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View Diary: The Black Holes of Health Care : The Melancholy Future for States that Refuse Medicaid Expansion (64 comments)

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  •  Question re this: (6+ / 0-)
    First of all, as originally written, PPACA requires states to accept the Medicaid expansion as a condition of staying in the Medicaid program.

    Did you get that?

    Current Medicaid will be cut in ALL the states, including the Sabotage States. Parts of it, like Medicaid that goes to hospitals, will simply be gone. Anything redundant to the new Medicaid expansion program will be cut. States that refuse it, will receive substantially less Medicaid funding than they did before.

    Does anyone know how this could affect those already on medicaid in the states that have refused to participate??  How it will affect the many children, those with disability, elders, vets, etc?
    •  I'm struggling to find an answer. (6+ / 0-)

      What I know right now, is that hospitals in some refuser states are going directly to the Federal Government to ask that they delay the Medicaid cuts for those states.

      Governors like Jan Brewer in AZ do not believe there is a way to stop those cuts. Certainly not through legislative channels. Because she believes the cuts will happen, she accepted the expansion funds.

      I know Medicaid will be cut to the extent that the states will have to raise money to keep hospitals open. I think they will have to raise money to keep the people currently on the rolls in place. Billions of dollars.

      I've been looking for states with a "plan." I haven't seen any state say they are going to cut current recipients. But I haven't seen a plan, yet, either that explains where they are going to get these billions of dollars.

      It's distressing all the way 'round.



      Denial is a drug.

      by Pluto on Wed Jun 05, 2013 at 09:46:56 PM PDT

      [ Parent ]

      •  Imagine just the number of folks in nursing homes (7+ / 0-)

        that are paid for with medicaid $ in any given state let alone the number of children or people with disabilities or anyone else that qualifies for medicaid.  That are already on medicaid.  

        How in hades will a state be able to maintain current population if there is a cut of Fed $????

        When you think about it, it is not just hospitals or doctors affected but every single "vendor" or provider throughout the supply chain.  From the nursing home to the therapist to the group home etc etc.  On top of the population not able to be enrolled.

        I really thought these states were posturing.  I live in one of them-whose gov has postured before (re stimulus funds etal) but sure took those fed $ anyway for everything from road construction to technology for schools.

        This is madness.

        I found an interesting commentary in the 6/2/2013 Savannah Morning News by a Mr. Jack Bernard who is "a retired health care executive, formerly with several national firms. He is also the former head of Health Planning for the state of Georgia. In addition, he is the former chairman of the Jasper County (S.C.) Republican Party and Jasper County Commission"

        In his commentary:

        According to a just-issued Joint Center for Political and Economic Studies report, 61 percent of Georgians support expanding Medicaid under the Affordable Care Act (Obamacare).

        In fact, that study indicates that in all five Deep South states surveyed (Georgia, South Carolina, Alabama, Mississippi and Louisiana), the majority of the public wants Medicaid expansion.

        That majority even includes a few Republican fiscal conservatives. Like me.

        He further outlines how many jobs for Georgia would be generated:
        Furthermore, a 2013 Georgia State University study has shown that expansion will create 70,000 permanent new jobs in Georgia. In the Savannah region alone, projections are that 4,304 jobs will be added, increasing payrolls by $209 million annually. That would be a real shot in the arm in these troubled times of high unemployment.
        (Emphasis added by me)

        He ends his commentary by telling the governor to take the expansion.

        Read  in full here:
        http://savannahnow.com/...

        A southern fiscal conservative Republican with ties to the healthcare industry wrote this.  How many other Republicans with a voice or position might be out there feeling or writing the same???

        •  Thanks. (3+ / 0-)

          Arkansas has come up with a plan that a lot of Southern states are watching.

          It's kinda odd. I haven't looked into it yet.

          They want to use the Medicaid expansion money to buy private insurance for the poor.

          Anyway, it's on the table. Waiting for a response from the Feds.



          Denial is a drug.

          by Pluto on Wed Jun 05, 2013 at 11:26:58 PM PDT

          [ Parent ]

        •  A very significant point regarding nursing home (5+ / 0-)

          care.

          I believe I read that a very large share (perhaps even the largest, percentage-wise) of the overall expenditures of the MedicAID program goes to cover nursing home care, not for other services under the program that might go to "just" poor people trying to live their lives and keep themselves and their kids decently healthy.

          And a good share of those people who are currently receving MedicAID-funded nursing home care were not during their earlier lifetimes, and certainly their relatives are not now, what many people would consider "poor".  They have simply become poor because they've exhausted their assets.

          Whether the MedicAID-supported nursing home residents have engaged in legal strategems to impoverish themselves (and thus protect assets to pass on to heirs) or simply gotten there the old-fashioned way: spending every penny they had for desperately needed care, the loss of MedicAID-funded nursing home beds will hit home in families and social groups that probably don't think of themselves as typical "poor" people.  

          At least not in the way they think of the "undeserving" poor people who receive MedicAID care. You know, the kind of people who are just getting all that  free care that they don't want to pay for.

          And that is going to be a huge eye-opener for a lot of families. Hey, they voted for these state officials.

          Chickens, welcome to your roost.

          Araguato

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