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medicaid

paulsenTrumpcare passed the U.S. House, by two votes. The vote of the allegedly thoughtful “moderate” Rep. Erik Paulsen (R-MN) was one of those that put it over the top. Reaction was swift and vehement. An op-ed subsequently appeared with his name on it. What a sniveling, impudent load of crap.
 

The bill empowers states to better design health care plans that meet the needs of their citizens. It provides a portable tax credit to assist Americans who do not receive coverage from an employer in purchasing health insurance. It enhances and expands the use of consumer-driven health care accounts, such as Health Savings Accounts, and it once and for all repeals the harmful medical device tax.
 
It is also important to point out what is not in this bill. Nothing in this bill would allow an insurance company to deny someone coverage, including to those with a preexisting condition. Nothing would allow an insurance company to cancel someone’s insurance policy should they become sick. Despite claims from opponents, the bill does not classify sexual assault as a preexisting condition. For those who maintain continuous coverage, the bill does not allow insurance companies to charge an individual more simply because they have a preexisting condition. It’s also worth noting that this bill includes $138 billion to assist states in making sure everyone, including those with preexisting conditions, has access to high-quality, affordable health care?
(Star Tribune)

– Where is your typical family these days, living paycheck to paycheck and way in debt, supposed to get money for “Health Savings Accounts?”
 
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clown carJohn Kasich said something odd during a recent appearance on Face the Nation, and I’m not just referring to “And when I left Washington, we had a $5 trillion surplus.” I’m referring to this:
 

But what I have found, as you know, I’m now — my campaign has gone on for slightly more than just two months, John, and you know I’m in the top tier in New Hampshire, I’m beginning to rise in Iowa. So if it — if what I’m saying is not true, then I should be — I should be getting out of the race, which I am not because I think we’re making really good progress and connecting.

 
What question must he have been responding to? Why he’s staying in the race when he’s doing so poorly? No, he was asked about a “climate” where experienced governors are getting nowhere in the GOP primary polls. He responded by justifying staying in the race. It seems that was the question he was expecting. Why would you be preparing that answer if you’re not having to convince the voters in the donor primary that you’re still a viable candidate?
 
Actually, I expect Rand Paul to be the next to drop out following news that a supporting superPAC has decided his campaign is a lost cause, but maybe Kasich won’t be far behind — especially given that his claims abut the polls are pretty much just happy talk. He’s sure stuck down in the milieu in the national polling, though he referred specifically to “beginning to rise Iowa” and being “in the top tier in New Hampshire”. That’s a pretty generous definition of “top tier”, and apparently he thinks “rise” doesn’t include any upward motion from a low point.
 
Friday’s Pew Poll even has Kasich below the soon-to-depart Paul, down in positively Walkerian levels of barely registering.
 
The thing that annoys me is hearing liberals saying Kasich seems like the reasonable one. Is there some requirement to pick out a less-clownish clown from the passengers of the clown car? Yes, it’s true he’s given conservatives some reason to dislike him, like when he kept saying in the second debate that foreign policy problems need to include working with allies, and he’s one of the few Republican governors who accepted the Medicaid expansion to cover the people who fell in the hole between Medicaid eligibility and eligibility for private plan subsidies. He even cited the bible in defense of a liberal belief. Wrong party for that.
 
However, something to bring to the attention if anyone saying he’s not so bad, when Kasich was in the US House, he wrote the law restricting food stamp eligibility for childless adults to just three months in any three year period. This was too harsh even for some of his fellow Republicans, so states were allowed to seek waivers if unemployment was high enough. As governor, Kasich accepted the waiver — for some poor Ohioans. He sought waivers of overwhelmingly white rural counties, but excluded counties with large minority populations.
 

In 2014, the Ohio Department of Job and Family Services (ODJFS) had the option to waive time limits on food stamps for the entire state. Due to a struggling economy and high unemployment, Ohio had qualified for and accepted this statewide waiver from the US Department of Agriculture every year since 2007, including during most of Kasich’s first term as governor. But this time, Kasich rejected the waiver for the next two years in most of the state’s 88 counties. His administration did accept them for 16 counties in 2014 and for 17 counties in 2015. Most of these were rural counties with small and predominantly white populations. Urban counties and cities, most of which had high minority populations, did not get waivers.

 
When you have to temper compassion with fiscal austerity, you recognize you can’t help everybody, so … just help the white rural areas. “So if it — if what I’m saying is not true, then I should be — I should be getting out of the race … ” I have a feeling the donors might soon agree.
 
#ThisGuyWantsToBePresident
 
Comment below fold.
 
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Hi MPPers,
I’m Barbara Mahowald and I’m a supporter of a Public Option in the Minnesota Health Care Exchange.  This week I attended an info session and learned about the fraud that’s going on with Minnesota’s HMOs and Medicaid. Even though it’s been in the news over the last couple of years, there is so much I didn’t know. Here are points that I’d like to share with you.
1.  DHS cost-plus contracts with HMOs are illegal and constitute fraud. Cost-plus contracts allow the insurer/payer HMOs the ability to never lose money.  

2.  Our state actuary, Milliman, says an audit of Medicaid spending for 10+ years is NOT possible because there is no data. No data at DHS or DoCommerce. No data from HMOs. What?!? Really?!?  Yes, it’s true.  We cannot tell if we have spent too much, too little, or just the right amount.

3. Most of fraud focus of DHS is on catching providers or recipients who scam the system. Of course, this is not right. However, there is never any attention on HMOs and their actual costs.

4.  Wendell Potter has written Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans (Bloomsbury Press hardcover, November 2010)

http://wendellpotter.com/allWe…

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More that voters should know about Willard

by Dan Burns on October 15, 2012 · 0 comments

I don’t think that this qualifies as an “October surprise.” Among other things, those are for campaigns that are behind, and President Obama’s is anything but.  But it does work as “piling on.”

The ties between Mitt Romney and Sensata Technologies are not strong. In fact, Romney was gone from Bain Capital by the time the decision was made to send jobs overseas. But as Romney has become more aggressive in calling out President Obama for not taking a harder line with China, especially the country’s accused manipulation of currency, many publications are using Sensata Technologies as an example that Romney himself has a complicated relationship with China.

According to The New York Times, Romney still stands to profit off of the Sensata outsourcing

More below the fold.
In fact, Romney’s dealings in China go far, far beyond the above.

On the campaign trail, Mitt Romney rips President Obama’s policy on China and talks tough against the rising global power. “We’re going to crack down on China,” he said at a recent event in Ohio. “They’ve stolen our jobs; that’s gotta stop.” But according to Romney’s recent tax returns, between 2008 and 2011 Romney invested more than a half million dollars in the stocks of 10 Chinese companies-including firms that embezzled, partnered with Iran, and stole US intellectual property…back in 1994 Romney himself said that blind trusts don’t absolve an investor of responsibility: “The blind trust is an age old ruse, if you will, which is to say, you can always tell the blind trust what it can and cannot do. You give a blind trust rules.”

Here’s a compendium of items that says a great deal about where Willard’s really at.  From abusive behavior toward women as a Mormon bishop, to pushing Bain employees to lie, to flaunting his ill-gotten wealth…it’s really ugly.

Romney’s plan for Medicaid is heinous.

On Medicaid, Romney wants to spend way, way less. And not just on poor people. As Jon Cohn points out, cuts of this size will have a huge impact on “dual eligibles,” elderly patients who rely on Medicaid to pay their nursing home bills. This is not a minor point of technocratic disagreement. It represents a massive change in our commitment to providing decent medical care for those who can least afford it. Medicaid, much more than Medicare, demonstrates what’s really at stake in November’s election.

After that litany of wretchedness, here’s something to mellow your mind.

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Mitt Romney would take away my daughter’s Medicaid

by Jeff Rosenberg on September 6, 2012 · 1 comment

Mitt Romney and Paul Ryan want nothing less than to dismantle America’s entire social safety net. It’s not enough that they want to end Medicare; they also want to gut Medicaid, too, as Bill Clinton emphasized last night:

They also want to block-grant Medicaid, and cut it by a third over the coming 10 years.

Of course, that’s going to really hurt a lot of poor kids. But that’s not all. Lot of folks don’t know it, but nearly two-thirds of Medicaid is spent on nursing home care for Medicare seniors who are eligible for Medicaid.

It’s going to end Medicare [sic] as we know it. And a lot of that money is also spent to help people with disabilities, including a lot of middle-class families whose kids have Down’s syndrome or autism or other severe conditions. And honestly, let’s think about it, if that happens, I don’t know what those families are going to do.

My daughter doesn’t have any of those severe conditions, but we do rely on Medicaid for her health insurance. If Mitt Romney and Paul Ryan are elected, and they’re successful in demolishing Medicaid, my daughter will almost certainly be kicked off of the program. That would be devastating to our family. I can’t even imagine how much worse it would be for families whose medical bills are routinely in the tens of thousands.

What makes this attack on my daughter hurt the most is that it will exclusively benefit the 1 Percent. The Ryan/Romney plan wouldn’t even reduce the deficit, which is their typical excuse for why they want to decimate Medicaid. The money that today pays for my daughter’s checkups will instead be used to reduce taxes for millionaires and billionaires, who are already paying their lowest taxes in nearly a century.

Like millions of Americans, I have a personal stake in this election. For millions of us, our families’ health and well-being is literally on the line. Whether it’s Medicare, Medicaid, or private insurance, a Romney victory in November could result in our loved ones — or ourselves — losing health insurance. As Bill Clinton said, we can’t let that happen.

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This includes a link to an interactive map that can be used as indicated (the reference is to congressional districts):

With Rep. Paul Ryan’s ascendancy to the Republican presidential ticket, Democrats Henry Waxman and Frank Pallone wanted to be sure that every member of Congress, and every voter, understand the impact that the Ryan plan would have back home. To that end, they’ve done the analysis, district by district, of what Ryan’s cuts would mean to health care access.

Willard Mitt Romney will sign off on whatever Paul Ryan tells him to.  Here on my home turf of MN-08 (where Rep. Chip Cravaack supports the plan):

The Republican proposal would have adverse impacts on seniors and disabled individuals in the district who are currently enrolled in Medicare. It would:

– Increase prescription drug costs for 9,200 Medicare beneficiaries in the district who enter the Part D donut hole, forcing them to pay an extra $90 million for drugs over the next decade.

– Eliminate new preventive care benefits for 125,000 Medicare beneficiaries in the district.

More below the fold.

The Republican proposal would have even greater impacts on individuals in the district age 54 and younger who are not currently enrolled in Medicare. It would:

– Deny 450,000 individuals age 54 and younger in the district access to Medicare’s guaranteed benefits.

– Increase the out-of-pocket costs of health coverage by over $6,000 per year in 2022 and by almost $12,000 per year in 2032 for the 112,000 individuals in the district who are between the ages of 44 and 54.

– Require the 112,000 individuals in the district between the ages of 44 and 54 to save an additional $26.2 billion for their retirement – an average of $182,000 to $287,000 per individual – to pay for the increased cost of health coverage over their lifetimes. Younger residents of the district will have to save even higher amounts to cover their additional medical costs.

– Raise the Medicare eligibility age by at least one year to age 66 or more for 59,000 individuals in the district who are age 44 to 49 and by two years to age 67 for 342,000 individuals in the district who are age 43 or younger.

Check out the facts for your district, and share them with friends and family. Especially the “undecided” ones.

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Apparently today is Irony Friday

Rep. Michele Bachmann (R-MN) has repeatedly called for an audit of Minnesota’s Medicaid program. There is a real issue here … shockingly. The HMOs that maintained our program kept millions upon millions. They eventually reimbursed the state to the tune of $30 million.

What is ironic is that Bachmann never once complained about Medicare Part D.

Medicare Part D prevented Medicare from negotiating the cheapest prices for drugs from the pharmaceutical companies. Furthermore, it prohibited Medicare from using generics when they were availalbe. It was a massive Republican/Bush Administration give-away to their Big Pharma donors.

Forbes estimated it would cost the government upwards of $1 trillion yet Bachmann never complained once about how it added to the debt.

So its merely a convenient attack against Medicaid and surrupticiously Obamacare rather than any real concern about corporations ripping off consumers or our government.

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Why has Bachmann flip-flopped on oversight?

by The Big E on February 23, 2012 · 1 comment

Even a broken clock is right twice a day

Rep. Michele Bachmann (R-MN) did something that surprised me. She came out in favor of more and better oversight of HMOs administration of Medicaid in Minnesota. What’s strange is that Bachmann has never before been in favor of oversight as far as I can remember.

As a member of Congress during the Iraq War, she never had any problems with the no-bid contracts that Halliburton received. She’s against more oversight of Wall Street, insurance companies or, actually, anything at all. Yet, here she is demanding government oversight of companies where the executives (aka The Magical Job Creators) pull huge salaries.

She said she was concerned about the “massive reserves” that have been accumulated by the four HMOs that manage Minnesota’s health Medicaid program.

The state’s Medicaid books have never been audited, Bachmann said, and “this lack of oversight creates a climate of complacency.”

She said she would be reaching out to congressional Republicans and Democrats alike to push legislation that would call for independent audits of the billions of dollars flowing to health care for millions of low-income Americans.

“It’s not a partisan issue,” said Bachmann, who nevertheless did not include any Democrats in her hastily-arranged press conference. She said she has no reason to believe the state or its HMOs are misusing the funds, but until there is an audit, there’s no way to say for sure.

Why the change of heart? Why the flip flop on oversight? I’m guessing she’s doing this for a few, cynical reasons.

  1. She has no legislative accomplishments ever.
  2. Low hanging fruit, many are clamoring for this anyway.
  3. This is proof, in her warped reality, that Obamacare is a failure.

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What’s wrong with this story, that requiring a photo ID for voting is no inconvenience because it’s required for Medicaid already?

There are two right answers, one that is spot-on, and one that is technically correct, but only sort of, IMHO.

The really right, spot-on answer is “People without photo IDs have been denied Medicaid”. From the Washington Independent:

A controversial federal law designed to keep illegal immigrants out of Medicaid is still ensnaring U.S. citizens 18 months after it took effect. It has prevented tens of thousands of eligible U.S. citizens from enrolling in the program, according to Medicaid officials representing at least a dozen states.

But as for the discrepancies among the different ethnicities, Allison had a different theory, originated by Virginia officials. Latinos, he said, are accustomed to requests for their citizenship documents, and therefore have them ready. Low-income African-Americans and whites, on the other hand, may have rarely been asked for those documents, and, as a result, have difficulty producing them. In no case does that mean that these people are not eligible citizens, he added.

“You can only imagine,” Allison said, “that this policy didn’t hit its target.”

    This program is denying service to many more citizens who should be eligible than it is denying illegal immigrants [the formatting problem is in the article, and appears to have been a quote]

Iowa health officials echoed Allison’s criticisms. “This program is denying service to many more citizens who should be eligible than it is denying illegal immigrants,” said Roger Munns, a spokesman for Iowa’s Dept. of Human Services. “It’s quite clear that we’ve got people coming to our door who are, in fact, citizens. But they simply can’t locate their documents.”

From a study for Kansas on the effect of requiring photo ID for Medicaid:  

Research finds that:
Survey of Medicaid Beneficiaries
• If required to do so, 64.2% of Medicaid beneficiaries would need to purchase one of the
three state-approved forms of identification.
• An average of 1.8 IDs would need to be purchased per household.
• A Kansas Driver’s License and State ID cost between $16 and $22. A passport costs
between $82 and $97.
• Medicaid beneficiaries estimate that they can spend between $5 and $8 for one ID.
• Tuesdays and Saturdays are the best days for most Medicaid beneficiaries to purchase
an ID. The best times are between 10AM and Noon and 2PM to 4PM.
• Slightly more than 85% of the beneficiaries needing a new ID “strongly agree,” “mostly
agree,” or “somewhat agree” with a statement suggesting that they would experience
financial hardship if required to purchase a photo ID.
• Slightly more than three-quarters (75.7%) “strongly agree,” “mostly agree,” or “somewhat
agree” that they would need financial assistance to purchase an ID.
• Regarding the statement “requiring Medicaid beneficiaries to show a photo ID is a good
idea,” 37.5% of the respondents needing IDs “strongly agree.” More than 20% do “not
agree” with the statement.

Full study here.

So people eligible for Medicaid were turned away for lack of a photo ID, and cost seems to have been the biggest obstacle to getting the required documentation.

An interesting bit from the Washington Independent article:

But not all states have seen drops in Medicaid enrollment as a result of the new guidelines. Health officials in Minnesota, for example, said that when the rules were installed they took aggressive steps, like retrieving birth records from other states. As a result, there has been no tangible effect on participation, they said.

So if a state is determined to get the necessary documents to eligible people, it can be done. Maybe with expense and difficulty, but it’s doable. Yet what do we see in the states requiring photo IDs to vote? They put up obstacles to getting IDs rather than making them more available, let alone “free”. That speaks volumes about the real goal. That might explain conservative complaints that Rhode Island’s law is too liberal, since the Democratic-passed photo ID law allows those without ID to cast a provisional ballot, and then the signature on the ballot envelope will be compared to the voter registration record. If the signatures match, the vote counts. That’s in addition to student IDs being accepted, which conservatives hate. Even the ID requirement is phased in, with non-photo Id accepted this year and photos required in 2014.

The answer I said was technically right but I don’t like it is “Voting is in the constitution, Medicaid isn’t”. Access to health care isn’t an enumerated right, but it sure seems covered by the 9th Amendment, “The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.” Obviously conservatives don’t think access to health care is a right, or they have a funny way of showing it, but us more civilized sorts do think so. That’s why I don’t like the “voting is a constitutional right” argument in this instance — it implies access to health care isn’t a right.

What about the other answers? Hopefully it’s clear “Medicaid doesn’t require photo IDs” is just plain wrong. “Medicaid makes the IDs” is wrong because the photo ID is required in order to get the Medicaid ID. “ID machines can double as X-rays” is just wrong. I think. Now that I think about, are we sure they just take our photo? Are we really….sure?

And that, ladies and gentlemen, is your moment of paranoia for the day.

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Fun with debunking the right: photo IDs for Medicaid

by Eric Ferguson on February 2, 2012 · 0 comments

UPDATE: Here’s the answer.

In honor of the state Senate’s hearing today on taking away the voting rights of those who commit the crime of failing to vote Republican often enough, this Fun with Debunking the Right is about requiring photo IDs for voting. Specifically, it’s about one argument used by those trying to stop poor people from voting, that requiring IDs is no bog deal because photo IDs are required for Medicaid. Here is the claim being made by the governor of South Carolina during an announcement of a law suit challenging the decision of the US Department of Justice that South Carolina’s photo ID requirement is discriminatory to blacks. The Medicaid claim is 4:50 in:

What’s wrong with this story?

Take your best guess in the poll, and feel free to explain your reasoning in the comments. I put up the answer 24 hours after posting the question.

I guess that was a peculiar use of the word “honor”.

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