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Medicaid and Health Reform-Past Present and Uncertain Future

On Tuesday, February 7th, we went to the City Club of Cleveland for a program titled "Medicaid and Health Reform-Past Present and Uncertain Future" in which the speaker was Professor Benjamin D. Sommers who, as the program notes stated, "is a practicing primary care internist, and he is also a Assistant Professor of Medicine at Brigham and Women's Hospital and Harvard Medical School. From 2011-2012, he served as a Senior Advisor in the Office of the Assistant Secretary for Planning and Evaluation in the U.S. Department of Health and Human Services, and he has continued to serve part-time in an advisory role in 2013-2015. His current research projects focus on barriers to health care access among low-income adults, Medicaid Policy, and national health reform."

The format consisted of Prof. Sommers speaking for about 15 minutes and then being queried by Professor J.B. Silvers, Ph.D., John R. Mannix Medical Mutual of Ohio Professor of Health Care Finance at CWRU. Lastly, the audience got to ask questions.

During the program, Prof. Sommers gave what we thought was a fairly honest presentation about the pluses and minuses of Medicaid Expansion and the Affordable Care Act. He cited convincing evidence that showed that due to these controversial (in the eyes of many) programs more people have been insured and their health has generally benefitted from them. In terms of alternatives, he questioned block grant proposals because they tended to not provide the necessary amounts of monies to be effective but he believed that waiver programs that would allow the states to experiment more with innovative ways to provide coverage held promise.

Specifically, Prof. Sommers made clear that he just wanted to see people get the necessary healthcare covered that they needed and didn't care if it came from the government, the private sector, or combination thereof.

Probably, the most telling moment came when a questioner talked about the Uber driver named Doug who drove her there and how much he liked his treatments that he was able to receive at home and hoped they would be able to continue because it was an example of an individual entity had recently made significant strides towards becoming healthier.

Overall, Prof. Sommers didn't profess to know the future but did say that the Trump administration didn't have the votes in the U.S. Senate or House of Representatives to abolish the ACA or Medicaid Expansion entirely but he could cripple them significantly through "budget reconciliation" aka cutting the funding. If that happened the administration could expect a large bipartisan backlash from state and local leaders whose constituents would be without coverage. Thus the best course of action would probably be "repair not repeal."

Afterwards, we said hello to Prof. Silvers and he told us to be sure to say "hello" to Ms. Margaret W. Wong who he has known for a long time. Other well-wishers included Ms. Anne Marie Warren and Mr. Mitch Wasserman who respectively served on the "Cleveland Public Library" and "College Now" boards with Ms. Wong.

We also met people who we hadn't seen at the City Club before like Rabbi A.L. Joseph from "Gesher Cleveland" which helps connect Cleveland families in need to the resources that can help them, and Mr. Jim McMahon, Senior Director of Product Development at the "Cleveland Clinic" who recently moved to Cleveland from Detroit to accept this position which was newly created.

To be sure, the topic of immigration and/or the Trump Administration Executive Order came up in several conversations including one we had with a person whose spouse had immigrated to the United States from the Philippines and was very concerned about future policies.

On the topic of immigration, we got to talk to Prof. Sommers for a moment and asked him if there were studies out there regarding immigrants and healthcare. Prof. Sommers replied that there were and mentioned that the those who are documented often do not take advantage of the health care options available to them due to cultural or language barriers combined with lack of guidance in terms of understanding how our system works.

He added an interesting note when he mentioned that he believed that the act of immigrating to the United States was such an arduous physical and mental process that a person would have to be healthy to successfully undergo it. What's more, many immigrants are healthier than a native-born people because they have not acquired our bad habits of eating unhealthy foods and not exercising.

By:

Michael Patterson

Community Liaison,

Margaret W. Wong & Assoc. Co., LLC.

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