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Southern Governors Secede from Medicaid

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Southern Governors Secede from Medicaid

Postby pjbogart » Tue Jul 10, 2012 8:04 pm

House Republicans are lining up to repeal the Affordable Care Act on Wednesday, but GOP governors in the South have a real plan to gut the law.

Govs. Rick Perry in Texas and Rick Scott in Florida have both said they won’t expand Medicaid to more of the working poor in their states — rejecting a central part of the law designed to cover 15 million more Americans.

The governors can do it because the Supreme Court ruled last month that states can opt out of the expansion without paying a penalty.


Southern Governors Secede from Medicaid

Scott Walker also seems intent on rejecting the Medicaid expansion, or at least milking the controversy for as much publicity as possible. But what are the implications of such a rejection? Will poor Wisconsinites find that they aren't offered subsidized insurance as promised under the ACA? Is this just a game of chicken to see if the Feds will pick up 100% of Medicaid costs instead of the 90% planned? Or maybe it's a plot to force the poor into the penalty for not having insurance by not offering them the Medicaid expansion?

How poor do you have to be to currently receive Medicaid or is it only for the unemployed and disabled? I think the new rule is 130% of poverty level so I guess that means that anyone who doesn't qualify now, but earns less than 130% of poverty level wages will be affected by the rejection. Will those people have no other option for health care or can they get subsidies through the exchange as well?

And lastly, is this good politics? If you're a governor with a chance to cover every single person in your State for only 10% of costs, wouldn't rejecting that aid be a dangerous political position?
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Re: Southern Governors Secede from Medicaid

Postby snoqueen » Tue Jul 10, 2012 9:41 pm

They're expecting to cover any loss of votes from people who won't get Medicare and will be upset. This will happen through the miracle of the Voter ID program.
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Re: Southern Governors Secede from Medicaid

Postby Huckleby » Tue Jul 10, 2012 10:09 pm

It's good politics to make a showy display of turning down the money.

Then it is good politics to quietly accept the money, a year or three from now when the furor over Obamacare has died down.

Governors in purple states like WI will take the money after the election.
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Re: Southern Governors Secede from Medicaid

Postby Donald » Tue Jul 10, 2012 10:19 pm

Medicaid was really a Republican idea meant to answer President Johnson's proposals for a more federally directed program. If states turn down money for Medicaid, it will bring an end to the Republican idea of state-federal partnership, and force a federal program, which is what Democrats want anyway. More power to these useful idiots.
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Re: Southern Governors Secede from Medicaid

Postby Cornbread » Tue Jul 10, 2012 10:24 pm

Southern Governors Secede from Medicaid

Sounds good to me, and over half of this nation too.
Good thing our (formerly) great nation is (supposed to be) a Confederation of States.

At least 15 governors have indicated they will not participate in the expansion of Medicaid under the healthcare law, striking a blow to President Obama’s promise of broader insurance coverage.

Before Thursday’s Supreme Court ruling, states had the option of either increasing their Medicaid rolls or being penalized by the federal government. The high court struck down that offer as unconstitutional.

http://thehill.com/blogs/healthwatch/he ... id-program


So it seems as though obamacare's mandate was, increase your medicaid rolls or suffer the consequences. That's the normal, "plata o plomo", 'silver or lead', 'go along with us or else....' deal that thug/criminal organizations always employ.

“You can make the political call real quick, but the actual decision is a complicated one,” said Matt Salo of the National Association of Medicaid Directors. “Governors are going to be looking at the numbers and asking: Does this make sense for us?”
[same link]


So that's the question, I guess, "Does this make sense for us?".
Apparently the answer seems to be "no" for both democrat and republican governed states.

BTW, what's with this leftist democrat race to see how many people they can get on food stamps, on medicaid, etc. ?

Once this (formerly) great nation is up to 80% of the population not working and on the dole, will that finally make us like europe?
UK? Greece? Spain? Italy?
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Re: Southern Governors Secede from Medicaid

Postby pjbogart » Tue Jul 10, 2012 10:41 pm

Hey, but the Republicans are hard at work to come up with some alternatives to the ACA...

In the last year and a half, House Republicans have sent the Senate just one 36-page bill designed to limit medical malpractice lawsuits, despite pledging to develop detailed legislation to slow rising healthcare costs, help Americans keep their health plans and broaden access to insurance.


Republicans focus on repealing, not replacing, 'Obamacare'

Ah, so to control rising health care costs, Republicans propose giving a wet, sloppy kiss to doctors and hospitals. Actually, I don't have anything against malpractice reform, per se, but it won't save us much money.

Bread and circuses. That's all they've got left.
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Re: Southern Governors Secede from Medicaid

Postby Cornbread » Tue Jul 10, 2012 10:52 pm

pjbogart wrote:Hey, but the Republicans are hard at work to come up with some alternatives to the ACA...

What's the aca? Is that the ObamaTax, that isn't, but it really is a tax on everyone and everything?

In the last year and a half, House Republicans have sent the Senate just one 36-page bill

I'm surprised they did anything with "cowboy poet" leftist democrat harry reid's ran senate. That's the place where all things go to die.

What's it been since the democrat ran senate put forth a budget? 4 years? Can you do that in your home/apt?

Actually, I don't have anything against malpractice reform, per se, but it won't save us much money.

relative to the $16,000,000,000,000 obamadebt we have now, you are correct. Heck, the "bush tax cuts" only run our government for what, 8 days? So I presume you're against increasing taxes by repealing tax cuts too, right?

Cutting health care costs, already posted here by me:
1. Stop illegal immigration.
2. Deport illegals when they commit a crime.
3. Lawsuit reform.
4. Stop unfunded mandates from congress.
5. Streamline FDA approval for drugs.

and I've not even talked about how docs are running from medicaid because they are reimbursed so little, they lose money with each 'government patient' they tread. Could be categorized under #4 though.
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Re: Southern Governors Secede from Medicaid

Postby Huckleby » Wed Jul 11, 2012 9:38 am

Cornbread wrote: Cutting health care costs, already posted here by me:
1. Stop illegal immigration.
2. Deport illegals when they commit a crime.
3. Lawsuit reform.
4. Stop unfunded mandates from congress.
5. Streamline FDA approval for drugs.

You may feel like you are onto something, but the facts are against you. As ridiculous as these proposals are, they actually are no more silly than most of the announced Republican positions. The four legs of the conservative table (and they have exactly 4 ideas):
1) High risk pools for pre-existing conditions
2) interstate insurance policies
3) tort reform
4) more "skin in the game" for consumers. Promote health savings accounts.

The first three ideas are COMPLETE bunk, they have no value whatsoever when tested in the market or analyzed by health care economists. It is unusual when one side of a debate has nothing at all, but that is the case here.

The fourth idea has merit, in my opinion. We could have a health care solution that emphasized free markets, and it might be better than Obamacare. The rub is it would have to be a hybrid solution with government subsidies for those that the free market leaves behind. Only a handful of Republicans have shown any willingness to craft such a compromise, the tea party rules.

Cornbread wrote: and I've not even talked about how docs are running from medicaid because they are reimbursed so little, they lose money with each 'government patient' they tread .
OK, fair enough. Are you sincerely interested in making Medicaid work better, or are you just trying to kill all funding that helps poor people?
Obamacare attempts to deal with the problem you cite. Three cheers for Obamacare, right?
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Re: Southern Governors Secede from Medicaid

Postby fisticuffs » Wed Jul 11, 2012 10:12 am

and I've not even talked about how docs are running from medicaid because they are reimbursed so little, they lose money with each 'government patient' they tread .


How exactly do docs "lose money"? Aside from their time what are their costs of a Medicaid visit?
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Re: Southern Governors Secede from Medicaid

Postby snoqueen » Wed Jul 11, 2012 5:19 pm

Actually, that's a verifiable problem with Medicaid. Medicaid has a standard reimbursement rate for various medical services including plain old office visits.

Many doctors find that rate so low they can't even cover their costs, let alone meet the rate they charge other patients. By costs I mean overhead (prorated staff, facility rental/mortgage, utilities, loan payments for equipment, etc); time spent by doctor, nurses, PAs, or techs providing direct services; supplies; and the like.

I think mostly they're saying this in good faith (there are always bad apples, but I mean overall). As a result they limit the number of Medicaid patients they take per month, and they're frequently booked up long in advance.

I have not seen even honest, service-oriented doctors deny this problem exists.
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Re: Southern Governors Secede from Medicaid

Postby fisticuffs » Wed Jul 11, 2012 5:42 pm

That's sounds reasonable for a dr with their own practice but how does that apply to a dr staffed at a hospital, or a salaried doc at the VA?
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Re: Southern Governors Secede from Medicaid

Postby Stebben84 » Wed Jul 11, 2012 5:46 pm

fisticuffs wrote:
and I've not even talked about how docs are running from medicaid because they are reimbursed so little, they lose money with each 'government patient' they tread .


How exactly do docs "lose money"? Aside from their time what are their costs of a Medicaid visit?


It's funny he mentions this cause I was talking to an ETN surgeon a few weeks ago about medical costs. Turns out, most private insurance companies only pay out about half the costs on the hospital bill. He said this forces the hospital to inflate the bill so that they will recoup what they are actually owed. The problem is that those folks who don't have insurance are forced to pay the FULL amount of these inflated bills.

It's amazing that it has come down to governors picking and choosing what legislation they want to follow. If a Dem governor did this during Bush's term conservative would be shitting all over them.
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Re: Southern Governors Secede from Medicaid

Postby pjbogart » Wed Jul 11, 2012 6:34 pm

I think the Republicans are getting close to jumping the shark with all of their feigned outrage and clownish press conferences. So they decided to devote two days to debating the repeal of Obamacare on the House floor, despite the fact that the Senate will never vote on it, the President wouldn't sign the repeal anyway and it's the 33rd time they've voted to repeal the ACA.

Right here on TDPF our resident conservatives crow about Obama's failure to accomplish anything while their own party is engaged in shameless politicking reminiscent of their effort to save Terry Schiavo. They're tying up the House of Representatives for two days just to hold a vote that every American recognizes is nothing but a circus performance.

80 House Republicans Sign Letter Urging Speaker Boehner To Halt Any Further Funding of Obamacare

Wait a minute! If Republicans "hold the purse strings of government," why are our taxes so high? Why is the deficit so large? Why is the debt growing out of control?

Perhaps they're all secretly leftists!
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Re: Southern Governors Secede from Medicaid

Postby Huckleby » Wed Jul 11, 2012 8:28 pm

pjbogart wrote:I think the Republicans are getting close to jumping the shark with all of their feigned outrage and clownish press conferences.


I saw a poll on news that 51% of independents think should GOP should abandon efforts to repeal Obamacare. We may have reached a tipping point.
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Re: Southern Governors Secede from Medicaid

Postby Cornbread » Wed Jul 11, 2012 8:38 pm

Huckleby wrote:
Cornbread wrote: Cutting health care costs, already posted here by me:
1. Stop illegal immigration.
2. Deport illegals when they commit a crime.
3. Lawsuit reform.
4. Stop unfunded mandates from congress.
5. Streamline FDA approval for drugs.

You may feel like you are onto something, but the facts are against you.

I'll bite. "facts" according to who/what?
With #1 alone, how many countries where there's socialized health care have no borders and don't ask/don't tell immigration policy for mandated health care w/o spending caps?
------->>> 0<<<----------

So I know that #1 is going against the political grain, but I'm honest and don't want to be elected to anything, don't politically advise any politician, and my business doesn't have to worry about any political pressures. So life's great for me. :D

BTW, I agree w/the four repub resolutions as a PART of the way to address the problem, but nothing can hope to be effective from anyone until #1 is addressed. #1 is economically destroying this once great nation.


Cornbread wrote: and I've not even talked about how docs are running from medicaid because they are reimbursed so little, they lose money with each 'government patient' they tread .
OK, fair enough. Are you sincerely interested in making Medicaid work better, or are you just trying to kill all funding that helps poor people?[/quote]
See above re: #1.
Illegal immigration is:
1. Driving down the wages of working americans\
2. Relatedly, lowering the benefits offered to employees due to access of a large pool of low wage, throw away workers.
3. Increasing health care costs.
4. Increasing tax costs paid by taxpayers* by the services they consume, especially when compared to the low/lower wage work they take. And when they double dip using multiple "IDs", one to work and one to take non work benefits, it exponentially makes things worse.

* a lot of illegals get paid by either cash, or 1099 (independent contractor) or outright fake/no ID. If they have a fake/stolen SSN or a TIN, they can file for EIC (cash for having claimed to have children).

I'm not even addressing the environmentalist nutjobs or osha nazis that are also driving jobs from this country that leave a smaller population of workers seeking fewer and fewer jobs, thus driving down their wages/bennies.

The conversation that we should be having, everyone has been pavlovian trained to avoid ("racist!!!"). So there cannot be any resolution of our downward spiral, IMO. Private sector health care won't work, but obamacare will institutionalize dysfunction along with adding taxes to everyone, mainly--again, the already struggling working class people.

FWIW, I don't see any way out of the decline that this formerly great nation has devolved into. It's just how fast it will take and I definitely think that for once, the leftists finally have a use for their high speed bullet trains.....us going down.
Romney will give us a little bump. Someone like Ryan would give us a longer views with more of a natural, conservativism.
Who knows--romney's still finding out how conservative he actually may be.






Obamacare attempts to deal with the problem you cite. Three cheers for Obamacare, right?[/quote]
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