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medicaid costs

The Center on Budget and Policy Priorities has a review of one of the Medicaid proposals the White House has forwarded in budget negotiations, warning that the cost shift it includes would mean a cut in services.
An Obama Administration proposal that’s on the table for budget negotiators would reduce federal Medicaid expenditures by reducing the federal share of Medicaid and CHIP costs, shifting costs to states and likely prompting states to cut payments to health care providers and to scale back the health services that Medicaid covers for low-income children, parents, people with disabilities, and/or senior citizens (including those in nursing homes). Reductions in provider payments would likely exacerbate the problem that Medicaid beneficiaries already face regarding access to physician care, particularly from specialists.

The proposal would replace the various matching rates at which the federal government reimburses states for their costs in insuring people through Medicaid and CHIP with a single “blended rate” for each state. A state’s blended rate would be set at a level that provided the state with less federal funding than under current law, thereby saving the federal government money....

The budget framework that the Administration issued in April envisions at least $100 billion in federal Medicaid savings over ten years. The savings would apparently come from three places: 1) a series of small but significant measures outlined in the President’s fiscal 2012 budget to increase Medicaid efficiency and reduce Medicaid’s costs in providing medical equipment, prescription drugs, and certain other items, which would save somewhere around $10 billion to $15 billion; 2) a proposal to sharply restrict or bar states from raising part of their matching contributions for Medicaid by taxing health care providers, which would save about $25 billion to $45 billion depending on how sweeping the proposal is; and 3) the blended-rate proposal.

By limiting how states can raise funds to help pay their Medicaid costs, the “provider-tax” proposals—like the blended-rate proposal—represents a cost-shift to states. The Congressional Budget Office and the Office of Management and Budget estimate these proposals would reduce federal Medicaid costs because many states would not find other revenues to replace the provider tax revenues—and would have to cut back their Medicaid programs as a consequence, which in turn would lower federal costs.

Under current law, the federal government pays a fixed percentage of each state's Medicaid costs, from 50 to 75% of costs depending on the state with an average of 57% nationally. It pays 70%, nationally, of the children's health program, SCHIP. The Affordable Care Act would increase that commitment to 100% for the population that is made newly eligible for Medicaid under the law, and for the first three years (2014-16) with a reduced commitment until 2019, when it's down to 90%. States that expanded Medicaid to cover patients who aren't traditionally covered (childless adults) could qualify for a higher matching rate from the federal government.

That's all if the ACA is implemented as written, in addition to current law. This new, blended-rate proposal, however, "would replace this mix of matching rates with a single matching rate for each state, which would apparently apply to all of a state’s Medicaid and CHIP expenditures, outside of administrative costs." And that would mean more burden on the states and, likely, curtailed ability on the part of the states to pay providers (meaning fewer doctors taking Medicaid patients) and to cover people who would otherwise qualify.

The blended rate would be set significantly below the combined effect of the various federal matching rates a state would otherwise receive. This would save money for the federal government—the federal government would pay a lower percentage of overall Medicaid and CHIP costs than under current law, and states would bear a greater share. To compensate for the federal funding reductions, states would either have to contribute more of their own funds or, as is more likely, shift costs to beneficiaries and health care providers by scaling back benefits and already-low payment rates....

The only way that the blended-rate proposal would not primarily shift costs to states would be if it produced large administrative savings for states that offset most of their loss of federal funds. But the proposal does not do so. There would be some administrative savings, but they would be slight.

The fact that it would undercut the expansion of Medicaid under the ACA—the most significant part of the law for actually expanding health care—should send White House negotiators back to the drawing board on what to do with Medicaid in these budget negotiations. This kind of across-the-board proposal hits every demographic among Medicaid recipients when, as a nation, we can least afford to have even more people uninsured. The graphic up at the top is a reminder that Medicaid as it currently exists is already "much, much, much cheaper than any other insurance product you can think of. It's cheaper than the health care members of Congress get, than private insurance, than Medicare. There's no trick that could substantially cut its costs below where they are now." Unless it's to cut people off, which is a lousy trick.

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Comment Preferences

  •  Thanks for focusing on this (29+ / 0-)

    By all signs, Medicaid is gonna get hit hard.

    It's one thing both parties can agree on, cutting services for poor people.

    •  It's amazing how, over 2 1/2 years (7+ / 0-)

      the connotation of "the fierce urgency of now" has changed the way it has.  From seize the moment to "brace yourself, this may hurt some."

      "In a nation ruled by swine, all pigs are upwardly mobile." Hunter S. Thompson

      by Keith930 on Mon Jun 27, 2011 at 10:48:16 AM PDT

      [ Parent ]

    •  I wish it weren't true (1+ / 0-)
      Recommended by:
      justmy2

      but as I've been commenting - Medicaid, Medicare AND Social Security are not LAST to be sacrificed but FIRST.

      And there are several reasons why - all of them matter-of-fact and not requiring any attribution of Teh Evil to the current Democratic party leadership.

      1. for most voters they're abstract threats, way in the future
      2. so this serves to buy time
      3. if you buy time, you buy time to reverse the setback later on under more favorable circumstances
      4. Also, on paper, even small moves on the projected value of these vast long-term liabilities can drum up trillions in savings in a hurry. How big? Even bigger than the so-called Ryan Plan - which is also about "on paper" savings (only at the cost of cutting programs for keeps)
      5. And, most of all, presented with a vote of Obama versus (Bachmann or  someone even worse, such as Perry), realistically no one's defecting in 2012. Perhaps 2020 but not 2012 - the infrastructure for a left-wing breakaway party just isn't there so it's  a non-threat.

      That's why the big entitlements are up on the chopping block - because ... for most peeps they're not really on the chopping block. Yet.

      And starting there saves a lot of shorter-term spending on things like, oh, food stamps...housing assistance.

      It's not evil. But it is calculating - and it is going to happen.

      It was always going to happen. For the reasons stated above.

      The day after meta blood starts flowing here will be the day all this is announced.

      It's happened before. It will happen again.

      •  Good read on our leaders (2+ / 0-)
        Recommended by:
        Pinto Pony, WisePiper

        But I don't think the proles may be as accepting of this as you think.  Especially on the Democratic side.

        •  Electorally speaking (0+ / 0-)

          1. the really poor don't vote,
          2. the working poor vote Republican,
          3. the retired vote in droves
          4. and they vote Republican these days

          Oh, almost forgot

          5. due to differential mortality rates, it will be some time before minority voters feel inclined to save Medicare and Social Security at the expense of more immediate needs like housing, education and supplemental income.

          If the Republicans want to hatchet-job the last national constituency - the elderly - I say give them two hand-axes. Sharpened.

          Then bemoan how those blackmailing SOBs forced such awfulness on America.

          And if the left decries weakness, point out that, ahem, what is a minority of a 'weak' party, then? Something Strong?

          if I worked for the administration, that's how I'd frame it.

          I don't ... but expect this plan to be activated soon.

          Because I think the ink is already drying on a deal a lot like I've described above.

          •  Well (1+ / 0-)
            Recommended by:
            neroden

            1. I don't think Dems can pass the blame on that one.

            2. That deal would nearly instantly deep-six the real  economy, as opposed to Wall Street.  The resulting middle-class unemployment will torpedo the Dems, while the Repugs can probably ride it out.

            •  All of DC is austerity-addicted (1+ / 0-)
              Recommended by:
              neroden

              As a consequence of 70-80 years of being told not to do anything that looks "Commie" - and 50-60 years of the Republicans being given more and more aggressive carte blanche to dictate what was and was not "Commie".

              And this is a game Democrats surrendered to long ago, when they had the strength to tells the GOPers to STFU.

              After three going on four generations of it, it's locked into the party's cultural DNA: Pubs get to say what's wrong with Dems, Dems are required to fix themselves to GOP's specs.

              Anyone who is surprised by this has not been paying attention.

              This is not a defense of what is, just a description of what is and a possible interpretation of why it's so.

              With more accurate definition of what's wrong in hand, we can start to contemplate fixes.

              I submit there is no internal reform possible for the Democratic Party - the like-it-or-leave it attitude of close Obama supporters is not an aberration, it's a continuation of a defensive mechanism that is older than most living people's parents these days.

              If and when the GOP melts down for keeps, I am very sure a split in the Dem party ranks will ensue.

              This is not yet the time for that fission. It's just not.

      •  All you have to do is look (1+ / 0-)
        Recommended by:
        cskendrick

        at the people being sent out to prep the patient...Coons, etc...

        This will not end well.

        "Senator McCain offered up the oldest Washington stunt in the book - you pass the buck to a commission to study the problem." - Senator Obama, 9-16-2008

        by justmy2 on Mon Jun 27, 2011 at 12:22:59 PM PDT

        [ Parent ]

        •  The USA as a superpower is playing for time (1+ / 0-)
          Recommended by:
          neroden

          before China pretty much clears its throat and takes over suzerainty of the planet.

          And the people who are in position to decide how best to buy that time are in position to decide how long a life Americans as a whole will lead (or don't), how healthy they will be (or won't), and how prosperous they will be (or won't).

          And how much time they can buy to adjust both themselves - and the country at large - to silver-medal status is a function of how much of a standard of living downsizing they can get the country as a whole to abide.

          Thus you are being sold grin-and-bear-it by your own party leadership.

          Because it's not 11d chess. It's a shift in the balance of global power and we are on the business end of it.

          •  Incompetent asshats (0+ / 0-)

            are running things, unfortunately.  Britain lost their empire, was devastated by WWII, had huge loan repayments piled on it,....

            ...and got Clement Atlee, the National Health Service, British Rail, and the "British welfare state".  Therefore Britain is doing all right.

            The asshats running the US are taking it down a road which leads to civil war or collapse of the Union, which is completely avoidable even during the collapse of our empire.  But they choose not to avoid it.

            Read pp. 1-7 of Krugman's _The Great Unraveling_ (available from Google Books). NOW.

            by neroden on Tue Jun 28, 2011 at 12:47:37 PM PDT

            [ Parent ]

      •  Many people are defecting in 2012. (0+ / 0-)

        Unfortunately, we're probably all in "safe states" one way or the other -- every one I've heard of -- so we don't figure into Obama's calculations.  All he cares about is personal re-election, and nobody in the "swing states" is defecting.

        And he actually prefers a Republican Congress, so Obama likes it if Democrats lose at the House and Senate levels.  (I will continue to vote for my Democratic House member, as he's a good guy and opposes this sort of shit.)

        Read pp. 1-7 of Krugman's _The Great Unraveling_ (available from Google Books). NOW.

        by neroden on Tue Jun 28, 2011 at 01:00:13 PM PDT

        [ Parent ]

    •  hey Joanne (0+ / 0-)

      are you going to report on the 600 billion in tax revenue increases that the White House is also proposing today?

      I know, that is meaningless in this debt ceiling negogiations...or is it?

      Fair and Balanced? I know, you do not pretend to do that here so no need for it.

      •  Tax loophole closures? Not elimenation of the (2+ / 0-)
        Recommended by:
        justmy2, wsexson

        Bush tax breaks for the rich?  Funny how closing tax loopholes usually just creates new ones.

        The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

        by accumbens on Mon Jun 27, 2011 at 11:45:35 AM PDT

        [ Parent ]

        •  From the AP story (0+ / 0-)

          I read this proposal will specifically go after oil tax subsidies and credits,hedge fund owners tax rates,favorable manufactuers inventory tax treatment,and jet plane deductibilty.

          Overall tax rates are set to expire at the end of 2012,and are a different discussion altogether,as well as general tax reform which is overdue.

          •  so what? (1+ / 0-)
            Recommended by:
            SpecialKinFlag

            what does that have to do with a democratic president cutting the american social safety net?

            you're PROUD that some tax deductions might expire?

            obama is proposing to cut the social safety net and the gop won't even DISCUSS raising taxes

            spin that

            blue dogs eat shit

            by wbgonne on Mon Jun 27, 2011 at 12:25:33 PM PDT

            [ Parent ]

          •  Yep, more crumbs from Obama. Feed the people the (1+ / 0-)
            Recommended by:
            neroden

            crumbs and give the cake to industry and the moneyed class.  I'd be interested in how much all those revenue enhancement add up to.

            The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

            by accumbens on Mon Jun 27, 2011 at 12:58:03 PM PDT

            [ Parent ]

      •  Hope not...becauase that wouldn't be true (0+ / 0-)

        there is not 600 billion of new revenue that will come in...sorry to disappoint you...

        "Senator McCain offered up the oldest Washington stunt in the book - you pass the buck to a commission to study the problem." - Senator Obama, 9-16-2008

        by justmy2 on Mon Jun 27, 2011 at 12:24:15 PM PDT

        [ Parent ]

    •  Wait--this is a WHITE HOUSE proposal? (7+ / 0-)

      This is the kind of thing Republicans propose.

      The White House is supposed to be saying, "Not on MY watch!" and drop-kicking it off the table to the cheers of the people, who will rise as one to re-elect the Hero President and give him bigger Congressional majorities than he had in 2009.

      What kind of crazy fucked up world did I wake up in, when the Republicans hand the Democrats an election, gift-wrapped, by proposing to destroy Medicare, and instead of tying it around their necks like a dead skunk, the Democrats respond with their own plan to destroy Medicare?

      FUCK YOU, Washington!

      "By Grabthar's Hammer, you have been avenged!" --attributed to President Barack Obama

      by AdmiralNaismith on Mon Jun 27, 2011 at 11:53:26 AM PDT

      [ Parent ]

      •  Yes, it is, because Obama is a Republican. (0+ / 0-)

        That would be the problem here.  Obama is a Republican of 20 years ago.  (And the Republicans of today are simply fascists.)  We need a Democrat, though I'd settle for an Eisenhower-era Republican.

        Read pp. 1-7 of Krugman's _The Great Unraveling_ (available from Google Books). NOW.

        by neroden on Tue Jun 28, 2011 at 01:01:46 PM PDT

        [ Parent ]

    •  Further evidence why actual health care reform (3+ / 0-)
      Recommended by:
      kareylou, wsexson, neroden

      was needed more than health insurance band-aids.

      Hit the things that make health care cost so much while delivering inferior care, and much of this problem fades away.

      LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

      by dinotrac on Mon Jun 27, 2011 at 12:14:14 PM PDT

      [ Parent ]

    •  See...ACA is just a first step...these things take (3+ / 0-)
      Recommended by:
      vacantlook, quagmiremonkey, neroden

      time...

      Oh wait?

      "Senator McCain offered up the oldest Washington stunt in the book - you pass the buck to a commission to study the problem." - Senator Obama, 9-16-2008

      by justmy2 on Mon Jun 27, 2011 at 12:21:47 PM PDT

      [ Parent ]

  •  Argh. (9+ / 0-)

    Bad policy and bad politics.

    Why have democrats stopped talking about killing rich-people tax cuts?  For a minute that was the story.  And it was a damned good story for a lot of reasons.

  •  not cool. (3+ / 0-)
    Recommended by:
    TomP, ohmyheck, supercereal

    "Intolerance is something which belongs to the religions we have rejected." - J.J. Rousseau -6.38, -4.15

    by James Allen on Mon Jun 27, 2011 at 10:15:05 AM PDT

  •  It is SO STUPID to shift costs TO the states, (7+ / 0-)

    when the Federal Government should be taking on more of the burden FROM the states! This would need to be reversed when the real economy gets better (i.e. improved employment), but for the time being would be the way to go.

  •  Hope this isn't where we end up. n/t (7+ / 0-)

    "George RR Martin is not your bitch" ~~ Neil Gaiman

    by tardis10 on Mon Jun 27, 2011 at 10:17:09 AM PDT

  •  Yes, and when they change the funding (16+ / 0-)

    it's going to make states like Texas -- where I live -- just cut out the planned availability of care through the ACA.

    It's kind of like states that have passed laws restricting abortion: sure, the right is still there, just try to exercise it.

    The same thing is going to happen with Medicaid, if only by doctors refusing to take Medicaid patients. It's already almost impossible to find a Medicaid doctor, and the clinics in my area specialize in pediatrics or geriatrics, with no allowance for anyone in between. They expect people of working age to be, you know, working.

    No, I guess I'm never going to actually get health care, not even in 2014.

    Perhaps if more time had been spent in fixing the economy in the first year of this administration, the need for goverrnment health care -- not health insurance -- wouldn't be so dire for so many, and we could afford to pay for it ourselves instead of relying on intermittent care on a catch-as-catch-can basis.

    "The difference between the right word and the almost-right word is like the difference between lightning and the lightning bug." -- Mark Twain

    by Brooke In Seattle on Mon Jun 27, 2011 at 10:22:53 AM PDT

  •  Mom Can Fit in the Closet I Guess--We'll Need a (3+ / 0-)
    Recommended by:
    shoeless, ohmyheck, Brooke In Seattle

    new waste gas stack though to handle the smell of her constant shitting.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Mon Jun 27, 2011 at 10:27:42 AM PDT

    •  This goes directly to the Nursing homes as well (6+ / 0-)

      and we are not going to take this,,,,People better start
      that letter writing and calling campaign because this is unacceptable.  Tell the hawks..Want war..tax it !!!! Therefore we will not have to let our part of the constitution fall by the wayside..You know..the part about providing for the general welfare?   Pisses me off !!!!

      We the People have to make a difference and the Change.....Just do it ! http://unitedveterans.aimoo.com/

      by Vetwife on Mon Jun 27, 2011 at 10:31:16 AM PDT

      [ Parent ]

  •  Oh come now. (10+ / 0-)

    Tut-Tut.

    Tisk-Tisk.

    This is merely an opening move by our Democratic Champion, Obama.

    I'm sure there's still plenty more cuts to be made in social programs - but first, it's important to set the stage in the Kabuki Theater of the Absurd.

    Ya know - he had no choice cause Rethuglicans control the House.

    He had no choice cause the Debt ceiling must be raised or Wall Street will be furious.

    etc...

    As a hardcore Democrat, Obama has shaken my faith. Imagine what he's done for independents.

    by Johnathan Ivan on Mon Jun 27, 2011 at 10:28:17 AM PDT

    •  Yep (0+ / 0-)

      0 is about what you have said.

      •  ? (1+ / 0-)
        Recommended by:
        wbgonne

        And here I was trying to offer up excuses as to why social programs will be cut, or more importantly, set up so they have to be cut.

        Here's a thought:

        Wall Street wants the debt ceiling to be raised - it is, for them, a key requirement.

        So why not call the Rethuglican's bluff and see if they hate social programs more than they fear Wall Street?

        The answer:

        Because when you choose a bankster thug as your Chief of Staff, chances are damn good you're not opposed to the plutocracy or its goals.

        But that ol' Rethuglican boogeyman sure does make for some fine excuses.

        As a hardcore Democrat, Obama has shaken my faith. Imagine what he's done for independents.

        by Johnathan Ivan on Mon Jun 27, 2011 at 12:27:00 PM PDT

        [ Parent ]

  •  As usual (6+ / 0-)

    the assholes try to screw us over again and again and again. HANDS OFF MY FUCKING MEDICAID!!!

  •  Every time I read a story like this (9+ / 0-)

    I go right to the whitehouse.gov page and click "Contact Us" and write an irritable letter.

    This one read something along the line that medicare medicaid and social security should absolutley not be on the table for cuts anymore -- and that if Obama wants to ensure a repeat of the lackluster Democratic performance in 2010 he's on the right path.

    I think if everyone did this immediately it would get his attention a lot more -- I do not think the PResident realizes how closely we the base pay attention to his activities.

    Just in case you forgot today: REPUBLICANS VOTED TO END MEDICARE. AND THEY'LL DO IT AGAIN.

    by slippytoad on Mon Jun 27, 2011 at 10:33:16 AM PDT

  •  No surprise here. Rather than (4+ / 0-)

    take on Medicare, and the uproar that would ensue, the POTUS decides to go after those who aren't as likely to turn out in droves to protest. He should know, however, that many seniors also qualify for Medicaid. All in all, I am so disappointed in our president. His mother needed social services to help raise him and his sister. Where is the compassion? At least Clinton could "feel your pain."

    I think, therefore I am. I think.

    by mcmom on Mon Jun 27, 2011 at 10:33:25 AM PDT

    •  Obama is an emotional isolate. That's where the (1+ / 0-)
      Recommended by:
      vacantlook

      "no drama Obama" affect comes from.  His wife commented to a friend early on that it was as if "he was raised by wolves."  Bad analogy because wolves are very pack socialized, but her point was his emotional isolation.

      "The worst that can happen to any group of people working to unseat an existing power base is their failure to imagine the lengths to which those in power will go to keep it." Cognitive Dissonance at Zero Hedge

      by CarolinNJ on Mon Jun 27, 2011 at 11:38:18 AM PDT

      [ Parent ]

      •  So, less like a wolf... (0+ / 0-)

        ...more like a snake.

        •  Snakes aren't isolates, either, and I have to (1+ / 0-)
          Recommended by:
          neroden

          object because they're exactly what they should be.  A little dicey to be around sometimes, but that's just in the nature of things.  No, Obama is fully and regrettably human in his emotional stuntedness.  I've read some chilling pieces about him as a child and it seems clear to me that while he wasn't abused in any sense that term is commonly understood, he knew very early that he was on his own, that nobody would take care of or protect him in the nurturing sense.  He's not overtly anti social but his emotional world doesn't extend beyond himself.

          "The worst that can happen to any group of people working to unseat an existing power base is their failure to imagine the lengths to which those in power will go to keep it." Cognitive Dissonance at Zero Hedge

          by CarolinNJ on Mon Jun 27, 2011 at 02:15:44 PM PDT

          [ Parent ]

    •  we saw this coming (1+ / 0-)
      Recommended by:
      neroden

      In all the brouhaha after the Ryan budget plan there was a notable silence on the subject of Medicaid. After all, the poor and disabled and blind usually can't make it to their polling place and don't have any money to buy influence. So Obama and the rest of the Democrats don't have any compunction about throwing them under the bus, rather than do hard things like cut government subsidies for big oil comapanies or end these sensless wars. Make no mistake these cuts will kill people. These are the real death panels but they don't care if they have to step over our dead bodies to get into their limousines.

    •  From Age 10 Obama Raised Upper Middle Class (1+ / 0-)
      Recommended by:
      neroden

      Starting with age 10 Obama started attending private school. His entire college education was through private schooling. His grandparents owned a furniture store and his grandmother became one of the first Female bank VPs in the nation. She had already had that position for a year when young Barrack moved in with her.

      Just like the Bush myth, where Bush was just some average Joe from TX, people love the Obama myth that he came from nothing. It simply isn't true. He certainly didn't come from the kind of background Bush came from, but he certainly had a far better upbringing then most Americans.

      Obama doesn't have deep empathy for what life is like for the average Middle Class person, because he never experienced it. In fact maybe he buys into his own mythos and thinks his upbringing was actually deprived.

      Clinton on the other hand really came from nothing and had to work his way up through force of abilities. It probably explains why he had more of connection to ordinary people.

  •  But, but, but, you (13+ / 0-)
    Lie.

    Typical of the true progressive where veracity and integrity aren't really part of the bargain.  You find me one fucking link that states the social security safety net is at all being bargained away.  

    That was a comment from a diary on the wrecklist from yesterday.  

    So thanks for this article.  Yes, I did post a link to it, so that said commenter would have his "fucking link that states the socila security safety net is all being bargained away."

    As well as stating  The 50 States' social security nets are being bargained away also.  Even worse.

    Of course, said commenter will put his fingers in his ears and scream some more.  Lalalalalalalaa!!!!!  I can't hear you!".

    Unfuckingbelievable.

    "Take away paradox from the thinker and you have a professor." Soren Kierkegaard

    by ohmyheck on Mon Jun 27, 2011 at 10:35:10 AM PDT

    •  Perhaps wrecklist diarist doesn't need the social (1+ / 0-)
      Recommended by:
      ohmyheck

      safety net?  If you don't need it, who cares?

      "The worst that can happen to any group of people working to unseat an existing power base is their failure to imagine the lengths to which those in power will go to keep it." Cognitive Dissonance at Zero Hedge

      by CarolinNJ on Mon Jun 27, 2011 at 11:40:14 AM PDT

      [ Parent ]

  •  That's @#$%in Brilliant! (1+ / 0-)
    Recommended by:
    SallyCat

    By which, I mean, @#$%in STOOPID!

    Umm, that's PRESIDENT Obama and SENATOR Franken, mr. o'reilly.

    by filby on Mon Jun 27, 2011 at 10:35:45 AM PDT

  •  Dems are terrible negoiators (3+ / 0-)
    Recommended by:
    Wolf Of Aquarius, ohmyheck, Johnny Q

    but that comes from the top-Obama.
    While the GOP keeps repeating the same refrain "NO tax increases!!" and at least appears to be standing firm, Dems are starting to wobble. The closer the date gets, the worse the wobbling is going to get. Presto- you can knock them over with a feather, and they've caved-in to GOP hostage demands.
    Our government at work.

    Absolute faith corrupts as absolutely as absolute power. Eric Hoffer 1902-1983

    by mchestnutjr on Mon Jun 27, 2011 at 10:36:38 AM PDT

  •  Somebody should tell the White House (10+ / 0-)

    that the states are broke.

    "If pro is the opposite of con, what is the opposite of Congress?" — Will Rogers

    by shoeless on Mon Jun 27, 2011 at 10:36:45 AM PDT

  •  I just dont get it (9+ / 0-)

    Why does every austerity measure end up fucking anyone but the rich?  How do politicians' careers survive when we get plan after plan to fuck over the whole country except their rich friends?!

    •  Rich friends have money to pay for elections (6+ / 0-)

      then we keep choosing the lesser of two evils and end up here.

      Not that hard to figure out really. No one backs up the ones who stand up (Weiner, Kucinich, Nader) even if they are not perfect because they are "unelectable" instead of trying to MAKE them electable,.

      Really you only have yourselves to blame.

    •  Because it is their rich friends who give (2+ / 0-)
      Recommended by:
      ohmyheck, wbgonne

      them the money they need to run ads convincing those of us without it that they are helping us. Some of us don't buy in, but not enough of us. Yet?

    •  Today the (1+ / 0-)
      Recommended by:
      mchestnutjr

      White House said some progress could me made in these discussions on the debt ceiling but hardened their stance on revenue increases of 600 billion thru elimation of oil subsidies and credits, elimination of other tax deductions for private jets, increasing tax rate on hedgefund owners from capital gains rates to regular rates,and elimination of favorable manufacturing inventory tax treatments.

      Jay Carney reiterated in his presser that it can get done but not without the above tax revenue increases.

      I sincerely hope that the dems hold to this line in the sand....but it sounds like they are not backing off.

      •  ya let's all hope that they keep to SOME (0+ / 0-)

        kind of line in the sand. i mean jesus. their history of actions shows they probably won't, because they clearly don't want the same things we want, but maybe if we just hope for a little longer....

      •  in other words...they are caving... (2+ / 0-)
        Recommended by:
        wbgonne, neroden

        http://tpmdc.talkingpointsmemo.com/...

        Fresh off last week's down-to-the-wire spending showdown, President Obama and Speaker John Boehner (R-OH) are locking horns again on fiscal matters -- and this time the stakes for the U.S. economy are even more monumental.

        The White House is demanding a "clean" bill to raise the nation's debt ceiling rather than using it to cut additional spending or for policy additions like last week's attempt to attach legislation defunding Planned Parenthood, but Boehner has already said that idea is dead on arrival. There's no way a debt-ceiling bill would pass the House (i.e. the muster of his unruly GOP conference) without some spending cuts for balance.

        Unlike in the beginning of the battle over this year's spending plan, the rhetoric over the debt ceiling is already white hot. White House spokesman Jay Carney on Monday said the consequences of failing to raise the debt ceiling would be "Armageddon-like" for the country.

        "We cannot play chicken with the economy in this way," Carney told reporters at a briefing. "It's just too darn risky. It's not appropriate."

        And if you think they are going to see 75% of that new revenue, you have a lot to learn...

        Once again, the WH tries to sell a $#!+ sandwich.  Let's see if people are hungry enough to eat it.

        "Senator McCain offered up the oldest Washington stunt in the book - you pass the buck to a commission to study the problem." - Senator Obama, 9-16-2008

        by justmy2 on Mon Jun 27, 2011 at 12:31:46 PM PDT

        [ Parent ]

        •  Obama: a loser who gives in to terrorists. (0+ / 0-)

          That will be what history says.  He's a fucking moron.

          He's already claimed unconstitutional "assassination order" powers and the power to kidnap people without trial forever.  Including American citizens.  Yet he pretends that the House Republican caucus has some power over him.  Seriously, the man does not understand geopolitics at all.  Loser.

          Read pp. 1-7 of Krugman's _The Great Unraveling_ (available from Google Books). NOW.

          by neroden on Tue Jun 28, 2011 at 12:52:59 PM PDT

          [ Parent ]

    •  Oh But they are Suffering (0+ / 0-)

      You know that it just tears them apart to know that they simply have to find a place for all that money that keeps pouring into their accounts. It is their patriotic duty to accept endless tax cuts.

      The golden rule: Those with the gold make the rules.

  •  you know (5+ / 0-)

    with each passing day it is getting harder and harder for me to keep my optimistic attitude about this country.  Cutting Medicaid and then our courts say its ok for kids to buy violent video games, just as long as the rape victims are not naked........some one talk me down, ok?

    We all have photographic memories. Some people just don't have any film.

    by fireflynw on Mon Jun 27, 2011 at 10:38:48 AM PDT

  •  In fact, this is about the wars (7+ / 0-)

    ...not health care or social services.

    The choise of one over the other.

  •  so, uh, no line in the sand here, huh? (2+ / 0-)
    Recommended by:
    Johnny Q, wbgonne

    i hope you're all ready to support Obama for his second term, after all, just think what a Republican pres would do

  •  I used to work in one of the bastions of (4+ / 0-)

    USA socialized medicine -- the New York City Health and Hospitals Corporation.  HHC runs the city's public hospitals, including severral skilled nursing facilities and many offsite clinics.

    I'll be conservative -- probably about 55% of HHC's revenue was from billing Medicaid for services rendered.

    New York State already made significant cuts to the Medicaid program this year.

    The Health Budget passed this week makes fundamental and far-reaching changes to New York’s Medicaid program, with savings reported at $2.8 billion.

    What pending fed cuts, on top of NYS cuts, will mean to these safety net hospitals remain to be seen -- but one cannot be hopeful.

  •  "Think of the kids." (4+ / 0-)

    It gets overused, but it's applicable here.

    It's the most boneheadedly obvious bit of overheated-but-effective rhetoric one could use, if one were so inclined to kill legislation that puts Medicaid (and by extension, CHIP) on the chopping block.

    Shout it from the rotunda: "Republicans want to kill our kids!"

    But no. It won't be used, because bipartisanship is important, Obama needs Boehner to fill out his golf team, and Beltway Democrats actually want this.

    Regards,
    Corporate Dog

    -----
    We didn't elect Obama to be an expedient president. We elected him to be a great one. -- Eugene Robinson

    by Corporate Dog on Mon Jun 27, 2011 at 10:40:43 AM PDT

  •  please clarify (0+ / 0-)

    If health care reform isn't struck down by the Robert's court, does it become law without any additional legislation?  What I'm try to say is, is the law safe as long as 41 Senators want it to remain?

    Apres Bush, le deluge.

    by melvynny on Mon Jun 27, 2011 at 10:49:44 AM PDT

  •  Enough bleeding the patient. Time to transfuse. (3+ / 0-)

    It's time to stop the deficit peacock posturing, the brutal austerity measures being imposed upon the poor to fund more tax cuts for the rich.

    For god's sake, are their no sane adults at all in the Obama administration?

  •  Bad enough (4+ / 0-)

    that we are a country that will let adults go without medical care.  It is criminal that we make children suffer.  The rest of the world should scorn us as a rogue state.

    •  They do, actually. The US boders are sealed to (2+ / 0-)
      Recommended by:
      msdrown, kareylou

      opinions from outside the country, but I have friends who travel and speak other languages.  Let's just say we're not well regarded.

      "The worst that can happen to any group of people working to unseat an existing power base is their failure to imagine the lengths to which those in power will go to keep it." Cognitive Dissonance at Zero Hedge

      by CarolinNJ on Mon Jun 27, 2011 at 11:48:27 AM PDT

      [ Parent ]

  •  worldwide conspircy by the richto push austerity (2+ / 0-)
    Recommended by:
    CarolinNJ, wbgonne

    the real question is why country clubs and gated communities shouldn't be firebombed, just asking.

    fact does not require fiction for balance (proudly a DFH)

    by mollyd on Mon Jun 27, 2011 at 11:22:24 AM PDT

  •  no anger: just a vow (1+ / 0-)
    Recommended by:
    CarolinNJ

    if obama tries to cut one dime from medicaid, medicare or social security, i absolutely will not vote for him in 2012

    period. full stop

    and if the democratic party acquiesces as obama cuts the social safety net, then the democratic party is dead to me

    period. full stop

    anyone else?

    blue dogs eat shit

    by wbgonne on Mon Jun 27, 2011 at 11:27:14 AM PDT

    •  yeah but doesn't that mean (0+ / 0-)

      you'd have to start not voting, period, full stop.... like now?

    •  Already there. Two years ago I saw this coming. (0+ / 0-)

      Made a comment about it, and a diary, right here on this very site.

      "The worst that can happen to any group of people working to unseat an existing power base is their failure to imagine the lengths to which those in power will go to keep it." Cognitive Dissonance at Zero Hedge

      by CarolinNJ on Mon Jun 27, 2011 at 11:50:11 AM PDT

      [ Parent ]

      •  it still hasn't happened but it is very close (0+ / 0-)

        if the wh negotiates a deal where the social safety net is cut, he is finished for me

        and, if the dems in congress approve that deal, then that's it for the democratic party

        that will, officially, stand for nothing

        hopefully, the party will implode and a real democratic party can be reborn

        in any case, if anyone has any opinions to share with the wh and the dempcratic party, i'd say it's time to speak up because the end is near

        blue dogs eat shit

        by wbgonne on Mon Jun 27, 2011 at 11:56:05 AM PDT

        [ Parent ]

        •  It has happened. Discussion doesn't get this far (0+ / 0-)

          if people haven't already taken a decision.  Both parties are living dead, just running out the string, not even aware of their one foot in the grave conditions.  And they're taking the US down with them.  Political end times in real time.

          "The worst that can happen to any group of people working to unseat an existing power base is their failure to imagine the lengths to which those in power will go to keep it." Cognitive Dissonance at Zero Hedge

          by CarolinNJ on Mon Jun 27, 2011 at 12:03:28 PM PDT

          [ Parent ]

    •  Fight local races. (0+ / 0-)

      There are still decent people in the Democratic Party at state and local levels, and when you abandon the Democratic Party, you want to take them with you.  This is tactical advice.

      Read pp. 1-7 of Krugman's _The Great Unraveling_ (available from Google Books). NOW.

      by neroden on Tue Jun 28, 2011 at 12:57:51 PM PDT

      [ Parent ]

  •  Gotta love that Obama. (3+ / 0-)
    Recommended by:
    WisePiper, wbgonne, justmy2

    There was a time I would have criticized Obama for being naive to think he could placate the Repubs with just a little red meat.  Now, I think it's quite clear he uses the Repubs as cover to advance a conservative agenda.  Not crazy conservative like the Repubs have become, but conservative nevertheless. Mr. Community Organizer screwing poor people - nice picture.

    The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

    by accumbens on Mon Jun 27, 2011 at 11:42:58 AM PDT

  •  Who are the morons in the White House (1+ / 0-)
    Recommended by:
    neroden

    who came up with this evil proposal?

    Are the morons just anonymous scum?

    Hiding like weasels and cowards...

    Give us a name! An address so we can visit with tar, feathers and torches.

  •  Give 'em Time (1+ / 0-)
    Recommended by:
    neroden

    Remember this is just the start of what Obama calls negotiating. He has more to give up before starting to talk to boener about what the R's demand.

  •  How To Tell The Democratic Party Should Fail...... (0+ / 0-)

    ...Just Sit Back And Watch.

  •  Insurance isn't care (0+ / 0-)

    Medicaid is a band-aid that punishes doctors and their clinics. The larger problem is the insurance paradigm and our prevailing culture that views insurance as comprehensive health care.

    How many people here will buy $400 iPhones but gripe about a $15 copay for an office visit?

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