Brian Schweitzer's run as a leftwing Teabagger seeking ACA repeal will fail miserably.

[ProSense]

66. Running

"Schweitzer is on record over and over and over saying that his problem with Obamacare is that it doesn't go far enough. He's one of the few Dem politicians of national stature out there with the guts to call it what it is -- a giveaway to the insurance companies -- and to explicitly advocate single-payer in the form of Medicare for all."

...against Obamacare is beyond stupid. Still, the current article seems to be designed to fan anti-Obama flames. Schweitzer can run on single payer, but if his goal is to be anti-Obamacare, he's going to have to explain his support for provisions that are clearly part of the law. If his position is a repeal of the law, he's out of his mind. From the OP article.

But he couldn’t help himself, slamming Obama’s record on civil liberties (the NSA revelations were “un-effing-believable”), his competency (“They just haven’t been very good at running things”), and above all, Obamacare (“It will collapse on its own weight”).

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Schweitzer said he agreed to to tone down his attacks after their meeting. But he went on to engineer a series of confrontations with the Obama administration that highlighted his critique of the law.

His request for permission to sell drugs at Medicaid prices in Montana was rejected. He tried to get a waiver to turn Medicaid into a single payer system, modeled on Saskatchewan’s, for all Montanans. That idea was rejected, too. But he did build a small network of free clinics for state employees that pay doctors by the hour instead of by the procedure to lower expenses. So far, they’ve gone over pretty well.

Vermont will be on it's way to single payer thanks to funding from Obamacare.

Single Payer movement in the era of Obamacare.
http://www.democraticunderground.com/10024090281

HHS strengthens community living options for older Americans and people with disabilities

The Centers for Medicare & Medicaid Services (CMS) issued a final rule today to ensure that Medicaid’s home and community-based services programs provide full access to the benefits of community living and offer services in the most integrated settings. The rule, as part of the Affordable Care Act, supports the Department of Health and Human Services’ Community Living Initiative. The initiative was launched in 2009 to develop and implement innovative strategies to increase opportunities for Americans with disabilities and older adults to enjoy meaningful community living.

Under the final rule, Medicaid programs will support home and community-based settings that serve as an alternative to institutional care and that take into account the quality of individuals’ experiences. The final rule includes a transitional period for states to ensure that their programs meet the home and community-based services settings requirements. Technical assistance will also be available for states.

“People with disabilities and older adults have a right to live, work, and participate in the greater community. HHS, through its Community Living Initiative, has been expanding and improving the community services necessary to make this a reality,” said HHS Secretary Kathleen Sebelius. “Today’s announcement will help ensure that all people participating in Medicaid home and community-based services programs have full access to the benefits of community living.”

In addition to defining home and community-based settings, the final rule implements the Section 1915(i) home and community-based services State Plan option. This includes new flexibility provided by the Affordable Care Act that gives states additional options for expanding home and community-based services and to target services to specific populations. It also amends the 1915(c) home and community-based services waiver program to add new person-centered planning requirements, allow states to combine multiple target populations in one waiver, and streamlines waiver administration.

For more information about the final rule, please visit: http://cms.gov/Newsroom/Search-Results/index.html?q=&filter=Press%20Releases+Fact%20Sheets&date-from=&date-to=

For more information regarding the Home and Community-Based Services available under Medicaid, please visit: http://www.medicaid.gov/HCBS

For more information regarding the Community Living Initiative, please visit: http://www.hhs.gov/od/community/index.html

http://www.hhs.gov/news/press/2014pres/01/20140110a.html

Krugman: The Medicaid Cure
http://www.democraticunderground.com/10024309532

Medicare could benefit from a drug program similar to Medicaid's

Medicaid Drug Rebate Program

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The Medicaid Drug Rebate Program is a partnership between CMS, State Medicaid Agencies, and participating drug manufacturers that helps to offset the Federal and State costs of most outpatient prescription drugs dispensed to Medicaid patients. Approximately 600 drug manufacturers currently participate in this program. All fifty States and the District of Columbia cover prescription drugs under the Medicaid Drug Rebate Program, which is authorized by Section 1927 of the Social Security Act.

The program requires a drug manufacturer to enter into, and have in effect, a national rebate agreement with the Secretary of the Department of Health and Human Services (HHS) in exchange for State Medicaid coverage of most of the manufacturer’s drugs. When a manufacturers markets a new drug and electronically lists it with the FDA, they must also submit the drug to the Drug Data Reporting (DDR) system. This ensures that states are aware of the newly marketed drug. In addition, Section II(g) of the Rebate Agreement explains that labelers are responsible for notifying states of a new drug’s coverage. Labelers are required to report all covered outpatient drugs under their labeler code to the Medicaid Drug Rebate Program. They may not be selective in reporting their NDC's to the program. Manufacturers are then responsible for paying a rebate on those drugs each time that they are dispensed to Medicaid patients. These rebates are paid by drug manufacturers on a quarterly basis and are shared between the States and the Federal government to offset the overall cost of prescription drugs under the Medicaid Program.

http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Benefits/Prescription-Drugs/Medicaid-Drug-Rebate-Program.html

The ACA increased the Medicaid rebate percentage.
http://www.medicaid.gov/AffordableCareAct/Timeline/Timeline.html

Issue Brief - Medicare Drug Negotiation and Rebates

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Medicare Part D is a voluntary prescription drug benefit for Medicare beneficiaries, established in 2003 under the Medicare Modernization Act (MMA). Prior to this law, Medicare did not offer a prescription drug benefit. In 2012, almost 65 percent (over 30 million) of Medicare beneficiaries were enrolled in a Part D plan (MedPAC, 2013).

Medicare Part D went into effect in 2006, providing prescription drugs through private stand-alone prescription drug plans (PDPs) and Medicare Advantage (MA) plans. Part D drug prices are determined through a negotiation between the private drug plan that administers the benefit and the drug manufacturer. By law, the federal government cannot negotiate for Medicare drug prices...Prior to the implementation of Part D, Medicaid paid the drug costs for individuals who were dually eligible for Medicare and Medicaid. Dually eligible individuals are generally low-income, sicker and expensive to treat. The costliest 20 percent of dual eligible individuals account for 66 percent of Medicare spending (MedPAC, 2012). When Part D went into effect, dually eligible beneficiaries’ drug coverage switched from Medicaid to Medicare and the manufacturer discounts were discontinued.

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Savings. One argument is that billions of dollars of savings would be produced if the federal government negotiated for Medicare drug prices. While there are no current Congressional Budget Office (CBO) cost estimates for federal drug negotiation, a report from the Center for Economic and Policy Research (CEPR) estimates that savings to the U.S. government would range from $230 billion to $541 billion over 10 years (Baker, 2013). CEPR noted that the U.S. pays twice as much as other wealthy countries for prescription drugs because their governments are able to negotiate for lower prices.

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Best Price. A third argument is that it makes sense for Medicare to receive the best price available for prescription drugs, just like Medicaid and the VA. In Medicaid, the drug manufacturer provides the federal government discounts for drugs, which are shared with the states. The discount is either the minimum drug amount or an amount based on the best price paid by private drug purchasers, whichever is less. Current law requires drug companies to charge Medicaid 23 percent less than the average price they receive for the sale of a drug to retail pharmacies. Drug companies also must provide another discount if a drug’s price rises faster than the rate of inflation (Thomas and Pear, 2013)...Medicaid rebates, if applied to Part D, would save the federal government money. According to a 2011 study conducted by the Office of the Inspector General (OIG) for the U.S. Department of Health and Human Services, Medicaid rebates were three times greater than the discounts negotiated by Part D for 100 brand name drugs. In 68 of these drugs, Medicaid rebates were twice as high as rebates granted by the drug companies for Medicare drugs (OIG HHS, 2011; Hulsey, 2013). Similarly, a 2008 study of drug pricing information by the U.S. House Committee on Oversight and Government Reform found that Part D paid, on average, 30 percent more for drugs than Medicaid (Hulsey, 2013).

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http://www.ncpssm.org/PublicPolicy/Medicare/Documents/ArticleID/1138/Issue-Brief-Medicare-Drug-Negotiation-and-Rebates

The President has proposed the same rate for Medicare (http://www.democraticunderground.com/10022670043 ), which would save even more than the Senate proposal (http://www.democraticunderground.com/10022725266), $164 billion to $141 billion, respectively.

A Health Care Success Story

Sen. Bernie Sanders on Wednesday brought together leaders of community health centers from across Vermont where three new centers opening in January are part of a dramatic expansion of affordable primary care. A Sanders provision in the Affordable Care Act authorized $11 billion to build, expand, and operate community health centers throughout the United States. “This is a huge step forward,” said Sanders, chairman of a Senate subcommittee that oversees primary health care.

Sanders was joined at the news conference by representatives of the Battenkill Valley Health Center in Arlington, Vt., the Five Town Health Alliance in Bristol, Vt., and the Gifford Medical Center in Randolph, Vt. The Bennington, Addison and Orange county centers will become the newest in the state thanks to $2.4 million in federal funding released last month.

The eight current Federally Qualified Health Centers already provide primary and dental care along with mental health counseling and low-cost prescription drugs to more than 130,000 patients.

The three new centers will bring the total number of Vermonters served to about 163,000, more than one in four people in the state and one of the highest participation rates in the country. In addition, about 25,000 Vermonters now receive dental care at community health centers, a number which will also rise.

http://www.sanders.senate.gov/newsroom/recent-business/a-health-care-success-story