Forum Thread

Obamacare Medicaid expansion too good to pass up by governors

Reply to ThreadDisplaying 10 Posts
  • Are you sure you want to delete this post?
        
    There are two prevailing thoughts regrading the Supreme Court making the Medicaid expansion provision of the Affordable Care Act (ACA) optional.  Lawrence O'Donnell is pushing the view that as many as half of the governors including some Democratic governors will decline to participate in that part of the ACA, thereby leaving as many as 8 million people without health care coverage.

    On the other hand, Ezra Klein writing for the Washington Post and filling in for Rachel Maddow tonight sees the Medicaid "carrot" too lucrative to pass up...even for Governor Perry of Texas.  Here's the link to his article:

    Health-care law’s Medicaid provision too good to pass up

    Medicaid is a joint effort by the states and the federal government, but the states set the eligibility rules. States like Texas, for example, now only cover working adults up to 26 percent of the poverty line, which is set at $11,170 for an individual. So 26 percent of $11,170 is $2,904. Therefore if you are single and making $3,000 a year you make too much money to qualify for Medicaid in Texas. It's not surprising then, that Texas has the highest uninsured rate in the nation.

    At the other end of the scale, Massachusetts covers working adults up to 133 percent of the poverty line and therefore covers people making up to $14,856/year.  They also have the lowest uninsured rate in the nation. Much of the credit goes to Romneycare. As Klein explains:

    "The Affordable Care Act wants to make the whole country like Massachusetts. Everyone earning up to 133 percent of the poverty line, which is less than $15,000 for an individual, gets Medicaid. And the way it does that is by telling states the feds will cover 100 percent of the difference between wherever the state is now and where the law wants them to go for the first three years, and 90 percent after 2020."

    The actual year by year federal contribution to the medicaid expansion would be 2014 100%; 2015 100 %; 2016 100 %; 2017 95 %; 2018 94 %; 2019 93 %; 2020 and beyond 90 %.

    Klein opines: "To get a sense of what an incredibly, astonishingly, unbelievably good deal that is, consider this: The federal government currently pays 57 percent of Medicaid’s costs. States pay the rest. And every state participates."

    Ironically, red states like Texas stand to gain the most from the ACA, while Massachusetts will gain the least.

    Klein's guest on the Rachel Maddow show tonight was Howard Dean. He says it would be "shear stupidity" for states to pass up the deal, especially for Texas that would get some $52 billion in Medicaid aid to help out those that can least afford health care insurance.

    I recommend you watch a fuller explanation by Ezra Klein at the Rachel Maddow show link.  Comparing the doom and gloom scenario of Lawrence O'Donnell versus that realistic assessment of Ezra Klein, I'm going with Ezra Klein's view.  Whatever bloviating that the Republican governors are doing now saying they won't participate, in the end they all will. They will not pass up the money...the citizens of their respective states won't let them.

    Comments invited...





  • Are you sure you want to delete this post?
        
    Yeah, Medicaid is a federal-state program, I don't know how the federal government can't change its terms. 

    And why do the States get to reject the Medicaid expansion, but they can't reject the mandate or the exchanges?

    Our Supreme Court is totally dysfunctional.

    Whatever. Take the compromise. But I'm not buying into "activity" vs. "inactivity" arguments.

    States would be idiots for rejecting federal funds for the Medicaid expansion. Those folks will still have ability to get on the exchanges and use federal subsidies.
  • Are you sure you want to delete this post?
        
    Carlitos Wrote: States would be idiots for rejecting federal funds for the Medicaid expansion. Those folks will still have ability to get on the exchanges and use federal subsidies.


    TeeHee

    Rick Scott Announces Florida Won't Take Medicaid Money
  • Are you sure you want to delete this post?
        
    Rick Scott, Rick Perry, Scott Walker and others that reject the government funds to expand Medicaid coverage are really exposing their selfish pettiness.  I can't believe that they are that ignorant...or stupid.  Maybe they are answering to "a higher authority"...their rich benefactors that fund their campaigns.

    Or maybe they hate President Obama so much that, like their counterparts in the Tea Party House of Representatives, they would rather f**k with the health and welfare of Americans than concede any victory to the President.

    Whatever...Democrats in those states need to have a massive publicity campaign of what those governors are giving up.  Then let public opinion and polling put pressure on them.  Of course Fox News viewers will remain forever ignorant on this issue.
  • Are you sure you want to delete this post?
        
    "I don't know how the federal government can't change its terms."

    The federal government can, however this is against the principals of the real American ideology of a Democratic Republic (although it is not a true Democratic Republic).

    "And why do the States get to reject the Medicaid expansion, but they can't reject the mandate or the exchanges?"

    The 3 major branches of government (Supreme Court, President, Congress), decide what choices individual states can make. If you disagree with it, you should appeal to the Supreme Court or your Congressman. 

    "Our Supreme Court is totally dysfunctional."

    Not exactly, but it is filled with tenured under-achievers who obtained their positions in a way opposed to the fundamental theory of a Democracy. 

    "Whatever. Take the compromise. But I'm not buying into "activity" vs. "inactivity" arguments."

    Well you aren't inactive, you are posting on a "Democratic Hub" message board, which by definition makes you active. Inaction is not a bad thing either. If you are not educated, and have no political views or opinions you should not vote. The idea of free election is to choose who you think can represent your needs. 

    "States would be idiots for rejecting federal funds for the Medicaid expansion. Those folks will still have ability to get on the exchanges and use federal subsidies."

    This is not meant to be condescending, but how familiar are you with each states medical care programs and facilities? Do you feel you are qualified to question why a state would or would not want government assistance? Personally I do not.
  • Are you sure you want to delete this post?
        
    republicans forget the g. bush  mandate PLAN D prescripion drugs. which we paid for and received nothing and if we did not pay  then we would be fined    please do not run OBAMA ads on your station we already like him run some where else ?   republicans are looking a coverup why not look at the NFL player who enlisted in the. . military and was killed by friendly fire and it took three years the BUSH group to the parents what happened  [  tillman ]    i have a sign in my yard saying[ vote for wall street or main street ]                                             good luck ED
  • Are you sure you want to delete this post?
        
    King Tut:

    Government has the operational ability to do, or attempt to do, whatever it wants by decree. We operate under a system of self-imposed constitutional restraints, and thankfully so!

    My point on Medicare is that it violates no principle of States' Rights to withhold FEDERAL AID for a state's non-compliance with federal terms.

    States don't have to participate in Medicaid! Just like with Wickard v. Fillburn, conservatives are on the wrong side of their ideology.

    Once again, they are defending a constitutional right to state subsidies. This is pure politics! Conservatives need to stop and think about what they are saying.  

    Roberts extracted a high price from the liberals on the court for his swing vote.

    Furthermore, "inactivity" is a relative term. Everyone is potentially in the healthcare market. It's a free-rider, moral hazard issue here. If you don't have insurance, and you get hit by a car, government agents (fed/state/local/ngo) will provide emergency care. If you are unconscious, there's no way of waving them off. There's no way for them to know if you're an anti-government libertarian who would rather die in the street than suffer the indignity of receiving government subsidized healthcare, or if you prefer to live. Now, you might still get a bill from the authorities, but at prices that subsidize non-payment and delinquencies. It's not secured like a student loan debt; if you fail to pay, the worst that can happen is reduced credit, and ineligibility to take advantaged of low-income healthcare plans within a particular hospital district (if you are admitted to the ER, they still will take care of you again and provide stabilizing care without regard to your ability/willingness to pay).

  • Are you sure you want to delete this post?
        
    Okay...remember all the hullaballo last month when several Republican Governors said they would not participate in the Medicaid expansion part of the Affordable Care Act.  Probably no one on that stage could match the Bloviater-in-Chief, Texas Governor Rick Perry. As the Texas Tribune quoted Perry on July 9th:

    "I stand proudly with the growing chorus of governors who reject the Obamacare power grab," he said in a statement. "Neither a 'state' exchange nor the expansion of Medicaid under this program would result in better 'patient protection' or in more 'affordable care.' They would only make Texas a mere appendage of the federal government when it comes to health care."

    He got lots of cheers for that, but as I noted at the time above in my original post :

    "Whatever bloviating that the Republican governors are doing now saying they won't participate, in the end they all will. They will not pass up the money...the citizens of their respective states won't let them."

    And now with all the bloviating quieting down, Think Progress notes that Rick Perry has built into his budget the funds available in President Obama's Affordable Care Act provision for expansion of the Medicaid program.

    "In a letter explaining how he would fill a budget gap left by Texas’ decision to defund Planned Parenthood, Perry’s office uses the money the federal government will pay states that make Medicaid available to individuals up to 133 percent of the Federal Poverty Line in its budgetary assumptions:

    "Greta Rymal, Deputy Executive Commissioner for Financial Services, has projected the fiscal impact of this rule for three years, assuming that all clients will be eligible for Medicaid following the expansion of the Medicaid program in January 2014 [...]"


    I guess Rick Perry is not so stupid after all...just don't let his base know it. I predict all the governors will follow Rick Perry's lead...as Texas goes, so goes the rest of the Republican nation. Ha!
  • Are you sure you want to delete this post?
        
    Carlitos Wrote:  (if you are admitted to the ER, they still will take care of you again and provide stabilizing care without regard to your ability/willingness to pay).


    Anyone crying out for '"REPEAL"  of the Affordable Health Care Act need to be thrown out in front of a passing train.  The most important benefit (speaking for myself) on the newly enacted health care law is what you have just stated above.  When you are brought to an ER they will now take care of you and not set you aside and bleed to death.  If anyone is not aware of this reality yet...they should stand at a New York ER Hospital and observe.  First thing they ask when you are brought to an ER in New York, is if you have health insurance, if the answer is NO, they set you aside and bleed to death.  But now that the ACA is in place, you need not worry to die at your own peril, they will take care of you. People who ARE crying out to repeal what they fondly call "OBAMACARE" should put this in their heads.
    Now talking about Medicaid Expansion......if you’re against Medicaid expansion, you’re for a higher mortality rate, especially among our most vulnerable populations. Provocative? Yes, maybe even demagogic, but no less true for being so.
    The reality, of course, is that when it comes to health care policy, we must make trade-offs that are both cruel and necessary. We’d probably also have a lower mortality rate if we stuck a paramedic in every home, but we’re not going to do that because the costs would far outweigh the benefits (though I suspect the firefighters’ lobbyists will propose this at the next legislative session.)
    When it comes to expansion of Medicaid — the federal-state health insurance program for the poor and disabled — the benefits far outweigh the costs.
    The federal government would pay 100 percent of medical costs for newly eligible Medicaid recipients through 2017. By 2020, federal funding would drop to 90 percent.
    Any Governor of any State would be stupid to refuse implementation of  this Medicaid Expansion. 
    I just could not remember the name of that one particular State that took ten (10) years for them to reconsider to implement Medicaid when it first was implemented ...all those Federal Funded money they lost, they regretted it because of that then stupid Governor who refuse to make Medicaid available to its citizens.  If anyone could remember what State that was, can you come back and tell me?
  • Are you sure you want to delete this post?
        
    Well, I hope they are not currently setting aside the uninsured in NY ER hospitals to bleed to death. That's a violation of federal law, given that every type of emergency facility in America receive public funds. And it was Ronald Reagan who signed that mandate into law. 

    You just can't make this shit up folks!

    The modern Republican party is totally insane.