“Facing The Reality Of Politics”: Will Red State Governors Opt Out Of Medicaid Expansion?
While supporters of Obamacare are cheering the Supreme Court’s ruling upholding the constitutionality of the law, the celebration may
be short-lived as focus begins to shift to the one key aspect of the Affordable Care Act that was limited by the decision – the expansion of Medicaid to bring health insurance to approximately 17 million previously uninsured Americans.
As originally drafted and passed into law, states that failed to adopt the expansion and offer Medicaid coverage to anyone earning less than 133 percent of the Federal Poverty Level risked losing 100 percent of the money they receive from the federal government towards their state run Medicaid programs, even as currently offered.
In the ruling handed down on Thursday, the court held that such a penalty was unconstitutional and that the federal government is not permitted to punish the states in such a manner, leaving it to the states to decide if they want to stand pat with the Medicaid programs they currently operate or accept the expansion —and the federal largesse that comes with it.
Under the law, the federal government will pick up 100 percent of the cost of expansion for three years, 95 percent for the two years that follow and 90 percent of the costs thereafter. The expansion will allow the states to provide the benefit to many more low income Americans without taxing their state budgets at all for three years and then only slightly in the years that follow.
Currently, the federal government picks up the tab for about 55 percent of the costs of a state Medicaid program.
Those governors who are strong objectors to Obamacare will, no doubt, feel a strong ideological urge to reject the expansion and leave things as they are. But is that really going to fly? After all, conscientious objection to Obamacare is one thing but the reality of politics is something else entirely.
So far, there have only been angry ‘rumblings’ from Republican governors like Sam Brownback of Kansas and Bobby Jindal of Louisiana who say they will continue their objection to the ACA by refusing to begin organizing a healthcare exchange in their respective states and wait for the outcome of the November election. Other governors, such as Texas’ Rick Perry, who has refused federal money in the past, are staying a bit quiet on the subject, saying only that they will look into the matter and make a decision at a later time.
While it is to be expected that GOP governors—particularly those who refused to implement the requirements of Obamacare until they heard from the Supreme Court—would engage in a bit of sabre rattling, we can expect few, if any, to be foolish enough to pass up the opportunity to expand their Medicaid programs when Washington is offering such an exception deal for them to do so.
As National Journal’s Ron Brownstein points out, the 26 states that sued to block the Medicaid expansion contain over half of the nation’s unemployed and an even greater percentage of the nation’s uninsured population. Texas—one of the plaintiff states in the healthcare lawsuit—alone accounts for slightly over 6 million of the uninsured, 2 million of whom would gain coverage under the Medicaid expansion.
Additionally, because the federal government picks up virtually all of the costs attached to covering more people through expanded Medicaid, the program represents a massive transfer of money to those red states that tend to have less generous Medicaid programs already in existence. As a result, a state like Texas, with a rather sparse program, is going to get an enormous sum of federal cash where Massachusetts, which already has a generous program, will get very little in federal funding.
Are these red state governors really going to sit by and watch the taxes their citizens pay to the federal government flow to the benefit of their neighboring states as the recalcitrant governors allow their own residents to miss the benefit of that money?
I don’t think so. Ideological opposition is one thing—denying access to health care to voters who could certainly use it when, to do so, would cost the state a relatively tiny amount of money, is just dumb politics.
The pressure will not come only from the voters.
If there is one lobby that is highly supportive of the Medicaid expansion it is the nation’s hospitals. For them, covering millions of low income Americans means dramatically less free medical services being doled out to people who cannot pay. With more of those who have depended on free emergency room care as their sole means of getting health care now eligible to have Medicaid coverage, hospital balance sheets can be expected to look a lot better in the coming years.
Expect lots of huffing and puffing on this topic in the coming days.
Expect GOP governors to continue pressing the case that a Romney victory means saving their states from the further economic distress that these politicians will claim to be the fate of expanded Medicaid.
But remember that this Medicaid expansion is the bargain of the century for each and every state in the union that does not already offer generous Medicaid programs—especially the red states—and that beneath the inevitable bluster, there isn’t a Republican or Democratic governor in the country who doesn’t understand that passing up a sweet deal like this will bring unhappy political results.
My prediction?
Medicaid expansion, as written in the Affordable Care Act, will take place in every single state in the nation, without exception.
By: Rick Ungar, Contributor, Forbes, June 30. 2012
“For Women Only”: Five Health Care Mandates Republicans Support
Republicans are in complete upheaval over Obamacare, fired up by the Supreme Court’s decision to uphold the law yesterday. They have continuously claimed that the government is ramming this legislation down the throats of the American people, and now they are calling it an unwanted financial burden on everyday Americans. In fact, the individual mandate — the portion of the law that Republicans most vociferously oppose — wouldn’t even affect most Americans.
It might be time for Republicans to take a look back at their own record of health care legislation that they did like — and that forced American people, particularly women, into a lot of things:
Forcing women to get transvaginal ultrasounds: Virginia Gov. Bob McDonnell wanted to force every woman seeking an abortion to go through the extremely uncomfortable and medically unnecessary procedure of a transvaginal ultrasound — sticking a medical wand far into a woman’s vagina to get a clearer ultrasound image.
Ordering women to cremate and bury their miscarried fetus: A huge abortion omnibus bill in Michigan could force women who miscarry to cremate the miscarried fetuses. This comes at no small expense to the woman: cremation of a fetus costs hundreds of dollars, and interment can be additional thousands. The bill has been passed by the Michigan House, and is awaiting a vote by the Michigan Senate.
Requiring doctors to lie to female patients: In Kansas, Republicans tried to force doctors to tell women that they faced risk of cancer from having an abortion. That is patently untrue, and making doctors say that it was true would be, in effect, requiring them to lie to their patients.
Making a dying woman consult two doctors before she can get a life-saving abortion: The New Hampshire legislature just overrode a veto by the Governor, forcing through a law that bans “partial birth” abortions. The law only reinforces federal law, but has the additional requirement that any woman who is exempt from the abortion ban because her life is at risk must visit not one but two doctors before she can get the procedure to save her life. For many rural women, especially those facing life-threatening conditions, this is near impossible.
Mandating people pay extra to give medical device companies a tax break: Rep. Erik Paulsen (R-MN) worked so hard to protect medical device companies from having to pay, that he has instead passed their costs onto the consumer — regular Americans — by increasing the cost of health coverage.
By: Annie-Rose Strasser, Think Progress, June 29, 2012
“Rigging The System To Keep Power”: Republicans’ Voter Suppression Project Grinds On
Mitt Romney was in Michigan this week trying to make it competitive in the presidential election. It’s a steep climb for the native Michigander because President Barack Obama’s auto bailout, which Romney opposed, has helped bring the state’s unemployment rate down by 5.7 points since 2009.
But Romney has a strong ally there: legislation being pushed this month by his fellow Republicans aimed at preventing the nonpartisan League of Women Voters from undertaking the voter-registration drives it has sponsored for nearly a century.
Across the country, the Republicans’ carefully orchestrated plan to make voting harder — let’s call it the Voter Suppression Project — may keep just enough young people and minorities from the polls that Republicans will soon be in charge of all three branches of the federal government.
Yes, both sides try to change voting laws to favor their team. The 1993 “motor voter” law that made voting more convenient by extending registration to the Department of Motor Vehicles helped mostly Democrats. That was at least in the long American tradition of expanding the franchise.
The Republican effort to restrict voting isn’t just anti- Democrat, it’s anti-democratic. No fair-minded person believes the tall tales of voters pretending they were someone else, which have been debunked by the Brennan Center for Justice and others. What fool would risk prison or deportation to cast a single vote?
This isn’t about stopping vote-stealing and other corruption, for which there are already plenty of laws on the books. It’s about rigging the system to keep power.
First we saw the efforts during the George W. Bush administration by Karl Rove and Justice Department officials to get rid of U.S. attorneys who refused to pursue bogus voter- fraud cases. When Republican prosecutors complained, Rove and company ran for cover.
Then came Crawford v. Marion County, the 2008 case in which the U.S. Supreme Court ruled that mandatory photo-identification laws were constitutional on the basis of ballot protection. The evidence presented included not a single case of in-person impersonation fraud — the only fraud that photo ID laws can prevent. And the millions of Americans — mostly less-affluent seniors — without driver’s licenses? Good luck.
The big Republican victory in the 2010 election was essential to the Voter Suppression Project. With the help of ALEC — a conservative lobbying outfit that spreads cookie- cutter bills to state legislatures — Republicans moved with lightning speed to implement their scheme. Since 2011, 18 states have enacted voter-suppression bills, with similar ones pending in 12 more.
In the presidential race, it’s hand-to-hand legal combat, with almost every battleground state embroiled in a struggle over voter eligibility.
Michigan’s bills attack the League of Women Voters by requiring some volunteers to attend state-approved training sessions before they can register voters. The catch is that the bill makes no provisions for such sessions. Ha! It does threaten them with penalties for registration offenses that aren’t specified.
The bill is modeled on Florida’s, parts of which a federal judge invalidated May 31 because he said they had “no purpose other than to discourage” constitutionally protected activity.
In Ohio, the Obama campaign helped collect enough signatures to put a referendum on the ballot repealing restrictions on absentee voting. Preferring not to face the voters directly on voter suppression, the Republican-controlled legislature repealed its own law, although it left intact a related measure that prohibits early voting on the three days before an election. That’s designed to discourage the tradition in black communities of busing worshippers from church to the polling place.
Several battleground states have new photo-ID requirements. Pennsylvania’s law allows valid student ID, but with a number of restrictions. Same in Wisconsin, which attached a series of bring-me-the-witch’s-broomstick demands for students looking to use a school ID. Fortunately, a state judge ruled against the Wisconsin law, although it’s being appealed.
Virginia’s legislation allows multiple forms of photo ID but restricts registering for an absentee ballot in person. A New Hampshire bill that required those without photo ID to fill out an onerous affidavit was thankfully just vetoed by Governor John Lynch.
The Obama campaign is obviously concerned about these ballot-access issues for political reasons. But even those with no dog in this fight should recognize that a great democracy doesn’t sully itself by suppressing the precious right to vote.
By: Jonathan Alter, The National Memo, June 22, 2012
“Nice Work If You Can Get It”: Why Mitt Romney Likes Firing People
Mitt Romney would prefer for you to recall just one number regarding his record at Bain Capital. That would be 100,000 — the number of jobs that the Republican candidate claims he created during 15 years at the private equity firm.
But now there is a more interesting, plausible and relevant number: $20,000. That’s how much money Romney is estimated to have made from each worker laid off during Bain’s many corporate takeovers.
In fairness, Romney’s goal at Bain was never to create jobs but to reap the biggest returns for their valued investors. Judging by that metric, he did exceedingly well, as even Bill Clinton accidentally admitted when discussing Romney’s “sterling” business career. And of course, Romney’s fortune, estimated somewhere between $190 million and 250 million, attests to that assessment.
But over the course of the Romney’s years at Bain Capital, at least five of the companies he took over eventually went bankrupt, while still rewarding Bain investors handsomely:
• American Pad & Paper: Bain invested $5 million in the Ohio paper company in 1992, and reportedly collected $100 million in dividends on that investment. But AMPAD went bankrupt in 2000, resulting in 385 employees losing their jobs.
• Dade Behring: Bain invested $415 million in a leveraged buyout in 1994, borrowed an additional $421 million, and ultimately walked away with $1.78 billion. Dade filed for bankruptcy in 2002, and laid off 2,000 employees.
• DDI Corporation: Bain reportedly invested $46.3 million in the electronic parts manufacturer 1997, earning $85.5 million in profits plus $10 million more in management fees. When the company went bankrupt several years later, 2,100 workers were laid off.
• GS Industries: In 1993, Bain invested $60 million in the Kansas City steel maker, borrowed a lot of money, and then took $65 million in dividends. But GS eventually went bankrupt in 2002, and 750 workers lost their jobs and pensions.
• Stage Stores: Bain invested $5 million to purchase the Houston-based retailer and took it public in the mid-’90s, reaping $100 million from stock offerings. In 200o, following Romney’s departure from Bain, Stage filed for bankruptcy and 5,795 workers were reportedly dismissed.
While it is true that some of those companies went under after Romney had left Bain, the job growth for which he now seeks credit also occurred after his departure in 1999. But the bankruptcies — and the bust-out scenario that helped Bain to profit anyway — are not news. What AOL’s Daily Finance has contributed to the Bain debate is a simple calculation: Bain Capital booked $1.995 billion in profits from the layoffs of 11,030 workers at various firms. And by that scoring, Romney earned roughly $20,000 himself for each of those fired employees. Nice work if you can get it (or take it away from someone else).
By: Axel Tonconogy, The National Memo, June 15, 2012
“Running Against Himself”: Mitt Romney’s Supreme Burden
Congratulations to Mitt Romney! His signature contribution to American life, devising a health plan that became a model for the only major Western democracy without medical care for nearly all of its citizens, has been upheld. If Romney accomplishes nothing else in life, he will go down in history as the man who first proved, in the laboratory of Massachusetts, where he once governed, that an individual mandate could work.
Jeers to Mitt Romney! As the presumptive Republican nominee for president, he stood in front of the Capitol just after the Supreme Court ruling on Thursday and promised to fight in the coming campaign against one big idea — his own.
Now Romney has no choice but to run against himself. It was Rick Santorum who put it in blunt political terms during the Republican primary. Romney, he said, “is the worst Republican in the country to put up against Barack Obama” because he is the intellectual godfather of the most consequential act of the Obama presidency.
If Romney was honest, and his party less locked in the grip of its far-right base, he could point with pride to the progress that Massachusetts has made. In the Bay State, compliance with the law is high, and nearly two-thirds of the people support it. The cost of insurance fell significantly in the first year after the law took effect. And fewer than 1 percent of the people chose to pay the penalty — or tax, as Chief Justice John G. Roberts Jr. helpfully clarified for Obamacare — rather than sign up for health insurance.
But the days of Romney praising his plan, which he did as recently as 2009, are long gone. Remember, it was in a moment of debate candor that Romney turned to Newt Gingrich and acknowledged the free-market, Republican origins of the mandate.
“We got the idea from Newt,” said Romney. “And Newt got it from the Heritage Foundation.” And the idea is a simple one: freeloaders cost the system billions and indirectly raise insurance for those who do the right thing.
To please a Republican Party that waves its gnarled fists at progress, Romney promises, crosses his heart and swears on his mother’s grave that he will repeal Obamacare on Day 1 of his presidency.
Except that, hedge, hedge, he wants the law’s most popular features — preventing insurance companies from dumping people who get sick or denying care to those with pre-existing conditions — to remain on the books.
All of this just reinforces Romney’s worst character flaw — the weasel factor. Every time he opens his mouth to denounce the individual mandate, he contradicts one of the most successful things he ever did as governor.
Plus, the Republican majority in the House has no intention of passing any measure that would keep the most popular parts of the health care act intact. Instead, the House will most likely vote next month to repeal the whole law, and from there it will sit in the Senate and await the election outcome in November.
The mandate is unpopular, without doubt. But big pieces of the law are supported by large majorities. People love the fact that insurance companies no longer have lifetime caps on coverage — an especially crucial element for those with long-term, chronic illness. Older Americans like closing the so-called doughnut hole in prescription drug coverage. Families like the part that allows children to stay on their parents’ insurance until the age of 26. And the medical community likes the law’s emphasis on preventive care.
We can expect a great deal of histrionic stewing and stomping from the Tea Party. Some of its followers have already called for Justice Roberts to be impeached or step down. Too bad Romney’s campaign Web site says he will nominate judges “in the mold of” John Roberts. We’ll see if that statement remains by next week.
The Tea Party, even with the flares that will light up after the court ruling, is a spent force, and most Americans have turned against it.
But Romney still has to carry the Tea Party’s anger at a time when independents — the key to the election — are sick of hyper-partisan scraps and want real solutions to national problems.
The health care law, if tweaked to help small businesses and properly implemented, can join Medicare and Social Security — which are, after all, mandates through taxes — as popular programs that elevate American life and help average people.
President Obama now gets a chance to resell his biggest legislative achievement. He did just that on Thursday, in a brief (for him) and very effective summary of the principles of the health care law: “People who can afford to buy health insurance should take the responsibility to do so.”
Sound familiar? It’s very close to what Romney said in 2009: “Using tax penalties, as we did, or tax credits, as others have proposed, encourages free riders to take responsibility for themselves rather than pass on their medical costs to others.”
Wait till the presidential debates, when Obama can use the words of Mitt Romney, health care pioneer, against Mitt Romney, health care obstructionist.
By: Timothy Egan, The New York Times Opinionator, June 28, 2012
Share This Blog
Unknown Feed- An error has occurred; the feed is probably down. Try again later.
mykeystrokes.com 