chronic and more expensive to treat. If anything, the report highlights the importance of investing in preventive care and expanding access to universal coverage sooner rather than later. The price tag for covering the uninsured would have been far smaller (party because their population was smaller as were health care prices) if lawmakers had expanded coverage under Clinton or Carter or Nixon.

After years of kicking the can down the road, the up-front cost of covering the uninsured is, indeed, impressive. But it’s also a necessary investment that will not only produce a healthier population, but could allow the government to spend less on health care (particularly uncompensated care). Even the short-term deal should be attractive for the states. A recent report from researchers at the Robert Wood Johnson Foundation and the Urban Institute predicts that states will save between $92 billion and $129 billion from 2014 to 2019 “because of provisions in the Affordable Care Act (ACA) that are designed to reduce the uninsured population and provide federal funding for functions that, in the past, have been financed by states and localities.” The federal government will spend “$704 billion to $743 billion more under ACA, while states will spend $92 billion to $129 billion less with ACA than without it.”

During a meeting with the editorial board of the Des Moines Register on Friday, Rick Santorum said that people who can’t afford health care should stop whining about the high costs of medical treatments and medications and spend less on non essentials. Answering a question about the uninsured, Santorum explained that health care, like a car, is a luxury resource that is rationed by society and recalled the story of a woman who said she was spending $200 a month on life-saving prescriptions. Santorum told her to stop complaining and instead lower her cable and cell phone bills:

SANTORUM: All the other necessities of life, we allow people to have varying degrees of creature comforts, if you will. Why? Because we are people who ration our resources based upon what’s important to us and health care has to be one of those things, which is in the mix of things we make decisions about as to what type of, what kind of money we want to allocate to that.

I had a woman the other day who came up and complained to me that she has to pay $200 a month for her prescriptions…I said, in other words, this $200 a month keeps you alive, she goes yes. I said, and you’re complaining that you’re paying $200 a month and it keeps you alive? What’s your cable bill? I mean, what’s your cell phone bill? Because she had a cell phone. And how can you say that you complain that you have $200 to keep you alive and that’s a problem? No, that’s a blessing!

Watch it:

But for the majority of Americans, crawling out of medical debt isn’t as simple as changing to a cheaper phone plan. According to a 2007 study, more than 60 percent of all bankruptcies are “actually capsized by medical bills” and most bankruptcy filers are “middle-class, well-educated homeowners” who can probably control their texting addictions. A more recent study published this year found that bankruptcy rates are particularly high among cancer patients, but “much lower for people age 65 and up, who would be eligible for Medicare.”

Members of Congress are back in their districts for the August recess, and some are claiming victory in the final debt ceiling deal by tying the spending reductions in the agreement to the Affordable Care Act. The Hill’s Elise Viebeck reports:

In one of the first town hall meetings of the break, on the morning of Aug. 2, freshman Republican Rep. Rob Woodall (Ga.) told a group of Rotarians in Forsyth County that the final debt deal cut roughly the same amount of spending that the Affordable Care Act would have incurred — about $900 billion.

“So if you think about what’s small and what’s big, understand that … we’re going to have erased…the same price tag that was on the president’s healthcare bill over 10 years,” Woodall said, according to the Forsyth News.

It’s a strange comparison, particularly since the same people who scored the debt ceiling — the Congressional Budget Office — also found that health care reform law lowers the government’s deficit by $210 billion over 10 years. And that’s a point proponents of reform should be making as Republicans travel around their districts claiming that “you can’t talk about the debt unless you talk about healthcare, that’s just a fact.” Because they’re right. You can’t talk about debt without mentioning that health reform helped reduce it.

Politico Pro’s David Nather offers this exhaustive menu of ideas to help the Super Committee — tasked with finding at least $1.2 trillion in spending cuts by Nov. 23 — get started. Below is my somewhat abridged version of his suggestions:

1) Crack down on Medicare fraud and abuse: As proposed by Obama’s fiscal commission, the idea is to give CMS more authority and more funding to track down fraud in Medicare payments.
What it saves: $9 billion over 10 years, according to the fiscal commission.

2) Raise the Medicare eligibility age: Gradually increases the eligibility age from 65 to 67.
What it saves: $124.8 billion over 10 years, according to the Congressional Budget Office.

3) Restructure Medicare benefits: Streamlines Medicare’s maze of co-pays and deductibles and saves money by doing it. Obama’s fiscal commission recommended setting one annual deductible of $550 for Medicare hospital and doctors coverage. Seniors would have to pay 20 percent coinsurance — that is, 20 percent of the costs — for any expenses above that.
What it saves: $110 billion over 10 years, according to the fiscal commission.

4) New rules for Medigap plans: Restricts how much the Medigap plans can cover, so seniors aren’t shielded from as much of the cost-sharing charges they’d have to pay otherwise. Obama’s fiscal commission suggested banning the plans from covering the first $500 in charges. And after that, seniors would have to pay half of the next $5,000 in cost-sharing fees.
What it saves: $38 billion over 10 years, according to the fiscal commission.

5) Fix the Medicare physician payment formula: Rewrites the current Sustainable Growth Rate formula, which has an enormous backlog of payment cuts that are about to hit doctors — because Congress postpones the cuts with a temporary legislative “doc fix” every time the cuts are supposed to happen.
What it saves: Ha ha! Funny. It’s going to cost money — about $358 billion over 10 years, according to CBO.

6) Raise Medicare Part B premiums: Seniors would have to start paying 35 percent of their premium costs, rather than the current 25 percent.
What it saves: $241 billion over 10 years, according to CBO.

7) Cut hospital payments for bad debts: Gradually gets rid of the Medicare payments that reimburse hospitals for unpaid co-payments and deductibles that they haven’t been able to collect from patients.
What it saves: $14 billion to $26 billion over 10 years, according to the Biden group.

8) Nursing homes/home health cuts: Charges higher co-payments or just cuts payments to skilled nursing facilities and home health care. The Biden group was looking at this option.
What it saves: $50 billion over 10 years, according to the Biden group.

9) Premium support pilot program: Obama’s fiscal commission proposed testing the idea of “premium support” — House Budget Committee Chairman Paul Ryan’s idea for reforming Medicare — by trying it out in the Federal Employees Health Benefits Program, which gives health coverage to federal workers. It would give these workers a subsidy for their coverage that grows slowly from year to year, saving money along the way.
What it saves: $18 billion over 10 years.

10) Medicaid block grants: Turns Medicaid from an open-ended entitlement into a block grant, with much more flexibility for states to decide what they will and won’t cover with it.
What it saves: Ryan’s version would have saved $750 billion over 10 years.

11) Medicaid “blended” matching rate: Obama’s idea for cutting Medicaid spending without restructuring the program is to change the federal matching formula. The proposal would replace a variety of different rates with a single “blended rate” for each state.
What it saves: $100 billion over 10 years, according to the target set by the Biden group.

12) Drug rebates for Medicare-Medicaid “dual eligibles”: Makes drug companies give rebates to people who are eligible for both Medicare and Medicaid — just as they already have to give rebates to people who get their drugs through Medicaid.
What it saves: $49 billion over 10 years, according to the fiscal commission.

13) Repeal the CLASS Act: Gets rid of the new long-term care insurance program created by the health reform law. It was one of the main recommendations of the Senate “Gang of Six.”
What it saves: So, funny thing — it costs $86 billion over 10 years.

Read Nather’s full report here.

Tim Pawlenty’s campaign is rebuffing this story accusing the former Republican Minnesota governor of embracing health reforms that were eventually incorporated into the Affordable Care Act, including: payment reform, Medicaid expansion, and establishing health insurance exchanges. Here is what Pawlenty spokesman Alex Conant is telling Politico:

“Gov. Pawlenty rejected individual mandates every time they were proposed in Minnesota, and said they were a bad idea in the same speech that’s being selectively pushed by some of his opponents now. His reforms in Minnesota used market-based reforms to lower costs and improve quality. Mitt Romney can’t debate President Barack Obama on health care; Tim Pawlenty can’t wait to.”

On the question of insurance exchanges, Conant adds: “Minnesota did study exchanges and concluded they didn’t work, which is why Gov. Pawlenty rejected the exchange proposals in Obamacare.”

Pawlenty praised Mitt Romney’s success in expanding health care coverage in Massachusetts and suggested that the mandate is something Minnesota might consider, but yes, he ultimately rejected that solution. What he did embrace whole heartedly — and this is where Alex Conant is really flubbing the facts — is the exchange. Pawlenty advanced the idea in Minnesota in 2007, arguing that a non-profit Minnesota Insurance Exchange could “connect employers and workers with more affordable health coverage options.” “If just two of your employees go out and buy insurance through the exchange, the benefits to the employer on a pre-tax basis — because of their payments to Social Security and otherwise into the 125 plan — more than cover the cost of setting up the plan,” Pawlenty explained at the time.

The proposal was part of the governor’s “Healthy Connections” health care plan, and he described the exchange as a structure that “will create another option for employers who would like to provide health insurance as a benefit for their employees.” “All individual health insurance policies in Minnesota will be required to be purchased through the Exchange. Individuals will also be able to pay for coverage with pre-tax dollars. The products will continue to be regulated by the state,” a press release for the proposal read.

Pawlenty’s support isn’t very surprising since the exchanges were initially conceptualized by the conservative Heritage foundation and advanced by Republicans as a way for insurers to compete head-to-head on equal playing field for beneficiaries. That he’s now distancing himself from this proposal — and his campaign is misrepresenting his role in advancing it — is, well not too surprising in a political environment where anything the Democrats or Obama embrace turns toxic for someone hoping to secure the GOP presidential nomination.

Last week, Florida Gov. Rick Scott (R) announced that he was consolidating the number of HMO health care coverage options offered to state employees to one per county, arguing that the change could “save taxpayers $400 million in two years.” But critics and some insurance carriers are alleging that Scott is awarding contracts to campaign contributors and supporters, while punishing companies that donated to his opponents:

The new HMO provider for 38 counties in the state — including Broward, Palm Beach, and Miami-Dade — also happens to have some close ties to Gov. Rick Scott. AvMed Health Plans, which won the bid to be the sole HMO provider in the 38 counties, happened to be very friendly to Scott on the campaign trail.

State campaign contribution records don’t provide details of donors’ employment, but Health News Florida reported during Scott’s campaign for governor that he received $5,000 from people associated with AvMed. The company itself also shelled out $10,000 for Scott’s inauguration party.

On the other hand, UnitedHealthcare of Florida — which claims it provided HMO coverage to 66 of the state’s 67 counties before it was butted out of most of them — has no such record of contributions to the governor. In fact, the contribution records show that someone named David Lewis — the same name of UnitedHealthcare’s CEO for Central and North Florida — and claiming to be of the medical profession donated $500 to Alex Sink, Scott’s Democratic challenger.

This isn’t the first time Scott has been accused of pushing reforms that would enrich him or his supporters. The governor approved legislation seeking to privatize the state’s Medicaid program that would require “most of the state’s 3 million Medicaid enrollees to join private health plans after July 1, 2012.” The proposal “gives managed care companies more control over the program that’s paid for with federal and state money” and could benefit Solantic, “a chain of urgent-care clinics aimed at providing emergency services to walk-in customers” that Scott founded in 2001. Scott has also signed an executive order “requiring random drug testing of many state employees and applicants for state jobs.” It’s probably only a coincidence that Solanic offers drug testing.

All of this is even more troubling in the context of Scott’s history. Before being elected to the governorship, Scott was fired as head of Columbia/HCA just as the for-profit hospital chain pled guilty to a massive array of fraud charges — which resulted in a fraud settlement of $1.7 billion dollars, the largest in U.S history. He eventually went on lead an advocacy group, Conservatives for Patients Rights, which sought to eliminate the public option from the health care reform law. In that capacity, he argued that a government health insurance option would lead to single payer and undermine choices in coverage — the very choices he’s now limiting for state employees.