Many losing Medicaid access in NC could be re-eligible under the new expansion

Plus: A hospital turns away patients with medical debt and what kind of healthcare system do we actually have?

Jun 02, 2023

Good morning and happy Friday. This is the Friday Pulse Check, your weekly newsletter with the healthcare headlines you need to know.

In the news:

COVID-19 Medicaid purge begins; in NC unwinding could limit expansion

Now that the COVID-19 public health emergency has ended, many states have begun re-evaluating who is eligible for the Medicaid programs. KFF Health News estimates that the total number of Americans who have lost access to the Medicaid system since April 1 is 600,000. Further analysis shows that four out of every five of those losing access are doing so simply because they never returned the required paperwork or were missing some required documents. Because of this, some are calling for a pause in disenrollment. Read more from USA Today.

N. Carolina Governor Signs Medicaid Expansion Bill Into Law - Chapelboro.com

In North Carolina, the unwinding of COVID-19 Medicaid coverage could limit the recently agreed to Medicaid expansion in the state. What was heralded as a significant reform could turn into a messaging problem for the governor. Terminations from Medicaid in North Carolina will begin in July and Medicaid expansion won’t happen until the state budget is approved. The North Carolina Department of Health and Human Services has confirmed that many who will be removed following the end of the continuous coverage requirement will be eligible again when Medicaid expansion takes effect. About 300,000 people could be removed from the system while 600,000 could be added once the expansion takes effect. Read more from NC Health News.

Hospital begins turning away patients with too much medical debt

Minneapolis, Minnesota based Allina Health System has begun turning away patients with too much medical debt and warning that they must pay down their bills before they can receive some specialty services at the hospital. The story was first reported by the New York Times. In a statement, Allina Health System said they only cut off patients after they have three instances of a debt greater than $1,500 and that they regularly call patients with debt to provide information on how to apply for financial assistance. The system said they have provided more than $18 million in aid to patients. The Times also reported that patients have been locked out of their electronic health records; Allina Health System responded saying, "patients retain full access to their medical records at all times despite the NYT article." Health records are the property of the patient. Read more in the New York Times. 🔒

Ron and I have talked about medical debt a few times on the FLATLINING Podcast. It is a tricky thing to deal with. Unlike car loans or student loans, most (if not all) people are not choosing to go into medical debt; it is simply thrust upon them. As some states try to negate the consequences of it, however, it could have a real negative impact on physicians. Hear our take on it from this past episode of the FLATLINING Podcast. Click here to listen.

Amazon’s RxPass now available in forty-four states

Amazon.com’s (AMZN 0.00%↑) online subscription pharmacy RxPass is now available in Pennsylvania. The program is only offered to Prime members. Patients with a prescription can purchase generic drugs and have them delivered to their home for $5 per month. Currently, RxPass is not available in California, Louisiana, Minnesota, New Hampshire, and Washington and it is not open to Medicare or Medicaid patients. Amazon has been working for a while to break into the healthcare space; in 2018 the company purchased Pill Pack and in 2022 purchased the primary care chain OneMedical for $3.9 billion. Read more from WTAJ.

The FLATLINING Podcast

This week on the FLATLINING Podcast, Ron and I talked a little bit more about California and some of the potential changes coming to the healthcare system in that state. The legislature is debating raising some of the Medi-Cal reimbursement rates for office visits and maternity care to 87.5% of Medicare rates.

Additionally, Democratic Governor Gavin Newsom has angered fellow Democrats in his state because he has collected over $1 billion from the state’s individual mandate fine but hasn’t spent it on healthcare as he promised. In fact, it hasn’t been spent at all; it is sitting in the state’s general fund.

We also talked a bit about the debt ceiling deal. If Congress manages to completely pass it by June 5, physicians will not have to work about Medicare payments being delayed. We’ll talk next week about what happens if there is a delay.

Listen to this episode

Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible.

Ukraine

Amid Russian drone attacks in Ukraine’s capital of Kyiv, former New York Governor George Pataki was there handing out trauma kits to the survivors. This is his fifth trip to the region. In an interview with the New York Post, he said, “We’re bringing in the kits and training civilians on how to stop bleeding, treat people and get through the initial trauma so they can be transported to more comprehensive health care.” Read more in the New York Post.

Final Thought

As frequent Friday Pulse Check readers and FLATLINING Podcast listeners will know, we take a sort of neutral approach to the type of healthcare system we have in the United States. Is it messy? Yes. Does it work? Yes, most of the time. Does it need reform? Absolutely. That is why we push back on policies that want to force a complete privatization of our healthcare system or a complete government take over. Both would significantly change, and we would argue adversely effect our access and ability to afford healthcare.

So what kind of system do we have now? Yes. That is the best way to describe it and the folks over at Kite and Key Media put together a short video that I think sums it all up quite well.

Have a good weekend,

Matthew