From The Washingtonpost.com editorial:
The Post’s View
Va. Republicans need to end their excuses for not expanding medicaid
REPUBLICANS IN Virginia’s House of Delegates are running out of excuses to refuse a huge pot of federal money for expanding health-care coverage to poor people. The legislature this week convened a special session, the product of House Republicans’ baseless refusal to compromise on the health-care expansion. Both Virginia Gov. Terry McAuliffe (D) and the state Senate have offered compromise plans, responding to the House GOP’s proffered reasons for opposition with more seriousness than they deserve. If the Republicans’ opposition is anything beyond thoughtless or cynical, they should come to the negotiating table now.
The special session was called to agree on next year’s budget. But the battle is over one piece of the state’s financial plan: whether to accept federal funds to expand eligibility for Medicaid, the federal-state partnership that offers health-care coverage to people below and around the poverty line. The Affordable Care Act’s coverage plan depends on this expansion, but the Supreme Court ruled that states could opt out. Virginia is one of those that hasn’t made up its mind, even though the federal government has committed to pay nearly the whole tab, in perpetuity, with tax dollars it is already collecting from every state, including Virginia, whether they expand or not.
Rather than accepting the federal offer and moving on, House Republicans attacked the design of the Medicaid program, insisting that it was too broken for them to expand it in good conscience. Senate moderates responded with a proposed expansion outside of the traditional Medicaid system, offering to use federal cash to buy people private coverage instead. The governor endorsed the idea. The House didn’t budge.
House Republicans then claimed that, even if the expansion were designed more to their liking, they couldn’t count on the federal government to hold up its end of the funding bargain. That argument has never made much sense: The state routinely accepts federal dollars on less generous terms without similar hand-wringing, and the legislature would be able to roll back the program if the feds pulled back on the funding. Nevertheless, Mr. McAuliffe answered that objection Monday by offering an explicitly temporary, two-year expansion of the Medicaid program in Virginia. The House hastily rejected this compromise offer in a committee vote.
House Republicans now insist that the Medicaid fight shouldn’t be part of the budget process. Pass a budget first, they say, then talk about expanding coverage. That argument fails to account for the fact that the governor wants to fund various measures with budget savings projected from the inflow of federal Medicaid dollars. It also amounts to a demand that those in favor of expansion surrender all of their leverage, which would be a lot more credible if House Republicans showed any interest in sorting out the Medicaid issue in good faith. Rather, their latest fall-back excuse seems to be more of the same: a desperate, trumped-up objection that exposes how weak their substantive case really is.
House Republicans are just lame. Their decisions are costing Virginians hundreds of thousands of dollars. They are grasping at straws. All that federal money helping people who are not covered by any insurance is going to waste. Are these bastards just mean or are they stupid?
The article said that about 77% of the reduced spending could be attributed to the poor economy. The remainder of the reduction was not well-explained.
I found one statement to be particularly ominous: Obamacare punishes hospitals for re-admission of patients for the same condition within 30 days. Given the existing push to discharge people very quickly, Obamacare could make it difficult to get admitted to hospitals for a recurring condition. This may well lead to unforeseen consequences, which is yet another reason why federally managed healthcare is not a great idea.
I am confused here. Are we talking about Medicare? Most people on Medicare aren’t working anyway. They would be independent of job markets etc. Some people are eligible but remain in the company plan for obvious reasons. It costs them and their spouse less in many cases.
Can you find out more about the readmission of patients to hospitals for the same condition? This might be a good thing. Hospitals are all too quick to discharge patients, especially older patients. Right now they like to dump them off in rehab (read: nursing homes) before they are ready. The medical care is often substandard in those places. I would like to see patients have longer time in hospitals rather than this around the rim and out policy.
My understanding is that the goal of the re-admission initiative is to prevent patients from being released too quickly. It penalizes hospitals in some situations for quick re-admittals, which should result in hospitals being more careful when releasing patients. Patients would still be re-admitted, but the hospital would be scrutinized more closely regarding the reason for re-admittal.
To me, that’s a good thing, along with the initiative under the ACA to look at promoting outcome-based medicine rather than service-based. This could save a LOT of money and not affect healthcare outcomes if done right.
There’s a lot of stuff like that in the ACA. I’ll say again, just as with clean air and water regulation, if the government doesn’t do these things, who will?
Certainly not the industrialists! @middleman
Show me someone who doesn’t want any government regulation and I will show you someone supporting cheaters.
Btw, one of the reasons I refuse to call myself a Democrat is because their leadership is completely gutless. They always seem afraid that they’ll lose a few independent votes if they take a strong progressive stand. The ACA is a perfect example- the initiatives above are just some of the things included that will bend the cost curve and improve care, but who knows about it? Why aren’t they blasting this stuff from the rooftops? Why are they running from this law instead of educating people and refuting the GOP lies? Makes you wonder.
Say what you will about the GOP, they have guts. Think about it, they blatantly block raising the minimum wage, immigration reform, extending unemployment insurance (right before Christmas!) and even providing Medicaid to the needy, all issues that the majority of Americans support. Now, THAT takes guts!
Guts and lower. I also am independent for pretty much the same reason. Get local and it gets even worse.
Clinton was just telling the Dems to stand up and support ACA, meet the fight with vigor, stop looking cowardly!
Cargo,
I believe that we should to at Germany and how the deliver healthcare. We should have a single payer system as a bare minimum for everyone. Then either as private citizens or as a benefit through your employer, you could have more coverage. The idea that we can all have the same insurance coverage does not seem reasonable, of that I agree.
“Why are they running from this law instead of educating people and refuting the GOP lies? Makes you wonder.”
Because its NOT lies. And the people are seeing the incompetence of the ACA roll out with their own eyes. Even the press can’t cover up all of the problems. The Democrats know that THEIR lies are coming home to roost.
@Elena
THAT would be a more honest discussion than what was done with the ACA. THAT would be Congress doing its job and looking at alternatives instead of trying to pass a law that merely promotes voting for Democrats.
Of course, even with the system that you described, the left would still demand that ALL of the treatments be free because “rich” people would still be getting better care.
Oh bull crap. The left would not be clamoring for that. I have better health coverage than people who make less money than I do. I am sure there are people out there who could eat my lunch with health care.
Cargo, I’m referring to lies like Boehner’s claim that the ACA has resulted in a net loss of insured Americans: http://www.mediaite.com/online/boehners-obamacare-claim-garners-four-completely-false-pinocchios/
Of course, there’s also the “death panel” lies, the claims that personal information on Healthcare.gov is not protected, care will be rationed, etc. etc. All in all, a concerted effort to undermine the law’s success.
Let’s hear it for death panels. Who was that, Sarah dumb-ass Palin? People need to have end of life discussions. Period.
@middleman
Since there has been a net loss of insured Americans….not a lie. Gov’t admits that there are only 6 million signed up and its unknown if that means that they are actually covered.. 6 million lost insurance. That link magically invents 9 million people covered when the gov’t cannot prove that they are covered. None of the gov’t’s claims have been proven or audited.
Death panel…. is there a committee to ration coverage and treatment to save money? Yes.
Personal info ISN’T protected. Even the gov’t stated that was a problem. The site was completely screwed. THAT was part of the problem with the roll out.
So…reporting accurately is “undermining” the law’s success. I call that holding the liars accountable.
Cargo…not everyone has to sign up for Obamacare. Yes, it is misrepresenting facts. For instance, if you are on an employer plan and like it, do nothing. I am only speaking for Virginia because I am not totally familiar with other states. If you have medicare. Do nothing. If you have Medicaid. Do nothing.
So the employeed (with employer provided insurance), those 65 and older, and Medicaid recipients all don’t have to do anything. I am not sure about federal workers and the military. I don’t think they have to do anything but I am not going out on a limb.
You are way too quick to call people liars, in my opinion.
Question, have you signed up?
How do you figure personal information isn’t protected?
I am not so sure how protected we all are from having personal information out there anyway. Did AARP send you information? How did they know your age? Case closed.
@Moon-howler
I am calling specific people liars…..because they lied. Repeatedly. And they continued to state untruths even when the evidence started to come in that rates and deductibles were going up and that access was dropping.
So…were they lying or completely and utterly incompetent?
Personal info at risk.
Paul Bedard at the Washington Examiner reports that with less than two weeks until the opening of the ObamaCare exchanges on October 1st, the White House is admitting the security threat is so serious that the Obama administration met late Wednesday to launch a new anti-fraud bureaucracy that will be charged with handling consumer complaints and educating Americans about the possible ObamaCare fraud and scams.
“Today we are sending a clear message that we will not tolerate anyone seeking to defraud consumers in the Health Insurance Marketplace,” Health and Human Services Secretary Kathleen Sebelius said after the meeting. “We have strong security safeguards in the marketplace to protect people’s personal information against fraud and we will work with our partners to aggressively prosecute bad actors, just as we have been doing in Medicare, Medicaid, and the Children’s Health Insurance Program.”
NOTHING has been reported as fixing these problems.
AARP knows ages because that is public knowledge. They don’t know my SS or credit card numbers.
And no…I didn’t sign up. While investigating it….I was told that the VA qualifies. Anyway, I couldn afford any of the rates that were showing up. I don’t qualify for a subsidy.
You should qualify for a subsidy, especially being a full time student.
Secondly, do you really want to rely on the VA?
I don’t think a person’s age should be public knowledge. Same for address and phone numbers.
I don’t know how much healthcare.gov knows either. I know that medicare knows stuff but it doesn’t broadcast it or give it out to others.
I am much more concerned over what is given out through voter registration.
@Kelly_3406
Yes, for three conditions – Heart attack, Pneumonia and Heart failure – if there are excessive readmissions from specific hospitals they will be penalized. There is significant evidence that cutting the stay short leads to set backs – so to increase outcomes for all, they want a method to make sure that hospitals are not pushing patients out the door too early. Not perfect but it is hard to enforce quality when an organization is also trying to cut costs.
@Moon-howler
Nope…my wife makes too much money. Its all about the income.
I don’t want to rely on the VA. I can’t afford other insurance. We are breaking even as is.
If you use the Obamacare websites, it REQUIRES you to give huge amounts of personal info even before you can look at the plans. THAT is wrong. Just put out the plans. IF and when we get one, THEN we give the gov our info. The fact that they demand info first is evidence that this is merely another intrusion and attempt at control.
Can you get on your wife’s policy?
Does VA work for well stuff or just military related stuff from the past?
and what was your option before ACA? How much was your plan then, were you even able to get coverage with your preexisting conditions?
False. You can search the plans without giving any information about yourself. Only information you have to give is age, state, county and household income. No identifiable information needs to be given to search the plans. A 50 year old in Henrico county can get a Bronze plan for $238 per month (non subsidized).
What is the deductible on that? I paid over $535 but no deductible, just co-pays.
$6,300 maximum deductible – and no copay after the deductible is met. For $253 a month you can get a plan (50y.o. in Henrico) that has a deductible of %5,500 and a copay of $15 per visit.
I hate being stupid but does that mean you pay $5,500 out of pocket before you get a dime paid for? I didn’t have a deductible like that. Tell me what it means.
Cargo, did you even read the fact-checker article? Looks like the bubble has descended ! No facts get in!
Yes… I read the article. I even mentioned some information from it.
@Pat.Herve
I’ll try it again. I remember that I had to give name, etc….. before I could see how much each costs.
…sigh.
@middleman
I’m sorry that you are so sad.
I’m sorry that you fell for mediaite’s spin.