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Texas to dump Medicaid?
Atomika
Live fast and get fucked or whateverRegistered User regular
Live fast and get fucked or whateverRegistered User regular
press release
arguments for:
and a'gin:
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.
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
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Posts
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"
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.
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.
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.
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.
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.
You can measure societal benefits in cost analysis.
I hate these people.
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.
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.
It's like Mexico, but new!
Rigorous Scholarship
eventually like NY it'll hit a point where there's simply no sustainable workforce because the commute has gotten too difficult
So.
Rigorous Scholarship
Someone has to fill those spots.
If ostracizing those people is the intent, then go for it, Texas!
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?
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?
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.
Rigorous Scholarship
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.
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!
http://www.theonion.com/articles/report-nations-gentrified-neighborhoods-threatened,2419/
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.
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
If you're interested in reading exactly why... here you go.
Of particular interest:
Also relevant:
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.
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.
A majority of doctors are Republican, so I hear.