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Dr Delos Cosgrove

Cosgrove sees premiums going up if Medicaid isn’t expanded

By Rich Daly
Posted: July 21, 2012 - 12:01 am ET

The head of largest Medicaid provider in Ohio said private insurance premiums will increase if that state opts not to expand the program.

Dr. Delos Cosgrove, president and CEO of the Cleveland Clinic, said if his state opts not to expand its Medicaid program to cover all patients with incomes of up to 133% of the federal poverty level with a 5% leeway up to 138%, then he expects the number of indigent patients will increase. Ohio is one of the majority of states where the governor has yet to decide whether to expand Medicaid following the U.S. Supreme Court’s decision upholding the constitutionality of the Patient Protection and Affordable Care Act. The ruling also struck down financial penalties for states that decide not to expand their Medicaid program.

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We will “have more patients without any reimbursement for us and that will cause the rest of us who buy insurance to have our premiums go up,” Cosgrove said at a Washington address to the National Press Club.

However, Cosgrove expressed concerns about other aspects of the 2010 federal healthcare overhaul, including the impact of payment change provisions that base reimbursement for devices or drugs on findings that they are efficacious. Specifically, the time and cost involved in showing relatively better efficacy may discourage investors from funding medical innovation.

“I’m concerned, frankly, that beginning to fund things on that basis will begin to drive a lot of innovation out of healthcare in the United States,” he said.

Other aspects of the law that he criticized were its lack of provisions to control the overall rise in healthcare costs and “not enough” wellness and prevention measures.

Cosgrove touted legislation he backed that Sens. Rob Portman (R-Ohio) and Ron Wyden (D-Ore.) introduced in March to provide financial incentives to Medicare beneficiaries remain healthy.

“We find that very small financial incentives drive significant behavior,” he said.

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