Joe Paduda did an excellent job with the latest edition of the Health Wonk Review over at Managed Care Matters. My favorite post in the HWR comes from Tim Jost, writing at Health Affairs. His article, about what would replace the ACA if it were repealed, is an excellent read. Jost digs deep into the Republican proposals for Obamacare replacement (most of which haven’t really gotten further than rough outlines), and explains the conundrum generated by the fact that the core goals of the ACA are not compatible with the core goals of ACA opponents – replacing the ACA essentially means heading in an entirely new direction, one that doesn’t necessarily take us to a point of having better overall access to healthcare and lower healthcare costs.
Another really interesting read in this edition is from Anthony Wright at Health Access California. Write explains the recent legislative push in CA to extend health insurance coverage to all California residents, regardless of immigration status. On the state level, the focus is on expanding Medicaid (Medi-Cal) to everyone who is eligible based on income, regardless of immigration status, and also allowing undocumented immigrants with higher incomes to purchase coverage in the exchange with their own money if they choose to do so (currently, under federal law, undocumented immigrants cannot purchase coverage in the exchange at all, even without a subsidy). There are also a variety of local-level initiatives to expand coverage to undocumented immigrants. While I imagine similar proposals would have a really tough time gaining traction in other states or at a federal level, it’s good to see a state recognizing the fact that we can’t simply ignore the problem of uninsured undocumented immigrants. Undocumented immigrants are here, and they contribute significantly to our economy. Yet without health insurance, they have a much more difficult time obtaining preventive and primary care, and emergency treatment is generally uncompensated for safety net hospitals. There’s a lot to think about, and Wright’s post is good food for thought.
There are plenty of other great articles in this week’s HWR. Many thanks to Joe Paduda for putting it together!