If these trends are more than a benign anomaly, they would not only ease pressure on the Medicare budget, but would moderate government health spending generally, a development that could vaporize concerns about the growing cost of entitlement programs.  As analysts of all political stripes have been saying, America’s government doesn’t have a spending problem; it has a health spending problem.  

For example, Medicare, the federal health care program for people ages 65 and older, requires certain Lawful Permanent Residents to pay an expensive premium, depending on their work history and length of residence. Naturalization ensures access to Medicare on the same basis as all other Americans. The same is true of Supplemental Security Income (SSI), a public program that pays benefits to disabled adults and low-income children. Lawful Permanent Residents who came to the United States in refugee status may receive SSI regardless of work history or length of residence, but generally only for seven years. 

The dream standard, which Obamacare does not aspire to meet, is a system that provides any care requested from any provider without worrisome costs.  Such care would include eyeglasses, hearing aids, dental work and unlimited physical and mental therapy, all conveniently available at sites where cost was never a barrier. There is no existing insurance plan in America that provides such a broad menu of services.  While these services may solve real problems, insurance typically limits or excludes them.

Even though the Affordable Care Act will significantly reduce California’s uninsured population, unless county-run health programs are well funded, those who don’t enroll, or cannot enroll because of their income level or their undocumented status, will be left with an “uneven safety net,” according to a study released last week by the Health Access Foundation. The report comes at a time when counties are making crucial decisions in the coming weeks on the scope of their safety net programs for indigent care after the full implementation of the ACA on Jan. 1, 2014.

With close to 10,000 letters in tow, a group of community leaders traveled to Baton Rouge Friday morning to make an in-person delivery to Governor Piyush Jindal. The Jeremiah Group, a faith-based, non-partisan community organization, started their “Life, Liberty, and Healthcare for All” letter campaign in July. The signed letters urge Jindal to accept Medicaid expansion for Louisiana and were collected from residents across New Orleans.

To buy or pay the penalty? That is the question that will confront many U.S. residents in the coming months, when open enrollment season begins for health insurance coverage, under the terms of the Affordable Care Act (ACA), also known as Obamacare. ACA will be fully implemented on January 1, 2014, when most legal U.S. residents will be required to have “minimum essential health coverage” or make a “shared responsibility payment,” as the Congressional Budget Office puts it in regulations it rolled out last fall. 

Reaffirming his commitment to protect current and future generations who depend on Social Security, President Obama declared in Tuesday’s State of the Union address, “Our government shouldn’t make promises we cannot keep -- but we must keep the promises we’ve already made.”  Indeed, we must keep the promise of old-age security that Americans have earned through hard work. The nation’s politicians should be held accountable to keep their word that they will not cut the Social Security benefits of older workers, retirees, people with disabilities and the children of deceased and disabled parents.

The GOP’s response to President Obama's first post re-election State of the Union Address in some ways will be markedly different than in its response to his prior addresses. But in one way it will be the same. Its blatant frontal assault on him didn’t work for four years. So this time the GOP’s rebuttal will be softer and gentler in tone and theme. But underneath the flowery rhetoric, the GOP’s relentless attack on his policies is still very much in place.

“Media elites have convinced themselves that there is a crisis in Social Security,” said Eric Kingson, a professor of social work at Syracuse University and co-chair of the advocacy group Social Security Works. Kingson, who served as a policy advisor on presidential commissions on the issue in the 1980s and ’90s, said there is indeed an increasing crisis around adequate funding for retirement in America. “But they [journalists] focus on the most conservative framing of the crisis,” he said. In reality, Kingson added, “Social Security is the one bright spot” in the federal government.

Will the U.S. economy go over the “fiscal cliff” after New Years Day? If so, what will that mean to the country’s most financially vulnerable people? Former White House economic advisor Jared Bernstein of the Center on Budget and Policy Priorities (CBPP) told reporters on a national telephone briefing Thursday, organized by New America Media and CBPP, that he believes Democrats and Republicans will take the budget negotiations to and possibly over the cliff’s edge.