Have you ever wondered – Where did my legislator get that idea about Medicaid funding? Why is my Congressman / Senator introducing that bill in relationship to Medicaid funding?
Well – in some cases, it may very well be related to the “education” they have received and continue to receive from the American Legislative Exchange Council (ALEC).
For those of you with little knowledge of ALEC there are links at the bottom of this diary for a full discussion. But to give you a quick overview – approximately 1/3 of all state legislators go to ALEC meetings every year where they meet with private-sector companies. While at these ALEC meetings your legislator and the corporations review and vote on “model legislation” that your legislator brings back to your state and tries to implement – whether or not you want it or need it. Remember, your legislator has been sitting and talking with corporations for three days about what the corporations want. And, based on my research of ALEC, it is my opinion (and I have supported in other diaries with verifiable ALEC content) [also see Bob Sloan’s diaries on ALEC legislation] that what ALEC members want more than anything is to privatize everything in the state government, so their corporations, at those meetings your legislator goes to and participates in, can make more money.
On to today’s tale about ALEC and Medicaid...
Some of the information may be dated - but keep in mind the information
presented is historical in nature.
In an archived screen shot of the ALEC 2003 web page called “Talking Points” they have a section on Medicaid. The first sentence is
Medicaid should be privatized.
In an archived screen shot of the ALEC 2003 web page called “Talking Points” they have a section on Long-term Care (specifically in relation to Medicaid spending). On this web page they state:
The program should be removed from the realm of government and be allowed to enter the market place.
The two first viable options (solutions) for Medicaid long-term care costs listed are:
“Allow consumers to access the equity in their homes for use in paying for long-term care.”
“Wholly transfer the issuance of long-term coverage to private insurance companies.”
BTW: Throughout ALEC literature Medicaid = “welfare entitlement”
I’m not the kind of person to just say something and not be able to support it – so here’s what ALEC has had to say on the issue of Medicaid.
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In a 2001 “Issue Analysis” ALEC released to its members entitled “Medical Waivers: Unintended Consequences” they looked at the use of section 1115 waivers. Some of the key points from this article include:
Waivers can be used to “implement market-based” reforms such as the
use of vouchers and cost sharing
Medicaid waivers should not be expanded to those beyond which it was
originally intended - the genuinely needy.
The article goes on to discuss a Vermont / Main case where they tried to apply 1115 waivers to seniors to be able to afford prescriptions drugs (which went to court and was overturned) Their conclusion was that Vermont/ Maine were using the waivers for “illegitimate purposes” which were short-sighted and that this would have been little to no benefit to the seniors and at high expense to the state – but they finish with these peculiar conclusions to the discussion:
“An actual prescription drug benefit modeled on private-sector insurance would provide greater coverage” and that other states should use this article as a means to
“implement innovative free market solutions”
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In April 2002 ALEC released “The State Factor Report” to their members, a 24 page article titled “Abolishing the Medicaid Ghetto: Putting ‘Patients First’”. The first paragraph of the article is tear-jerking about how people on Medicaid only have access to “second-tier” level of care. Then they get down to real business.
Some of the key points of this article are:
Turn over Medicaid 100% to the states
Congress should mandate market based consumer choice reform and
return Medicaid’s administration to the states.
Most preferable Federal / State relationship? No Continued Federal Control
or Mandates.
State would implement and administer the market oriented consumer choice
plan using a defined contribution approach.
Return as many people to the private market rather than absorb them into
a Medicaid program.
“The goal of health care public policy shouldn’t be to expand coverage but to have the uninsured return to the private sector” (p. 5)
And they end the article by stating that by doing everything that is in the 24 page report federal and state officials can create “ a vibrant, superior system of consumer-based private health insurance plans”.
**
In July of 2004 ALEC released “The State Factor Report” to their members titled “Medicaid’s’ Perverse Incentives”. Some of the key points they make in this article are:
Medicaid patients [currently] have negligible, if any cost-sharing requirements
The federal match is most responsible for fiscal problems of Medicaid
(they pay too much, too often) to states that have “financing schemes”
and “financial shenanigans” for Medicaid
Their solutions?
Congress should block-grant the program so states can’t use their
“financing schemes” and “financial shenanigans”
An allowance for Medicaid participants “put dollars in the hands of patients”
– so people can buy their own services – “allowing them access to the
free market” (private sector) for limited range services, and long-term
chronic conditions
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In 2005 ALEC released a report to their members, written by The Council of Affordable Healthcare , titled “The Long-term Care Dilemma: What States Are Doing Right”.
The report looks at the upcoming influx of Boomers into Medicaid, specifically into long-term care facilities. The report notes that Medicaid should be available to the “genuinely needy” and that it should require “affluent seniors” to pay for their own long-term care.
Here we go – making recommendations based on the extremes. So we are left with the question of what are the people in the middle suppose to do without the Medicaid long-term care option – they are not “genuinely needy” and they are not “affluent”. Well, the press release that introduced the report stated “Reverse mortgages are the key missing part of the long-term care financing puzzle.” Their solutions is – if you own your home – that you take out a reverse mortgage on your home to pay for your long-term care – until you are broke and then you can have Medicaid. This option comes with high interest rates, additional financing fees and if you can’t pay your taxes – you lose your home. (private-sector, private-sector, private-sector)
In the introduction to that report it states:
In other words, the easer Medicaid is to obtain and the more attractive its long-term benefits are, the less likely people will be to plan early and pay privately for long-term care and the more likely they will be to become depending on public assistance.
In the recommendation shown on page 38 – the second recommendation of “what states can do” is:
Document the extent to which Medicaid chills the market for private long-term care financing alternatives.
Why this focus on long-term care? Well if you go back to the introduction of the report the first two items are
“Nursing homes are financially stressed” and assisted living facilities “fill too slowly to be profitable”. (private-sector, private-sector)
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There is so much wrong in what I just shared with you - it would take me a book to outline everything that is wrong. All you need to do is look at current legislation being introduced and question "Who are they representing - really, who are they truly representing with this legislation?"
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So why is all of this important? You need to know that your legislators are not “just coming up with this stuff” – they are being educated by ALEC on a regular basis on this topic and others on how to move more of the government to the private sector.
It's really important that we all start paying closer attention to what is being introduced in our legislatures.
We need to speak up and say "NO!" to legislation that makes no sense to the common person - in your state.
DO NOT assume that legislators are introducing bills that appropriate and needed in your state.
You pay your legislators - they should be repsenting you!
You need to do the footwork / paperwork and identify your legislators that are members of ALEC - don't ask someone else to do it for you. It's your legislator and your responsibility. (And then share that information in the comment section here - so we all know)
You need to remove ALEC legislators from office. They are no longer representing you.
When the goal of your ALEC legislator or congressman or senator becomes privatization, they are no longer representing you, but are representing the corporations they sit with or sat with at the ALEC meetings.
If you don’t know what ALEC is – please read this, or this, or this, or this.