You do realize we already have a public plan, right?

Insuring Resources Commentary:

The House health care reform bill includes a public plan option, meaning its a plan that would compete against insurers. This story is about the public plan that is the last available option, Medicaid, for many folks.

The attached story below is about the huge expansion nationwide of state Medicaid programs in the wake of the recession. During these tough times, Wisconsin has expanded its Medicaid program while most others have seen their enrollment expand without trying. But Wisconsin has expanded Medicaid through its BadgerCare program to cover more low-income uninsured persons... many of whom ARE employed. Wisconsin now covers uninsured persons with and WITHOUT kids up to 200% of fpl if they don't have employer coverage. For a family of four that's about $37,000 annually. The expanded group do pay a subsidized premium. Do you know a family on BadgerCare? I bet you know several. I'd bet several of my son's elementary school classmates are covered by it.

So for those who talk and warn about the "government takeover of health insurance", please get your head out of the sand. Its been happening for awhile.

By most estimates in 2009 we had between 45-47 million uninsured in the US. So now we have a roughly equal amount, according to Kaiser 46.9 million, on Medicaid programs.

Guess what folks, fewer and fewer of us have employer-based coverage- the last number I saw, for 2008, was 59%. You know that's lower now, right? By the way, in 2000 69% of us had employer-based coverage.

Isn't it time for an overhaul?

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Kaiser Analysis Finds Record Medicaid Enrollment Growth in 2009

Largest Ever One-Year Increase Illustrates Medicaid's Role In Covering People During Economic Downturns But Further Strains Tight State Budgets

WASHINGTON, Feb. 18 /PRNewswire-USNewswire/ --
With the country mired in a deep recession, nearly 3.3 million more people were enrolled in state Medicaid programs in June 2009 compared to the previous June, according to a new analysis by the Kaiser Family Foundation's Commission on Medicaid and the Uninsured. It was the biggest ever one-year increase in terms of absolute numbers, and boosted the June monthly Medicaid enrollment by 7.5 percent to 46.9 million people nationally.

It was the first time in decades that every state experienced an increase in Medicaid enrollment, and in 32 states enrollment grew at least twice as fast as the year before, according to the analysis, which includes data breakouts by state.

"State Medicaid programs have been able to help millions of Americans who have nowhere else to turn in a recession," said Diane Rowland, Executive Vice President of the Foundation and Executive Director of KCMU. "But the states obviously face significant fiscal pressures as increases in enrollment push up costs at a time when state budgets are already severely constrained."

The increase in enrollment reflects the role that Medicaid plays in reducing the numbers of people who become uninsured when the economy falters, with many people turning to the program for help after being laid off and losing their employer-based health insurance. Millions more who were not eligible for Medicaid likely joined the ranks of the nation's uninsured.

A new Kaiser survey of state Medicaid directors finds that 44 states and the District of Columbia are experiencing higher than expected program enrollment, resulting in increased spending for fiscal year 2010. At least 29 states say they are considering additional mid-year cuts in provider rates and program benefits.

Enhanced federal matching money for Medicaid provided through the American Recovery and Reinvestment Act of 2009 has proved critical in helping states maintain coverage. But that money is scheduled to expire on Dec. 31, 2010, which will increase the strain on state fiscal year 2011 budgets, Medicaid directors reported.

Although Medicaid enrollment is on the rise, costs of the program as measured on a per-person basis are not climbing at a faster rate than health costs more generally. (See "An Actuarial Rorschach Test" [link to http://www.kff.org/pullingittogether/021610_altman.cfm]). Moreover, in past recessions, after the economy has improved, Medicaid enrollment growth has slowed and sometimes contracted, suggesting that the record rate of enrollment growth seen in 2009 will eventually subside.

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