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“Ideology Standing In The Way”: How To Get Sicker, Die Sooner, And Pay More For It

It is painful that five years after passage of the Affordable Care Act, 19 states still have not taken advantage of its option to expand Medicaid. It becomes more so with each new report on the deeply flawed U.S. health system.

The latest, from the National Academy of Sciences, finds that rich people live about 13 years longer than poor people. The researchers note that consequently, rich people end up getting the lion’s share of Social Security benefits. Such inequity should be attacked at its root. At the very least, we could use available tools to help low-income people get health insurance.

The NAS report is far from the first to highlight problems in our approach and results. The Commonwealth Fund last year examined health systems in 11 western industrialized nations. For the fourth time in a decade, the United States system placed first in cost and last in what it delivers. Our system is less fair, less efficient, makes us less healthy and gives us shorter lives. All that for an average of $8,508 per person, way more than second-place Norway at $5,669. In case you were wondering, Britain’s socialized National Health Service was No. 1 at less than half the U.S. cost.

That information landed just as Allan Detsky published a New Yorker analysis of two 2013 reports on global health systems by the Organization for Economic Cooperation and Development and the National Institutes of Health. The study of the 34 OECD countries found an alarming trend: The United States ranked 20th for life expectancy at birth in 1990 and fell to 27th in 2010. On a measure combining level of health and length of life, we plunged from 14th to 26th.

The NIH report by the federal Institute of Medicine found that Americans fared worse than people in 16 “peer” countries in nine areas: infant mortality, injuries and homicides, teen pregnancy, HIV and AIDS, drug-related deaths, obesity and diabetes, heart disease, chronic lung disease, and disability. Why? The authors cite a larger uninsured population than peer countries, worse health habits, more poverty, and more neighborhoods designed to require automobiles.

We have gained a few new tools since some of those studies were done. Some, such as Michelle Obama’s “Let’s Move” initiative and money for electronic medical records in the stimulus law, are nudging us slowly in a better direction. Among the most significant advances are the ACA’s new marketplaces (where individuals can buy insurance regardless of their health status) and the law’s expansion of Medicaid (even though the Supreme Court transformed it into an option that states could take or leave).

The Medicaid expansion is designed for people who make too much to qualify for traditional Medicaid but too little to afford even subsidized private insurance plans. In states that have rejected the expansion, nearly 4 million people are stuck in an absurd coverage gap. That’s even though the federal government is footing the entire bill for the additional enrollees until 2016 and will pay at least 90 percent for them after that.

If we’re already spending a huge amount on health care, why should we sink more into it? It’s a good question — yet we might not have to spend more if we were spending more wisely. We could start by slashing our astonishing medical pricing. It costs more than eight times as much for an MRI here as in Switzerland, a typical example from a study of nine countries released last year by the International Federation of Health Plans. Just this month, The New York Times reported on a 62-year-old drug that went from $13.50 to $750 per tablet overnight.

How can we get a grip on costs? In part by getting a grip on politics. Medicare, overcoming “death panels” alarmism, recently announced it will reimburse doctors for discussing end-of-life choices with patients. That may lead to a decline in expensive, painful and futile treatments. Next, we should lift bans on research into gun violence, the better to reduce shootings and their public health costs.

Ideology is standing in the way on guns, as it is in the 19 states refusing so far to expand Medicaid. The struggles of purple-state Virginia have been among the most epic. Democratic Gov. Terry McAuliffe has been repeatedly thwarted by Republican lawmakers in his push to expand Medicaid. Last year, a disloyal Democratic lawmaker resigned and threw the state Senate into GOP hands. This year Democrats are trying to win back the chamber and, along with it, the slim chance of a Medicaid deal. In the meantime, some 350,000 Virginians are stranded in the coverage gap.

And this, dear readers, is how you get to be last place in the developed world.


By: Jill Lawrence, The National Memo, September 24, 2015

September 25, 2015 Posted by | Affordable Care Act, Health Care Costs, Medicaid Expansion, Uninsured | , , , , , , , | 1 Comment

“A Purely Political Operation”: How The Koch Network Exploited The Veterans Affairs Crisis

As the scandal over waiting lists at Veterans Affairs hospitals exploded earlier this year, there was widespread outrage—and justifiably so, as the country learned that more than 100,000 veterans waited over ninety days for care or never received it.

An ever-present force in this debate was a group called Concerned Veterans for America. Its leader, Peter Hegseth, frequently appeared on cable news segments about the scandal, and CVA was often mentioned on the floor of the Senate.

Though the group doesn’t disclose its donors, it has for a long while been clear the group is funded in part, or perhaps even in full, by the Koch brothers. Any remaining doubt can now be erased thanks to audio from the secretive Koch donor retreat this summer, obtained by The Undercurrent and reported here.

Hegseth addressed the crowd and not only confirmed that the Koch network “literally created” CVA but explained giddily “the central role that Concerned Veterans for America played in exposing and driving this crisis from the very beginning.”

Most notably, during his roughly ten-minute speech, Hegseth outlined how the group was turning legitimate grievances over Veterans Affairs care into a political weapon to attack both the Obama administration and the idea of government-provided healthcare.

When Kevin Gentry, vice president of the Charles G. Koch charitable foundation, introduced Hegseth to the assembled donors, he noted that “you all helped build a group called Concerned Veterans for America.”

At various points, Hegseth took pains to express his gratitude to the people funding his operation. “Concerned Veterans for America is an organization this network literally created to empower veterans and military families to fight for the freedom and prosperity here at home that we fought for in uniform on the battlefield,” he noted.

“We utilized the competitive advantage that only this network provides: the long-term vision to invest and the resources to back it up,” he continued.

Hegseth also created a distinct impression for the audience that CVA was responsible for bringing the VA crisis to the forefront:

Now, unless you’ve been living under a rock for the last couple of months, you know about the crisis at the Department of Veterans Affairs. What you probably don’t know is the central role that Concerned Veterans for America played in exposing and driving this crisis from the very beginning.

After years of effort behind the scenes privately and publicly, the scandal eventually made national headlines when initially in Phoenix it was exposed that veterans were waiting on secret lists that were meant to hide the real wait times veterans had at VA facilities of months and months and months.

Indeed, CVA played a key role in bringing the scandal to the national consciousness. In early April of this year, a doctor from the now-infamous Veterans Affairs hospital in Phoenix retired and went to The Arizona Republic with allegations of falsified data about long wait times for patients.

But despite the story, it remained a local issue. One of the things that helped drive it into the national news was a rally organized by CVA in Phoenix with Republican Representative Dave Schweikert. Not long after, CNN reporter Drew Griffin ran a long investigative piece that sent the story viral.

The scandal surely deserves attention. But Hegseth’s speech is striking for the naked political motivations behind CVA’s advocacy, and what he deems most important:

Perhaps most importantly to this effort, we have created a new line of defense against the march towards socialized medicine, educating veterans and Americans in the process. Veterans have had government-run healthcare for decades. We’ve had the preview of Obamacare, and the scandal has exposed the inevitable result of central planning for all Americans: massive wait times, impenetrable bureaucracy, de facto rationing, wasted tax dollars. It goes on and on.

Throughout this effort, Concerned Veterans for America, along with our network partners, have intentionally broadened the debate to include big government dysfunction generally, further fortifying a new skepticism that AFP and others have brought to what government-run healthcare does.

Even before this year’s scandal, CVA was using problems with Veteran’s Affairs healthcare as a political cudgel against both the Affordable Care Act and vulnerable Democrats. This ad taken against Representative Alan Grayson is a good example, in which a veteran explains his troubles getting care and then says “If you want to know what Obamacare’s going to be like, just look at the VA system.”

CVA operates in the expanding world of 501(c)(4) social welfare organizations that, in reality, are pure political operations. The group’s finances are hard to parse, but it appears much of their spending is on ads targeting Democrats in swing states—late this summer, for example, CVA began a $1.6 million advertising campaign against Democratic Senator Kay Hagan in North Carolina. (Notably, the air time was already reserved by the Koch-affiliated Freedom Partners, but they canceled their buy and turned it over to CVA.)

Finally in his speech, Hegseth claims that Republican senators were working hand-in-glove with CVA to pass the Sanders-McCain legislation this summer on veteran’s healthcare, and that the Koch network alone is responsible for the “market-based” reforms included in the bill:

Ten days ago, the Senate struck a historic deal, a deal that Concerned Veterans for America was central to in every aspect literally ensuring that the language stay focused on real market-based reform, and we pushed the ball across the Now usually deals in the Senate include only one thing: billions and billions of dollars in more spending. Not this one.

This deal, as with the legislation in the House, was instead built on two market-based reforms that were injected by Concerned Veterans for America and advanced the entire point, the entire way.

He names the accountability measures that allow quick termination of under-performing VA managers, which was initially advanced by Senator Marco Rubio.

Hegseth then says the “crown jewel” of the bill is the ability for veterans to obtain private healthcare if they are waiting too long in the VA system. “The latter reform, which seems like a no-brainer to everyone in this audience, is a huge development, rocking the core of big government status quo in Washington,” he claims.

Here, Hegseth is engaging in some undue bravado. The option for privatized care is for veterans is significant, though only available to veterans who have to wait thirty days or more for care or live more than forty miles from a VA facility. Hegseth doesn’t mention the provision has a sunset of three years or until funding runs out, whichever comes first.

And speaking of funding, the legislation increases the deficit by $10 billion. That would seem to go against much of the fiscal conservatism trumpeted elsewhere in the donor conference.

Nevertheless, the Hegseth speech is an interesting window into how the Koch network operates: funding an ostensible advocacy group that is, in fact, a relentless political operation—and one that can, with the right situation to exploit, do everything from take out political attack ads to help craft legislation.


By: George Zornick, The Nation, September 23, 2014

September 24, 2014 Posted by | Koch Brothers, Politics, Veterans Administration | , , , , , , | Leave a comment

“Veterans And Zombies”: The Hype Behind The Health Care Scandal

You’ve surely heard about the scandal at the Department of Veterans Affairs. A number of veterans found themselves waiting a long time for care, some of them died before they were seen, and some of the agency’s employees falsified records to cover up the extent of the problem. It’s a real scandal; some heads have already rolled, but there’s surely more to clean up.

But the goings-on at Veterans Affairs shouldn’t cause us to lose sight of a much bigger scandal: the almost surreal inefficiency and injustice of the American health care system as a whole. And it’s important to understand that the Veterans Affairs scandal, while real, is being hyped out of proportion by people whose real goal is to block reform of the larger system.

The essential, undeniable fact about American health care is how incredibly expensive it is — twice as costly per capita as the French system, two-and-a-half times as expensive as the British system. You might expect all that money to buy results, but the United States actually ranks low on basic measures of performance; we have low life expectancy and high infant mortality, and despite all that spending many people can’t get health care when they need it. What’s more, Americans seem to realize that they’re getting a bad deal: Surveys show a much smaller percentage of the population satisfied with the health system in America than in other countries.

And, in America, medical costs often cause financial distress to an extent that doesn’t happen in any other advanced nation.

How and why does health care in the United States manage to perform so badly? There have been many studies of the issue, identifying factors that range from high administrative costs, to high drug prices, to excessive testing. The details are fairly complicated, but if you had to identify a common theme behind America’s poor performance, it would be that we suffer from an excess of money-driven medicine. Vast amounts of costly paperwork are generated by for-profit insurers always looking for ways to deny payment; high spending on procedures of dubious medical efficacy is driven by the efforts of for-profit hospitals and providers to generate more revenue; high drug costs are driven by pharmaceutical companies who spend more on advertising and marketing than they do on research.

Other advanced countries don’t suffer from comparable problems because private gain is less of an issue. Outside the U.S., the government generally provides health insurance directly, or ensures that it’s available from tightly regulated nonprofit insurers; often, many hospitals are publicly owned, and many doctors are public employees.

As you might guess, conservatives don’t like the observation that American health care performs worse than other countries’ systems because it relies too much on the private sector and the profit motive. So whenever someone points out the obvious, there is a chorus of denial, of attempts to claim that America does, too, offer better care. It turns out, however, that such claims invariably end up relying on zombie arguments — that is, arguments that have been proved wrong, should be dead, but keep shambling along because they serve a political purpose.

Which brings us to veterans’ care. The system run by the Department of Veterans Affairs is not like the rest of American health care. It is, if you like, an island of socialized medicine, a miniature version of Britain’s National Health Service, in a privatized sea. And until the scandal broke, all indications were that it worked very well, providing high-quality care at low cost.

No wonder, then, that right-wingers have seized on the scandal, viewing it as — to quote Dr. Ben Carson, a rising conservative star — “a gift from God.”

So here’s what you need to know: It’s still true that Veterans Affairs provides excellent care, at low cost. Those waiting lists arise partly because so many veterans want care, but Congress has provided neither clear guidelines on who is entitled to coverage, nor sufficient resources to cover all applicants. And, yes, some officials appear to have responded to incentives to reduce waiting times by falsifying data.

Yet, on average, veterans don’t appear to wait longer for care than other Americans. And does anyone doubt that many Americans have died while waiting for approval from private insurers?

A scandal is a scandal, and wrongdoing must be punished. But beware of people trying to use the veterans’ care scandal to derail health reform.

And here’s the thing: Health reform is working. Too many Americans still lack good insurance, and hence lack access to health care and protection from high medical costs — but not as many as last year, and next year should be better still. Health costs are still far too high, but their growth has slowed dramatically. We’re moving in the right direction, and we shouldn’t let the zombies get in our way.


By: Paul Krugman, Op-Ed Columnist, The New York Times, June 19, 2014

June 23, 2014 Posted by | Health Care Costs, Health Reform, Veterans Administration | , , , , , , | Leave a comment

“Content-Free Carping”: From VA To Obamacare To Medicare

At the moment most Republicans are looking at the VA scandal that broke out in Phoenix as a sheer political bonanza without any long-term significance: a federal agency responsible for an especially valued constituency (veterans) has screwed up fatally on Barack Obama’s “watch.” That’s enough to powerfully reinforce a number of important conservative memes about Obama (and indirectly, Democrats): he and his people are incompetent, they don’t have the normal patriotic impulse to take care of veterans, and when held accountable they stonewall and lie.

But a few voices are beginning to figure out how to link the VA mess not only to the overriding issues of Obamacare, but to the “socialized medicine” treatment of Obamacare that would be applied to Medicare, too, if the political climate was right.

Here’s the Cleveland Plan Dealer‘s Kevin O’Brien spelling it all out:

Putting a government bureaucracy in charge of one’s health is a gamble likely to end badly.

And yet, if Obamacare stands, that is precisely the gamble each and every American eventually will take.

There is no better predictor of the course of a single-payer medical system in the United States than the VA system, because it is a single-payer system….

Americans who watch this story play out and fail to make the clear and obvious connection to Obamacare will be guilty of willful ignorance. The systemic flaw is identical. It’s just magnified on a massive scale. Rather than making a false promise to treat all of the ills of a relatively few sick and injured military veterans, Obamacare has put the federal government on the path to taking responsibility for the medical needs — and the attendant costs — of the entire U.S. population.

Like most conservative attacks on “bureaucracy,” O’Brien’s ignores the powerful bureaucracies that operate in the private sector with even less accountability. As TNR’s Jonathan Cohn puts it:

It’s worth remembering that some of the problems veterans are having right now have very little to do with the VA and a whole lot to do with American health care. As Phil Longman, author of Best Care Anywhere, noted in his own congressional testimony last week, long waits for services are actually pretty common in the U.S.—even for people with serious medical conditions—because the demand for services exceeds the supply of physicians. (“It took me two-and-a-half years to find a primary care physician in Northwest Washington who was still taking patients,” he noted.) The difference is that the VA actually set guidelines for waiting times and monitors compliance, however poorly. That doesn’t happen in the private sector. The victims of those waits suffer, too. They just don’t get the same attention.

But nonetheless, the longer the VA scandal stays in the public eye, the more we will hear arguments the VA should be broken up and its services privatized with federal regulations and subsidies replacing federal bureaucracies–creating a system much like the one contemplated by Obamacare, as it happens. But at the same time, we’ll be told Obamacare itself is a failure because it involves the government in guarteeing heath care. And where conservatives speak to each other quietly, it will be understood that Medicare is subject to the same complaints and deserves the same fate.

No wonder most GOP pols confine themselves to content-free carping about Obama being responsible for the VA scandal.


By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal. May 22, 2014

May 31, 2014 Posted by | Health Care, Republicans, Veterans Administration | , , , , , , | Leave a comment

“Intentionally Obscuring The Obvious”: Five Things Every American Needs To Know About Health Care Reform

“Discover the obvious,” Jonathan Cohn said on Monday.

Cohn is one of the nation’s foremost health care journalists and the keynote speaker of the journalism portion of “Hearsay or Fact: A Symposium on the Communication of the Affordable Care Act,” hosted by the Center for Healthcare Research and Transformation.

A senior editor at The New Republic and author of Sick: The Untold Story of America’s Health Care Crisis—and the People Who Pay the Price, Cohn decided to use his time to give five rules about reporting on the Affordable Care Act (ACA). His first rule was an admission that people who follow the everyday tribulations related to Obamacare — like wonks in every field — often assume they don’t need to report on “the obvious” and thus fail to report on the issues that matter most to the public.

He pointed to the success of fellow panelist Stephen Brill’s Time magazine cover story “Bitter Pill: Why Medical Bills Are Killing Us” that illuminated the outrageous variation in medical prices and profits from one hospital and one patient to the next, a well-known fact to experts that came as a shock to many Americans.

What’s obvious to everyone about the debate over Obamacare is that the public is confused. Nearly two-thirds of Americans didn’t know in late September that the health care exchanges were opening on October 1 and 67 percent of the uninsured said “they don’t have enough information about the law to know how it will impact their families,” according to the Kaiser Health Tracking Poll. The uninsured, of course, make up this law’s key demographic. They are the people this law is designed to help most, and their participation in the health care marketplaces will determine if the law is a success.

Why are people so confused? Much of what should be “obvious” has become obscured — intentionally.

Democrats passed the ACA with only Democratic votes — and Joe Lieberman. Republicans have responded with an unprecedented effort to scare voters, starve implementation and sabotage the law, an effort that helped doom the launch of, which the White House has to own as a greater act of self-sabotage than anything Republicans could have pulled off themselves.

The political battle over the law has overwhelmed any pertinent policy discussion. So it’s no wonder that people can’t even agree on the basic premises that made health reform necessary and an improvement over the current system, with 56 percent of Americans saying they’ve heard more about the politics and the controversies of the law than any discussion of its practical impact.

Here are five “obvious” premises that every American needs to understand so we can begin to have a rational debate on health care reform.

Before The ACA, America’s Health Care System Was Already ‘Socialized’

You should know by now that the United States spends more than any country on health care, even though approximately 50 million citizens have no insurance whatsoever. This is how we ended up with the 46th most efficient health care system in the world.

The Affordable Care Act attempts to fix this in a number of ways, including health care exchanges, subsidies, Medicaid expansion and regulation.

Since 2011, the government has set how much insurance companies have to spend on actual care – 80-85 percent depending on their size — and the minimum standard for the policies they can offer, among several other regulations. So even though private insurers remain in business and the government hasn’t taken control of the medical industry as it has in the United Kingdom, Republicans argue that it’s “a government takeover” of the health care system. Based on this standard, health care has been “taken over” by the government and even “socialized” for decades.

Since 1965, Americans over 65 and under the poverty level were guaranteed basic care, though it took until 1982 before the last state, Arizona, accepted Medicaid. This left America with a single-payer system, with a giant hole mostly made up of Americans under 65 with jobs, and their families.

In 1986, President Ronald Reagan signed a bill that tried to plug that hole — the Emergency Medical Treatment and Active Labor Act. This law states that any hospital that accepts any federal funds — which basically every hospital in America does — cannot turn away any patient, regardless of his or her ability to pay. As this bill provides no reimbursement for this care, the costs of those who can’t pay get passed on to those who can.

In 1996, Congress passed and President Clinton signed the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which mandated guaranteed renewability for all health insurance plans, requiring that an insurer has to offer you renewals of your policy without charging you any more based on any new information it has about your health.

These are three of the key “government takeovers” that helped lead to the broken health care system that we are now attempting to fix, while maintaining a private insurance industry.

The ACA clearly isn’t a one-size-fits-all solution, health economist Thomas Buchmueller pointed out at Monday’s symposium.

That would be a two-page bill that said, more or less, “Everyone is now on Medicare.”

Rich People Get Their Health Care Subsidized By Taxpayers

Single payer is a simple, proven system that would insure all Americans, save lives and cut costs. And it will likely never happen in America as long as the filibuster exists in the Senate. Still, liberals will not stop offering this ideal solution whenever Republicans complain about costs or cancellations.

The right has its own fantasy solution that is about as improbable as single payer: getting rid of the tax exclusion of premiums for employer-sponsored insurance.

As a result of an accident of history, employers and employees do not have to pay taxes on costs of health insurance policies.

Conservatives hate this. “We call the tax exclusion for ESI a tax ‘break,’ but when you think about it, it operates more like a tax hike,” writes the Cato Institute’s director of health policy Michael F. Cannon, another symposium participant. “It coerces workers into handing control over $11,000 of their earnings to their employers, who then choose the workers’ health plans for them.”

John McCain campaigned for president on ending this “tax break,” which costs taxpayers more than the costs of all the subsidies and Medicaid expansion in the ACA, according to symposium participant Dr. John Z. Ayanian. This will never happen because it would be far more disruptive than Medicare for All and — unlike effective single-payer systems around the globe — it has never been proven to work, anywhere.

As a result, taxpayers will continue to help subsidize takers like Ted Cruz, whose family’s $40,000-a-year insurance policy from Goldman Sachs entitles them to a subsidy large enough to put a family of four on Medicaid, though the Cruzes are clearly able to afford their own health insurance.

Republican Arguments Against Obamacare Are Opportunistic And Contradictory

Republicans fought the passage of the ACA by conjuring images of “death panels” pulling the plug on grandma and a “government takeover” that would destroy America.

The problem with these warnings was that approximately 80 percent of Americans get their health insurance through their employers. Most of these people haven’t and likely won’t notice much of a change in their coverage whatsoever, unless they’ve gone in for preventive or reproductive health care and discovered that they didn’t have to pay a co-pay for it.

That’s why Mitt Romney’s continual assertion that President Obama was embracing “European” solutions never made sense to most Americans.

Republicans didn’t seize on the president’s now-disproven promise “If you like your insurance, you can keep it” until late 2013, though it was clear that it never jibed with his other promise to make sure insurance policies met minimum standards.

Now their fixation on cancellation notices boxes them in, in two ways. First, it ignores that their plot to repeal Obamacare would result in as many as 137 million cancellation notices. Second, right-wing policy proposals would force cancellations that target far more than the estimated 5 percent of Americans who are having their plans changed by the ACA.

“Even if free-market health care reformers were able to pass the plan of their dreams — which would involve tweaking the tax code to end the bias in favor of employer-sponsored insurance — it would likely mean a lot of people would get dropped from their current plans,” the Washington Examiner’s Philip A. Klein notes.

The Republicans’ advantage is that they’re so stuck on the “repeal” part of “repeal and replace” that they’ve never actually passed an ACA replacement. Their rhetoric, and the fact that the only real conservative alternative to single payer requires an individual mandate, means any plan they pass would likely end up generating the same criticisms they’re lobbing at the ACA.

We Can’t Go Back To The Pre-Obamacare Health System

Dr. Ayanian pointed out that though the ACA may not be embraced by a majority of the American public, three key policies have: young people staying on their parents’ plans until age 26, closing the Medicare Part D prescription-drug donut hole, and the ending of concerns about pre-existing conditions.

The Republican Study Committee Obamacare replacement plan, which the House has not voted on, provided pre-existing conditions protections, but only for those who are already insured.

The Washington Post’s Jonathan Bernstein puts it simply — repeal “is dead”:

No one is ever going to kick young adults off their parents’ insurance (or change the law so that insurance companies are allowed to do it). No one is going to bring back the various limitations in pre-ACA insurance policies. Some trimming of the new Medicaid rolls might be possible. But no one — no politician who has to face reelection, at least – is going to just toss all those people off their insurance with nothing to replace it.

Beyond all this is simply the Humpty Dumpty-ness of the situation: The old system has been slowly pushed off the wall for three years now, and by this point it’s really beyond repair, whatever the merits or politics of the situation. Garance Franke-Ruta captured some of this in making the point that delaying things would be impractical at this point, but it really goes beyond that. Too many people have already done too many things to make a full reversal even remotely plausible.

Before the ACA became law, millions of Americans lost their insurance, rates were rising faster than the rate of inflation and the federal government was absorbing more and more health care costs. Repealing it would be a nightmare in that it would reveal a broken health care system badly in need of some type of fix.

Republicans Are Hurting Themselves, Their States And The Working Poor To ‘Punish’ Obama

Because the Supreme Court gave them the chance to do it, about two dozen — all Republican — states have completely rejected the Medicaid expansion in the ACA, even though the government will cover 100 percent of the costs of the expansion for the first three years. States could then opt out of the coverage or continue it with the feds’ contribution decreasing to 90 percent by 2020.

Medicaid expansion should be a huge transfer of wealth from rich blue states to poorer red states, as most of America’s public assistance programs are. Instead Texas, with the largest uninsured population in the nation, has rejected expansion, but will still contribute to helping to insure Californians.

By rejecting Medicaid expansion, just four states – Florida, Texas, Georgia, and North Carolina —  will leave 5 million poor people with jobs uninsured. This will result in more emergency room visits that the uninsured cannot afford, and higher rates for the insured in those states.


By: Jason Sattler, The National Memo, November 5, 2013

November 6, 2013 Posted by | Affordable Care Act, Health Reform | , , , , , , , | Leave a comment

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