Last week, we wrote about why it’s getting harder and taking longer to get doctors’ appointments. And it’s getting worse. Payments to physicians for treating Medicare patients were cut by 3.4%, starting January 1.
The American Medical Assn. is among many others fighting to reverse the cuts. AMA President Jesse Ehrenfeld says Congress must include a fix in the budget deal it currently is negotiating because more and more doctors “are just stopping seeing new Medicare patients, or opting out of the program entirely.” Medicare physician pay declined 26% from 2001 to 2023, adjusted for inflation.
The Medicare Payment Advisory Commission (MEDPac), a congressional advisory panel, considers a vast amount of data regarding the impact of Medicare changes. One shows a decline in Medicare participation by primary care physicians.
MEDPac recommend in meetings this week increasing Medicare payments to hospitals, doctors, and dialysis centers with reductions in payments to nursing homes, home health agencies, and inpatient rehabilitation facilities starting next year. It’s now up to Congress to decide.
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Obamacare’s impact continues to shock us. Health Care News reports that federal taxpayers now are paying millions for child sex-change surgeries, required as “medically necessary gender-affirming care.”
HCN reports that these provisions led to a 150% increase in sex reassignment surgeries in the U.S. in just one year, from 2016 to 2017, with countless more since then. Boston Children’s Hospital, “which boasts of having the first pediatric transgender surgery center in the country, has performed hundreds of gender surgeries on children since 2017 and has offered phalloplasties for 18-year-old boys and vaginoplasties for girls as young as 17,” the must-read publication reports.
Merrill Matthews, a resident scholar at the Institute for Policy Innovation, says that while facilities boast of how many transgender surgeries they are performing, “a small but growing number” of these patients “are now de-transitioning and asserting that what they really needed was mental health care. Their lives and their bodies have been changed forever…with lasting physical and mental scars.”
Fortunately, some states are stepping up to protect children, including Florida that banned spending tax dollars on sex change procedures, not just minors. The Ohio House voted this week to override Gov. Mike DeWine’s veto of legislation banning the sex surgeries and treatments for minors and preventing women and girls from competing on female sports teams. The Ohio Senate, where Republicans have a supermajority, is expected to vote later this month whether to support the House’s override.
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Oh, and California’s expansion of health coverage to all illegal immigrants includes access to procedures and drugs “that bring primary and secondary gender characteristics into conformity with the individual’s identified gender.”
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The Biden administration is bragging that 20 million Americans have signed up for 2024 ACA health plans. This is a record number. And it shows that when the government is offering highly subsidized health insurance and suffocates the market for alternatives, people will “flock” to the coverage.
The administration also is lamenting that 14 million people have been cut from Medicaid as states begin checking eligibility for the first time in three years. Many are no longer eligible, but states couldn’t update their rolls during COVID restrictions.
Once again, many people rely on Medicaid because they have nowhere else to go for coverage. Adding millions of illegal immigrants and able-bodied Americans with other options for coverage only makes it harder for the most vulnerable to access the care they need.
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Finally, health care came up late in the CNN debate on Wednesday night between former UN Ambassador Nikki Haley and Florida Gov. Ron DeSantis. And the two candidates agreed on two issues: abortion restrictions and a better way to expand coverage.
In an otherwise contentious debate, the two candidates said they support states’ rights to restrict access to abortions after six weeks and said they support block-granting money to states, like Florida and South Carolina, that opted not to expand Medicaid.
“I think what you do is you block grant the program and then let states run the way they see fit to do,” Gov. DeSantis said. “I can tell you this, expanding Medicaid leads to less private coverage. It doesn’t necessarily increase access to quality care. I want to actually people get good healthcare.” (Transcript: 1:30:27)
We have argued for years that block grants are the correct course. States have vastly different problems and resources that cannot be accommodated through federal legislation or regulation. Giving states more power and resources would go a long way toward solving many of the problems the federal government has created, including crushing innovative local health insurance markets.
Taking us right back to where we began today’s newsletter…
