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Do you think Governor's who didn't expand Medicaid ...

  1. My Esoteric profile image90
    My Esotericposted 2 years ago

    ... are trying to encourage those who fall in the Medicaid gap they created to move out of their State?  Hospitals in those States are reporting increased unpaid (meaning you paid) emergency room visits from this group.

    1. wilderness profile image98
      wildernessposted 2 years ago in reply to this

      Who do you think paid for medicaid patients?  Hint: it wasn't them.

    2. Credence2 profile image87
      Credence2posted 2 years ago in reply to this

      From what I hear, many of the Governors that are not participating are doing it for ideological reasons only. That is unacceptable.

      1. wilderness profile image98
        wildernessposted 2 years ago in reply to this

        Or maybe because the state doesn't have the funds to do it?

        1. Credence2 profile image87
          Credence2posted 2 years ago in reply to this

          I understand that as long as that is the only reason, but I can't help but to note that red states with GOP governors seem to be making all the fuss.

          1. wilderness profile image98
            wildernessposted 2 years ago in reply to this

            Yeah, but to be fair it always seems to be the GOP that resists raising taxes on the general population just to give it to someone else while the Dems are happy to do just that (or borrow from our kid's future).

            I suppose you could call that ideology, though...

            1. Credence2 profile image87
              Credence2posted 2 years ago in reply to this

              It has been the GOP that has resisted everything Obama has proposed since 1/20/09, and I dare to say that the mule like intransigence and opposition was not all about ideology....

              1. wilderness profile image98
                wildernessposted 2 years ago in reply to this

                I fully agree.  Our political system has become more about a power base for the leaders of one party or the other than about running the country.  And it matters not one whit which party it is; they both do the same thing - witness the entire democrat allegiance vacating the state (Michigan?  Minnesota?) to avoid a vote on a republican bill in the state legislature.

                1. Credence2 profile image87
                  Credence2posted 2 years ago in reply to this

                  Yes, indeed, I agree with your opening sentence. The situation you mentioned happened in Wisconsin under Gov. Walker about 3 years ago. There was an impending vote in the state legislature to effective remove the right of collective bargaining by public employees. Rather than being required to vote and lose, the Democrat legislators scurried off to neighboring Illinois under the cover of darkness. Running was not right as we should accepted defeat with a determination to win the next round. Such restraint on the rights of public employees is not unusual, I worked under such terms. What poed me about Walker is that his restraint applied to all public employees save police and firefighters. Why were they exempted? If anything, the nature of their work would make such a labor restriction all the more imperative for them. Walker was playing politics exempting a portion of the public workforce that he believed were his political and ideological allies.

                  Senator McConnell (scarecrow) is already on some sort of vendetta against the President. Now that the GOP has taken control of both houses of Congress, now if something is broken they own it. The GOP will have to find the finesse to govern without the threat of shutting the Goverment.......

                  1. wilderness profile image98
                    wildernessposted 2 years ago in reply to this

                    That's the one - Wisconsin, not Michigan or Minnesota.  I knew it was up there somewhere.

                    My prediction - now that the GOP has control of both houses, the Dems will "scurry off".  They, not the GOP will become the "party of NO", not the GOP.  Neither one is interested in compromise, but only in pushing the party platform onto the country.

                    (And it wasn't the GOP that shut down the country - the Dems did that through Obama.  There was offering from the GOP as a way to proceed and it was ignored and turned down.  Typically, the one party said "Either my way or nothing" and Obama agreed, shutting down.

                  2. 60
                    retief2000posted 2 years ago in reply to this

                    You are absolutely right! The Democrats in Indiana did the same thing rather than permit a vote on "right to work" legislation in Indiana by preventing a quorum. They have paid a terrible political price in each of the subsequent elections by losing so many seats in the Indiana General Assembly as to be absolutely irrelevant - of the 50 seats in the Indiana Senate Democrats hold 10, of the 100 in the Indiana House Democrats hold 30. Democrats are unlikely to recapture the General Assembly any time soon as the Republicans continue to give the state exemplary service.

              2. 60
                retief2000posted 2 years ago in reply to this

                Over 300 bills passed in the House of Representatives have languished on Harry Reeds desk. Three quarters of the legislation Obama has signed has originated in the Republican House. It is merely convenient to label the opposition as intransigent or in other words, ideologically expedient.

                1. My Esoteric profile image90
                  My Esotericposted 2 years ago in reply to this

                  299 of them want to repeal Obamacare.

                  1. 60
                    retief2000posted 2 years ago in reply to this

                    Hardly, but continue the talking point.

                2. My Esoteric profile image90
                  My Esotericposted 2 years ago in reply to this

                  If they are funding bills, isn't that where most of them originate?

                  1. 60
                    retief2000posted 2 years ago in reply to this

                    All spending must originate in the House, this makes Obamacare vulnerable as it originated in the Senate and passed as part of a reconciliation vote in the House. If the Supreme Court views this as a violation of the Constitutional structure, not the rules or practices, of the Congress then Obamacare could fall apart. Although no one can speak the mind of the court, Obamacare is in danger from the sloppy power grab necessary for its creation.

        2. psycheskinner profile image80
          psycheskinnerposted 2 years ago in reply to this

          All states take in a health amount of tax, what varies is what they choose to spend it on. And health care is not purely a cost, the preventive aspects and reduced use of emergency rooms can really make that money go a long way.

          They are throwing away Federal money with weak excuse like 'they might stop paying it' -- which even if plausible would just meant the could withdraw the services again but this time for a halfway sensible reason.

          1. GA Anderson profile image87
            GA Andersonposted 2 years ago in reply to this

            With no derogatory intention... this is truly an instance where "a little knowledge is a dangerous thing."

            "All states take in a health amount of tax, what varies is what they choose to spend it on."

            You are right all states do receive money from the Fed earmarked for healthcare costs. And they receive it from a several different avenues. The largest ones deal with Fed money to hospital and medical care systems to help offset uninsured care provided, and, compensation for shortfalls in medicare/medicaid payments that are actually less than the costs of services provided.

            You can Google the topic for the particular programs and clearer details - but that is the gist of it.

            One looming problem for states is that the two major programs for hospitals and medical care systems, (worth hundreds of millions of Fed dollars), will be drastically reduced, (and in some cases eliminated), starting July 2015. (an action that was included in the ACA)

            I'm shooting from the hip here, but I seem to recall one of the two largest hospital/healthcare systems in Florida, (covering the largest segment of uninsured residents - citizens and illegals), will lose around $500 million when these programs are cut.

            So, while it is true, states do receive healthcare money from the Fed, it is not enough, and will soon be even less. Unless of course the state gives in and lets Nanny Fed share the driver's seat.

            And do you really think a state could cut back its Medicaid enrollments down the road when the Fed says, "Its all on you now Mr. State?" I can see the headlines now, "XYZ STATE TO KICK CHILDREN AND MOTHERS OUT OF MEDICAID! WE CAN'T AFFORD YOU ANYMORE!

            If you check into this topic a little deeper you will see that the rest of your comment , although a popular perception - misses the mark of reality also.

            It is true that states that do not expand are passing up an opportunity for tons of Fed money that will initially, (long-term is unclear), pay for the expansion, but a lot of governors took a good look at the cost of accepting that money and decided it wasn't such a good deal as is portrayed.

            GA

            1. My Esoteric profile image90
              My Esotericposted 2 years ago in reply to this

              If the Feds were going to pass all costs on to the States as you suggest they might, why haven't they done so already?  I think that is a red herring.

              Anyway, I looked up the $500 million.  That is, as you related, from the Disproportionate Share Hospitals (DSH) program that reimburses hospitals for additional costs incurred over and above revenues received from Medicaid for services rendered to Medicaid and uninsured patients.  It was a $17.4 billion program in FY 11; $500 million is 0.3% of the total.  The highest "planned" (not guaranteed) reduction is $5.6 billion in 2019, that is  32% for that year. 

              The amount "actually" reduced will end up being dependent on how many uninsured stop showing up at the hospital door; actuaries are estimating $500 million worth in 2015 (it was 2014, but was pushed a year, I think). 

              What this means:

              1) States who expand Medicaid will get more Medicaid revenues but less DSH funding because hospital shortfalls will be reduced through lower uninsured visits.
              2) States who fail to expand Medicaid will continue to get high DSH payments to pay for the uninsured citizens who they let fall through ACA coverage gap.

              1. GA Anderson profile image87
                GA Andersonposted 2 years ago in reply to this

                We seem to agree on the gist of the point, except for the non-expansion state DSH payment. And the fact that I did not suggest the Feds were going to pass on all costs. That point was in one of the linked articles as a listed uncertainty, (and possibility), after the Fed's documented commitments ended in 2022/2023. Of course it could be a Red Herring point if stated as you implied, but I read it as an uncertainly/possibility - not a sure thing.

                I don't want to start a links duel, but the info I find repeatedly states non-expansion states will still see those program cuts.

                Here is one link that seems to explain it clearly: (written in 2013, but updated with start date info)
                From The Advisory Board Company, a healthcare research and think-tank organization:
                "Despite lobbying, states that do not expand Medicaid will still see deep DSH cuts

                The DSH payment reductions have been a major source of anxiety for hospitals in states that have opted not to expand Medicaid.

                The cuts were developed as an offset for the cost of the ACA's Medicaid expansion and are based on the assumption that the ACA's coverage expansions would reduce a larger portion of hospitals' uncompensated-care costs. Altogether, the ACA requires $18.1 billion in total reductions from fiscal year (FY) 2014 through FY 2020, effectively halving the size of the safety-net program.

                However, the Supreme Court's ruling on the ACA allowed states to opt out of the expansion. In theory, this meant that hospitals in states that do not expand Medicaid would lose DSH funding without benefiting from an influx of new Medicaid patients.

                In an effort to avoid the financial blow in 2014, hospitals have urged the Obama administration to delay the scheduled pay cuts. And initially, the Obama administration appeared to be listening: In President Obama's proposed budget for FY 2014, the DSH cuts were delayed by one year, starting instead in 2015. But the proposal was never converted into regulation or leg

                Source:For states not expanding Medicaid, DSH cuts will deal a tough blow

                Also note that, (again, shooting from the hip because I did not save the link), a couple participating states have already produced stats that show your first point about new medicaid patients relieving the uninsured patients burden on hospitals has not proven to be the case.

                GA

                1. My Esoteric profile image90
                  My Esotericposted 2 years ago in reply to this

                  The rule was passed in Sep 2013 which the Sep article you referenced is talking about.  The one I found is an analysis from Kaiser in Nov.  It basically covers all of the same technical points I found in your link but only had this to say about the effect on states who do and don't expand.

                  "If the current methodology were maintained for years beyond FY 2015, states that implement the Medicaid expansion could see fewer uninsured and therefore see larger percentage reductions in DSH compared to state that do not implement the expansion. However, states that implement the Medicaid expansion are expected to see new patient revenues associated with new Medicaid coverage that could potentially offset the DSH reductions while states that do not move forward will not see new revenues from new Medicaid coverage but continue to see high uncompensated care costs. "

                  So, however you want to interpret that. Here's the link, in case you are interested, it is very short. http://kaiserfamilyfoundation.files.wor … he-aca.pdf

                  As to the laws impact, I'll wait until they have a year's worth of data across the 50 states before I can seriously review the numbers.  Until then, it is just interesting anecdotes unless they are large and all in one direction.

                  1. GA Anderson profile image87
                    GA Andersonposted 2 years ago in reply to this

                    Regarding both the DSH payments, and the mention of stats that say expanded Medicaid has not changed the uninsured rate of ER usage - I agree with you, more time and data are needed to be sure of its affects.

                    But I think the point of the original response - there is more to medicaid expansion than just the perception of uncaring partisan Republican governors - is still the valid point.

                    GA

          2. junko profile image80
            junkoposted 2 years ago in reply to this

            Liberals, poor whites, and other poor people of colors is not  causing the fall of America. The Conservative's marriage to super rich Capitalists and their affair with Corporate Persons  controls and seek to spend all federal spending. Greed and Selfishness Will cause the fall of America, not liberalism. To be liberal is to be unselfish. Capitalism is about self.

        3. My Esoteric profile image90
          My Esotericposted 2 years ago in reply to this

          And that is a truly bogus argument since there was no cost for the first 2 or 3 years and no more than 10% after that, if memory serves.  Now, I understand it isn't in the Conservatives DNA to help those that are down, only those that are up, but certainly they could find a few shekels for the sick; guess not.

          1. wilderness profile image98
            wildernessposted 2 years ago in reply to this

            Right.  There is no cost to picking up medical care for thousands of people.  Got it.

            I have this neat bridge for sale...

            1. My Esoteric profile image90
              My Esotericposted 2 years ago in reply to this

              And please explain how you came to that hyperbolic statement from what I said.

      2. GA Anderson profile image87
        GA Andersonposted 2 years ago in reply to this

        I think there are several good reasons for states to not expand medicaid as dictated by the Obamacare changes. A big part of those reasons may be ideology - but does that mean they is wrong?

        The ideology of not giving more state control and autonomy to the Fed - the Fed does not pass out money without strings attached.

        Or the ideology of not increasing state taxes to cover budget shortfalls caused by the expanded Medicaid. Wait! I know the forecasts only predict a 1% - 3% increased costs, but if Medicaid expenses are already busting state budgets, where will that measly 1%-3% come from if not new taxes?

        Or the ideology that it is just another step along the nanny state/government dependance road? For instance; Why is 138% of poverty line income the new threshold?

        I don't think this is a topic that can be decided on strictly dollars and cents.

        Here are a couple good links to see how it is being spun...

        This one is obviously against expansion - but does that mean its reasoning is wrong?
        Why States Should Not Expand Medicaid

        And this one is pro-expansion - and I think it is really really wrong. It mainly talks about all the Fed money that will be coming to states that expand. Really? We will take more money from all citizens to give states that expand more money as bribes to expand? Of course you may see it differently.
        How States Stand to Gain or Lose Federal Funds by Opting In or Out of the Medicaid Expansion

        My opinions are more inline with the first linked article.

        GA

        1. wilderness profile image98
          wildernessposted 2 years ago in reply to this

          "We will take more money from all citizens to give states that expand more money as bribes to expand?"

          Of course we will - one of the biggest things a politician can offer their constituents is more federal money from the wallets of people in other states.  This is just more of the same, coupled as you say with more federal control.

          1. junko profile image80
            junkoposted 2 years ago in reply to this

            The cash cow for American Capitalist has Always been The Federal Government. Corporate and Business Entitlements and welfare cost the Federal Government much much more than  The ACA.  If tax evasion wasn't the Capitalist goal since the Boston Tea Party healthcare for every American would be , no problem. The American people nor Business can survive without Big Brother"s (Federal Goverment) Tax Colections. The Question is who will be served by the Government, people or corporations?

            1. GA Anderson profile image87
              GA Andersonposted 2 years ago in reply to this

              And this is your answer to why some states chose not to expand Medicaid?

              GA

        2. Credence2 profile image87
          Credence2posted 2 years ago in reply to this

          I read the hyperlinked article it was excellent in taking a difficult subject and explaining it in such a way that a layman can become informed. I should know better, I have seen much of what was in the article unfold on the Big Island of Hawaii. It has been always difficult to impossible for those that exist on Medicaid to obtain a primary physician. Now, I know why, paperwork and inadequate reimbursement of expenses. I read an article that was in favor of Medicaid expansion to evaluate their arguments.

          The fear of many of the resisting Governors was the reasonable possibility that in later years this program would amount to an unfunded mandate from Washington on to their taxpayers. But, it was also said that the Governors were fearful that those that had been eligible under Medicaid who have not applied will under the impetus of the new program step up and claim their benefits. That is unreasonable and is an excuse as the State needs to prepare for all those that were always eligible.

          The article made a good point, which I corroborated with what is going on in Hawaii. That this program, by not adequately compensating care providers, has everybody operating in the red and that cannot be sustained indefinitely. The argument from the pro side saying that jobs would be created and the problems associated with having the underinsured or those with no insurance no longer overwhelming our physicians and facilities was not a solid as I would have hoped.

          So, I think that rather then threatening Obama with the dismantling of ACA, both parties work together to mend it and not end it. The ideas of subsidies provided to care providers, requiring those above the current Medicaid threshold to contribute to the costs of their care, seems reasonable to me. Some way of bringing in the private sector and addressing the reality of what this all will cost is necessary.

          The concept of ACA is sound but the devil is in the details . Moving forward and correcting as we go is better than the status quo ante.

          1. MizBejabbers profile image92
            MizBejabbersposted 2 years ago in reply to this

            This is the most sensible answer I've read so far. My husband and I voted for the ACA knowing it was flawed and saying that it was a step in the right direction. We believed that further details would be worked out after its passage and that it would become a structurally sound program. We also had a selfish motive -- our son was classified as uninsurable because of diabetes and a rare autoimmune disease which will eventually destroy his kidneys. It appears that we were wrong on all counts. Our state's governor made sure that the program worked in our state, a good thing, but he is term-limited out and his replacement was elected on an anti-Obamacare platform. The premiums are so high that our son can't afford them even with assistance, and he is still on medicaid. So we are wondering if we made a mistake in voting in what should be a good program because of the fallibility of the President who hasn't been able to get it fixed, AND the American people who, instead of demanding that it be fixed, are demanding its repeal..

            1. Credence2 profile image87
              Credence2posted 2 years ago in reply to this

              Thank you, kindly, MizB!

        3. My Esoteric profile image90
          My Esotericposted 2 years ago in reply to this

          Tell me, what is your opinion of what responsibility the State (not feds) has to its citizens?

          1. GA Anderson profile image87
            GA Andersonposted 2 years ago in reply to this

            Nope. smile

            GA

            1. My Esoteric profile image90
              My Esotericposted 2 years ago in reply to this

              Nope, your not going to tell me, or nope, a State has no responsibilities toward its citizens?

              1. GA Anderson profile image87
                GA Andersonposted 2 years ago in reply to this

                Nope as in I am not going to hijack this thread with the long response that would be needed to answer your question.

                A simple answer, such as, I think a state's responsibilities mirror those of the Federal government - in essence, would be too ambiguous and general to start the journey your question prompts.

                But I would be glad to participate in such a thread if you wanted to start one. smile

                GA

                1. wilderness profile image98
                  wildernessposted 2 years ago in reply to this

                  That would be an interesting thread as many of the listed federal duties are denied the state.  A military, for instance, or protecting our borders.  A medium of exchange.  Others commonly thought of as the states (education, maybe) are effectively denied via economic manipulation by the federal.  So whats left?

                  1. GA Anderson profile image87
                    GA Andersonposted 2 years ago in reply to this

                    See, there you are. The start of an interesting discussion that is completely off-topic.

                    So I will start one with your response. smile

                    GA

                2. My Esoteric profile image90
                  My Esotericposted 2 years ago in reply to this

                  OK, done. "What Responsibilities do States (not the Fed) have toward its citizens?"

      3. Laramy74 profile image79
        Laramy74posted 2 years ago in reply to this

        Governors of the States are not in favor of expanding Medicaid because the Federal and States cannot handle more spending of a program that needs revision, not adding more fuel to the fire.

    3. junko profile image80
      junkoposted 2 years ago in reply to this

      I am confused about the ideology expressed publicly politically speaking concerning Obamacare. Two of the Reddist of red states in the south and their governors have excepted and promoted Obamacare under other names. West Virginia and Kentucky, states with above average uninsured medicaid will also go back to claims that must be paid by tax payers. There are a lot of Clyde Bundy types that might not want to loose their right to be healthy and return to the good old days before Obamacare. If the ACA is good enough for Kentucky and West Virginia why not the poor of Wisconsin and Mississippi?

      1. MizBejabbers profile image92
        MizBejabbersposted 2 years ago in reply to this

        Junko, you left out Arkansas. Our governor fought hard to have a good workable program in our state.  Unfortunately, as I wrote to Credence, he is term-limited out and his replacement was elected on an anti-Obamacare platform. Some of the poorest people in our state are "redders" as you are calling them, and don't want to be helped. They want those of us who are working to pay their share in the emergency rooms. They go mouthin' around through their decayed teeth against Obamacare. I've also heard that some of the people who were against it are now supporting it because they now are enjoying its benefits. I wonder if they can convince their peers that it wasn't a good thing to lose it.

        1. Credence2 profile image87
          Credence2posted 2 years ago in reply to this

          I have trying to figure out for the longest time why people allow their hatred of anything Obama to take precedence over considering programs that could benefit them.

          "They go mouthin' around through their decayed teeth against Obamacare."

          Now that's funny!

          1. wilderness profile image98
            wildernessposted 2 years ago in reply to this

            Probably because Obama doesn't care what the long term economic results are to the country.  Just how many votes he can buy for his party, and how many people he can lock into dependency.

            1. Credence2 profile image87
              Credence2posted 2 years ago in reply to this

              If that is true than he is no different from his predecessors, Bush II, Reagan? You have always said that they all are about the same regardless of party.......

              1. wilderness profile image98
                wildernessposted 2 years ago in reply to this

                Personally I would say the GOP has the future of the country closer to their heart than the Dems, but not by much.  They do NOT, however, have as much consideration for social freedom as the Dems do.

                1. Credence2 profile image87
                  Credence2posted 2 years ago in reply to this

                  Personally, I believe the opposite. But what the heck, this is America and we all have a right to our opinions.

                  1. wilderness profile image98
                    wildernessposted 2 years ago in reply to this

                    I agree.  And we could probably work together.

                    Unfortunately I do ask a little more than an opinion from my representative - I expect some pretty exhaustive research and a conclusion that is not based primarily on how much good it will that politician.  And I don't get it.

            2. My Esoteric profile image90
              My Esotericposted 2 years ago in reply to this

              What has PBO done or said specifically, that convinces you he doesn't care about the long-term economic results are?  The fact that Ds believe in one kind of economic theory and Rs believe in a different one doesn't, ipso facto, mean he doesn't care; so it must be something else.

          2. GA Anderson profile image87
            GA Andersonposted 2 years ago in reply to this

            Nope, it's not funny at all. It's so damn condescending that it speaks volumes about the author's human perception. It is also just as damning an example of the type of stereotyping that completely destroys the credibility of anything that preceded it.

            Would the opposite be taken to infer an "unspoken truth" if it spoke of that Gruber fellow mouthing his denigration of American voters through his  multi-thousands of dollars worth of perfectly aligned pearly white orthodontics work?

            GA

            1. Credence2 profile image87
              Credence2posted 2 years ago in reply to this

              Sorry for the Lil Abner, Dogpatch reference. No more disturbing than the reference to people in the voter Id issue being less than honest about getting an ID because they need an ID to get liquor, buy cigarettes and food stamps. It is easy to get caught up in coded language.

        2. junko profile image80
          junkoposted 2 years ago in reply to this

          MizBejabbers, I left out Louisiana also and its my home state. I considered mentioning Arkansas but the knowledge of your love for the south and my desire to not mention your home state either. I am hopeful that your son will somehow continue to get the financial aid needed to live a comfortable life and you and your husband will not have to revisit the stress of possible bankruptcy for healthcare. You should that what you are experiencing is being experienced by tens of millions of Americans nationwide. Millions have heard about how stressless people in states that have The ACA. The toothless poor are usually uneducated and know that all they have of value is their votes which Capitalists can control making them feel included in the haves not the have not's. There are millions of them and millions knowing the truth. The Republicans know that they can't repeal the good in the ACA but, they can replaced and reallow medicare advantage. The silent majority will speak up and out if insurance companies are given the right to be wrong again. The Conservatives want to control and rename Obamacare not destroy it, its too late for that move. Arkansas will have an Affordable Care Act by another name, don't worry be happy.

          1. Brendan Spaar profile image77
            Brendan Spaarposted 2 years ago in reply to this

            Glad you mentioned Louisiana.I was born & raised there.Gov Jindal has his eye on the White House more than his heart in Louisiana.Did you see him on Meet The Press?  It boggles my mind to hear him try to explain why he is against expanding Medicaid. The bottom line is he's against it because Obama/ Democrats initiated it. If a Republican sent this through it would be a different story. Maybe everyone needing expanded coverage should show up at the Governor's mansion  with their suitcases & move in with him. You know he has good coverage.

            1. junko profile image80
              junkoposted 2 years ago in reply to this

              Governor Jindal has said a lot of things that don't make sense in his attempt to Further his political career on a Federal level because he failed to do anything to help poor Republicans or Democrats in the state of Louisiana as Governor. If Cassidy wins the last senate seat after those that hate Obama and Obamacare vote him in and Mary out, he will keep the seat warm for Jindal. Jindal has gone all in and all out to be become a part of the Federal Government( Big Brother) the now Republican foe. It is a real possibility Cassidy may win in Louisiana but Jindal's political gig is up in La. It would serve him right if the National  GOP is just using him. Sen.David Vitter wants the Governor's seat when he term limit out and will accept Obamacare under another name after two more years of deaths due to lack of healthcare.

        3. My Esoteric profile image90
          My Esotericposted 2 years ago in reply to this

          It is an odd situation.  Most people like 95% of the individual pieces of ACA, but they don't like the package.  They want to keep the "can't be denied insurance for pre-existing conditions part" but don't want it paid for with requiring skaflaws to buy insurance to lower premiums.  They want to keep the "no lifetime max" benefit, but don't want to pay for it with the medical device tax.  The list goes on and on.  What it sounds like is those who want the parts of ACA but not Obamacare, want welfare for themselves.

      2. My Esoteric profile image90
        My Esotericposted 2 years ago in reply to this

        I like that comment.

        1. junko profile image80
          junkoposted 2 years ago in reply to this

          Thanks My Esoteric, You do know(this) your forum is in the process of being hi-jacked by you being  invited to leave or start elsewhere.

          1. GA Anderson profile image87
            GA Andersonposted 2 years ago in reply to this

            Oh my! And here I thought I was being courteous by trying to stick to the forum topic - as started.

            Oops... was I that wrong?

            GA

    4. brakel2 profile image86
      brakel2posted 2 years ago in reply to this

      Our governor opted out, because of a money issue. Medicaid expansion has allowed some people in the middle class to be eligible for Medicaid. People above the poverty level are now eligible. Even though the federal government is helping to foot the bill, the governor does not believe that this will continue. I read an article that Medicaid will expand so much that a huge percentage of our country will be on Medicaid. Neither the federal government nor the states can afford to fund such a huge program, especially if those on Medicaid get a cash grant. I am not sure if a cash grant is now part of the program, as it is for single parents with children and little income. I will check that out, because I do not believe the expansion includes a cash grant without meeting other eligibility requirements.

      1. My Esoteric profile image90
        My Esotericposted 2 years ago in reply to this

        @Brakel2, how much in earnings do you consider "middle class" and what kind of lifestyle do you suppose "middle class" people live?

  2. MizBejabbers profile image92
    MizBejabbersposted 2 years ago

    I agree with you.
    Our state has a great governor who made sure that this was funded. Anyone not participating is not doing it out of ignorance. Unfortunately he is term-limited out, and our governor-elect promises to work to do away with  Obamacare at as many levels as he can. That means we will go back to paying for those who can't or don't want to pay because we just elected a legislature who will back him.

    1. wilderness profile image98
      wildernessposted 2 years ago in reply to this

      Where did he get the money?  From the wallets of taxpayers?

      And if you mean paying for health care for those that can't or don't want to pay themselves, what do you think medicaid does?

      1. MizBejabbers profile image92
        MizBejabbersposted 2 years ago in reply to this

        You are leaving out the fact that many of the people who use emergency rooms are people who had rather buy new cars or drugs than pay for health insurance (that may be how some of them afford the pearly white crowns). You are also leaving out the fact that the money to pay their bills does not all come out of taxpayers' pockets. Those of us who pay for insurance pay higher insurance rates because the hospitals raise their rates to make up for charity cases. Society, whether we like it or not, has always paid for those who don't pay.

        1. wilderness profile image98
          wildernessposted 2 years ago in reply to this

          I'd have to say that those having their rates raised are the ones paying taxes, too.  Which means that they are the ones paying, whether through taxes or higher rates.

          The point was supposed to be that someone besides one on medicaid foots the bill, whether through increased taxes or increased rates.  Medicaid is not free, anymore than food stamps or any other forced charity is.

          1. MizBejabbers profile image92
            MizBejabbersposted 2 years ago in reply to this

            I agree with your points, Wilderness, except that technically "taxes" are defined legally as money that goes to the government (and medicaid is paid for by tax money). "Raised rates" are money that goes to the business to cover expenses. We need to distinguish between "medicaid" patients who are financed by government taxes and the people who are not on medicaid and go to emergency rooms without insurance. Their expenses are not necessarily reimbursed by the government, although the government requires for-profit hospitals to take in a certain percentage of charity patients and absorb the expenses. If we pay the higher rates to the insurance company because the hospital is charging paying patients more to cover uninsured, non-medicaid patients, that is a cost of doing business, so technically not a tax because the raise in rates is non-mandatory. It's just a technicality, but I get your point and don't disagree because either way, it is money out of our pockets. (I'm a legal editor of state law books, so this is where I'm coming from. And dang, I love to argue fine points! Have a great day, friend.)

  3. brakel2 profile image86
    brakel2posted 2 years ago via iphone

    If a state already has financial issues, this plays a big part in a decision about Medicaid expansion. I worked with the Medicaid program, and cannot even imagine what it would be like with thousands more on the roles. A shortage of primary care physicians has already caused their turning away potential patients. By raising the income limit for Medicaid in an expansion of the program, too many people become eligible, and it will become unmanageable in a few years. The Supreme Court made it optional for a reason.

  4. Perspycacious profile image74
    Perspycaciousposted 2 years ago

    Not in Utah where Governor Herbert is trying to negotiate with the federals to fashion a version of ACA that meets the needs of Utahns rather than the "one size fits all" that was passed as "not a tax" but "is a tax."

 
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