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Medicaid card
The states that are refusing to expand Medicaid money under the Affordable Care Act aren't just going to be losing billions in Medicaid money, they'll be losing funds that have been provided by the federal government to community health centers as a bridge until Obamacare is fully implemented in 2014. At that time, expanded Medicaid was supposed to cover the population relying on the community health centers. But that's a population that will now be left out in the cold in states that aren't expanding Medicaid, unless Congress acts to extends the funding for community programs.

Here's what will happen in Michigan, as an example.

More than 150,000 Michiganians stand to lose health coverage if the state Legislature fails to expand Medicaid coverage.

The low-income residents are covered by county health plans that provide last-resort medical care for childless adults. But federal funding for the plans will start to dry up in 2014 under the Affordable Care Act. [...]

The two main sources of federal funding for the county plans will be rolled back by the government starting in 2014 under the Affordable Care Act. The law, called "Obamacare" by some, anticipated the funds would no longer be needed because of the Medicaid expansion.

And in another twist, the Affordable Care Act also blocks people at or below the poverty line from obtaining coverage on state health care exchanges, an Internet insurance marketplace for the uninsured. That's because Obamacare assumed that all of these people would be covered by the Medicaid expansion.

President Obama has asked Congress to extend the funding to prevent this gap in all the states where Medicaid won't be expanded to pick up what will be hundreds of thousands of people caught in the gap. The question is, does Congress give a damn? In the meantime, Michigan's legislature is still trying to figure out whether to take the Medicaid money.

Originally posted to Joan McCarter on Fri Jun 07, 2013 at 02:41 PM PDT.

Also republished by Daily Kos.

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Comment Preferences

  •  Tip Jar (26+ / 0-)

    "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything: telephone conversations, telegrams, it doesn’t matter."--Frank Church

    by Joan McCarter on Fri Jun 07, 2013 at 02:41:31 PM PDT

  •  They will find a way to blame Obamacare, though, (5+ / 0-)

    of course. And the MSM will not fact check the lies, or report them as such, except perhaps to bury them on p.12 or fail to mention any causality and thus smear the program by lies of omission.

    Whereas, ideally, the good (though poor) citizens of such states would be made aware of the callous disregard their ideologue corporatist elected officials have for their well-being. Too much to hope for.

    "Government by organized money is just as dangerous as Government by organized mob." -- Franklin D. Roosevelt

    by Kombema on Fri Jun 07, 2013 at 02:51:57 PM PDT

  •  The Republicans in Congress not only don't give a (9+ / 0-)

    damn, their goal is to absolutely ensure that Obamacare fails. They've proven that over and over and over. So, throwing hundreds of thousands of people under the healthcare bus is exactly what they would like to do. They will never pass the fix that Obama is requesting.

    •  Just an observation, but the GOPer crazies don't (1+ / 0-)
      Recommended by:
      dragonlady

      see "their" people suffering the predictable consequences of a denial of viable health care.

      They see Democrats.  They see nonvoters.  They see people whom they never met or don't remember doing so because they waited on them at a restaurant or a coffee shop and weren't really worth a recognition.

      There really are two Americas.  But they only see their America.

      Our challenge is to overcome a self-absorbed and lazy administration by making them be responsive to "our" people.

  •  The GOP in Wisconsin won't even join (8+ / 0-)

    in on exchanges much less take Medicaid money.  Their plan?  To enable only those folks who are the poorest of the poor to get Medicaid (BadgerCare) and only after they jump through hoop after hoop to ensure they're really, really, really poor and the rest are on their own.

    This is going to be a great big wake up call to farmers and other rural Republican voters as they find themselves and their children without health care coverage unless they pony up the large bucks for individual health insurance policies.  

    Of course, Walker and his cronies will blame ObamaCare and every Goddamned newspaper and teevee station in the state will "report" on that "fact".

    There already is class warfare in America. Unfortunately, the rich are winning.

    by Puddytat on Sat Jun 08, 2013 at 02:23:43 PM PDT

    •  Perhaps it is time for rural voters to understand (6+ / 0-)

      that blindly voting Republican is not in their best interest.

      Filibuster reform, 2013 - woulda, coulda, shoulda.

      by bear83 on Sat Jun 08, 2013 at 02:34:00 PM PDT

      [ Parent ]

      •  Exactly (7+ / 0-)

        For some reason, Republican voters have no empathy, have no comprehension of how stealing from the poor hurts us all, and no interest in anything that doesn't affect them personally.

        I always roll my eyes whenever I hear from a Waukesha Republican voter that hates Medicaid (because he's convinced that Medicaid is only used by those "blah people"), but doesn't comprehend that his mother gets her nursing home care paid for by that very same Medicaid that he hates.

        They fail to comprehend that the largest Medicaid spending is on nursing homes and care for the disabled.

        There already is class warfare in America. Unfortunately, the rich are winning.

        by Puddytat on Sat Jun 08, 2013 at 02:38:19 PM PDT

        [ Parent ]

    •  The GOP in Texas is in charge of (4+ / 0-)
      Recommended by:
      Puddytat, DSPS owl, Rick B, dragonlady

      all three branches of state government, and they are also refusing both Medicaid expansion and the creation of exchanges.  Reportedly over 1.3 million Texas residents will be left with no access to health care unless they are able to pay for it out of pocket or rely on emergency rooms.

      I was hoping hospitals and community clinics making a huge effort to lobby the legislature and governor to accept federal help and expand Medicaid would convince the lawmakers.  But no - they remained impervious to rational thought.  With them it's all about rebelling against the federal government, the needy people of the state be damned.

      "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

      by SueDe on Sat Jun 08, 2013 at 03:43:48 PM PDT

      [ Parent ]

      •  Wisconsin Republicans on the ER situation (3+ / 0-)
        Recommended by:
        peptabysmal, Puddytat, Rick B

        People without health insurance have to turn to the emergency room in times of crisis. We know that. The Republicans who control the Wisconsin legislature are providing money in the budget to reimburse hospitals for unpaid care, instead of expanding Medicaid to people who need it and letting them have some peace of mind with regard to their medical needs. But no, that would be too simple.

        •  How short-sighted of the WI lege. (1+ / 0-)
          Recommended by:
          dragonlady

          Instead of reimbursing hospitals for unpaid care, it seems it would be much less expensive to have Medicaid pay for the care with the Feds paying the cost, at least for the next three years, and 90% of the cost thereafter.  And of course it would take care of your peace of mind issue, too.

          Amazing what irrational judgment the Republicans in the states are willing to exhibit just to refuse to cooperate with the federal government.

          "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

          by SueDe on Sun Jun 09, 2013 at 04:55:19 PM PDT

          [ Parent ]

          •  Exactly right (1+ / 0-)
            Recommended by:
            SueDe

            And the reason behind this irrationality? It's about being true to their hatred of all things Obama, with a dash of helping Scott Walker impress the tea partiers when his presidential campaign begins in earnest.

  •  The DO give a damn! (1+ / 0-)
    Recommended by:
    dragonlady

    (At least House Republicans).

    After all, they voted 37 times to repeal ObamaCare. They oppose any "government take-over" of medical care. They still want to privatize Medicare. Steve King calls ObamaCare "this unconstitutional takings of American liberty." And that was after the Supreme Court ruled.

  •  when red state relatives hear from blue state .... (5+ / 0-)

    relatives that they have health care (when the red state auntie does not).......that's when the real voter backlash against those evil republicans will begin. The DEMS surely will be able to run strongly on Obamacare in 2014 as they have recently announced.

  •  You really have to ask? (4+ / 0-)
    Recommended by:
    cocinero, Matt Z, Rick B, dragonlady
    The question is, does Congress give a damn?

    The answer is obvious - they don't give a damn. Any bad thing that happens is Obama's fault - just ask them.

    Filibuster reform, 2013 - woulda, coulda, shoulda.

    by bear83 on Sat Jun 08, 2013 at 02:32:40 PM PDT

  •  400,000 in Virginia would qualify... (0+ / 0-)

    under Medicaid. Community health centers here and across the country can not keep pace with the uninsured and underinsured that seek care at these facilities. Hospitals, which increasingly own primary care community based practices exacerbate this problem by funneling unassigned (i.e. uninsured) to community health centers rather than their own practices. This, combined with higher overhead costs based on accountability and reporting requirements could mean disaster for CHCs.

    "We can have democracy in this country, or we can have great wealth concentrated in the hands of a few, but we can't have both." - Louis D. Brandeis

    by VA6thDem on Sat Jun 08, 2013 at 03:09:43 PM PDT

  •  Why would ACA block low-income folks from (0+ / 0-)

    health care exchanges even if they did qualify for Medicaid?

    •  Answer from the diary: (1+ / 0-)
      Recommended by:
      peptabysmal
      That's because Obamacare assumed that all of these people would be covered by the Medicaid expansion.

      The Republicans are defunding, not defending, America.

      by DSPS owl on Sat Jun 08, 2013 at 04:19:14 PM PDT

      [ Parent ]

      •  I don't think that's right (1+ / 0-)
        Recommended by:
        dragonlady

        Senator Donnelly's office told me that those under FPL WOULD INDEED have access to the exchange, but they won't get the subsidies and must pay full price. Although it's still a major flaw in the ACA after the SCOTUS ruling, that's a HUGE difference from what the article said! I think the article got it wrong.

        According to http://www.healthcare.gov/... ...

        Who’s Eligible?
        Anyone can use the Health Insurance Marketplace to explore their health insurance options, even if you already have insurance now.

        The only requirements to get insurance through the Marketplace are:

        You must live in the U.S.
        You must be a U.S. citizen or national (or lawfully present)
        You can’t be currently incarcerated

        The problems that exist in the world today cannot be solved by the level of thinking that created them. - Albert Einstein.

        by Cvstos on Sat Jun 08, 2013 at 04:34:05 PM PDT

        [ Parent ]

        •  Worthless access (1+ / 0-)
          Recommended by:
          peptabysmal

          Someone making less than 100% of poverty can get unsubsidized access to  the exchanges.  Someone making $12,000 a year will be able to buy an insurance policy costing anywhere from $3,000 to $9,000 a year depending on their age.

          So yes, they technically have access to the exchange, but they will have to pay 25% to 75% of their income to get a policy that has a $3,000 deductible.  They can get the coverage, but they wouldn't be able to eat, have clothes or have a roof over their head.

          Senator Donnelly's office should have made that simple caveat when they gave you the legally correct answer.

          •  They did (0+ / 0-)

            But it's worth pointing out that the article made that mistake.

            Also, I don't know if the special out-of-pocket maximums for the 100-400% FPL crowd apply to those under 100%.

            And, with the Medicaid money sitting around they might be able to amend the ACA with the Dems back in power to give them subsidized access in states that didn't expand Medicaid.

            In my state, Indiana, there's a chance the state insurance plan, HIP, will take the place of the Medicaid expansion. Which may or may not be a good thing depending on the circumstances of it.

            The problems that exist in the world today cannot be solved by the level of thinking that created them. - Albert Einstein.

            by Cvstos on Sat Jun 08, 2013 at 10:27:07 PM PDT

            [ Parent ]

  •  This really gets me angry. (1+ / 0-)
    Recommended by:
    Matt Z

    Our repub governor even said he wants the expansion, now the legislature is holding it up.

  •  I'm disappointed we haven't seen more of a (1+ / 0-)
    Recommended by:
    Rube Goldberg

    grassroots effort in states to mobilize people on this issue. I mean it's as simple as vote for a Democratic legislature and Governor and get health insurance. If this type of campaign works for farmers and agricultural aid, it can work for voters lacking health insurance.

    -1.63/ -1.49 "Speaking truth to power" (with snark of course)!

    by dopper0189 on Sat Jun 08, 2013 at 05:25:53 PM PDT

  •  Letters From Republicans Seeking Obamacare (2+ / 0-)
    Recommended by:
    Matt Z, dragonlady

    Revealed: Letters From Republicans Seeking Obamacare Money

    It’s the height of hypocrisy: They call for repeal of the law but plead for its dollars on behalf of constituents.

    Read more:

    http://www.thenation.com/...

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