Unintended consequences
Friday, Aug 2, 2013 - Posted by Rich Miller
* From David Ormsby…
Because of an oversight in the [federal] Obamacare law, those who require a residential stay to power their recovery are unable to use the vast majority of Illinois drug-treatment residential programs with 17 beds or more because they are prohibited from being Medicaid certified due to an older Medicaid law.
So, what does this mean?…
An unemployed, homeless man who was living in a Chicago homeless shelter managed, through the help of friend, to present himself at a suburban Cook County drug treatment agency, pleading for help to overcome his alcohol abuse. The assessment revealed he needed residential treatment due to severity of his condition.
The response from CountyCare’s HMO provider? Denied.
The individual was denied both because the residential program was not — and could not be — Medicaid certified and because the man, struggling on his own to overcome his alcoholism, had taken no alcoholic drink in two days. The agency was told that the client needed to fail first in outpatient care — he had to resume drinking — before residential treatment became a viable option. Just what the doctor ordered.
What happened?
The man finally reported to the CountyCare HMO that he began drinking again, leading the HMO to hospitalize him in medical detox — a vastly more expensive option than residential treatment. And Obamacare picked up the bill.
Before CountyCare, this man would have received the less costly clinical detox in the agency’s residential program for men under its contract with Illinois Division of Alcohol and Substance Abuse. But for those now enrolled CountyCare, the state option is no longer available. The state, which is looking to save money, is no longer willing to expend its own precious tax dollars because the promise of Obamacare was to save states money by having the feds picking up the tab.
Oy.
And, of course, we can’t expect any congressional trailer bills to fix problems like this because the US House is bound and determined to repeal the law.
In the meantime, though, the state needs to revisit its policies here.
- CircularFiringSquad - Friday, Aug 2, 13 @ 10:33 am:
And congrats to the local media coverage of the $400 million Chase fine for stealing $125 million from electric users in CA and “Midwestern states.”
- CircularFiringSquad - Friday, Aug 2, 13 @ 10:36 am:
Oh wait…
WASHINGTON (Reuters) - Two Democratic Senators on Wednesday asked U.S. energy regulators for more details on how terms of a settlement were reached on alleged power market manipulation in California and the Midwest by a unit of JPMorgan Chase & Co.
In a letter to Jon Wellinghoff, chairman of the Federal Energy Regulatory Commission (FERC), Elizabeth Warren and Edward Markey, both of Massachusetts, questioned whether the settlement announced on Tuesday included “adequate refunds to defrauded ratepayers.”
JPMorgan Ventures Energy Corp agreed to disgorge $125 million in profits and pay a civil penalty of $285 million for 12 “manipulative bidding strategies” identified by regulators as having taken place between September 2010 and November 2012.
It was the second largest penalty in FERC’s history but, the Senators wrote, “equal to roughly 1.3 percent of JPMorgan’s 2012 profits.”
Warren and Markey also asked FERC why certain JPMorgan executives accused by FERC “of stiff-arming its investigators by refusing to comply with subpoenas,” will not be punished, and why the company was permitted to avoid an admission of guilt.
Craig Cano, a spokesman for FERC, said the commission does not comment on Congressional correspondence but that Wellinghoff would respond to the Senators.
To bad Comando Make it UP (Sen Kirk) did not slap his name on this one
- Formerly Known As... - Friday, Aug 2, 13 @ 10:43 am:
“We have to pass the bill so you can find out what’s in it.” Perhaps if they read it first things like this would have been caught.
More locally, this is a tragic story. An indigent man finds the will to finally seek help and gets turned down by our tax dollars.
What use is the social safety net if it is not catching the folks it is intended to help?
Someone, at some level, needs to fix this. Cook County? The state of Illinois? The public is watching and looking to you for leadership, since the House clearly isn’t addressing this particular problem.
- Fed up - Friday, Aug 2, 13 @ 10:49 am:
I support national health care but the law that was passed is terrible. That’s why all the exemptions are being handed out and Obama is not enforcing the employer mandate until after 2014 election. It will kill jobs if ever enforced. The Dems jamed a crap bill though without any care, and the GOP refuses to help fix all the problems. Congress at its best.
- Chicago Cynic - Friday, Aug 2, 13 @ 10:50 am:
It’s a technical problem that, as Rich suggests, just needs what we would call a trailer bill to fix. But you can bet those on the right who’ve now passed 39 useless bills to repeal Obamacare, will somehow turn this into a major political talking point. Wow, how I long for the days of a functioning Congress. Little did we know how good we had it.
- 47th Ward - Friday, Aug 2, 13 @ 12:38 pm:
Too sober for Medicaid treatment is like being too sane for a Section 8 military discharge. Somewhere Jospeh Heller is smiling.
- Responsa - Friday, Aug 2, 13 @ 1:00 pm:
If congress had been “functioning” this particular unworkable Obamacare bill which is chock full of “unintended consequences” would not have been passed as it was. The time to actually successfully reform healthcare services availability was in committee, *before* it was hurriedly passed on a wing and a prayer and (unfortunately for all of us) without any of the legislators of either party having time to read it. The “trailer bills” needed to fix this mess would fill a trailer and the discretion over language holes and to make policy which was left to an unelected cabinet secretary is shocking. But of course it’s all “the right’s” fault.
- Marie - Friday, Aug 2, 13 @ 2:22 pm:
The 17 bed rule has been part of medicaid for a very long time and did not start with the affordable care act
- Rich Miller - Friday, Aug 2, 13 @ 2:25 pm:
Yes, Marie, that’s noted above. It’s what has to be changed.
- Anonymous - Friday, Aug 2, 13 @ 3:58 pm:
If I read this right, the problem isn’t in the Affordable Care Act. Rather, the state chose to stop funding something that was more generous than the benefits available under the ACA. The “fix” isn’t necessarily for the ACA to be amended — it’s for the State to continue providing what they had always provided.