Expanding Medicaid Means Reducing Education

[spursncowboys]

Expanding Medicaid Means Reducing Education
Posted November 6th, 2009 at 9.19am in Health Care.
In his September address to the joint session of Congress, President Obama stated he would be the last President to take on health care. Perhaps, but that may be at the cost of everything else, including education.
By expanding Medicaid in the health care bill, Congress will set off political tornadoes across the country that will leave governors and state legislators to clean up afterward. The math is simple. State revenues are still in a slump and will continue for a least a few more years. The two largest state and local expenditures are education and Medicaid. If you have a balance a budget, which nearly every state does, and you cannot touch the entitlement to Medicaid, where will you turn to fill the budget gap? There will be little choice than to go after education.
According to The Fiscal Survey of States, published by the National Association of State Budget Officers, 31 states cut higher education and 26 states cut K-12 education in 2009. Even with additional federal funding for Medicaid, 25 states still made reductions in Medicaid by cutting reimbursement to providers. Next year will be more of the same. Some states are already reporting higher Medicaid costs due not only to increased enrollment because of higher unemployment but also because of packed emergency rooms due to the swine flu. Governors of both parties are wondering whether Washington really knows what is going on around the country.
There are more former governors serving in the U.S. Senate than in the U.S. House of Representatives which means the Senate should be more aware of the Medicaid vs Education cage match. When legislation gets to the Senate floor, it will be interesting to watch whether the “former governor caucus” will work together across party lines to protect all states or only their own.
Congress and the President have incorporated all sorts of budget gimmicks to protect the federal budget. But they will be wrecking havoc on state budgets.
http://blog.heritage.org/2009/11/06/expanding-medicaid-means-reducing-education/
For more on Medicaid and Obamacare see:
Federalization of Medicaid: Health Reform Bill Would Reduce State Authority
Why Congress Wants to Force More Americans into Medicaid
The Baucus Medicaid Provisions: The Senate’s Massive Welfare Expansion

[spursncowboys]

Cutting reimbursment to providers? This will icrease the overall price, decrease doctors who participate on medicaid.

I had a dentist who wouldn't take me because if Tri-care doing the same thing.

[boutons_deux]

Where does the privatized Prison Industrial Complex fit into state budgets?

The big states spend more per prisoner than they do per student.

California's education budget is surpassed by its prison budget.

[Winehole23]

in Texas in it will mean sending billions to other states to expand their Medicare system, while forgoing billions in Federal matching funds that would pay for indigent hospital stays and mental health for inmates, costs that fall hardest on cities and counties.

http://www.wacotrib.com/news/189491721.html

[boutons_deux]

The elephant in the room is the for-profit, greedy, fraudulent helath care system.

You pay our insane prices, or you get no care.

The solution that must be tried is non-profit public insurance option, with non-profit health care with salaried (not profit-center-ed) docs, is the answer, as we see in countries not being raped by their health care system.

heritage of course is always pimping for the corps and 1%.

RickyBobby and his posse of Repug/"Chritian" nutcase sociopath extremists will really fuck up TX, esp the public school system and the poor, many of whom are takers, but WORKING POOR. RickyBobby "tax-expenditures" $19B/year to corporations.

[boutons_deux]

And since when do Repugs and "Christians" GAF about education?

They only care about FOR-PROFIT scam education and the govt-guaranteed sub-prime financing of education, and "Christian" supremacy indoctrination with Biblical fairy-tales-as-science.

[Winehole23]

Christians aren't a monolith: 20% of evangelicals voted for Obama.

http://www.pewforum.org/Politics-and-Elections/How-the-Faithful-Voted-2012-Preliminary-Exit-Poll-Analysis.aspx

[boutons_deux]

Christians aren't a monolith: 20% of evangelicals voted for Obama.

http://www.pewforum.org/Politics-and-Elections/How-the-Faithful-Voted-2012-Preliminary-Exit-Poll-Analysis.aspx

so 80% of evanglicals voted against him, aka, a landslide :lol

And it's not Presidential voting that counts here, it's the gerrymandered Repug red-states that are obstructing progress at national and state levels.

[TeyshaBlue]

And since when do Repugs and "Christians" GAF about education?

They only care about FOR-PROFIT scam education and the govt-guaranteed sub-prime financing of education, and "Christian" supremacy indoctrination with Biblical fairy-tales-as-science.

lol simpleton.

http://www.spurstalk.com/forums/showthread.php?t=207242&p=6263637&viewfull=1#post6263637

lol coward

[Winehole23]

so 80% of evanglicals voted against him, aka, a landslide :lolthe total for all Christians was much narrower.


And it's not Presidential voting that counts here, it's the gerrymandered Repug red-states that are obstructing progress at national and state levels.lol equating the success of Democratic Party policies with "progress."

[boutons_deux]

the total for all Christians was much narrower.

lol equating the success of Democratic Party policies with "progress."

it's not much, but it's way head of the retrograde Repugs.

[Winehole23]

how so?

[boutons_deux]

how so?

Barry's EPA is putting pressure on polluters, while the Repugs and libertarians was to kill EPA, OSHA, etc.

ACA was fucked up by the health care system, but it's a big step in the right direction, and can be fixed (but probably won't be du to Repug obstuctionism, their voting to repeal mutiple times, their intention to gut/defund it )

Dems intend to protect Medicare and SS, while Repugs want kill both by privatization.

Dems want to fix immigration, Repugs will block all reform.

etc, etc.

There is HUGE difference between the two parties. Dems aren't great, but Repugs, and their voters, are so much worse.

[Winehole23]

that's ridiculously oversimplified, but is at least a slight deviation from the Parmenidean monism you usually espouse.

[boutons_deux]

...

[boutons_deux]

that's ridiculously oversimplified, but is at least a slight deviation from the Parmenidean monism you usually espouse.


you retort is ridiculously absent.

[TeyshaBlue]

you retort is ridiculously absent.

lol.
Delicious sauce is delicious.

[Wild Cobra]

in Texas in it will mean sending billions to other states to expand their Medicare system, while forgoing billions in Federal matching funds that would pay for indigent hospital stays and mental health for inmates, costs that fall hardest on cities and counties.

http://www.wacotrib.com/news/189491721.html
Medicare and Medicaid are not the same program...

[ChumpDumper]

State revenues are still in a slump and will continue for a least a few more years.Emphasis yours.

Not at all true in Texas.

[Winehole23]

quite true WC, but this is topically relevant

[Wild Cobra]

quite true WC, but this is topically relevant
OK, but in post #4, you confused the programs.

[Winehole23]

you're right, I misfiled the update.

thanks for the correction: everyone can keep up now.

[Winehole23]

coverage gap. single child parents in Texas earning over $4000 a year are too rich to qualify for Medicaid and too poor to qualify for premium subsidies for Obamacare:


There's a big divide between the states that participated in Obamacare's Medicaid expansion and those that didn't. States that signed up extended Medicaid eligibility to all adults earning up to 138 percent of the federal poverty level, or about $16,105 for an individual.


But if you live in one of the 23 states that didn't expand coverage, the limits can be really strict, according to a new report (http://kff.org/medicaid/report/modern-era-medicaid-findings-from-a-50-state-survey-of-eligibility-enrollment-renewal-and-cost-sharing-policies-in-medicaid-and-chip-as-of-january-2015/?utm_campaign=KFF%3A+General&utm_source=hs_email&utm_medium=email&utm_content=15657680&_hsenc=p2ANqtz--AKXaV93ISxsWtbg3YsGTvLLoAB39fyJg0AZ3Yo_-fpZjj-jqR_vaAvnsk2_C1dZicSTNylyo11eCCH46wn6I3L4XANBanspo iwD1iRe5uKdBr5pg&_hsmi=15657680) from the Kaiser Family Foundation. The result is that a lot of people end up being caught in a gap where they make too much money to qualify for Medicaid but too little to get assistance through the new Obamacare health insurance exchanges.


As the Kaiser foundation reports, 14 states currently set Medicaid eligibility for parents at below half of the federal poverty level. One of the most stringent requirements is found in Texas, the largest state sitting out the Medicaid expansion. Medicaid coverage in Texas is cut off for parents earning above 19 percent of the federal poverty level — or $3,760 for a family of three. The eligibility cutoff for parents of a dependent child, according to the Kaiser foundation report, is only lower in Alabama ($3,562), and it isn't much higher in Missouri ($4,551) or Louisiana ($4,479). The income thresholds do increase with more dependent children.

http://www.washingtonpost.com/blogs/wonkblog/wp/2015/01/20/parents-earning-more-than-2800-are-too-rich-to-qualify-for-medicaid-in-texas/

[boutons_deux]

How Republicans are making Medicaid less efficient and more expensive (http://www.dailykos.com/story/2015/01/19/1358814/-How-Republicans-are-making-Medicaid-less-efficient-and-more-nbsp-expensive)


Medicaid is a lean, efficient, program and is in fact far less expensive (http://www.dailykos.com/story/2015/01/05/1355700/-Is-the-country-spending-enough-on-nbsp-Medicaid) than the rest of our healthcare system. It's also very popular (http://www.nytimes.com/2014/10/10/upshot/medicaid-often-criticized-is-quite-popular-with-its-customers.html?abt=0002&abg=0) with its customers, more so than private insurance is with people who have it.

So clearly the job for Republicans is to fuck all that up, and they're doing it by adding layers of complexity and cost (http://www.newrepublic.com/article/120781/republican-governors-accept-medicaid-expansion-make-it-costlier) under Obamacare's Medicaid expansion program.


Take, for example, Arkansas—the state that got the ball rolling for red states seeking GOP twists on Medicaid expansion with its privatized version known as the "private option."Last month the state got approval for a byzantine new program, called Health Independence Accounts, that imposes co-pays on some beneficiaries unless they pay a small monthly fee. Those who have paid their fees are eligible, under certain conditions, for up to $200 to pay for the costs of private health insurance if their income goes up and they transition off of Medicaid.

To run the program, the state will pay a third-party administrator about $15 million annually (covered by the feds as part of the cost of expansion).

Meanwhile, Iowa is now imposing low premiums, tied to a wellness program, on some beneficiaries. "The administrative complexity of the system the state is contemplating is somewhat mind-boggling," Joan Alker of the Georgetown University Health Policy Institute commented when Iowa's waiver was approved, adding that "[t]he wellness program is of questionable policy value."

Indiana's proposal includes small premiums and savings accounts tied to different benefits packages, leaving advocates for beneficiaries worried that low-income adults "face categorization into a bewildering array of benefit plans and options." […]

"All of those ideas, leaving aside their policy merits, they all presuppose a pretty intensive level of government involvement in people's lives," :lol :lol Alker, an expert on Medicaid waivers, told me by phone.

Alker points out that the original proposal by Pennsylvania suggested that the state would eventually be tracking everything from cholesterol level to work history to legal record. (In the end, the feds accepted just four of Pennsylvania’s initial 24 waiver requests.)

The implicit bargain has been to offer a social safety net for the poor, but only via an intrusive REPUG nanny state. :lol


Wait, isn't that what Republicans are always complaining about? Excessive and expensive bureaucracy and government intrusion into people's lives?

There are a couple of possible motivations here, which aren't mutually exclusive.

One is to make getting assistance as miserable and difficult as possible for poor people because that's what they deserve.

Another is to wreck what is essentially a very good federal/state program that helps a lot of people, because the first step to destroying government is to make it not function.

http://www.dailykos.com/story/2015/01/19/1358814/-How-Republicans-are-making-Medicaid-less-efficient-and-more-nbsp-expensive

Repugs only bitch about nanny state/regulations affecting the 1% and BigCorp.

As with law enforcement, the Repugs are super aggressive in fucking around in poor peoples' lives, and especially in their vaginas.

"the first step to destroying government is to make it not function."

... which is actually the VRWC/Repug long-term strategy is, and is why the Repugs don't GAF about obstructing Congress down to a 10% approval rating, because people disaffected, alienated from politics are people who don't vote.

VRWC/Repugs say govt is useless, evil, counter-productive and they work very hard, spent $Bs to self-fulfill that prophecy.

[boutons_deux]

Cut funds for education? a fundamental VRWC goal is busting public education and teachers unions.

Heritage GAF about education? :lol

What All Americans Need to Know About How Poverty Impacts Education

"For the first time in at least 50 years, a majority of U.S. public school students come from low-income families, according to a new analysis of 2013 federal data, a statistic that has profound implications for the nation."

In 40 of the 50 states, low income students comprised no less than 40 percent of all public schoolchildren. In 21 states, children eligible for free or reduced-price lunches were a majority of the students in 2013.

Most of the states with a majority of low income students are found in the South and the West. Thirteen of the 21 states with a majority of low income students in 2013 were located in the South, and six of the other 21 states were in the West.

Mississippi led the nation with the highest rate: *71 percent, almost three out of every four public school children in Mississippi, were low-income. The nation’s second highest rate was found in New Mexico, where 68 percent of all public school students were low income in 2013.

recent international comparisons to underscore the point:

Finland, the highest scoring nation in recent years, has less than 4% of its children in poverty.

Even using somewhat out of date statistics from OECD, which sponsors the PISA tests used to bash US schools in comparison with international competitors,

US schools with less than 25% of their children in poverty perform as well as any nation, and

those with 10% or less of their children in poverty outperform Finland.

http://www.alternet.org/education/what-you-absolutely-must-understand-about-how-poverty-impacts-education

Get back to us when Heritage VRWC STINK TANK gives a tiny little fuck about reducing poverty.

[Pelicans78]

LOL Medicaid. Hardly any doctors see medicaid patients because it doesn't reimburse anything. It serves a purpose, but its a pain in the ass as well.

[Winehole23]

not expanding Medicaid may have cost Texas a lot of money. check at the link under "Economic Effects"

https://www.kff.org/medicaid/issue-brief/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review-march-2018/

[boutons_deux]

17 red/slave non-Medicaid-expansion states leaves 2M uninsured, 500K in TX

while the sadistic racist Repugs target blacks and browns to deny them health care, the majority of the no-Medicaid Repug victims are white, just like the majority Americans covered by the Repug-targeted safety net are white.

[rmt]

not expanding Medicaid may have cost Texas a lot of money. check at the link under "Economic Effects"

https://www.kff.org/medicaid/issue-brief/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review-march-2018/

A 2016 study found that growth in state Medicaid spending in expansion states has been lower relative to non-expansion states, but an uptick was predicted for state fiscal year (SFY) 2017, primarily due to the phase-down in the federal share for the expansion population from 100% to 95% in 2017.

The states have had a free ride up through the end of 2016. Now comes the part where they chip in up to 10% by 2020 (and they are going to struggle to find that 10% from state budgets which mostly must be balanced - not like the Feds who can run up debt).

One analysis found that in 2014, among those states reporting both spending and enrollment data, spending per enrollee for the new adult group was much lower than spending per enrollee for traditional Medicaid enrollees.320
A June 2017 study showed that per enrollee Medicaid spending declined in expansion states (-5.1%) but increased in non-expansion states (5.1%) between 2013 and 2014. Researchers attributed these trends to the ACA Medicaid expansion, which increased the share of relatively less expensive enrollees in the Medicaid beneficiary population mix in expansion states.321

Duh - if you are comparing states wtih TRUE (traditional) Medicaid enrollees (elderly or disabled) to expansion states who have basically added millions of low-income people (who are not old or disabled), of course spending PER ENROLLEE in those expansion states is going to be lower. The cost in those expansion states will be seen as the years go by and the states eventually have to fund their 10% portion - that money must come from somewhere (other pieces of the state spending pie).

Marketplace effects - so if you remove a big swatch of people who are low-income and probably less healthy from the marketplace, don't you expect the remaining higher-income/probably higher educated and probably healthier population to get lower premiums. The result is that the Feds and states end up with the entire bill of covering all these low-income people - which those higher-income/higher educated/healthier people are on the hook for.

[boutons_deux]

"who are not old or disabled" :lol

medicaid expansion is for people in poverty who can't AFFORD health insurance or medical bills.

And lot of these are "working poor", not Welfare Queens in Cadillacs.

[rmt]

"who are not old or disabled" :lol

medicaid expansion is for people in poverty who can't AFFORD health insurance or medical bills.

And lot of these are "working poor", not Welfare Queens in Cadillacs.




Cost per expansion enrollee [fed match 100% (2016) to 90%(2020)] is gonna be less than old people in nursing homes or disabled/blind, etc. (fed traditional match 50-73%) - it's obvious that medicaid expansion is gonna bring down PER ENROLLEE cost and (in the beginning) "advantage" (or at least not negatively affect) state coffers.

[Winehole23]

The states have had a free ride up through the end of 2016. Now comes the part where they chip in up to 10% by 2020 (and they are going to struggle to find that 10% from state budgets which mostly must be balanced - not like the Feds who can run up debt).Very true.

Mightn't states tax their citizens to cover the investment in their health?

[Winehole23]

you act like having to pay for government services is some insuperable hurdle. it isn't.

[Winehole23]

you also act like states having to chip in 10% is a ripoff.

it isn't.

[rmt]

I don't mind paying for children, old people in nursing homes and disabled/blind (traditional Medicaid) but I don't want to pay for health insurance for the whatever % above poverty line that ACA Medicaid expansion covers. These are for the most part, able-bodied, probably healthy people. The former category is limited and can't fend for themselves. The latter are able-bodied and in the same situation that I was when I was young and starting. There is no limit to this latter category as more and more low-skilled people move into our country/state.

10% is a GREAT deal (much better than the 50% that the states chip in for the TRULY needy) and the remaining 90% is paid for by ALL taxpayers (not just from expansion state tax). FREE for how ever many years before 2017 (since 2014?) was the HOOK Obamacare used to reel in the states to expand Medicaid - but the piper eventually has to be paid. CA will be crying when they have to pay that 10% for so many and other states will be slapping on work requirements to reduce their expansion numbers and scrambling to see where (education/transportation/pension[I guess not]) to cut from to pay for the expansion.

[boutons_deux]

"These are for the most part, able-bodied, probably healthy people. "

typical Bible humping conservative FUCKING IMMUNE TO FACTS

most of the people on Medicaid ARE working, goddammit, as studies have shown when countering the REPUG lie that safety people MUST work or lose benefits

and I bet the same is true for the poor people in red/slave states who were screwed out of Medicaid expansion by the Repugs. Esp in rural areas, there ain't no fucking jobs available

this is out of date, but any new jobs since then have been filled

https://www.ers.usda.gov/topics/rural-economy-population/employment-education/rural-employment-and-unemployment/

[Winehole23]

Dallas Morning News invesitgated Medicaid providers for two years. Providers skimped on care, endangering patients. State officials were aware of the problem, but covered it up.

1071799744194928640

[Winehole23]

1071799756362526720

[Winehole23]

.

[rmt]

you also act like states having to chip in 10% is a ripoff.

it isn't.

It's a rip off (90%) at the federal level that we have to pay or keep printing. The 10% is the states' enticement to expand Medicaid via ACA (poverty level calculation) - instead of the 50?% for "true, original" medicaid - disabled, old, children.

[midnightpulp]

I don't mind paying for children, old people in nursing homes and disabled/blind (traditional Medicaid) but I don't want to pay for health insurance for the whatever % above poverty line that ACA Medicaid expansion covers. These are for the most part, able-bodied, probably healthy people. The former category is limited and can't fend for themselves. The latter are able-bodied and in the same situation that I was when I was young and starting. There is no limit to this latter category as more and more low-skilled people move into our country/state.

10% is a GREAT deal (much better than the 50% that the states chip in for the TRULY needy) and the remaining 90% is paid for by ALL taxpayers (not just from expansion state tax). FREE for how ever many years before 2017 (since 2014?) was the HOOK Obamacare used to reel in the states to expand Medicaid - but the piper eventually has to be paid. CA will be crying when they have to pay that 10% for so many and other states will be slapping on work requirements to reduce their expansion numbers and scrambling to see where (education/transportation/pension[I guess not]) to cut from to pay for the expansion.

How about when the able-bodied are busting their asses at low-paying jobs that don't provide healthcare? Illegal immigration is at a comparative low compared to the 90's,

https://itdoesnotaddup.files.wordpress.com/2014/07/capture5.png?w=584

[Winehole23]

It's a rip off (90%) at the federal level that we have to pay or keep printing. The 10% is the states' enticement to expand Medicaid via ACA (poverty level calculation) - instead of the 50?% for "true, original" medicaid - disabled, old, children. Disagree.

Medicaid is the most efficient healthcare delivery system there is in the US (just compare administrative cost with private healthcare) and a prudent investment in our most vulnerable citizens.

[Winehole23]

not expanding Medicaid may have cost Texas a lot of money. check at the link under "Economic Effects"

https://www.kff.org/medicaid/issue-brief/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review-march-2018/Not expanding Medicaid may have cost Texas lives as well.

NBER found deaths were significantly reduced in states that expanded Medicaid in the four years studied:

http://papers.nber.org/tmp/87670-w26081.pdf

[ElNono]

Not expanding Medicaid may have cost Texas lives as well.

NBER found deaths were significantly reduced in states that expanded Medicaid in the four years studied:

http://papers.nber.org/tmp/87670-w26081.pdf

That's a shame. Keeping the moochers alive only makes it more expensive for rmt... :rolleyes

[boutons_deux]

rmt doesn't care about human lives, only about her precious money "taken" by the govt.

rmt doesn't whine and bitch about $750B wasted by the military, with NO accountability, no traceability, every fucking year.

[boutons_deux]

of course she would

Trump's Medicare Chief:

'I View a Public Option and Medicare for All as Equally Dangerous'

https://www.commondreams.org/sites/default/files/styles/cd_large/public/headlines/seema-verma-public-option-medicare-all-dangerous.jpg?itok=8MkxzILW

Verma's remarks calling for an expansion of the current for-profit healthcare system :lol

given her record (https://www.commondreams.org/news/2019/01/14/make-no-mistake-people-will-die-backlash-against-relentless-war-medicaid-waged-trump) of seeking to strip away healthcare "protections and provisions for vulnerable people," and,

more recently, calling (https://www.commondreams.org/news/2018/11/01/trump-white-houses-great-halloween-fear-not-vampires-not-ghosts-providing-quality) a single-payer plan like Medicare for All "bad" and "scary."

"we need government to be more hands-off."

https://www.commondreams.org/news/2019/07/22/trumps-medicare-chief-i-view-public-option-and-medicare-all-equally-dangerous

iow, like a perfect oligarchy kakistocrat (auditioning for a $1M/year job after she leaves the govt),

SV wants for-profit profit-care to expanded for extracting even more $100Bs from Americans.

Fuck this lady to hell

[Isitjustme?]

That's a shame. Keeping the moochers alive only makes it more expensive for rmt... :rolleyes

Poor rmt feel bad for that jamaican black trumper lady

[boutons_deux]

Looks like Kansas will be DUMBERER

Kansas looks to become next red state to expand Medicaid (https://www.dailykos.com/stories/2020/1/9/1910473/-Kansas-looks-to-become-next-red-state-to-expand-Medicaid)

extend health coverage to some 150,000 low-income Kansans.

a low-key slam on the Trump administration and other red states' work requirements.

"includes a robust work referral program that promotes self-reliance for non-working Medicaid beneficiaries,"

"while limiting costly administrative red tape that drives up overall costs to taxpayers."

a reference to the ridiculous amounts of money states are spending to set up the tracking systems they're creating to punish poor people.

https://www.dailykos.com/stories/1910473 (https://www.dailykos.com/stories/1910473)

So it looks like ACA is a huge success that Repugs are committed to destroying, to spite Pres Knitter.