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Another good article -
"Perry argued that expanding Medicaid coverage would bankrupt the state, though by investing $15 billion in the expansion, Texas would receive $100 billion in federal funding and cover 1.8 million newly enrolled residents under the program."
Thirteen Governors Screwing Over the Uninsured
http://www.motherjones.com/mojo/2013/02/meet-governors-rejecting-expansion-medicaid
And increase individual states expenses. See "An Economic and Policy Analysis of Florida Medicaid Expansion" as just one example:Quote:
Originally Posted by try2bfrugal
As previously mentioned, the states don't enjoy the same deficit leeway that the feds enjoy. In case you weren't aware of this, consider the following:Quote:
Effect of the ACA on Florida Medicaid Enrollment and Costs. The ACA encourages states to expand Medicaid eligibility to 138 percent of poverty ($32,500 for a family of four). The federal government would initially pay 100 percent of the cost of benefits for adults for three years — dropping to 90 percent in 2020 and thereafter.
If Florida expands its Medicaid program, up to 1.6 million additional individuals may enroll. Of these, 250,000 or more would not qualify for the enhanced federal match, because they were previously eligible but never enrolled. They would only qualify for the older — and much lower — federal matching rate of 59 percent. About 1.3 million would be newly eligible and subject to the enhanced federal match. This number will include some who drop private health insurance coverage. Despite generous federal payments, the Cato Institute estimates the ACA’s requirements would force Florida to increase general revenues allocated to Medicaid from just over $6 billion in 2008 (prior to the ACA), to nearly $24 billion in 2030 under an expanded program.
There are three general kinds of state balanced budget requirements:
- The governor's proposed budget must be balanced (43 states and Puerto Rico).
- The budget the legislature passes must be balanced (39 states and Puerto Rico).
- The budget must be balanced at the end of a fiscal year or biennium, so that no deficit can be carried forward (37 states and Puerto Rico).
Those are realities that states must consider while being pressured by the federal government to increase their expenses. It seems to boil down to whether or not any given state's legislature is willing to think long term or short term.
Well, I don't know what to tell you Alan, but I'm with Jan Brewer on this one. The states without the expansion are still going to be paying the taxes to support the programs without getting any of the benefits in return, as well as leave thousands, in some states millions, of people uninsured.
I know how I'd vote if I was uninsured in a state without expansion, or was insured but had compassion for the uninsured.
Aren't the Koch brother behind the Cato institute? The ones Wikipedia says fund and support organizations that contribute significantly to Republican candidates, and that lobby against universal health care and climate change legislation -
http://en.wikipedia.org/wiki/Politic..._Koch_brothers
I understand that the fault actually lies with the states making the choices they have (and it being backed up by the Supreme Court). I meant that I think the ACA should have foreseen that possibility (as well as some other ramifications to the plan) and made a "Plan B" to make sure those who actually needed to have affordable cover the most would be able to get it. Those people should be put into a federal program like everyone else who can get subsidies is.Quote:
Originally Posted by try2bfrugal
Agreed. If they can make federal subsidies to many people all across the USA, they can make those same subsidies (and perhaps more) to those truelly low income and low asset people who need coverage. Why even go the Medicaid route at all? Just include those people in the federal ACA program.Quote:
Originally Posted by Alan
Why can't they just give us all enough cash to do what we need?Quote:
Originally Posted by Spartana
https://lh5.googleusercontent.com/-8...Awesomized.jpg
LOL, it looks like you underestimated yourself.Quote:
Originally Posted by try2bfrugal
Except for when it doesn't.Quote:
Expansion makes economic sense for every state.
There's nothing wrong with voting with your heart, but there are always realities which must be acknowledged.Quote:
I know how I'd vote if I was uninsured in a state without expansion, or was insured but had compassion for the uninsured.
He He! That will only buy you one laser sighted plasma rifle in the 40 watt range. And which is what many people would probably buy rather than health insurance if you gave them some money directly :-)! As an advocate for some sort of universal healthcare, IF we are going to have some kind of tax payer funded health insurance, I'd like to see some level of equality across the board. Some flat tax we all pay (and not just Alan) towards our coverage (like we do for Medicare and Social Security) and equitable insurance coverage available to all for the same costs irregardless of income level. If I and many others who are fit and healthy and choosing not to work voluntarily and have high-ish assets can get if for free or low cost on Alan's dime, than Alan and you et al should be able to also. And those who are truly poor with no other options should be at the head of the line to get the ACA taxpayer funded benefits rather than just left in the dust.Quote:
Originally Posted by bae
Rick Scott in Florida has said, "While the federal government is committed to paying 100 percent of the cost of new people in Medicaid, I cannot, in good conscience, deny the uninsured access to care."
In Texas, Governor Perry won't budge. But an extensive lobbying effort pushed by hospitals, city and county government officials and church groups is ratcheting up the pressure on him.
Two of those groups, the interfaith alliance Texas Impact and Methodist Healthcare Ministries of South Texas, have released an authoritative study showing an enormous positive financial and healthcare boost from joining the Medicaid expansion.
About 2 million uninsured Texans would reap the healthcare benefit, says the report from Billy Hamilton Consulting. Hamilton has enormous credibility in Austin. For many years, he was the state's deputy and then chief deputy comptroller, and in that role he was the state's chief revenue estimator. The entire state relied on his numbers.
Read more here: http://www.star-telegram.com/2013/02...#storylink=cpy
So if you are reading this and want to help have insurance for all, vote the Medicaid expansion blockers in your state out of office. Your state is paying the taxes for the ACA anyway, why not reap the full benefits?
I was in downtown Austin last year, innocently eating a slice of cheese pizza, when the big screen TV at the pizza place I was eating at showed Rick Perry delivering his state of the state speech last January. He went on and on about the evils of expanding Medicaid in Texas and how that was just not going to happen on his watch.Quote:
Originally Posted by try2bfrugal
Two things made me very angry - the suffering of those in Texas without insurance - and Texas has the highest percentage of residents whose lives are not worth health insurance in the country. The second thing that made me angry was how pompously and arrogantly he brushed aside the suffering of over a million people in his state. Seriously, if he found himself without assets and access to health insurance, he might very well sing a different tune.
I left Austin with the feeling that social class lines are drawn even more starkly in Texas than what I am used to in Arizona. Austin's a great place, don't get me wrong, but it is in Texas nonetheless and the "leadership" in Texas clearly does not value the lives of the poor within Texas state lines. Rob