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Subscribe to RSSSince Mitt Romney picked Paul Ryan as the GOP vice presidential candidate, the congressman's budget proposals have become the campaign’s most hotly debated issue. But it’s not the House Budget Committee chairman’s plan to reform Medicare that would affect today’s seniors, that redesign would impact only those who become eligible only in 2032 and later.
Medicaid is where he’d make immediate changes.
Although few of us want to admit it, once we (or our parents) become old and chronically ill, we (or they) will likely end up in a nursing home with care paid for by Medicaid.
Ryan’s proposal in his fiscal year 2013 budget blueprint: convert the federal portion of Medicaid (currently about $270 billion a year) into grants to each state, with payments indexed to the inflation rate and to the growth in state population.
Medicaid spending has been growing at a much faster rate than the inflation rate – from 2007 to 2010, Medicaid outlays grew at an annual average rate of nearly 7 percent, 5 percentage points faster than the inflation rate during that period.
Does anyone have the facts on the Romney-Ryan ticket's stance on Medicare straight? The Washington Post's Ezra Klein and the New York Times' David Leonhardt discuss.
So Ryan’s reform would mean a reduction in future federal Medicaid outlays. His budget blueprint, which the House voted to approve in March but which the Senate voted to reject in May, assumes $810 billion in reduced federal spending on Medicaid from 2013 to 2023 if his block grant ideas were approved.
In the House Budget Committee report accompanying his blueprint, Ryan said under his reform the states “would no longer be shackled by federally determined program requirements and enrollment criteria. Instead, each state would have the freedom and flexibility and to tailor a Medicaid Program that fit the needs of its unique population.”
Ryan head in the opposite direction from the Affordable Care Act, which imposes uniform national eligibility standards for Medicaid.
His proposal plan raises immediate questions:
- What would governors and state legislatures do if they had the freedom to spend the federal Medicaid money they now get?
- How much would states re-allocate away from some Medicaid recipients, for example single mothers with young children, and toward others, for example, elderly people in nursing homes?
- And despite Ryan’s reference to “each state’s unique population,” in most states aren’t the people who’ll rely on Medicaid the same types of people: the poor and the elderly and disabled who need long-term nursing care? So in the end how different would state-run plans really be from the current system?
According to the nonpartisan Congressional Budget Office (CBO), Ryan’s plan might allow states to “improve the efficiency” of Medicaid in delivering health care to low-income people.
Conservative policy experts point to a Florida Medicaid experiment begun under former Gov. Jeb Bush which uses managed care, financial incentives for healthy behavior, and other strategies to hold down costs. According to an analysis by the Heritage Foundation, a conservative think tank, the five-county pilot project has saved Florida up to $118 million annually.
“If Florida’s Reform Pilot experience were replicated nationwide, Medicaid patient satisfaction would soar, health outcomes would improve, and state Medicaid programs could save up to $28.6 billion annually,” the Heritage report said.
David Gregory breaks down the political week including the Romney campaign going on offense in the Medicare fight and the tone of the race.
Whether similar experiments would work in other states would need to be proven, but one thing is certain: converting Medicaid into a block grant system would push decision making and political bargaining to the state legislatures and governors, rather than having decisions fought it out in Congress and in the glare of national media publicity; it might be harder for advocates for the poor to fight battles state by state for higher Medicaid spending.
A study last year by John Holahan and others for the Kaiser Family Foundation found that block granting Medicaid would likely lead to states reducing eligibility or reducing benefits for those who were eligible. Hospitals would be forced to provide more charity care to the uninsured.
“To avoid enrollment cuts, states would be required to substantially increase their own Medicaid spending to make up for the loss in federal spending,” the report said.
In one scenario, “states would be relatively protective of the aged and disabled” and would cut Medicaid spending on those groups by less than they cut spending on low-income adults and children.
Taking an opposing view is Anthony Keck, director of Health and Human Services for South Carolina and a former adviser to Louisiana Gov. Bobby Jindal.
The current Medicaid design, he said, is awkward and inflexible. Medicaid has “become a patchwork of hundreds and thousands of specific waivers” from federal rules as states seek to tailor their Medicaid spending to their needs.
It's the topic Republican presidential candidate Mitt Romney wishes would go away – but it won't. On Thursday, Romney tried to keep the focus on Medicare, but questions about his taxes just kept coming. NBC's Ron Mott reports.
Keck said, “Every state is very different and even when you look within every state, every county and almost every zip code has very different health care problems. There are some counties that have lots of doctors, there are other counties that don’t have very many doctors. There are zip codes where the level of STD (sexually transmitted diseases) is five times the level of the zip code right next to it. So in order to focus on health, you’ve got be able to focus very specific strategies for very different realities and different populations.”
He said, “We know very well that there are extreme pockets of deprivation and poor health outcomes in the state. We know where they are. We can geo-code it perfectly. We want to go work where the problems are.” Instead the Affordable Care Act would require the state to pay for lower-middle income healthy people ith incomes up to about $32,000 for a family of four.
He added that in a block grant scenario there must be accountability for how the federal money is spent.
“If the feds are going to send down to us $4 billion a year in Medicaid money, they certainly deserve a return on that (investment) and they deserve to have a say in how it’s spent, but the sad truth is right now we don’t have any contract with the federal government that says, ‘for the money we are sending down, we want you (the state) to lower childhood obesity by 10 percent in the next five years’ ... There’s none of that, so the feds don’t know what they’re buying.”
He added that states such as South Carolina have told the federal government if it would give them more flexibility, then the states would negotiate with federal officials “goals for the programs that everybody can buy into” such as decreasing the incidence of diabetes. “We’ve never said, ‘just send us the money and let us do whatever the heck we want with it.’ We’ve said, ‘Send us the money and let us negotiate robust goals for actually improving health, and if we don’t meet those goals, then we would be open to building in financial penalties.’ ”
He added under current law Medicaid’s only goals are “cover as many people as possible and make sure nobody is stealing the money. That’s just not what this program should be about. It should be about health."
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The problem with letting states run their own Medicaid program, is that states are having a hard enough time making their budgets work without the added albatross Medicaid would become.
Then we are back with the states asking the government to intervene once they begin having problems. Not a good idea! We need another plan!
Mr. Keck, I beg to differ. Why shouldn't the program be about covering as many people as possible? Yes, it should be about health, but it should be about health FOR ALL CITIZENS.
Understandably, theft (or fraud) should be a concern, so I don't take issue with that.
State by State seems like a good idea. This allows the States to practice different formats that eventually would lead to a better functioning program.
In Federal hands is the government can borrow $5 trillion a year a year for Medicaid. That's what we all want isn't it? The government can borrow as much as possible to make sure Medicaid and Medicare stay afloat.
We already know this is disastrous based on Medicaid. A state like Arizona that declined to participate in Medicaid for many years finally decided to participate -- But then in 2011 froze new enrollments thus starting a new legal battle and the waste of money and time in the courts.
Team Romney's spokesperson Andrea Saul had it right when she said the couple in Indiana could have had preventative care if they lived in Massachusetts. Those who could move to states with good programs, would move. Talk about anarchy.
Conservatives are all about state's rights except when it doesn't serve their diabolical purposes like gay marriage. Also block funding or vouchers are really just another way to destroy trust fund programs and most voters are on to this.
alan_static -- Why is everything always black and white for rightwingers? No, we don't have to borrow. There are many solutions to consider, for example raising the cap on FICA withholding for Social Security up to $500,000 in income.
There is $700 billion of lost revenue in the Cayman Islands alone -- Think what that could pay for, a stimulus, extending Medicare another eight years, not cutting Medicaid, etc.
Rich 1%ers like Romney/Ryan want you to think YOU need to make more sacrifices so they won't have to pay taxes. Their plan is to lower the rate on capital gains, dividends etc. to .082%, and Ryan wants to lower the highest income rate down from 35% to 25%.
Join the majority of Americans and tell these plutocrats NO more "free stuff" for you!
All these hack "journalists" keep failing to mention that Ryan isn't on top of the ticket.
How about paying this much attention to Romney's plan? You know, the one bot Ryan and Romney said they are going to follow.
NBC stop trying to deflect. You suck at that too.
Now f'ing way...can ya'll just imagine what Jan Brewer would do with this money. She already raided 50 million our of the mortgage relief fund, and has created a slush fund of over 200 million dollars which she wont say whats its even for.
One of my co-workers volunteers at a retirement home, not a single person there will be voting for Romney she says...Seniors are scared to death of Romney / Ryan.
Aren't these the same ones who accused Obama of taking away the job hunt for welfare recipients when the administration wanted to give more power to the states in the matter? Hypocritical much? Why would it be ok to have the states handle Medicare but not welfare?
A libertarian would say if some gay people want to get married let them.
Also a libertarian would say government run health care is a game where the government takes $1 and provides $0.50 in services. Grandma may have been better off investing that money herself and buying her own hospital and emergency room visits.
To quote Paul Krugman: “The Romney and Ryan plans by design don’t force any austerity measures on the wealthy. The austerity is designed for everyone else.”
Romney has gone about the country talking about “free stuff.” You know what “free stuff” really is? It’s TARP to bail out Wall Street and the Banksters. It’s tax cuts for the rich, especially tax breaks on dividends, capital gains (carried interest), and estate taxes – Breaks that only apply to the very rich. Romney is on video promoting “free federal money” in tax credits for businesses.
It’s the great big share of the budget given to the Military Industrial Complex. The defense budget, which includes subsidies to Europe and military bases in Japan, as well as thermo nuclear weapons no longer needed as defense against a Soviet attack. The largest growing public sector is Homeland Security. What a mushrooming monstrosity this has become.
You know what’s NOT “free stuff?” Trust fund entitlement programs that YOU pay into like Social Security and Medicare, or even unemployment insurance that your employer (and you in lower wages) pay premiums for. And what do Teapublicans like Paul Ryan and Romney want to do? Despite the IOU, they want YOU to make the sacrifice and accept cuts to those programs. And not to pay down the deficits, but so the rich can get more tax breaks!
They want YOU to pay for unnecessary wars Bush/Cheney did not pay for, and deregulation of Wall Street that depleted your home equity and 401ks, and possibly loss of your job and the wages and benefits along with that job. If you had to file bankruptcy because you lost health care coverage -- too bad. So the Republicans mismanaged the economy, and for a decade job creation has barely kept pace with population growth, and wages have been stagnant for even longer. It is YOU, the middle class and working poor who are called upon to pay for the mess, and to provide more “free stuff” to the rich.
Social Security and Medicare are the only things Wall Street, the Banksters, and Big Business don’t control--yet. Fight for these programs, for your parents, for yourself, and for your children, because these programs are all you have left.
Obama/Biden – 2012!
Krugman watches too much Jim Cramer
Also, why would it be ok to have the states handle health care insurance but not tort reform?
Yes, the hypocricy is stunning.
Since when does centralized control on a national level make sense? Just what has our national government done lately that has been so spectacular? The only thing that they ever did that was cost efficient was the Post Office and that's now in the dumper. National control of Social Security is a corruption infested nightmare--no real oversight--Doctors charge for whatever they need to pay for their kids college and new Mercedes--and patients never see the bills. No accountability--just charges, charges, charges.
Bigger doesn't mean better. Who better to judge the needs of the state than the state government itself--Oh, we can't trust them to "do the right thing?" What kind of logic is that? The folks in Washington aren't a different "breed" of folks--just more ambitious than the local folks. Is there any evidence that Federal Law Makers are more intelligent? Are they more ethical? Are they less concerned about single moms and kids? What a bunch of crap! Local control usually means more accountability, efficiency, and better targeted care. The fewer people involved in processing the paperwork--the lower the overhead. It's a no brainer!
I like the idea of states handling their own medical spending, so long as that money can't be diverted to anything else. The more managers (read federal govt) that are involved in something, the more wasteful it becomes and the fewer people it helps.
Krugman is a socialist.
Romney and Ryan seem determined to try to steal our money. Republicans are trying to find a way to keep our money and get rid of us!
Republicans will say ANYTHING, OTHER THAN ok, we know you paid into this all your working life, how about we give you all your money back with interest at the legal rate.
No, Republicans are trying to find a way to keep every penny of our hard earned dollars, and they seem to be promising those who haven't paid any money into Medicare or Social Security will be the ones to benefit from OUR money, and make the decisions about OUR money.
That's just like saying, hey folks, we've got a trillion dollars over here that belong to those guys on the other side of that wall over there. Anybody say we keep this trillion dollars and run, or should we give them their money, and then all the Republicans scream, Run! (and they take off running with our money)!
I wouldn't trust these guys for even one minute!!!
Obama/Biden 2012
TO: elliot-3020456 who wrote:
Elliott, the "Plan" that Ryan & Romney and all of the Republicans in the Congress signed onto IS THE RYAN PLAN!
Do you get it now? Romney adopted The Ryan Plan as his own plan just like all the other Republican Politicians did, and just like ALL of the Republicans signed on with Grover Nordquist to never raise taxes on the rich. (Of course, it's ok to raise taxes on everybody else, but NOT the rich.)
Darn Republicans can't remember anything worth a darn!!!
Obama/Biden 2012
Once again the devil would be in the details. The country is polarized so what are we going to see, low medicaid rates with republicans in office and higher rates when democrats are in office?
TO: Eric-913730 who wrote:
Eric, you got that backwards.
(Scheesh!)
Obama/Biden 2012
Some things like civil rights have to be enforced at the federal level, otherwise we would still have slavery. Another benefit of federalism is standardization, for example education. Gawd, look at Texas and Louisiana.
But let's take this argument from a rightwing point of view. Look at what a mess gun laws are when you want to pack heat and cross state lines, or making English the national language.
Face it, conservatives only like state's rights when they need it as an excuse to pursue some diabolical agenda of theirs. Definitely NO more federal funds without strict strings attached to prevent governors stealing from the constituents to balance their budgets. The GOP/TP will throw the American people under the bus to get reelected every time.
I am more concerned about "Forced Ultrasound Ryan's" War Against Women than his War Against Medicaid and Medicare.
I hope that women know that Ryan believes in the criminalization of ALL women who use birth control or receive in vitro.
All the other problems we are facing can be worked on, but ANY woman who votes for Romney/Ryan is a traitor to ALL women in this country and around the world. We are not going back!
Obama/Biden 2012
The states ARE the best means to administer these programs. If one goes bankrupt, then all don't. As Pointed out, each state has different needs, different cost factors. Even within states there can be huge differences.
Study the auto and home insurance industries. Their rates are set by the county because that is the only efficient way to manage the risks and apply the appropriate premiums to fund the costs incurred.
The Biggest failure of central planning was the USSR.
Alaska Girl
No, not to all the women in the world, only to the 20% - 35% of women who think like you.
Never stop asking
Novel idea, declare that someone is declaring war, when they have not.
I think taking $30 billion from the ACA womens' birth control program is more offensive than taking the remaining $10 Billion to pay for the discount on Student loans that the democrats didn't fund in the first place. Besides, what was done by the Democrats was promise such funds to women, then take them away hoping they wouldn't notice the thuggery to temporarily fund a "new" version of the medicare bridge program. Then, how long until they take the better part of the $30 billion to fund something else to buy another groups votes.
Oh, I forgot, the funds were cut by those rascal republicans. Give me break!
Oh no...no way!!! Would anyone seriously hand healthcare money to Southern governors and legislatures and tell them to use it for healthcare? What a disaster waiting to happen! I live in AL, and if anyone thinks the Republicans in charge here would let the folks who need these services get a penny they are naive or nuts. They would find some way to divert it (oh yes they would even if it were illegal) or call it something else, keep those who need it the most from getting it, or refuse it and let the sick people just go die.
Seriously, what are they thinking? No way. We are screwed enough already here, thanks anyway. Wealthy people and big business owners will get a break no matter what the poor people have to give up, but would anyone with a grain of common sense give those people more control to take more away from people who need it? Scary thought...sigh.
Notice the 700 billions that will be save from 2013 - 2023. This same 700 billions in saving will be fund to the tax cut for the rich from 2013 - 2023 just like in Ryan's plan.
Mr. Ryan, don't fix it if it isn't broken.
And if people like you broke it, let others that are more reasonable, knowledgeable and more competent take care of it.
This is why Paul "Kill Medicare" Ryan is a G-- D--- Monster.
Tennessee has reportedly told Obama that they will do whatever they please with ANY block grant from Social Security, Medicare, Disability and Medicaid. There was one Block Grant I think it was an education Grant that the Republican't-Corporate Teabagger Legislature of Tennessee used to repair the Governors Mansion then the rest of the Education Grant went to the slush fund because Tennessee said it could do what it pleased with the money.
its very hard for me to understand why so many would vote for Tax Cheats like Monster Paul Ryan and Corporate Raider Willard Romney. If Corporate Raider and Tax Cheat Willard Romney and Tax Cheat Monster Paul Ryan win, God help us all!!!
And thats my opinion.
"Ryan plan sparks debate"
Did anyone see this coming?
There are many problems with the notion of state run Medicaid... let's just start with Kansas... or California... or Mississippi... or New York... the four ends of the spectrum that illustrate the need for the moderation that the federal government provides.
But extremes aside, the states have no safety net capability. When they are out of money, they are out of money. They're having enough trouble matching funds today, imagine if it were totally under their control.
All the states negotiating independently with drug companies and providers over rates is a loser and does nothing but add costs.
It would be a mess.
American Girl:
Just like SS, the money you have "paid into this" is not and never was yours. SCOTUS has on numerous occasions ruled that it's a tax, just like any other and goes into the general fund. Why don't you ask the Feds to give you back with interest all the income taxes you have ever paid (assuming you DID pay). All your statements about Stealing OUR money sound real good, but then there's those pesky facts.
All the Democrats including Obozo LOVED Ryan's ideas before he became the Vice Presidential nominee.....now he's the Anti-Christ....
LOL talk about a flip flop.
Obama's already started his 500+ billion dollar Medicaid cuts. Instead of writing an article about what's already happened, MSNBC decides to post an article debating something that is still an idea, not what's actually going on already.
Wait till these specialty doctors start getting paid 1/2 of what they make now under Obamacare. Think they're going to hang around? Nope. Obamacare will be the end of quality heathcare that we get now.
This article is so misleading. States already run their Medicaid program. The Medicaid program varies greatly from State to State. Eligibility rules vary from one state to another, although there are guidelines that govern local options. While federal regulations require all states to cover certain groups and limit the additional groups that states may cover, each state can elect to include other groups falling somewhere between the federal floor and ceiling. As a result of these differences among states, the same person may be eligible in one state but ineligible in another.
So, really nothing much will change other than how the State's receive their funding.
Did you miss the headline? The subject is MEDICAID!!! You pay into MEDICARE. Two totally different programs. At least know the difference befor you comment.
Rradiko
The unfunded liabilites of Social Security, Medicare, and medicaid is $44 Trillion. Any funded liabilites are Treasury bills and assurances of he good faith and credit of the US Government (no long in Triple A status).
When did the federal government pay anything to it's lenders anything other than interest on it's debt or replace a payment with another I.O.U.?
Even in 1999 and 2000 when the Federal On-budget portion showed black in of $1.9 Billion (1999) and $86 Billion (2000), according to the US Treasury Department, it had to borrow a minimum ot $16 Billion that has never been paid back to keep the Federal government running.
And Illinois is doing such a great job of controlling Medicaid under the current system. Illinois is currently behind on $8 billion to healthcare providers it owes them. For years they have increased coverage in order to pull more federal funds. Now Illinois politicians they are finally beginning to realize that it can't continue.
If federal funds were block grants, they would have been forced to live within their means.
Kill Medicare Ryan is the gateway drug to killing Medicaid, too.
What a novel idea, give each state the opportunity to tailor medicaid so it actually addresses their needs instead of forcing them to waste money on things that don'twork. Kinda like buying a shoe that actually fits them! Only defenders of Joe Biden could complain about a concept like that because It would be even easier for him to stick his foot in his mouth!
So, doesn't anyone ever wonder WHY we send so much money to the Federal government to just have them send it back to us?
Medicaid, grants, subsidies, loans and other vehicles go from the States to the Federal government and then back to the State. Wouldn't our money be better managed at the State level than having it percolate through the layers of bureaucracy and then trickle back down to us?
Wouldn't it be easier to deal with fiscal problems at the local level than worrying how poorly or well the Federal government manages its revenues? The original intent of the Constitution was to limit its power to those mandated in Article 1, Section 8 and everything else go to the States. Looking at the dysfunction of our Federal government would preclude one to prefer our money stay in the State coffers.
As the article states, lobbyists can much easier influence Congress at the Federal level than at each individual State. We all know how much the lobbyists hurt our economy, why make it that much easier for them. The old saying of, "All politics is local" should be embraced and expanded to "Everything fiscal is local".
LMarcT
Where do you think all that "safety net" money comes from.
They're having trouble matching funds because we send our Federal income tax money to Washington and then they decide who, what and where the money goes. If the money stayed in the State we wouldn't have to worry about "matching" anything.
Isn't it easier to deal with your money at a State and local level than trying to rip it out of the hands of the Feds who just manipulate it for votes?
TruePatriot-445959 thank goodness there are educated people like you...
There are so many reasons why this should not even be on the table.
For one like you mentioned Az does not participate in Medicare, instead its AHCCS. Which they, by the direction of Jane Brewer have allowed transplant patient to die and be removed from the list of donor receipt. The state keeps taking the money to go somewhere else...to pay for other programs on their agenda. When we passed the edcuation law two years ago , not a day later they said sorry the funds are going to have to be spend on past debt not even related to education...so the kids got left out and all the voters got dupped.
How will the CMS be able to enforce rules if the states take over...how will this effect the ICD-10 coding implementation on Oct 1, 2013. Wouldnt it take millions to put the proper administration and computer technology to complete the medicaid billing and coding and collections? This would bankrupt and already fragile systems and should never be considered. This would just make fraud and abuse even worse.
American Socialist you nailed it on your above post, thank you for watching out for us.
the one good thing about this debate, its revealing certain senators....
and i really like to know what some people are experiencing in their states...
Im an AZ person....and ya'll know about Jane Brewer, she was a hopeful, but what she did to the transplant list and what she let happen to the education fund is what I want you all to remember about her.....
Tell me about your guy/gal...dem or rep...I want to know what you have to say...tell me
I don't know where you live, but in NJ, auto/home insurance rates are approved by the state, not by the county (luckily, given the politics of my county). But, in reality, insurance rates are controlled by the states because it give them more political power, not because it is more efficient. We'd all be better off with less regulation at the state level. There's too much expensive replication.
no because how would we be the United States if we all lived in our own little world aka your states...
I am scared that America would fall apart if we did this...its a long shot but I find it comforting that my state is equal to yours....but what would happen if AZ was left to fight the border by its-self? What would happen to CO, NM, CA soon after? Its just a scary thought.
Would your state close its borders if you provided better healthcare than the state next to yours? don't you find that scary? its a way to divide us, and frankly I like knowing we are all in this together...i don't want you to be against me, and that what I think would happen.
I don't want Ohio taking over this program. They were not very responsible when they received money from the tobacco lawsuits many years ago. The money was supposed to go to prevent smoking. Some money did go into that program, but then they took it and put it in the general fund for other uses. They promised that would replace a major bridge in Cleveland and then when the work was started they said, they only had enough money for half of it. The rest of the money to finish it won't be available for years. They claim to have a large surplus, yet they won't use it for anything. I am afraid that they will take this money and put it into something else. They seem to change the laws to fit their republican agendas and not the needs of the people. No thank you.
To Mr. Ryan and the Republican Party letting the States run the Medicade Plan makes total sense.
If the States ran Medicade then Florida, Ohio, Arizona, Texas, and Louisiana could then provide very little care to the Medicade population. I guess you noticed that all the referenced States have Republican Governors.
What a disaster that would be with All States having different rules and rates for Medicade patients.
It could create a new company dedicated to helping Nursing Home Patients SHOP for a good state to spend the rest of their life.
Every thing these two clowns propose seems to be a new act.
Sure and then like Gov. George Wallace in the 60's you'll have governors handing out bus tickets to those they don't want in their state, inflicting them on other states. IDIOT! The current Republican Party is UnAmerican. In fact they are Anti-American, owing their loyalties to their own greed and the Banks and Multi-National Corporations that fill their pockets. Let people like Romney live in Grand Cayman where they keep their blood money attained by destroying the American worker. Can't believe that rather than show his tax return Romney would state that he "never paid less than 13% tax on his income." I made 50K last year, didn't cause Americans to lose their jobs or home, and I paid 28%. More than double what he claims. And he still won't show his returns to back up even this rediculous claim. SHOW US THE RETURNS!
P.S. I will not hire any Republican to work for me. I consider them too stupid and disloyal.
We've already experienced the dismal care and value from private insurers gouging individuals and determining coverage while also gouging the government. With no federal patient advocate you can kiss you and your money good bye.
Ed. So much for the Tolerant Left.
Are you really arguing that having a Medicaid administration in each of 50 separate states is more efficient than having one at the federal level?
Can you add?
No, folks - this is just one more example of the Republican strategy of "divide and conquer".
Remember when they wanted welfare divided into limited-term cash payments, work supports and childcare subsidies?
Where are those work supports and childcare subsidies today? Take it apart and shoot it one piece at a time. I guarantee you there's a plan somewhere in Grover Norquist's office that lays it all out.
The main reason to manage Medicaid and welfare programs at the Federal level is to ensure continuity of care. If we were to allow each State to run their own programs and set their own rules, I am quite certain that one State would be the worst State, and that is what central Federal management avoids. We do not want to let States compete to see which one can do the poorest job, and this principle applies to a host of other Federal programs too. Would any of you want to see which State was the worst at building bridges or the worst at airport security?
I just cringe whenever I hear some libertarian Constitutionalist like Jim Spence arguing that America should go back to the days before a strong central government ensured the continuity that we all enjoy today. Those same libertarians oppose the income tax (enacted in 1916) as well as oppose the Fed (enacted in 1913) and historically oppose any and all social spending or discrimination mitigation too.
Basically many libertarians want to enjoy an America where they have absolutely no responsibility for anything or anyone but themselves, and many lack the kind of empathy and compassion for their fellow man that has made America a great country over many years. How many of you want to gut almost all of our social and economic progress since before the US Civil War and start over from there, allowing the locals the freedom to discriminate, conduct slavery as they see fit, gut social programs as they see fit, etc, etc...??? That is the kind of freedom that many libertarians want, a future with absolutely no central control other than for the common defense.
Paul Ryan's plan might be good in some more-liberal States where social spending is driven by empathy and compassion for the plight of our fellow men, but it would be a very bad policy for the less-fortunate residents of the more-conservative States, who might have to move out-of-State in order to get social services, or avoid getting discriminated against, and that is an outcome that we Democrats don't want in America, obviously.
And isn't that just what it is all about? It is much easier to steal at the local level. It is easier to steer funds to your crony capitalists and buy influence.
Everything Republicans tout comes back to one thing: steering government money to supporters for the next election and personal gain.
The health care debate brings up a big example of this:
Medicare Advantage was started by George W. Bush with the idea that competition among the private insurers would reduce costs. But the plans have actually cost more than traditional Medicare. Government subsidies for administering these plans fill the pockets of private health insurers.
In 2008, a newly Democratic Congress tried to scale back these subsidies to Medicare Advantage providers as a cost-cutting measure. Intense lobbying by the medical providers led Bush to veto it.
A lot of that $716B that Obama implemented as cost-savings (not cuts, damnit, they are reductions in current costs) in the ACA come from scaling back those subsidies to Medicare Advantage providers. Who lobbied the hardest against the ACA? Who leads the pack in donations to Republican candidates that promise to end Obamacare? Those same providers of Medicare Advantage plans that enjoy government subsidies and cost our country more than traditional Medicare.
It is time to end Republican vote-selling and influence-peddling!
Laker Steve, oh yeah, and just were do you think those specialist are going to go there Stevie boy? China?
OMG Spellchecker.......you don't mean that they will have to talk about real issues like the economy, jobs, entitelments. I was all set to listen to the current administration talk about everything but the issues. I guess that is changed now..........About damn time.
* Mitt Romney Get's the Garage Elevator ~ Our Seniors and Disabled "Get the Shaft!" *
Grandma Can't Get her New 'Wheelchair Upgrade' but Mitt Gets a kick a*s Multi-Level Garage Installed? The Choice for 2012 Election: Obama Cares vs. Romney "Who-Cares, Really?"
Mitt Romney's newly nominated 'step-and-fetch' sidekick Rep. Paul Ryan evidently solely passed a grand total of TWO bills into law during more than a DECADE of 'slash-and-burn 'service' to his beleaguered state-employees as well as his elderly, poor and disabled Iowa constituents.
Rep. Paul Ryan 'passing' TWO bills into law - in more than a DECADE! (10 yrs? - Wow!)
And now the new vice presidential nominee wants just "FOUR MORE YEARS" to endeavor in his latest effort thus far (just like the his state employee benefits back in Iowa) in their campaign: "Rom on Rye with no more meat and cheese; but plenty of mustard" GOP Nominees Health Care Platform evidently stands for: 'Razing' and Ruination of Senior, Disabled Care and Choices for Caucasian Black and Latino Female Reproductive Rights'
Ryan only passed a grand total of two bills into law in more than a decade. Thus far the "Rom and Rye GOP Nominees Health Care Platform" evidently stands for: Raze and Ruination of Senior, Disabled Care and Choice for Female Reproductive Rights. Nothing would please these two more than the prompt-as-possible demonization and de-evolution of Planned into "Unplanned" Parenthood.
The Mitt and Paul philosophy with regards to senior, disabled, women's health care access: "If You Tear it Down - Instead of Building and/or Rebuilding it - They Will No Longer Come" Rep. Paul Ryan's more recent declaration: "Our rights come from nature and from God, not the buttinski government."
Anyone having lived through the 60's era the above line remembers statements such as that one bring readily churned out by the Klan (and others) in the name and under the blatantly false guise of 'God and Country - Not the government' granting people their civil rights as well.
But this ticket's principal undoing will be the fact that they both freely admit that their primary goal will be promoting that 'times are tough so give all the breaks to (and for) the rich folks' as well as simultaneously turning Medi-Care into 'Medi- Who-Cares'
* Why the Medicare health care coverage cuts now? When they are needed most? *
Solely so Mitt and his fellow cronies and backers continue declaring a maybe 14% or even less on their yearly tax 'burden' on their returns? As a result, the country's grannies and grandpas and disabled people on Medicare get their health care cut and/or either cannot see their doctor anymore because they cannot pay the enormous increases anymore? And who's next to demonized? Perhaps VA compensable service- connected conditions as well as those veterans needing home care and inpatient hospitalizations. Will Romney/Ryan eventually demonize these guys and gals as well down the road?
Mitt and his 'Koch Bros Wannabees" get to keep 86% of their enormous 'Individual Wealth Asset Hogs of the Venture Capitalists' company 'backers' who were the people who originally got us all into this mess in the first place needing 'bail-outs' while the nations' grannies and grandpas on Medicare (who had absolutely nothing at all to do with their mismanagements) - they are the ones who get the CUTS! And for god's sake: They are the ones who get their health care slashed and cannot pay the enormous increases anymore?
There's one thing even more atrociously despicable than elected pols who knowingly, deliberately and unendingly demonize the poverty stricken, elderly/disabled and disseminate demoralizing mistruths and that is: One that does so solely at the behest as well as in the best interests of their Koch and Co. backers; in order to continue increasing the nominee's campaign's (unquestionably nearly bottomless) campaign war chests.
Tough to stand by and remain silent when you're listening to this pampered and pompous pretty-boy prattle on and (during these 'no-questions-please' campaign stops) whose idea of a "Return to American Values" is making the wealthy wealthier and simultaneously dismantling Medicare; literally 'crippling' out seniors ability to maintain their vital health care coverage with security and level of dignity.
What's at Stake?
* Health Care for ALL vs. Health Coverage to 'Forever Forestalled' *
Do we really want to choose the GOP who continue to demonize our senior's Medicare lifelines and demoralizes it's worthy beneficiaries - those who worked an entire lifetime in order to be eligible for it - recipients who are usually decent, independent; mostly humble folks who are currently living on a meager and fixed income, who simply need a little or a even bit more aid when grandpa or granny's 'Misery' is acting up?
To top it all off; replacing 'ensured' insurance with "Scratch Ticket Vouchers" which take away our seniors and disabled people's vital (can't-live-without) health care coverage while consequently forcing grandma and grandpa in a homeless shelter because they and their grown children are unable to afford subsequent higher deductibles and new co-payments - sacrificial vivisection of seniors former assured Medicare coverage.
In addition t that potential dilemma; who exactly do you think is going to be forced to lend a hand and consequently foot the bills for the future whopping out-of-pocket expenses senior and disabled ever-increasing medical bills - their families, that's who! And when their savings runs out; do we stand by silently and go back to the days of the aged being forced to stock up on cat food cans or being compelled to live in homeless shelters when they can no longer afford their homes or stay with their children any longer.
For example: Having to suddenly foot-the-entire-bill for much higher deductibles as well as for the extra costs and higher copayments for their prescriptions; which will likely result in non-use of essential meds and medical services for these seniors and disabled peoples care: Will their children and/or their other already-struggling families be forced to pay the difference?
And who's next to having their coverage on the Chopping Block? Our war weary US service veterans, perhaps?
These guys also want to "End Food Stamps as We Need it" for the folks who are either senior, disabled and/or those who's unemployment eligibility has dried up. And who's next to demonized? What about VA compensable service-connected conditions. Will Romney and Ryan eventually also demonize and then chuck these guys and gals under the bus too? Maybe in addition to the multi-level Garage Elevator Mitt might need a three story Gazebo in the backyard, perhaps?
First 'welfare-queens' were to blame - and now the Seniors and Disabled are our latest 'lot in life' and then down the road: Perhaps they will get sick of illusionary claims of VA benefits' hogging squanderers w/service-connected conditions as well as those veterans needing out-patient in-home care as well as prolonged inpatient hospitalizations?
Re: Voter ID and the Pols
Regarding citizens' new voting-related requirements like I stated earlier, is the 'sticking point' - I totally agree with the politicians' favoring this and their premise: that it is a fact that many, many poor, minority and senior citizens do not have; and therefore cannot produce even a basic photo ID.
Additionally, I entirely agree that these Voter ID Laws are being enacted by those who have absolutely no concern whatsoever as to why the people have no ID at all, and that they are being entirely disingenuous, regarding the 'proven to be fantasy' claims of even the remote possibility these laughable proclamations regarding any rampant 'multiple voter' fraud.
Nobody is currently disputing that they NEED and ID for a more convenient life in our modern society. These affected people are nearly all; likely not showing their ID because they most often do not HAVE one available - not because of 'the refusal to offer' one - as is now being 'required' in more and more places by pols who do not care about those constituents - for the SOLE reason that they are (likely) not going to vote for them - because they may favor another political party.
Rest assured: if these affected citizens were potential voters who were most likely to be 'right-leaning' voters, the GOP Republican officials would be sending interns as volunteers in stretch-limo busses to their homes and offering to assist in pulling the voting levers for them. (lol)
Romney and the GOP (That reads: Greedy Oppressive Party) cronies that fill his campaign chest; get to keep the whopping 86% of their enormous INDIVIDUAL wealth... Individual wealth that gets THIS single, individual American (with a multilevel garage and limo drivers) vs. helping out seniors, Disabled and US veteran men and women who were harmed while serving our country. YOU CHOOSE!
Which is the better investment in America's FUTURE?
You Decide ~The Clear Choice in the 2012:
"Charitable Benevolence for the Suffering and Disabled vs. Continued Tax Cuts!"
Yeah it's the government keeping grandma alive? If she dies then the government is responsible? When did this logic take over?
I call this sound like a threat to me to extort even more taxes. If grandma hadn't paid so many taxes during her life maybe she could afford her own health care.
Boss Hogg 2012
That is one long comment by the way, you should work for NBC.
From the Center on Budget and Policy Priorities:
'Nuff said.
He can't really work for them. He is just spewing information that he read or heard somewhere else. When are those living on the extreme left or extreme right going to start thinking on their own instead of just believing everything that they hear from the media on both sides. Why not put some actual thought into things. I have to agree with Alan on this one...Before everyone decided the government should give them everything, families took care of the elderly. Now, everyone expects the government to do it. I have no problem with the government helping out, but I'm tired of how inefficient they are at helping. Some states actually manage their budgets instead of increasing taxes to pay for the bloat.
True: The extreme Ryan budget also does not balance until 2040 either.
That is not a typo:
2040.
I'm all for new ideas, and trying new things, but when the savings go to huge tax cuts for the wealthy I'm not about that.
TO: babina who wrote:
I heard on the news, and Paul Ryan admitted, he really doesn't know "when" it would balance, and to me that sounds a whole lot like, he doesn't know IF it would balance either, especially when you take into consideration any number of intervening factors.
Republicans - full of poop.
Obama/Biden 2012
My mouth fell open when I heard him say that he really didn't know when it would balance! I mean, this is supposed to be the "numbers" man. He has had alot of time to figure this stuff out. There was an economist on t.v. the other night who said to not even bother looking for numbers to match up because you won't find them. This is who the Republicans want running this country? Didn't we suffer enough under Bush? Please.
Obama/Biden 2012
Marty - True years gone by families did take of the elderly as my mother took care of her parents
However - unless your son or daughter was a doctor, nutritionist, pharmacist, or any other health provider - your reasoning is terribly flawed and ridiculous
Senior citizens need more than housing They need prescriptions, which can be costly Sometimes eye surgery for glaucoma - hip replacements - maybe bypass heart surgery - diabetic counseling and medicine and a myriad of other health aids
So tell me my friend how can your children provide for all these necessities - when they can hardly provide for their own children
Your living in a dream world - most of those people you speak of that their children took care of died much too early because of lack of professional care
Yes, and in years gone by, the life expectancy was much, much shorter. In 1965, a white male could expect to live to about 68; now it's 75. There are more parents still living for people to take care of than there used to be.The average medical cost for a person's last year of life is $50,000. And that is just that last year, and that is just one parent.
How many middle class families could afford this expense? This is why Medicare was put into effect in the first place, so families wouldn't be bankrupted by caring for their elderly family members.
http://www.ssab.gov/documents/TheUnsustainableCostofHealthCare_graphics.pdf page 5
True Patriot
Isn't it amazing how many liberal hack think tanks there are that pretend to be neutral?
I think I am starting to understand where Ryan has gotten his inspiration on top down economics from...........He is a devout Roman Catholic........OK, religion might not matter in politics but in his philosophy just remember the structure of the Catholic church and how the Pope, Cardinals and Bishops live off the "donations" of the masses.............compare the lifestyles of the "faithful, devout" Catholics vs. their plutocrat elites.........similar to the 1%ers you think???? So Mr. Ryan, you seem to want the same structure for the US that has served your church so well?
computable: don't see a word about what lanny davis or erskin bowles said about the ryan budget or medicare plan. Remember bowles. obama's hand picked man on the Bowles-simpson committee. Yeah, forgot about that one HUMM. ya lamebrain lib. Well, here is what bowles said. "never met a man as smart as ryan. very intelligent. I thought that I was good with numbers, He can run circles around me." Davis. ryan's budget and medicare plan makes more sense than president' obams's. it will work." guess obama and the left wing main stream press didn't want ya to hear or read.
Obama knows he is done. Asked Hilary to run for Vp on wed. declined. HA-ha. she knows if she wants to run for president in 16 she has to stay away from obama. Smart lady. what other frick that obama as frack going to pick to get rid of biden. That will be a hoot.
Well, for once a politician is finally telling you the truth. No one can predict when a budget is going to balance based on the current economic position of the country. If we get worse, far less revenue comes into the treasury, thus taking longer for the budget to balance. If we get major economic growth as we did in the 90's during the dot.com and revenue increases dramatically into the treasury then the budget get balanced sooner. Its simple economics...to bad most people cannot comprehend that.
This is the first step in privatization of medicaid. Once the states have control of it and start spending the money on other local issues the states will then realize they can't afford it.
Medicaid will be sold to the highest bidder for over priced generalized healthcare. Big Pharma will bankroll the changeover, the care will go down the costs will be pocketed by corporations.
Just like prison privatization. Human pig pens while the political cronies rake in millions (at each state ). Just another way to extract huge sums of money from the tax base and re-direct it to a privileged, connected few.
GCooper - What has been lost in this debate is that the Administration Cost of administering Medicare is 3% Yessir boys and girls 3%
Insurance Companies - administration costs are upward to 40% - and under ACA it is capped at 20%
And under Romney/Ryan could probably exceed that 40% and who do you think bears the cost?
The federal government is the best place for all the benefit plans to stay. We can't trust that people are going to do anything responsible and just any more. There was a time when people did try to do what was right. Now with the GOP extremist greed upon corruption there is no way to trust. It has to be verify, verify and more verifying.
Barbara
A whopping large part of the Medicare administration is outsourced and not included in the 3% number.
This according to Forbes Magazine, Heritage.org, and this other article, all three agree that medicare costs more to administer than the private providers.
http://www.medibid.com/blog/2011/05/medicare-vs-private-admin-costs-facts-stand/
http://www.forbes.com/sites/aroy/2011/06/30/the-myth-of-medicares-low-administrative-costs/
Oh, DB, Heritage? You know, you say so much but it is so slanted it loses credibility. And then you criticize think tanks? Lol.
So DB Akron What you do not address is the cost of Insurance Companies do you dispute the cost of 40+% costs
What you don't address is that the ACA - cuts insurance's overhead to 20%
So give the whole picture - not just the Heritage Foundation where all unemployed Republican failures go to get there money to survive
Like John Bolton's daughter who wrote two papers and got $70,000 toward her college degree
And Liz Cheney - leaching money off of them
Not really a credible source - would you think?
Nice try!
Barbara
A cut from 79% to 80% is not significant. There were only a handful of companies ever to reach a 40% overhead. BTW - these weren't the big profitable ones, they were the little ones. Big ones get to spread the costs of actuaries, and fraud enforcement over a much greater pool.
These smaller companies have been swallowed by bigger ones before they were totally bankrupt.
Last I looked the Federal Government is far less trustworthy than anyone else.
There is not enough space on this board, let alone on the Internet to list all the waste our Fed Gov't has done with our money. What we know is that it is the WORST place to trust our tax dollars will be used wisely.
Vicki
That is just a bunch of Liberal BS. The GOP is out to hurt the little people, but the little people can't do what is right so the government has to do it!!! The next liberal that states that the Republicans are trying to take their rights away I will rub this in their faces. Thanks Vicki for helping elect Romney.
BTW Barbara
That actual administrative costs by the ACA are held to 15%. The 80% of premiums must be paid for care leaves only 5% for the insurance company to set back against the liabilities they have contracted to pay for. A good business plan would put back between 7 & 10%. 5% is a prescription for failure.
This would destroy the Democrat Party controlled states. Of course, they are already bankrupt. California and Illinois (Obama is the top pol in Illinois) are in a financial crisis. Corruption and incompetence has festered over the last 50 years. The people in these states may have to stage a revolt to throw Democrats out.
ALL states and municipalities have struggled financially thanks to failed supply-side superstitions that Paul Ryan is all about. Where were you in 2008? The economy was nearly tanked by Wall Street Gone Wild, people lost their jobsand their homes and states lost all the revenue from income tax and property taxes.
Puleeze, don't conservatives have any sense of history, even just the last decade? Your beloved Teapublican Party has blocked all efforts for recovery, and your plutocrat candidates Romney/Ryan want to go back to doing the same idiotic crap that got us into this mess -- All so they won't have to pay taxes.
The real story is Red States have been the welfare states that have paid less to the Federal treasury than they receive. If the South had seceded, it would be a third world country now getting foreign aid. In one of my posts above, I use Arizona as an example of why people would move from states like that to Massachusetts or Vermont the first chance they could get.
Spare us the ignorance, and please educate yourself if you plan to vote.
TO: Jamie Alvarez who wrote:
Republicans are the ones who, throughout history, have spent money they don't have, and have never paid any of the debts they created, and that is the true definition of "bankrupt"!
For example, Republicans voted in favor of "No Child Left Behind" but never funded it, Republicans started 2 wars and never paid for either. THAT is spending without having the money to back it up!
Democrats, on the other hand, have always been able to answer the question: Where you gonna get the money, AND Democrats have been the only ones to balance the budget, AND Democrats run surpluses NOT deficits.
Republican voters have been listening to politicians too much, and not spending enough time thinking for themselves!
Obama/Biden 2012
The Democrat controlled states??? You mean the states that contain about 80%....................YES, 80% of our population. The MAJOR CITIES.
Are some of you people corporations????
That's cute Jaime; you think corruption and incompetence are unique to democrats.
Go take a look at some of the "red" states and then get back to us.
Mr. Alvarez you do know who (and his actions) pretty much bankrupt California don't you? That would be Ronald Reagen. He and his policies made years ago has strapped this state with debt and no ability to do anything about it, unless the state does something extraordinary (like a totally legal pot law) to get out of this black hole.
I get really tired of Reagan hailed as some hero. I remember in my town (in a very red state) when Reagan was in office unemployment here was 20% or more and there were lines around the employment building where people were desperate to find something to do. And that was back when Republican didn't mean extreme right. It is still Republican in this state and the amount of poverty is appalling, the lack of health care for many is appalling, and the perks big business and wealthy people get are just as appalling. Yeah, cut funding to services people really need, but make sure your rich buddies have all the tax breaks they need. It's disgusting.
Actually Angelo and Mr Alvarez, the person most responsible for California's financial issues is a Right Wing Nut Job from Orange County named Howard Jarvis, who got Proposition 13 on the ballot, and with the help of his RWNJ friends, convinced the average voter that taxes were a bad thing... and thus it capped how much California could take in, while exenses continue to increase.
We here in Washington have the same thing... Timmy Eyeman. (Fortunately for Washington most of Timmy's initiatives have been found unconstitutional)
But as Angelo pointed out, its generally the conservative Republicans that cause the financial issues our local and national governments face.
Illinois is bankrupt. Because the idiots here keep voting in corrupt morons like Blagojevich. And look at Jesse Jackson Jr....another corrupt moron who's done nothing since he was elected except leech public funds to support his Bigot dad.
California is bankrupt because of all the illegals leeching free services the stupid Demwits keep giving them. My sister-in-law lives there, is ILLEGAL, and just received last week a FREE $15,000 eye operation, courtesy of the the state of California Public Health System.
Now Obozo gives amnesty to millions more illegals? Yep, that's sure going to help the states' budgets and the national unemployment rate! Like everyone has been saying.....right after Obozo took office unemployment skyrocketed to 15% and hasn't dropped one iota since he's been in office.
Watch & see the 8.2% current rate jump to 15, once these illegals are added to the number....
You post actually amaze me and they really do reinforce the poor quality of the US Public Schools system.
No Child Left Behind has been funded every year since its inception. Congress, who is responsible for funding, has not funded the program to what is called Authorization Levels which is the highest they can go on the scale for funding. The scale is written into the law. Congress never funds any program at Authorization Levels. For the record, that Congress who is responsible for funding laws up till 2008 were Democrats from 2004-2007. But the program has been funded but remained flat (meaning they didn't increase it), but the program is still funded.
Wars are never paid for when they start and it takes years for us to pay for them after they have ended. Do you think Lincoln pre-paid for the Civil War, Roosevelt pre-paid for WWII, or Truman pre-paid for Korea, or Kennedy pre-paid for Vietnam? No, they did not pre-pay before we went into these wars. It took decades to pay these Wars off that began under both parties. Last I looked we are still at war under a President who promised we'd be out by now, so this cost is on his dime now.
Not true at all. In the last 80 years, the U.S. government has managed to post 12 surpluses. Those surpluses occurred under: Harding (R), Coolidge (R), Hoover (R) Truman (D), Eisenhower (R), Nixon (R), Clinton (D), Bush II (R).
Deficits; Counting all the ones above who ran a deficit part or most of their term, with the exception of Harding & Coolidge who ran Surplus their entire term. We have the Presidents who ran a deficit their entire term. Roosevelt (D), Kennedy (D), Johnson (D), Ford (R), Carter (D), Reagan (R), Bush Sr (R), Obama (D)
Source: davemanuel.com/history-of-deficits-and-surpluses-in-the-united-states.php
You can count can't you....
Looks to me like you're the one who's listening far to much. Seems you certainly didn't get a very good education with our tax payer money and learn to do your research. If you had then yes you actually may have been able to think for yourself.
Yes, let the "states" dole out Medicare FOR A FEW. If "states" were allowed to fund the healthacre for their citizens could you imagine the crappy service a medicare patient would receive in Mississippi, OR Louisiana< or Florida< or Kentucky. These republicrap led states would have so many burials due to death panels the mortuary's would be open 24 hours a day. You would have to take a number to pay your respects to the ones that died because they "didn't get medical care in time to save their lives". This "idea" is just another in the list of republicrap ideal situations needed to dominate society, DOMINATE NOT SERVE, there is the difference.
Most people equate Medicaid with "lazy welfare recipients." But as the article points out, most Medicaid dollars go toward nursing and assisted living facilities for elderly people with medical issues. This need is only going to grow as the baby boomers age. Working with states to be more efficient with these dollars is absolutely needed, but cutting the funding and dumping the difference on state's budgets while giving additional tax cuts to people like Romney is immoral and absurd.
TO: Bluecat 55 who wrote:
I think "lazy welfare recipients" get Medi-cal, not Medicaid.
And I don't care how lazy some folks are, the only folks who can get Medi-cal are minor dependent children, and their parents.
If you leave it to the states to manage, it won't happen. A lot of states can't even balance their budges (i.e. California and Illinois, NJ, and the list goes on). We're already seeing people leaving Illinois for Tennessee because Illinois cutout care for special needs children.
The states are poor about policing fraud. The govt always has to step in and rescue states.
I think it would behoove everybody who gets old to move to a country (Canada, Belize, for example) where you're cared for better than in the U.S.
?????? There is no Federal progam called Medi-cal. Welfare recipients are on Medicaid. welfareinfo.org/apply/
Medi-cal is the name of CALIFORNIA's Medicaid program ie "-cal". Each State has their own name.
You really really do need to google stuff before you post anything else!! On second thought please continue because I am having just too much fun!!
That's a good idea. And if any state wants to get rid of Medicare, Medicaid, SS, they can because they are all Ponzi Scams.
alan_static
That's a good idea. And if any state wants to get rid of Medicare, Medicaid, SS, they can because I don't have a penny in any of those accounts, so it doesn't mean anything to me anyway.
What kind of silly childish thinking is that? How old are you 11? If you don't have to put anything into a SS account its because you aren't of working age yet, or you are not a citizen of this country. If it is the latter please pipe down so that the rest of us can have a grownup conversation. Taking money out of a paycheck for SS benefits happens automatically in this country, you don't have a choice. The "it doesn't mean anything to me anyway" line was total and complete bull@!$%#. thinking like that is the reason this country will be picking up arms against one another in the next 50 years. Its idiots like you who think they live in a society complete with only themselves. What a totally selfish person.
How nice some are...wow.
I hate like hell to say it, but next states will no longer need ambulances just throw grandma in her car carrier put her on top of the car and drive her to the hospital.
A little humor never hurts.
It just sounds like kicking the can. If we leave it up to the states it is no longer an issue the Congress will have to deal with.
Let's let the state legislatures deal with it.
I do not have the answer, but I definately do not like this.
Yes, let the states deal with it!
Like the mortgage relief that was block-granted to state governments who's governors then used it to balance the budget instead of what it was intended for-help stabilize the housing market?
The AL state government should be allowed nowhere near Medicare, Medicaid, stimulus funds, Social Security, or any other money. Citizens on AL won't see it if they are. Sad, but true.
Ram
The same can be said for Texas.
And WI!!! Walker stole the mortgage relief fund money intended for struggling homeowners and offed it up to Milwaukee County so he can "make it look like he created 30,000 jobs there" all in his effort to destroy his Democratic opponent in the recall election Tom Barrett who is the Milwaukee Mayor. Right after the election was "stolen by Scooter", our unemployment numbers were right back where we have been in national job creation-DEAD LAST.
He stole the money intended for the first implemntation of the health insurance exchanges by refusing to start them up here and KEPT IT, instead saying the would not cut Medicaid funding in the state but only after he found out he COULD NOT do that by the Federal government so he slashed Badgercare, our "state run program" for the working poor who "make too much money to be eligble for Federal MA". He also slashed funding for Seniorcare-our state run RX program that costs seniors about $28.00 per month and covers a lot more than the hideous MC D Rx plans do which are much more expensive to puchase for the elderly. He cut FamilyCare-our state run program that pays for the elderly to have homecare by a visiting nurse and custodial care which allows them to stay in their homes vs being sent to an SNF that costs THOUSANDS of dollars a month since SNFs jack up their costs to resident elderly by excessive O-T, P-T and misc ancillary charges since THIS is where they make the big bucks.
I was BOM of a nursing home and they said themselves: "Get as therapy as you can on the bill and make those OLD PEOPLE WALK and out of their wheelchairs since we don"t want them warming their beds and being lazy". I heard the cries of pain from these people being forced to do so from my office everyday as aides pushed them to the limit-FRAIL ELDERLY who looked half dead already!
Do you know what pays for these people to be in these places after MC pays the first 90 days? They drop to "self pay" until their personal assets are exhausted and then SS and MA pays until they die. Depending on the state you live in, you CANNOT trust that state's government to do what that money is intended for if MA becomes a state block program because they WON'T use for healthcare for these people or anyone else who needs it. I'VE SEEN WHAT SCOTTY WALKER has done when gets "grants from Washington" and it sure is not going to help the people who need it the most.
The money has been stolen to pay for his huge tax cuts to big business and favours to his fat cat campaign donors-(mostly from out of state) and the person who was in state that gave 500 million to his campaign Laurie Hendricks did not pay any WI state tax for FIVE YEARS while the rest of us have to. That same 500,000 million was what got slashed from the De Pere School district as a result of his horrific cuts to education here and that is just the City of DE PERE. Over a MILLION was cut from Green Bay schools and Milwaukee? Far worse as his so-called budget actually shifts 30% of Milwaukee taxpayer money to VOUCHER, Private and charter school!!! No way will theives like Ryan and Robme keep taking from US to give to the RICH. Social DARWINISM in action!!!
Obama/Biden 2012 and get rid of the do-nothings in Congress who want to keep lining their own pockets and keep the best taxpayer funded healthcare and pensions for LIFE when the teahads and DINOS vote to strip us of what we paid into this system to be there for us!!! My husband is 54 years old and misses the Ryan plan cut-off date for being able to have MC and SS as it is after paying into it all these years. No,no and NO!! Besides MA pays for much more than the healthcare of those "welfare mothers".
MA funds the Women's Cancer Care Program, Family Planning only coverage and also pays for the indigent elderly through MC "buy-in" so the can get MC part B covered if they can't pay the premiums themselves to get it because their SS checks are so minimal they can't afford to even pay their Part B premium themselves to name just a few things MA funds. I was a healthcare biller/insurance and collector for almost SEVEN years and saw it ALL. from the abuses of the commerical insurance industry who will do anything not to cover claims, slash proivider reimursement levels with their ridiculoiusly contracted rates on managed care plans to the so-called MC Advantage plans which are nothing more then commercial managed care plans with all the commerical insurance restritctions they can throw in. READ, educate yourselves and ask those who KNOW what these attacks and savage cuts to the last of social safety nets mean for anyone who does not 6 digit bank accounts and more $$$ then they already know what to do with while they whine about their taxes being "too high".
My family has no qualms about paying taxes as long as I know they're being used for the common good of ALL people in the state of WI, not enriching the fat bank accounts of the greedy. LEARN, LEARN, LEARN!!!
P.S. We should "trust Ryan and Robme" when only after being called out on the letters Ryan personally signed but claimed "he could not recall" about accepting federal stimulus $$ for earmarks in his own district but then had to admit he DID take that "failed stimulus money". Not so " failed was it Ryan"? LIARS!!
Teresa A.Van Remortel-De Pere, WI
The Federal Government is our savior. All hail chief Obama, maybe he can even drive grandma to the hospital in the car carier on top of the ambulance.
Your statement becomes me
Or you could stop being silly, Alan. Grow up. We aren't playing games here. This is about people's lives.
This is why that woman in Florida can't afford her blood pressure medicine. 5 governors in the Jesus states are the same way.
Why can't the women in Florida afford her medicine again?
How about this, then? How about each state sets its own drug (war) policy. Let each state decide whether to run medicinal marijuana shops, or legalize it completely. States' rights, after all.
That's a good idea.
The closer gov't is to the people, the more accountable it will be to the voters. People must get more involved and hold these pols feet to the fire. Otherwise, any program will just run amok.
This is somewhat amazing considering that the GOP and friends just spent so much money criticizing the President for providing States with more flexibility. When will people who call themselves conservatives become consistent conservatives?
They aren't, so they won't ever become that.
The states already have differing criteria for eligibility for Medicaid, particularly the minimum income necessary to qualify. Some states $4000, $5000, $11,000, etc. This grant money for Medicaid would be a boon to the coffers of the Republican dominated states as they'd reduce even further the eligibility criteria and end services that benefit the poor and in particular women, i.e., you'll see an end to Planned Parenthood if they have their way. It's babies for everyone no matter the health of the woman, the fetus, or their economic ability to handle a child.
So it's understandable that Paul "Ayn Rand" Ryan wants to scrap any federal regulations and support for Medicaid and he'd rather let it die a quick death in the states. Let people fend for themselves regarding healthcare, the new Republican death panel philosophy.
It's his back door agenda to ending planned parenthood and all other women's health issues and rights. If Paul Ryan had his way he would completely do away with all things women, yet women make up 58% of the electorate. What a fool. I will say it again, ANY woman, right or left, that votes the Romney/Ryan ticket is a traitor to ALL women in this country and around the world.
sick very very sick u are
This is exactly what I was saying...the criteria in AL are obscenely low, and you know they would use it to get what they want instead of for the citizens who need it.
The states can't do any worse than the feds. States would have a better shot at cutting fraud, waste and abuse. Except maybe California, New York and Illinois
States that carry the BULK of our population are considered evil or what by "you people" on the right?????? I really don't understand the disconnect between the red states and the blue. I thought our flag brought these two colors together and bound them with the white, making us the UNITED STATES OF AMERICA.
No longer.
Oh yes they can do worse...much worse. Well, guess that would depend if you are rich or big business. They would be fine. Everyone else wouldn't be fine at all.
You can see the same neurons firing: Ergo, the full Republican Agenda of Mitch, Orin, and their boy Paul Ryan = the former Democratic Agenda of Stephen A. Douglas: "Let the States decide if its OK to let people own other people." [Times can't change, what I say is true, All is real] Paul Kantner
This is about slicing away further at services for people who are poor, elderly or whose jobs were shipped to China by the folks backing the Republicans and the Tea Party. One cookie jar isn't enough for them, they have to get the crumbs from another one and let grandma get kicked out of the ambulance. This is a national problem and requires a Federal solution. To farm this out to the states is a divide and conquer strategy by rhe Republicans and will lead to millions of people being booted off the system and left to end their days in misery.
This story contains at least two errors, so far as I can determine. First, most people in old age do not use Medicaid because they are covered by Medicare. Medicaid is a program for the very poor and the indigent. An ordinary working person who had paid into SS during working years would not need, nor be eligible, for Medicaid. This information is from the Maryland Department of Health, but generally applies nationwide.
Some people who needed extraordinary care might become eligible for Medicaid by selling all of their assets and putting themselves into poverty. This happens on occasion when people are forced to do so to cover medical bills.
Second, not all old people require care in a nursing home. My father in law, for example, is now 90 yrs. old, living on his own with his wife, who is a few years younger. They care for themselves in just about every way. A high percentage of people do require more extensive care in the last months or years of their life, but not everyone. A lot of people die in their 40s, 50s, and 60s, never requiring a moment of intensive care and certainly not being placed in a nursing home.
As to the general idea of having state set the standards for their own programs, it is good in concept and often very bad in practice. The idea of choice by the state seems like a good one, because it allows flexibility. When put into action, however, states that traditionally don't provide strong services would likely try to save money by cutting way back.
For the individual, living in a state that narrowly defined eligibility could turn into hell. In most other matters, people might decide to live in a state like New York instead of Texas or Mississippi, but by the time they were in dire need, it would likely be too late. What would happen when the state hit a downturn in revenues, like a recession? Thousands of people could be thrown out of the program. Many states are required to balance their budgets every year, which means they can't go into debt in down years to cover the shortage of revenues.
These kinds of debates don't really fit into a presidential campaign. The choice is not one that is assured of wonderful results by changing the program.
medicare only pays for relatively short recovery stays in nursing homes. After you reach the lifetime limit, you must descend into destitution to become mediCAID eligible. Oh, and don't try to sell your house or pass it to the kids! It has to go to the state (NOT the feds, you note), and this is retroactive 3 years before you applied!!! Here you can own NO personal property except a car worth less than $1200, or you must forfeit it all.
My aunt after spending $300,000 which was her life's savings on assistant living care and now nursing home care. She is 91 and has dementia as well as other problems. She is on Medicaid. When she was on her own dime, most of the people in the facility were on Medicaid. Most families can in no way afford the cost of nursing home care. She would be appalled to know it has come to this. She gets her SS check most of which is turned over to the nursing home. She has Medicare as well as a gap insurance paid for from her SS check and a couple of annuity payments. Every year the county she resides in requalifies her just in case she acquired more funds somehow.
My Mother was on Medicaid and Medicare. Medicare does not help pay for a nursing home,Medicaid does.
I don't know too many people who can afford nursing home care in their foreseeable futures. Medicare does not cover those services beyond 100 days and the state requires that you are devoid of assets when ask them for help.
What are we boomers going to do???
some states have a "lookback" period of 5 years. The state can take all assests from 5 years back. So, if you sell your house and give to kids, if less than 5 years, the state takes that money for MediCADE
Let me straighten all of you out on how nursing home care is paid for: I was Business office manager of a large SNF group in WI and here goes: MC pays for the first 90 days of care in an SNF and if the patient has a Medigap plan, that picks up the rest of the eligible expenses or if the patient has an MC Advantage Plan, it pays according to the benefits laid out by that MC replaecment plan but again for the first 90 days of care and then the patient "is on their own" and is dropped to "self-pay" for the remainder of their stay and have to pay out of their pocket unless they're fortunate enough to be able to afford a LTC policy which covers custodial care and other limited services and if they have the luxury of being able to afford being placed in an assisted living facility with round the clock medical staff to look after them while there, LTC policies will pay for tha but these policies are very expensive and out of reach for most on average "middle class incomes", let alone what an elderly person on SS and any supplemental income like a pension or if they d/n get their retirement in a 401k, IRA wiped out after 2008 can afford if they tried to "shop around for one".
Then after their assets are liquidated, except for their home as it is willed-(I hope ahead of time), and the "spend-down" factor to the poverty level to qualify for MA is met, then their SS check minus a small amount that is set saide for personal use such as maybe $60 a month for transportation to the doctor, shampoo, soap, a hairdresser to come and do the women's hair, etc is taken to pay the SNF and whatever the SS check cannot meet, MA pays the rest of "eligible expenses" until the resident leaves or dies. If there is any expenses that remain unpaid because they're N/C, survivors are respnsible to pay them or they do have to come out of the estate of the deceased. I dealt endessly with family members who were the POA of the resident and/or their attorneys as often estates were tied up in probate and we waited and waited with A/R on the books that were years old unpaid and I had to send to collections.
But let's go ahead and privatize these programs or give granny and gramps a "voucher" to "empower them to shop on the open market" shall we and turn MA into a state block grant program and hope certain governors can be trusted to d the right thing with those funds.WRONG!!!!
I know this article is old but I am sick and tired of people posting on things they obviosuly have no clue about and I've seen this for so long I can't begin to say how fed up I am with it as I've been doing this since the debates STARTED on HCR!!! Unless you have any knowledge of insurance law, worked in it or have bothered to look up any statutes governing it from a federal level to at least the ones in your own state, be QUIET!!!
I have an iidea...let's let the states run everything. No more central military - just each state armed against any invasion - pity those up against our borders. No more interstates...just a race to see who can run the most pot-hole undermined stretches. No more promises to our elders or the infirm. End poverty...kill our poor...oh wait we're already doing that. And who says we're not a Christian nation?
Oh, you mean like the USSR? Really? Let's just let the South secede once-and-for-all. Then once they see how different their life is w/out their Federal subsidies we can laugh at them on our way to the highest standard of living known to mankind.
Gloria, you roll the country back to the exciting days of the Article confederation. You know, where states were imposing crossing the border fees to people and products that crossed state lines.
United we stand divided we fall. The purpose of the fed was to keep us from being easy pickings to other foreign entities. Quarreling with each others is a good start to fall apart.
Beg your pardon, but weren't the repubs just demonizing the prez for wanting to grant some waiver? Anyway, you can be sure we in the south will lead by example - the $5,000 per year income max to get medicaid (it really is the case!!) will become the standard. It's just the conservative's way of blowing the lifeguard whistle; those who can't swim in the deep end just need to get out of the gene pool!
You mean like Texas?
I don't really know what i pay in taxes.it has never been over 13 percent..but even if I don't know..Im being over tax .I cant see My taxes but I am over tax somehow?!!!?????
Dumb and Dumber! States can't even run their own budgets let alone effectively handle something complicated like Medicaid. Where is this country in terms of thinking. Everyday, they must wake up and begin anew, as if they never had a thought. Well, maybe they haven't. That's the problem. If people can not see by now that health care does not lend itself to the free market and something as to be done on a large scale to control costs, then the country might as well go back to sleep. How is it that every other modern industrialized capitalist country has universal health care and we do not? Well, educational testing results explains that in a nut shell.
I do not really know much about the Florida plan but maybe there are things to learn in running efficient programs.
I dont know how much i pay in taxes...so how does he know he is over tax??
do you people know why he wants the states to run there own health care..so they can get around the constitution of laws
I see disaster written all over this plan. Illinois has an unfunded pension system to the tune of 83 billion because for decades they took thier matching funds and spent it on legistative favorite projects. The workers paid their share every paycheck. Give them several billion a year in Medicaid funds and you can kiss senior care and the State of Illinois goodbye. Many, many other states are on the brink of default already, this will be seen as a great source to solve budget crisis everywhere.
Default is an answer
And you think that the federal government doesn't do the same thing? The bigger the program the more chance of waste, fraud and misuse.