Republican politicians across the country claim that Obamacare’s expansion of Medicaid, the widely popular program which makes health insurance available for lower-income Americans, will increase costs for states. Ten Republican governors have pledged not to accept the Medicaid expansion funds and 22 other governors are considering turning down the money.

Directly disproving Republican claims, an extensive study reveals that the Affordable Care Act significantly benefits states by reducing their uncompensated care costs. In the months preceding the passage of the ACA, the President’s Council of Economic Advisors released a report on the impact of the bill on state budgets. Though the bill hadn’t yet passed when the report was written, the Council studied the Medicaid expansion which has since become law. The Council looked at the uncompensated care spending of 16 states demographically and geographically representative of the country (AR, CA, FL, ID, IN, IA, ME, MI, MN, MO, NE, NC, OR, PA, VT, WY).

The report reveals that states are currently spending billions each year providing coverage to the uninsured in three ways. Obamacare addresses each source to reduce state health insurance costs.

1. Under Obamacare, states no longer have to finance health insurance for people above 133 percent of the federal poverty level. Many states fund health insurance programs which cover residents living at more than 133 percent of the federal poverty level (FPL). Obamacare makes residents at higher than 133 percent of the FPL eligible for subsidized health insurance through state insurance exchanges at no cost to states. For example, Idaho would no longer have to fund health insurance for its 63 percent of uninsured residents who are above 133 percent of the FPL, reducing its $47 million annual uncompensated care cost to $17.3 million.

2. Under Obamacare, states pay billions less to cover people below 133 percent of the federal poverty level. States pay billions in health insurance programs for residents living at less than 133 percent of the FPL. After five years of Obamacare, the federal government will cover 90 percent of insurance costs for state residents making less than 133 percent of the FPL. For the first three years of the expanded Medicaid program, the federal government will cover 100 percent of Medicaid costs. The surveyed states will save $4.2 billion (100 percent of their uncompensated care costs) annually for the first three years, and $3.0 billion annually starting in 2019. For example, Michigan pays $212 million annually in uncompensated care costs. After five years of Obamacare, Michigan would have to pay only $68 million annually in the expanded Medicaid program.

3. By making health insurance universally available, Obamacare slashes the “hidden tax” states pay in health insurance premiums. States pay a “hidden tax” in the form of higher insurance premiums to account for the cost of covering the uninsured. “By greatly reducing uncompensated care,” the Council explains, Obamacare works to “reduce this hidden tax.” For example, North Carolina would see its annual $58.6 million insurance premium “tax” reduced to reflect a much smaller number of people without health insurance.

This study blows a hole in Republican claims that Obamacare has ill economic effects. In reality, Obamacare saves states money while improving the overall economy. Republicans who care more about fiscal responsibility than political gamesmanship would do well to embrace it.

– Ben Sherman

Fox News medical contributor Dr. Marc Siegel appeared on Fox Business Tuesday afternoon and expressed strong resentment for having to provide more health care coverage to sicker Americans in the aftermath of the Supreme Court’s decision upholding the constitutionality of Obamacare.

During a discussion about how medical providers will respond to the law, Siegel argued that some physicians won’t accept newly insured patients with pre-existing conditions who “eat all the wrong foods” and “gain weight” because “they are not paid enough”:

TOM SULLIVAN (HOST): Right now you can say I don’t accept Medicare or Medicaid? Right?

SIEGEL: Tom, that the untold story. There has been no consideration to the fact that many physicians do not take insurance. Many surgeons don’t take insurance…The more Obamacare floods the gate, the less they will take insurance. If they’re not getting paid and an insurance company says, I have to cut somewhere.

They are forcing me to cover all pre-existing conditions, which sounds great. Let’s take care of everybody’s pre-existing condition. You lie on the couch for 30 years, you never exercise, you gain weight, you eat all the wrong foods, you get diabetes and now you have Obamacare. But the fact is, doctors don’t have to play ball with it. If they are not paid enough they won’t play ball with it.

Watch it:

In reality, only a small minority of doctors in higher-income areas refuse to accept insurance. Most providers participate in Medicare and Medicaid and will continue to do so under the Affordable Care Act.

The law increases incentive payments for primary care physicians in Medicare, general surgeons in rural and underserved areas, and some mental health services. Primary care physicians in Medicaid will also receive a payment bump in 2013 and 2014. ACA also invests in preventive care and wellness initiative to encourage people to lead healthier life styles.

House Republicans have already set the date for another symbolic vote to repeal the Affordable Care Act, despite bipartisan support for some provisions of the law. Despite Republicans’ promises to eliminate Obamacare, the children of several congressional Republicans join the 6.6 million young adults up to age 26 covered through their parents’ health care.

According to the Huffington Post, these Republicans include Sen. Bob Corker (TN), Rep. Joe Walsh (IL), and Sen. Scott Brown (MA). This has not stopped Republicans from calling for a full repeal, without proposing a viable alternative:

“He [My 24-year-old son] is on his health plan right now — on his mother’s plan — but again, that wouldn’t weigh in on where I stand on the issue,” said Rep. Joe Walsh (R-Ill.) last week, before the Supreme Court handed down its ruling. “Again, I just think the whole thing needs to be scrapped. And I don’t even want to think about certain provisions yet.”

But Walsh and his GOP colleagues are soon going to have to start thinking about which provisions they want to keep if they are going to try to repeal Obamacare. Republicans are almost completely unified in wanting to get rid of the health care law, but they are significantly more divided on what a plan would look like going forward — and whether they should keep some of the law’s most popular provisions.

On Sunday, Rep. Paul Ryan (R-Wis.) said Republicans would not require parents’ health insurance plans to extend eligibility to adult children if Obamacare is repealed.

Walsh demurred when asked if he supported maintaining the provision.

“No, I don’t know that I do. I don’t know that I do,” he said. “I don’t know where I am on that, and that’s a lousy thing to say. My oldest is 24. That doesn’t matter to me, though, irregardless of that.”

Other lawmakers, including Reps. Mark Amodei (R-NV) and Pete Sessions (R-TX) assume the Republican alternative would include the provision. “Oh, sure. … It would be [incorporated] in any Republican proposal,” Sessions said. Rep. Allen West (R-FL) defended key provisions, including insurance for young adults, as well.

So far, it is unclear what Republican alternative would be. House Majority Leader Eric Cantor (R-VA) said they would revert to the GOP’s 2009 plan, an option that would leave 52 million Americans uninsured.

A Republican running for Congress in one of the nation’s most competitive districts claimed that Americans “don’t die from prostate cancer, breast cancer” in order to justify his opposition to health care reform.

Chris Collins, the GOP nominee opposing Rep. Kathy Hochul (D-NY) in New York’s 27th congressional district, gave a wide-ranging interview to The Batavian late last month. The New York Republican said he opposed Obamacare, claiming that the situation in America is not nearly as dire as some might think:

Collins also argued that modern healthcare is expensive for a reason.

“People now don’t die from prostate cancer, breast cancer and some of the other things,” Collins said. “The fact of the matter is, our healthcare today is so much better, we’re living so much longer, because of innovations in drug development, surgical procedures, stents, implantable cardiac defibrillators, neural stimulators—they didn’t exist 10 years ago. The increase in cost is not because doctors are making a lot more money. It’s what you can get for healthcare, extending your life and curing diseases.”

In fact, over 28,000 men will die of prostate cancer this year. According to the American Cancer Society, “Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. About 1 man in 36 will die of prostate cancer.”

Approximately 40,000 women will die from breast cancer in 2012. The American Cancer Society says it’s the “second leading cause of cancer death in women, after lung cancer.

(HT: Daily Kos Elections)

A Florida rape victim is suing her county jail and its medical contractor after one employee allegedly refused to give her emergency contraception, citing religious reasons.

After the woman — identified as R.W. — was raped, she went to the jail to identify her assailant. While there, the victim was placed under arrest for an outstanding warrant. It was during this arrest that the incident occurred.

According to the court filing, R.W. had taken one of a two-pill emergency contraception set. But when she needed to take the second pill, the difficulty began:

The next morning, January 28, 2007, Plaintiff requested the second anti-conception pill from Spinelli, explaining that Plaintiff had recently been raped, visited the Rape Crisis Center, and had a prescription from a medical doctor instructing her to take the second pill after twelve hours to prevent the rape from resulting in pregnancy. Spinelli refused to administer the pill to Plaintiff, allegedly stating that it was against her religious beliefs.

This is yet another example of the disturbing trend of conscience-clause excuses for not providing emergency assistance to rape victims. Florida has such a clause, which allows health care providers to deny care if it goes against their religion. Another incident, where a doctor in Oklahoma denied emergency contraceptives to a rape victim, relied on the same “religious beliefs” excuse.

R.W’s rape did not result in pregnancy, and she was permitted to take the second pill — though late — under another person’s supervision.

After last week’s legal validation of the Affordable Care Act, the Supreme Court’s ruling has nudged Republicans to begin discussing the “replace” part of their “repeal and replace” mantra. Not surprisingly, when Republicans actually talk about which specific health reform measures would be best for the country, their examples are suspiciously similar to the constitutionally sound Affordable Care Act.

House Republicans will hold another symbolic vote to repeal Obamacare on July 11, leading many to question what alternatives they would provide. In the past few weeks, some Republicans have broken away from the “full repeal” battle cry, pledging to maintain some Obamacare provisions while still neglecting to offer tangible provisions of their own:

• REP. RICK BERG (ND): A spokesman for Berg — who has previously voted to repeal Obamacare — said the congressman supports banning discrimination against those with pre-existing conditions and closing the Medicare “donut hole.”
• REP. ALLEN WEST (FL): In May, the Tea Party favorite told ThinkProgress he would like to maintain the provision allowing young adults to stay on their parents’ health insurance plans until age 26. The measure — which was one of the first to take effect upon the reform’s passage — has already incorporated millions of young people into insurance pools. “We’ve got to make sure no American gets turned back for pre-existing conditions,” West also argued.
• REP. ERIC CANTOR (VA): Last year, Cantor told college students at American University, “We too don’t want to accept any insurance company’s denial of someone and coverage for that person because he or she may have pre-existing condition.” Cantor told students that Republicans would push for a repeal of the health care bill while simultaneously submitting a replacement bill that also had provisions barring discrimination due to pre-existing and offers young people more affordable care options.
• GOV. SCOTT WALKER (WI): Earlier this month, the embattled governor argued that Republicans should find an alternative to the individual mandate to ensure that people with pre-existing conditions can attain health insurance. “I think there are good elements. I just don’t think you need the federal government to do most of those things,” Walker said. Of course, without a mandate that expands insurance pools with healthy bodies, insurance companies would find it nearly impossible to systematically incorporate millions of Americans with pre-existing conditions.
• SEN. ROY BLUNT (MO): Blunt broke ranks with Republicans when he came out in support of allowing young people to stay on their parents’ plans. An early endorser of Mitt Romney, Blunt argued that increased young people in risk pools would be a good way to “get a significant number of the uninsured into an insurance group without much cost.”
• SEN. SCOTT BROWN (MA): Brown voted three times to repeal Obamacare, but revealed in May that he uses the young adult provision to keep his 23-year-old daughter on his congressional health insurance plan. Brown brushed off calls of hypocrisy by arguing that he was merely taking advantage of the law in Massachusetts. Brown’s plan — the Federal Employees Health Benefits Plan — is actually regulated by the federal government, not state legislation.
• REP. PHIL ROE (TN): According to Roe, “It would be hard to write a 2,700-page bill and not have something in there that you like.” Roe’s hedged position differed from his party leadership’s promise to nix the entire bill.
• REP. TOM PRICE (GA): Price, the chairman of the Republican Policy Committee, has been one of the most vocal supporters of repeal efforts. But with the Supreme Court decision looming, Price relented on his staunch position earlier this month. “There are some things that have been instituted that a lot of folks have begun to rely upon and plan — make their family plans — based upon. Twenty-six-year-olds being on their parents’ insurance is one of them.”
• SEN. JOHN BARASSO (WY): Barasso echoed his colleague’s sentiment about the under-26 provision. “That’s something that I and other Republicans have supported from the beginning. And it should have been in an initial cooperative effort by Republicans and Democrats to actually lower the cost of health care, allow more people to be covered, and that’s an important part of what we need to do in the future.”
• REP. PHIL GINGREY (GA): Gingrey told ThinkProgress that the ruling “was one of the worst decisions in Supreme Court history.” Weeks ago, Gingrey pledged to take care of the sick once Republicans repeal Obamacare. “We have to make sure that we have a program — and we will, I can assure you we will — to take care of these folks.” He also called the under-26 provision a “good policy.”

Republicans placed their entire health policy on the incorrect assumption that the individual mandate would be ruled unconstitutional. Now that they have lost their central rallying cry, it has become increasingly clear they have no real plan to incorporate the 57 million people with pre-existing conditions should they actually repeal Obamacare.

But when they drop the impassioned anti-Obamacare rhetoric and address its actual provisions, many Republicans realize that Obamacare’s reforms are cost-effective ways to guarantee health insurance for millions of Americans who would otherwise be uninsured.

– Steven Perlberg