Senate Republicans on Thursday night used their new majority to pass a two-year budget that eliminates any opportunity for Gov. Terry McAuliffe or a year-old legislative commission to expand Medicaid or a private insurance alternative.
They were backed by House Republicans who said they would not approve the budget — even though Senate Democrats and moderate Republicans had removed an insurance marketplace — unless it included language to prevent any expansion without the approval of the full General Assembly.
The Senate passed the budget on a 21-18 vote. Sen. Lynwood W. Lewis Jr. of Accomack County was the only Democrat who backed the spending plan.
Just before midnight the House of Delegates voted 69-31 to adopt the budget, as lawmakers sought to end a three-month stalemate and address a $1.55 billion revenue shortfall.
The blame for this partisan stupidity cannot even be placed on the Virginia GOP. The blame clearly should be laid at the feet of Virginia’s own Benedict Arnold, Senator Phillip Puckett. Puckett chose his own personal career advancement and that of his daughter over 400,000 Virginians.
If lawmakers only knew how many people simply do not have medical coverage because of finances, they might take a different look at this problem. If Republicans would only take a look at how much uninsured people really cost the nation, I think we would see a change. Some people are so afraid that someone is going to get something for nothing that they cut off their noses to spite their faces.
So we have a budget. I happen to feel any budget that doesn’t include Medicaid expansion is immoral and costly in the long run.
With the Advent of Obamacare, doesn’t everyone have access to insurance? Do we need to attack this problem from multiple, incongruent angles?
No, everyone doesn’t. If you can’t afford it, it is unaccessible.
How does someone out of work afford insurance?
The feds will pay for it for 3 years and then 90% after that.
I’m not uncomftable with that. I’m not inrterested in an America where people don’t need to work, and the government protects them ad infinitum.
I am speaking of people who cannot find work.
For instance, males rarely get Medicaid unless permanently disabled. Medicaid doesn’t have to be permanent.
What about people who have been terminated from their work for whatever reason?
What about people released from prison? People in that position have a difficult time finding work.
They just don’t make singing voices like this anymore: https://www.youtube.com/watch?v=7fdynmsMomw
The issue is that we are paying for their healthcare anyway, we are just paying for it in the most expensive way possible – ER visits and letting treatable conditions fester until they require much more intensive therapy to resolve. All we are doing is allowing the taker states like Kentucky, etc to have more federal dollars and become more taker and continuing to allow hospitals to teeter on bankruptcy because they are required to provide treatment and people walk out on their bills.
@Pat.Herve
Except that those states that expanded medicaid have seen the number of ER visits RISE. Just because you have medicaid does not mean that you can find a doctor that will take it.
@Cargosquid
Yes, the number of ER visits might rise – temporarily – but should come down as insured people go to alternatives (other clinics, pcp, etc). Not funding our hospitals and doctors will not help in the long run. I have had plans where I had very few providers in the plan – those in the medicaid realm need to either deal with it, or get a better plan.
“those in the medicaid realm need to either deal with it, or get a better plan.”
@Pat.Herve
If they could get a better plan, they would not be on medicaid.
And how will the rise be temporary?
There AREN’T alternatives…..that’s the point.
There are fewer doctors available under Obamacare and fewer and fewer are taking medicaid…so the patients will still go to the ER’s. And our tax money pays for it.
Cargo, your speculations aren’t supported by facts. I haven’t seen any proof that there are fewer doctors because of Obamacare. Same with Medicaid. That is simply speculation. Why not medicare? You left that out. Here’s the deal on that. Its harder to find doctors at the end of the year because they have filled their quotas. Then come January, everything opens back up. Also, there is attrition.
Here’s another point: if we have a 1.55 billion dollar shortfall WITHOUT medicaid expansion….how would we have paid for the expansion? The FEDS do not pay 100% of the expansion.
On the other hand, the GOP demanded a medicaid audit. If they don’t order one now…they are hypocrites.
The feds would pay for expanded Medicaid for 3 years at 100%. It’s stupid not to take the deal. 400,000 more people covered. that saves billions actually.
@Cargosquid
you will need to ask McDonnell why there is a 1.5 billion dollar short fall.
So, should someone on medicaid get a gold plan?? Not every doctor takes medicaid, not every doctor takes Aetna. Under your plan, you cannot go to the facility of your choice. If someone does not like the medicaid plan, they need to find an alternative – which could mean to go get a job or increase in pay.
How should a diabetic be treated if they have no coverage and they have no means to pay the inflated self-pay rates? Do you even realize the inflated costs when a diabetic shows up with severe hyperglycemia – a lot more than insuring them and giving them care to prevent the ER visit.
There are not fewer doctors under ACA. BS. If someone shows up to the ER right now, we all pay and the hospital is out the money – which has caused some hospitals to close.
McDonnell set up a task force 2 years ago – what is the status right now of the task force – crickets – they have reported nothing. Medicaid audit – crickets – nada, nothing. McDonnell did not say no because he knows it will need to be a yes.
GOP said pass a clean budget – and first chance they got, they encumbered the ~~clean~~ budget with an amendment….yeah, clean.
An aging population and more people able to obtain medical care under ACA will put pressure on the number of Dr’s but ACA is not causing fewer Dr’s. Hasn’t been enough time to make that claim. Insurance companies in the 70’s and 80’s encouraging medical malpractice did that. But changes in health care practices, out patient care, technology will probably offset new demands.
I have seen no valid policy argument for not accepting the federal money and expanding Medicaid in Va., and I have asked my representatives directly. The expansion increases eligibility levels to 136% of the poverty line, or $23,550 for a family of four. The eligibility level is currently set at about $10,000 for a family of four in Virginia- if you make more than that, you have to buy your own insurance. Someone please tell me how a family of four with an income below $10,000 could afford even $300 per month for insurance- that would leave $533.00 to pay rent, buy food, maintain a car, etc.
Every state currently already covers those with no income, so the expansion would almost exclusively go to working poor and their families. The expansion covers the gap between those with current Medicaid eligibility and the poor who can afford private health care using subsidies under Obamacare, so it is a key element of Obamacare. That, and only that, is why Republican governors are refusing to expand Medicaid- it’s one of the areas in their control that they can use to try to defeat Obamacare. They are willing to deny this badly needed access to healthcare to those most in need to try to make a political point. Truly disgusting.
Here’s a look at who the expansion would help:http: //www.washingtonpost.com/local/by-resigning-virginia-lawmaker-phillip-puckett-betrayed-his-own-people/2014/06/09/8ee6abe4-f015-11e3-bf76-447a5df6411f_story.html
I meant to say an income AROUND $10,000, not BELOW $10,000 in the post above. The expansion would cover those between the current $10,000 cut-off and $23,550 for a family of four.
and there is also the $400 Million spending in the current budget which will not be reimbursed – i.e., with medicaid expansion, we would not be spending that $400 million.
And what do we do after that three years that the feds cover? How do we pay that? NO ONE has an answer for that.
As for the current short fall, I don’t need to ask McDonnell…. Its from his term. But we need to cover it now.
The point was that ObamaCare is supposed to reduce ER visits, especially the Medicaid expansion.
It doesn’t.
That is my point.
You have not proven your point.
After 3years the Feds will pay 90%. Think of what will have been saved in three years. It’s really an issue of Money and decency.
I’m still waiting to hear the policy argument against expanding Medicaid in Virginia. Anyone?
I am all for expansion. It will save the Old Dominion money.
@Moon-howler
I did not try to “prove” a point.
If we have a 1.5 billion dollar shortfall NOW…how do we pay an extra 10% on HIGHER medicaid costs? And as I said, we need to audit our current medicaid spending.
What taxes do you want raised to pay for it? If its for decency..then taxes should be raised to cover any spending that helps the poor. Why stop at medicaid?
What WILL have been saved in that 3 year time? The patients will still be going to ER’s.
Again, because you say so doesn’t make it true. I just took my husband to the ER. He has great coverage. Someone will always be going to the ER.
We have a shortfall because…well…Thank you McDonnell. Expanding Medicaid wouldn’t have cost Virginia a dime this year.
I believe everyone should have basic health coverage at a minimum.
@middleman
You haven’t been reading my comments.
@Pat.Herve
Why wouldn’t we? We still have to pay for our CURRENT share of the medicaid program. The Feds pay only 100% for the first 3 years on the EXPANSION.
@Cargosquid
Please provide references for your claims on the rise of ER visits.
@Cargosquid
Here is what the CBO has to say about the impact of the expansion of Medicaid under the Affordable Care Act:
“Expanding Medicaid is thus a very favorable financial deal for states.
CBO estimates show that the federal government will bear nearly 93 percent of the costs of the Medicaid expansion over its first nine years (2014-2022). The federal government will pick up 100 percent of the cost of covering people made newly eligible for Medicaid for the first three years (2014-2016) and no less than 90 percent on a permanent basis.
The additional cost to the states represents a 2.8 percent increase in what they would have spent on Medicaid from 2014 to 2022 in the absence of health reform, the CBO estimates indicate.
This 2.8 percent figure significantly overstates the net impact on state budgets because it does not reflect the savings that state and local governments will realize in other health care spending for the uninsured. The Urban Institute has estimated that overall state savings in these areas will total between $26 and $52 billion from 2014 through 2019. The Lewin Group estimates state and local government savings of $101 billion in uncompensated care.”
Quit drinking the Republican Kool Aid Cargo–it’s bad for your health–you could wind up in an ER.
@Cargosquid
Oh, I’ve been reading them, Cargo- and I still haven’t heard a rational argument from you or anyone else.
These are real people who need help NOW. By definition, they are not unemployed- they just don’t make enough to afford health care. They are families and hard-working individuals, some with two or three jobs. Even if we only helped them for 2 years, it would be a great service to them. Whatever happened to helping the least among us? Have we lost all compassion in Virginia?
+1 middleman
There are many who are opposed to the medicaid expansion and the only reason why they say so is that the feds may (may, might) not continue funding in the future – just like every other federal program that exists. They have no alternative or solution – as this was their plan with a few modifications.
@George S. Harris
http://www.usatoday.com/story/news/nation/2014/06/08/more-patients-flocking-to-ers-under-obamacare/10173015/
The CBO also said that Obamacare would save us money and increase access.
The CBO has walked back that prediction.
@middleman
They can go where they would go if they ended up on expanded medicaid……the ER. Because the expansion does not expand access.
@Pat.Herve
So Pat, how DO we pay for the increase in medicaid costs? What shall we NOT pay for instead? Unlike the Feds, we can’t print money. And we’re already in the red….so, please, tell me how we pay for this.
We can’t be in the red. Ask McDonnell.
We don’t pay anything for the first 3 years.
Sick people cost more than Medicaid. People who haven’t had medical coverage cost more than Medicaid.
Let’s all agree that we cant just leave people in the street to die.
@Cargosquid
How to we pay for a diabetic who shows up in the ER in hypoglycemic shock? It would have been cheaper to give him medical care to prevent the incident.
What is the economic cost to the community when a rural hospital closes?
I do not think you really know the topic and how (long term) it will work.
The Republican plan of lets do nothing – healthcare, tax reform, immigration reform, etc – is not good for our long term prospects.
I think Pat makes a good point about long run plans. The GOP has offered very little in the way of long term plans. They ignore the fact that there is an aging population as baby boomers outpace <---(HA) younger populations. Business as usual will change. The geezers today do not represent those of us in the pre-geezer state right now. Politically, the boomers are going to be a force to be reckoned with. Remember, they do not go quietly. Never have, never will.
“Let’s all agree that we cant just leave people in the street to die.”
And we don’t.
@Pat.Herve
Again, you are missing the point. ER visits are RISING due to the medicaid expansion.
And that alleged rural hospital will not stay open because of the medicaid it gets.
The Republican plan of not letting the Democrat ruin even more of the country by bankrupting it further is better than letting the Dems have their way.
Tax reform? Since when is raising taxes….tax reform. Immigration reform? Amnesty is bad for the nation as is being shown by the current invasion. Healthcare? We have that. It is a disaster.
Please, point out where any of the Democrat ideas have been good for the country since Obama took office.
The GOP knows that any of their plans will be dead in the water no matter how good they are. The Senate and the President will veto any GOP plans.
Yes, that rural hospital will stay open with medicaid funds – the way it is now, it gets no funding for many of the patients. Yes, ER visits have risen as expected and will taper off.
Tax reform is not just about raising taxes. Right now, there is no conversation about what to do, although both sides say that tax reform would be a good thing.
Immigration – needs to be fixed – but nothing done on immigration during all the Bush years while the undocumented came in and reduced middle class jobs down to cash paying minimum wage. Nothing has been done to change this under Obama either.
Healthcare – the heritage foundation plan.
Doing nothing hurts us all.
Rupert Murdoch is now calling for immigration reform – it must be getting bad if he is looking for reform, and says politicians should not be looking at the short term impact, but the long term consequences. http://online.wsj.com/articles/rupert-murdoch-immigration-reform-cant-wait-1403134311