As was foretold, we've added advertisements to the forums! If you have questions, or if you encounter any bugs, please visit this thread: https://forums.penny-arcade.com/discussion/240191/forum-advertisement-faq-and-reports-thread/

Texas to dump Medicaid?

AtomikaAtomika Live fast and get fucked or whateverRegistered User regular
edited November 2010 in Debate and/or Discourse
press release
The Heritage Foundation, conservative research and policy center, approximates Texas could pocket $60 billion from 2013 to 2019 by dropping out of Medicaid and the Children’s Health Insurance Program. The Texas Health and Human Services Commission, which accounts for 3.6 million children, people with disabilities and poverty-stricken Texans enrolled in Medicaid and CHIP, will put out its own study on the effect of halting the state’s participation in the federal match program before January 2011.


arguments for:
The Medicaid program is a joint state-federal entitlement program designed to provide health care to eligible low income individuals. The Texas Medicaid program primarily serves low income children, pregnant women, elderly, and people with disabilities. Texas expenditures for Medicaid more than doubled between 1996 and 2006, and the program currently accounts for 26 percent of the Texas state budget. Funding for Medicaid continues to compete with other critical programs and priorities, while increasing health care costs have eroded employer-based coverage. In addition to surging Medicaid caseloads and increasing medical costs, 25 percent, or 5.5 million people in Texas, do not have health insurance. This places additional pressure on Medicaid. Public hospitals report spending billions of dollars a year for care provided to the uninsured.

and a'gin:
So under Perry’s proposal, the state would give up millions of dollars in federal funds and dedicate its remaining state share to cover individuals and families with disabilities. The poor who are currently enrolled in the program would find private coverage from the new health care exchange. Or at least that’s the theory. In reality, the poorest Texans would never be left uninsured because under the ACA, individuals under 100% of the poverty line are not eligible for federal tax credits. And even if they were, they would have to contribute 2% of their incomes to health insurance.

Meanwhile, the state, in all its “innovation,” will have to stretch its contribution to cover Texans with disabilities and seniors in the face of rising health care costs. Even if it somehow managed to do that — and that’s a big if — the state will face the challenge of dealing with the uptick in uncompensated care. As Judy Solomon of the Center for Budget and Policy Priorities explained to me, by opting out of the Medicaid program, Perry would be “taking billions out of the state economy that goes on to support hospitals and other providers,” ensuring a revolt from the provider community. Hospitals and doctors would have to swallow the costs of caring for uninsured individuals who will continue to use the emergency room as their primary source of care.



An interesting crossroads, I be raptly awaiting the results of that study. A correction right off the bat in the argument against removing Medicare: people using ERs as primary care facilities are only protected under EMTALA statutes, meaning that without produceable means of payment at time of services rendered, only Level One emergencies (immediate danger to life or limb) are mandated to be covered. To sum up, if you're not dying on the spot, hospitals have no legal or financial obligation to treat you.

As well, from a professional perspective, Medicare is the absolute bane of the private healthcare industry, so removing Medicaid reimbursements will in no measurable way "ensure a revolt from the provider community." In fact, quite the opposite. The day care facilities aren't beholden to the arbitrary whims of JCAHO accreditation is the day you'll see privately-employed doctors throwing a ticker-tape parade.

Atomika on
«1345

Posts

  • ChillyWillyChillyWilly Registered User regular
    edited November 2010
    I work for an insurance company (at work right now, in fact :D) that deals with the Medicare Advantage program, but Medicaid is a bit of a different animal. I don't know much of anything about it. So, in complete ignorance, I ask this question:

    Is it even legal for Texas to just drop out of a Medicaid? Nothing about the legality of it is really spoken of, so some clarification on how they would do that would be much appreciated.

    ChillyWilly on
    PAFC Top 10 Finisher in Seasons 1 and 3. 2nd in Seasons 4 and 5. Final 4 in Season 6.
  • OhtsamOhtsam Registered User regular
    edited November 2010
    I work for an insurance company (at work right now, in fact :D) that deals with the Medicare Advantage program, but Medicaid is a bit of a different animal. I don't know much of anything about it. So, in complete ignorance, I ask this question:

    Is it even legal for Texas to just drop out of a Medicaid? Nothing about the legality of it is really spoken of, so some clarification on how they would do that would be much appreciated.

    Our glorious governor is not bound by the pitiful law of the "United States"

    Ohtsam on
  • AtomikaAtomika Live fast and get fucked or whatever Registered User regular
    edited November 2010
    Is it even legal for Texas to just drop out of a Medicaid? Nothing about the legality of it is really spoken of, so some clarification on how they would do that would be much appreciated.

    I wondered this myself, but listening to Perry talk, he made it sound like canceling a magazine subscription.

    From what I understand, it was created under Johnson's Great Society bills and ratified by all fifty states, but did not carry a mandate. Which probably means that since it's not a constitutional provision, removing its provisions is not unconstitutional.

    Atomika on
  • MalkorMalkor Registered User regular
    edited November 2010
    Why not try it out for a few decades and see what happens. Theorycrafting is all well and good, but sometimes you actually need someone to go out and fail or succeed at things.

    Malkor on
    14271f3c-c765-4e74-92b1-49d7612675f2.jpg
  • Pi-r8Pi-r8 Registered User regular
    edited November 2010
    Wait what? So Texas is spending too much money on medicare, despite the fact that it's also receiving money for it from the government? And they want to save money by

    1)giving up the federal money. lol.
    2)not giving health care to the poor? And forcing them to get private health care insurance? Despite the fact that 5.5 million people in texas don't have health insurance while the state HAS medicare. This will just add to that problem.

    The only way I can possibly see this working for Texas is if they manage to convince the federal government to foot the bill for all their new uninsured under the new healthcare reform legislation. Which doesn't really save any money at all, it just transfers the bill from the Texas government to the federal government.

    Pi-r8 on
  • AngelHedgieAngelHedgie Registered User regular
    edited November 2010
    AR, the providers will be happy up till they see the massive gaping hole in their bottom line. They won't miss the regulations, but they sure as hell will miss the money.

    And I would like to see Perry try this, because nothing would make me happier than to see the Texas Republican Party cease to be a relevant part of the national discourse.

    AngelHedgie on
    XBL: Nox Aeternum / PSN: NoxAeternum / NN:NoxAeternum / Steam: noxaeternum
  • ChillyWillyChillyWilly Registered User regular
    edited November 2010
    Is it even legal for Texas to just drop out of a Medicaid? Nothing about the legality of it is really spoken of, so some clarification on how they would do that would be much appreciated.

    I wondered this myself, but listening to Perry talk, he made it sound like canceling a magazine subscription.

    From what I understand, it was created under Johnson's Great Society bills and ratified by all fifty states, but did not carry a mandate. Which probably means that since it's not a constitutional provision, removing its provisions is not unconstitutional.

    Say that Texas does actually pass this law. I'm wondering what kind of legal recourse (if any) the people of Texas have if they want to try and go against the decision in any way.

    ChillyWilly on
    PAFC Top 10 Finisher in Seasons 1 and 3. 2nd in Seasons 4 and 5. Final 4 in Season 6.
  • electricitylikesmeelectricitylikesme Registered User regular
    edited November 2010
    Pi-r8 wrote: »
    The only way I can possibly see this working for Texas is if they manage to convince the federal government to foot the bill for all their new uninsured under the new healthcare reform legislation. Which doesn't really save any money at all, it just transfers the bill from the Texas government to the federal government.

    This is like, the exact thing I immediately assumed is actually going to happen somehow.

    electricitylikesme on
  • ChillyWillyChillyWilly Registered User regular
    edited November 2010
    Pi-r8 wrote: »
    Wait what? So Texas is spending too much money on medicare, despite the fact that it's also receiving money for it from the government? And they want to save money by

    1)giving up the federal money. lol.
    2)not giving health care to the poor? And forcing them to get private health care insurance? Despite the fact that 5.5 million people in texas don't have health insurance while the state HAS medicare. This will just add to that problem.

    The only way I can possibly see this working for Texas is if they manage to convince the federal government to foot the bill for all their new uninsured under the new healthcare reform legislation. Which doesn't really save any money at all, it just transfers the bill from the Texas government to the federal government.

    Medicaid, not Medicare.

    Medicaid serves low-income families and people with certain disabilities. It is both state and federally funded.

    Medicare serves those 65 and older and has caveats for people with certain disabilities as well. It is only funded by the federal government.

    When I used to work customer service for Medicare Advantage at my job, I would sometimes talk to folks who were in the 20's, 30's etc. who were in Medicare because they had debilitating illnesses or injuries and could not provide for themselves. It was rare, but they are out there.

    ChillyWilly on
    PAFC Top 10 Finisher in Seasons 1 and 3. 2nd in Seasons 4 and 5. Final 4 in Season 6.
  • Pi-r8Pi-r8 Registered User regular
    edited November 2010
    Pi-r8 wrote: »
    Wait what? So Texas is spending too much money on medicare, despite the fact that it's also receiving money for it from the government? And they want to save money by

    1)giving up the federal money. lol.
    2)not giving health care to the poor? And forcing them to get private health care insurance? Despite the fact that 5.5 million people in texas don't have health insurance while the state HAS medicare. This will just add to that problem.

    The only way I can possibly see this working for Texas is if they manage to convince the federal government to foot the bill for all their new uninsured under the new healthcare reform legislation. Which doesn't really save any money at all, it just transfers the bill from the Texas government to the federal government.

    Medicaid, not Medicare.

    Medicaid serves low-income families and people with certain disabilities. It is both state and federally funded.

    Medicare serves those 65 and older and has caveats for people with certain disabilities as well. It is only funded by the federal government.

    When I used to work customer service for Medicare Advantage at my job, I would sometimes talk to folks who were in the 20's, 30's etc. who were in Medicare because they had debilitating illnesses or injuries and could not provide for themselves. It was rare, but they are out there.

    right, right. I do know that, that was just a typo.

    Pi-r8 on
  • CouscousCouscous Registered User regular
    edited November 2010
    approximates Texas could pocket $60 billion from 2013 to 2019 by dropping out of Medicaid and the Children’s Health Insurance Program
    That doesn't mean it makes sense from a cost perspective. There is the whole money saved by being in the program and therefor getting federal money and making sure that poor people aren't completely fucked over and willing to do certain things.

    Couscous on
  • Psycho Internet HawkPsycho Internet Hawk Registered User regular
    edited November 2010
    Sometimes I wish concepts such as societal benefits and human decency were taken more seriously by lawmakers.

    Psycho Internet Hawk on
    ezek1t.jpg
  • electricitylikesmeelectricitylikesme Registered User regular
    edited November 2010
    Couscous wrote: »
    approximates Texas could pocket $60 billion from 2013 to 2019 by dropping out of Medicaid and the Children’s Health Insurance Program
    That doesn't mean it makes sense from a cost perspective. There is the whole money saved by being in the program and therefor getting federal money and making sure that poor people aren't completely fucked over and willing to do certain things.

    Conversely, Texas has spent decades "streamlining" the death penalty.

    electricitylikesme on
  • CouscousCouscous Registered User regular
    edited November 2010
    Sometimes I wish concepts such as societal benefits and human decency were taken more seriously by lawmakers.

    You can measure societal benefits in cost analysis.
    Far-right conservatives are offering that possibility in post-victory news conferences. Moderate Republicans are studying it behind closed doors. And the party’s advisers on health care policy say it's being discussed more seriously than ever, though they admit it may be as much a huge in-your-face to Washington as anything else.
    I hate these people.

    Couscous on
  • jungleroomxjungleroomx It's never too many graves, it's always not enough shovels Registered User regular
    edited November 2010
    Let 'em.

    What you're going to see as a result is a stream of working poor and lower middle class people leaving the state, those who can afford it, and going to cheaper pastures like Oklahoma or New Mexico.

    ER's are going to be jam packed, doctors overworked, and you'll see the quality of health care decline in Texas. Clinics are going to be doing booming business, though.

    jungleroomx on
  • ThanatosThanatos Registered User regular
    edited November 2010
    As well, from a professional perspective, Medicare is the absolute bane of the private healthcare industry, so removing Medicaid reimbursements will in no measurable way "ensure a revolt from the provider community." In fact, quite the opposite. The day care facilities aren't beholden to the arbitrary whims of JCAHO accreditation is the day you'll see privately-employed doctors throwing a ticker-tape parade.
    Medicaid is a huge cash cow to a ton of different people, including a whole bunch of medical providers.

    This seems like a great plan, though; give up a fucking shit-ton of federal matching funds. Texas' current FMAP rate is 59.44%, which means that for every dollar Texas spends on Medicaid, the feds hand over $0.5944. I think that money has to be spent on Medicaid, but I'm not entirely sure.

    Anyhow, Perry is proposing to save money by taking a pass on all the federally-mandated stuff that goes along with administrating Medicaid; I guess he thinks his state can do it better for well under 60% of the cost. Of course, that means there's going to be much less federal money pouring into the state, but I fully support this. This means that Perry is saving me a bunch of money. He'll be contributing towards cutting down the national debt, and the only people suffering for it will be Texans, which means they probably deserve it.

    Thanatos on
  • ThanatosThanatos Registered User regular
    edited November 2010
    Couscous wrote: »
    Far-right conservatives are offering that possibility in post-victory news conferences. Moderate Republicans are studying it behind closed doors. And the party’s advisers on health care policy say it's being discussed more seriously than ever, though they admit it may be as much a huge in-your-face to Washington as anything else.
    I hate these people.
    I love these people! "In your face, Washington! Have your $40 billion back! Hahah!"

    Thanatos on
  • CouscousCouscous Registered User regular
    edited November 2010
    We shouldn't screw over innocent Mexican immigrants.

    Couscous on
  • jungleroomxjungleroomx It's never too many graves, it's always not enough shovels Registered User regular
    edited November 2010
    New Mexico is right next door.

    It's like Mexico, but new!

    jungleroomx on
  • Modern ManModern Man Registered User regular
    edited November 2010
    Let 'em.

    What you're going to see as a result is a stream of working poor and lower middle class people leaving the state, those who can afford it, and going to cheaper pastures like Oklahoma or New Mexico.

    ER's are going to be jam packed, doctors overworked, and you'll see the quality of health care decline in Texas. Clinics are going to be doing booming business, though.
    From a cynical perspective, this is attractive to most governments. Here in DC, we've been gentrifying poorer people out of the District and there hasn't really been a downside.

    Modern Man on
    Aetian Jupiter - 41 Gunslinger - The Old Republic
    Rigorous Scholarship

  • jungleroomxjungleroomx It's never too many graves, it's always not enough shovels Registered User regular
    edited November 2010
    I understand that republicans hate anyone making under $250,000 a year.

    jungleroomx on
  • nexuscrawlernexuscrawler Registered User regular
    edited November 2010
    Modern Man wrote: »
    Let 'em.

    What you're going to see as a result is a stream of working poor and lower middle class people leaving the state, those who can afford it, and going to cheaper pastures like Oklahoma or New Mexico.

    ER's are going to be jam packed, doctors overworked, and you'll see the quality of health care decline in Texas. Clinics are going to be doing booming business, though.
    From a cynical perspective, this is attractive to most governments. Here in DC, we've been gentrifying poorer people out of the District and there hasn't really been a downside.

    eventually like NY it'll hit a point where there's simply no sustainable workforce because the commute has gotten too difficult

    nexuscrawler on
  • Modern ManModern Man Registered User regular
    edited November 2010
    I understand that republicans hate anyone making under $250,000 a year.
    In most places where poor people are being gentrified out, the government is run by Democrats and most of the actual gentry coming in are heavily Democratic.

    So.

    Modern Man on
    Aetian Jupiter - 41 Gunslinger - The Old Republic
    Rigorous Scholarship

  • jungleroomxjungleroomx It's never too many graves, it's always not enough shovels Registered User regular
    edited November 2010
    Unless an area is a specialized area, like Manhattan, the exodus of the people who serve your food or do other lower-paying jobs is kind of a bad thing.

    Someone has to fill those spots.

    If ostracizing those people is the intent, then go for it, Texas!

    jungleroomx on
  • jungleroomxjungleroomx It's never too many graves, it's always not enough shovels Registered User regular
    edited November 2010
    Modern Man wrote: »
    I understand that republicans hate anyone making under $250,000 a year.
    In most places where poor people are being gentrified out, the government is run by Democrats and most of the actual gentry coming in are heavily Democratic.

    So.

    Is this a generalized brush-stroke "Fact" due to liberals being more abundant in urban and metro areas, or is there, you know, some data behind it?

    jungleroomx on
  • joshofalltradesjoshofalltrades Class Traitor Smoke-filled roomRegistered User regular
    edited November 2010
    There are lots of better places for Texas to trim fat from the budget without screwing over lower-class working Texans

    I will go into more detail when I'm not stuck in a big field in the middle of nowhere

    joshofalltrades on
  • AngelHedgieAngelHedgie Registered User regular
    edited November 2010
    There are lots of better places for Texas to trim fat from the budget without screwing over lower-class working Texans

    I will go into more detail when I'm not stuck in a big field in the middle of nowhere

    Of course, but the Kochtopus must be fed, remember?

    AngelHedgie on
    XBL: Nox Aeternum / PSN: NoxAeternum / NN:NoxAeternum / Steam: noxaeternum
  • oldsakoldsak Registered User regular
    edited November 2010
    Doctors in McAllen are going to throw a fit.

    oldsak on
  • Modern ManModern Man Registered User regular
    edited November 2010
    Modern Man wrote: »
    I understand that republicans hate anyone making under $250,000 a year.
    In most places where poor people are being gentrified out, the government is run by Democrats and most of the actual gentry coming in are heavily Democratic.

    So.

    Is this a generalized brush-stroke "Fact" due to liberals being more abundant in urban and metro areas, or is there, you know, some data behind it?
    Gentrification tends to occur in urban areas, which also tend to be heavily liberal. The poorer black people who used to live in Dupont Circle were not pushed out by Christian conservatives, but rather (initially) by gays moving into the neighborhood, for example.

    Governments in general don't really have a use for poor people, and they're usually happy to see them leave. This is true regardless of who actually runs the government in question.

    Modern Man on
    Aetian Jupiter - 41 Gunslinger - The Old Republic
    Rigorous Scholarship

  • IncenjucarIncenjucar VChatter Seattle, WARegistered User regular
    edited November 2010
    Modern Man wrote: »
    Modern Man wrote: »
    I understand that republicans hate anyone making under $250,000 a year.
    In most places where poor people are being gentrified out, the government is run by Democrats and most of the actual gentry coming in are heavily Democratic.

    So.

    Is this a generalized brush-stroke "Fact" due to liberals being more abundant in urban and metro areas, or is there, you know, some data behind it?
    Gentrification tends to occur in urban areas, which also tend to be heavily liberal. The poorer black people who used to live in Dupont Circle were not pushed out by Christian conservatives, but rather (initially) by gays moving into the neighborhood, for example.

    Governments in general don't really have a use for poor people, and they're usually happy to see them leave. This is true regardless of who actually runs the government in question.

    Gentrification isn't generally done on purpose. It starts with people going "Oh hey this land is cheap and poor people are cool too I won't mind living next to them."

    Not really a comparable thing.

    Incenjucar on
  • jungleroomxjungleroomx It's never too many graves, it's always not enough shovels Registered User regular
    edited November 2010
    Yeah, I would say that building a rail system or subway stop in a poor area to help them out and, as a result, unintentionally (or intentionally) drive up housing prices is different than this.

    Texas should have a sign on their state highway border signs saying YOU MUST MAKE "THIS" MUCH A YEAR TO LIVE PAST 40, with a cheerful cartoon cowboy. It'll be like going to the fair!

    jungleroomx on
  • CouscousCouscous Registered User regular
    edited November 2010
    Couscous on
  • mcdermottmcdermott Registered User regular
    edited November 2010
    I see this policy leading to less Texans.

    I support it.

    EDIT: Not that some of you aren't cool. Don't take it personally. On the whole, though, less Texans has got to be a net positive.

    mcdermott on
  • joshofalltradesjoshofalltrades Class Traitor Smoke-filled roomRegistered User regular
    edited November 2010
    It's a good thing that Medicare is totally federally funded or else that would be getting the axe too.

    Wait, what the fuck, that's not true at all.

    So, Rick Perry is just fine with taking federal money for old people to go get their arthritis meds, but then he turns around and brags about rejecting federal money for education? And then turns around again and uses federal emergency money for education to improve the state budget outlook after cutting education funding? And keep in mind, this is a state where we're considering an amendment to raise property taxes to help pay for education. Education in Texas is horrible, and in dire need of an infusion of funds/good people.

    Just... the cognitive dissonance... I need to lie down before my head explodes.

    joshofalltrades on
  • FartacusFartacus __BANNED USERS regular
    edited November 2010
    I sometimes wonder if allowing for a certain type of secessionary status would be enough to save progressivism on the national level. Say, for example, if Texas decides to accept this sort of territorial status, their federal representation would be curtailed, but also so would their taxes, any federal programs they participate in, and certain federal laws. They all profess to be strict Constitutionalists, so they can stay under the Constitution but otherwise opt-out of Federal government as we know it.

    As long as this were paired with a dramatic or total reduction in their representation in Congress (both houses), I don't see why we shouldn't offer something like this to all the Southern states, where people have made clear that they'd rather have no government at all than one that might allocate some resources to brown people.

    Meanwhile those of us who live in states that still find a benefit in federalism can continue on, unencumbered in our pursuit of a strong, empathetic federal government. Whether the secessionary states ultimately fall apart and come back into the fold is irrelevant -- they'll provide horror stories to keep progressivism strong within the union that still exists

    Fartacus on
  • joshofalltradesjoshofalltrades Class Traitor Smoke-filled roomRegistered User regular
    edited November 2010
    By the way, I'll admit to being more than a little wary of this idea just because Rick Perry is involved with it, and he's among America's Worst Governors, according to a report by CREW (Citizen's for Responsibility and Ethics in Washington).

    If you're interested in reading exactly why... here you go.

    Of particular interest:
    In March 2009, Gov. Perry announced that he would reject nearly $555 million in federal
    stimulus funds to expand state unemployment benefits, arguing that the money would increase
    the tax burden on Texas businesses. He did, however, accept most of the nearly $17 billion in
    federal aid set aside for his state.
    Texas currently covers the smallest percentage of
    unemployed workers of any state, according to the Center for Public Policy Priorities, with
    nearly four out of every five unemployed workers not qualifying for benefits. At least one
    business-backed tax group predicted that by rejecting the funds, the state would be forced to increase taxes on businesses to avoid a projected unemployment fund shortfall. The group said
    accepting the stimulus funds would have reduced the potential tax increase. Members of both
    political parties opposed the governor’s actions.

    Also relevant:
    All of this makes very little sense, which has led several health care wonks I’ve spoken to seriously question the legitimacy and sincerity of these proposals. However Perry wants to define the chain of ownership behind federal tax dollars, the reality is that under health care reform, states that offer the skimpiest Medicaid programs — in Texas, parents qualify for Medicaid only if their family income is below $5,720 — will receive the largest infusion of federal funds to help them expand their programs. Texas, for instance, “can expect to see Medicaid enrollment rise by 46 percent while state spending on Medicaid rises by about 3 percent.” The federal government will pick-up most of the tab, as its costs will increase by 39 percent!

    So under Perry’s proposal, the state would give up millions of dollars in federal funds and dedicate its remaining state share to cover individuals and families with disabilities. The poor who are currently enrolled in the program would find private coverage from the new health care exchange. Or at least that’s the theory. In reality, the poorest Texans would never be left uninsured because under the ACA, individuals under 100% of the poverty line are not eligible for federal tax credits. And even if they were, they would have to contribute 2% of their incomes to health insurance.

    Meanwhile, the state, in all its “innovation,” will have to stretch its contribution to cover Texans with disabilities and seniors in the face of rising health care costs. Even if it somehow managed to do that — and that’s a big if — the state will face the challenge of dealing with the uptick in uncompensated care. As Judy Solomon of the Center for Budget and Policy Priorities explained to me, by opting out of the Medicaid program, Perry would be “taking billions out of the state economy that goes on to support hospitals and other providers,” ensuring a revolt from the provider community. Hospitals and doctors would have to swallow the costs of caring for uninsured individuals who will continue to use the emergency room as their primary source of care.

    In other words, it’s a lose-lose for everyone involved, and, since it’s cheaper to cover individuals in Medicaid rather than through the private exchange, shifting the eligible Medicaid population out of that program, will also force the federal government to spend more on federal tax credits.

    But of course, if Perry believes that Medicaid is such a bad deal, he can continue petitioning the government for a waiver that would allow the state to alter some of the rules of the program — so long as he can demonstrate that his ‘Texas solution’ is comparable to Medicaid’s coverage standards. Perry hasn’t proposed anything remotely plausible during his first term as governor and while he talked a lot about states acting as “laboratories of innovation” in the above CNN interview, he didn’t list a single “good idea” for how Texas would provide care more efficiently than Medicaid.

    joshofalltrades on
  • Irond WillIrond Will WARNING: NO HURTFUL COMMENTS, PLEASE!!!!! Cambridge. MAModerator mod
    edited November 2010
    Modern Man wrote: »
    Let 'em.

    What you're going to see as a result is a stream of working poor and lower middle class people leaving the state, those who can afford it, and going to cheaper pastures like Oklahoma or New Mexico.

    ER's are going to be jam packed, doctors overworked, and you'll see the quality of health care decline in Texas. Clinics are going to be doing booming business, though.
    From a cynical perspective, this is attractive to most governments. Here in DC, we've been gentrifying poorer people out of the District and there hasn't really been a downside.

    Texas doesn't have a PG County a few miles away on a rail line that their cooks and janitors can ride in on.

    Also, DC is a strange collection of social, economic and demographic factors that don't really apply to anywhere else.

    Irond Will on
    Wqdwp8l.png
  • LanlaornLanlaorn Registered User regular
    edited November 2010
    Fartacus wrote: »
    I sometimes wonder if allowing for a certain type of secessionary status would be enough to save progressivism on the national level. Say, for example, if Texas decides to accept this sort of territorial status, their federal representation would be curtailed, but also so would their taxes, any federal programs they participate in, and certain federal laws. They all profess to be strict Constitutionalists, so they can stay under the Constitution but otherwise opt-out of Federal government as we know it.

    As long as this were paired with a dramatic or total reduction in their representation in Congress (both houses), I don't see why we shouldn't offer something like this to all the Southern states, where people have made clear that they'd rather have no government at all than one that might allocate some resources to brown people.

    Meanwhile those of us who live in states that still find a benefit in federalism can continue on, unencumbered in our pursuit of a strong, empathetic federal government. Whether the secessionary states ultimately fall apart and come back into the fold is irrelevant -- they'll provide horror stories to keep progressivism strong within the union that still exists

    Lol, do you seriously believe this? Look, those southern states you hate? They get more federal funding than they pay in federal taxes, a lot more. They won't leave.

    New York, Texas, California? These are the states that pay MORE than they recieve, if they could pick a Puerto Rico like situation where they the benefits but pay none of the costs they would go for it and every other state would be fucked.

    Edit: I just checked, from the latest Census Bureau PDF Texas is ranked 42nd for Federal government expenditure per capita. Meanwhile they're a huge state with a lot of people and a huge chunk of our economy.

    If Texas just paid for it's own social services it undoubtedly would save money. And most of the states in the top 20 would be fucked.

    Edit #2: Can't find numbers for 2009 but in 2004 Texas' recieved:taxed ratio was 0.94, so Texas appraently just about breaks even. New York and California are at 0.79 so they'd save a ton. And these are the, by far, three biggest states for federal tax revenue. Meanwhile Alabama is at 1.71, Louisiana at 1.45, West Virginia at 1.87, New Mexico apparently had the sweetest setup at 2.0 dollars recieved:taxed in 2004.

    Your crazy plan would just drive the good states away.

    Lanlaorn on
  • wwtMaskwwtMask Registered User regular
    edited November 2010
    Man am I glad I left Texas, and I say this as a Floridian. All things considered, I'm much better off being governed by Rick Scott than Rick Perry.

    wwtMask on
    When he dies, I hope they write "Worst Affirmative Action Hire, EVER" on his grave. His corpse should be trolled.
    Twitter - @liberaltruths | Google+ - http://gplus.to/wwtMask | Occupy Tallahassee
  • bowenbowen How you doin'? Registered User regular
    edited November 2010
    oldsak wrote: »
    Doctors in McAllen are going to throw a fit.

    A majority of doctors are Republican, so I hear.

    bowen on
    not a doctor, not a lawyer, examples I use may not be fully researched so don't take out of context plz, don't @ me
Sign In or Register to comment.