Red States Pressured To Expand Medicaid As Care Contrasts Emerge


#1

Pressure is building on states to go along with the expansion of Medicaid benefits under the Affordable Care Act as new studies and financial reports from health care companies point out stark differences between states treating more poor Americans and those that aren’t.

One of the nation’s largest hospital operators, Tenet Healthcare, last week opened a window into the differences for patients and hospital financial coffers between those states with Medicaid dollars and those without.

“In our five states that expanded Medicaid in 2014, we benefited from a significant migration of patients from uninsured into Medicaid with a 54% decline in uninsured admissions and a 27% decline in uninsured outpatient visits,” Tenet chief executive Trevor Fetter said during the company’s second-quarter earnings call last week.

Tenet saw across-the-board increases in “admissions, outpatient visits, surgeries and emergency department visits,” Fetter said.

The federal government traditionally picks up a little more than half of the cost of Medicaid. But funding under the health law is unlike past efforts to expand Medicaid in that the federal government will pick up the full tab this year as well as 2015 and 2016. The state gradually has to pick up some costs in 2017, but by 2020, the federal government is still picking up 90 percent or more of the Medicaid tab.

There are two dozen states, largely led by Republican governors, that have yet to go along with the Medicaid expansion under the health law.

Source: Forbes


#2

None of this would be a problem if the government had stayed out of the free market in the first place.


#3

No, many people would have died, the perfect solution for the health care as a profit producing business only.


#4

I don’t think we know that. Increased profitability for Tenet Health care does not necessarily translate into improved outcomes for patients. Some of the people Obamacare kicked onto Medicaid almost certainly already had insurance, but insurance that did not pay for unneeded ER visits. Some likely left ERs unpaid. Now that Medicaid pays for at least some ER visits that were previously unpaid, can anybody be said to have benefited other than Tenet Health Care?

There is nothing in this article that tells us healthcare was improved for anybody.


#5

Maybe the states that didn’t expand Medicaid couldn’t afford to.


#6

I think when the governing bodies of the states looked at the reality that they’d have to pick up more and more of Medicaid down the road, they refused to take it. Simply accepting Medicaid from the Feds wasn’t the no-brainer everyone thought it would be.


#7

I wish that the states would all expand Medicaid. I know people who suffer a great deal because they are uninsured.


#8

And how should the states pay for this?


#9

Of course, the states aren’t stupid. Well, some of them aren’t anyway.


#10

Oh? You have proof that “many” people would have died if the government hadn’t intervened in health care right? Or is this all just speculation.


#11

For starters, making cuts in other non-essential areas, applying for increased federal asistance and if that is objectionable, then an increase in taxes whether a basic increase or excise tax, etc. You cannot place enough value on human life due to a lack of money; As an example, I’d rather see highway monies go towards helping to pay medical costs as opposed to being spent on repaving highways.


#12

That’s up to the states and the citizens in those states, is it not? Maybe citizens don’t want taxes raised. Maybe states have already cut as much as they can. My state has horrible roads and streets.

Raise taxes on who? The rich? The middle class who are already struggling to meet ends meet?

By the way, highways are funded by a specific tax, the gas tax.

How does not expanding Medicaid have anything to do with the value of a human life?

What if, after raising taxes, cutting, and redirecting funding, they still can’t pay for the Medicaid expansion. What then? Raise taxes more? Cut more?

The solution is not as black and white as you see it.

The states should not have to depend on federal money. Not to mention, the federal government withholding money unless the state does what they want is clearly unconstitutional and violates the separation of powers between the states and the federal government.


#13

Just chiming in. Withholding of federal funds actually is constitutional, as found in South Dakota v Dole.

Separation of powers is actually an idea used to describe the interaction of powers within the federal government. The word you’re looking for here is Federalism.


#14

I think each state has to decide which is more important; cutting back on expenditures on non-essential costs or human life.

It wouldn’t have to be limited to just the rich; there are various ways to raise taxes across the board where everyone pays a fair share. Again, you don’t have to raise taxes if the citizens agree to cuts in non-essential areas.

You could be correct; I’m not an expert on the tax system, just thinking out loud.

I would think that if that scenario presented itself, the states could apply to the federal government for aid; afterall they apply for aid many times after disasters occur and normally receive funding.

I don’t see it as black and white; rather as one with options that allow the states choice.

It would be nice if states didn’t have to depend on federal funding, but in this day and age, its a fact of life. As I mentioned earlier, many states apply for assistance, whether its for emergency disaster aid or other forms of assistance. I’m a little confused to your reference to constitutional vs. unconstitutional; can you elaborate more on that?


#15

The USSC has ruled that the Government can not withhold Medicaid funds from States that did not institute an exchange


#16

How about we start with the 48% who pay no federal income tax?


#17

And if the states, and the citizens in those states, decide that they cannot cut anymore, don’t want taxes raised, and don’t want to expand Medicaid then they are wrong right? They should expand Medicaid no matter the cost and no matter the burden to the citizens of those states.

What does Medicaid have to do with “the value of a human life”?

It wouldn’t have to be limited to just the rich; there are various ways to raise taxes across the board where everyone pays a fair share. Again, you don’t have to raise taxes if the citizens agree to cuts in non-essential areas.

As always, the middle class will bear the burden of any tax increases.

I would think that if that scenario presented itself, the states could apply to the federal government for aid; afterall they apply for aid many times after disasters occur and normally receive funding.

It would be nice if states didn’t have to depend on federal funding, but in this day and age, its a fact of life. As I mentioned earlier, many states apply for assistance, whether its for emergency disaster aid or other forms of assistance. I’m a little confused to your reference to constitutional vs. unconstitutional; can you elaborate more on that?

There is a difference between the federal government giving funding to all states who apply and the federal government denying funding unless the state does what the federal government says. That is clearly unconstitutional as the federal government is not supposed to have that kind of power over the states. The states have rights too, even if the federal government doesn’t believe it.

None of this would be a problem if we didn’t have the tax system we have.

A person’s taxes should first go to his local government and spent by his local government in his local community.

Then, his taxes should go to his state and spent by his state in his state.

Finally, whatever is left would go to the federal government.


#18

Yes, however I was addressing the claim made that the federal government is not allowed to do this-in other areas it is.


#19

The problem arises when the federal government withholds money unless the state does what they say. Do you not see a problem with this?


#20

The purpose of Obamacare was to insure the uninsured. Instead, it uninsured the insured.

We can improve Medicaid by returning to the program’s original purpose: a limited, state-managed safety-net program to meet the health care needs of the poorest and neediest among us. The current open-ended entitlement nature of Medicaid is bankrupting federal and state budgets.

In a final regulation issued last year, the Internal Revenue Service (IRS) assumed that under Obamacare the cheapest health insurance plan available in 2016 for a family will cost $20,000 for the year.

Under Obamacare, Americans will be required to buy health insurance or pay a penalty to the IRS.

The IRS’s assumption that the cheapest plan for a family will cost $20,000 per year is found in examples the IRS gives to help people understand how to calculate the penalty they will need to pay the government if they do not buy a mandated health plan.

The examples point to families of four and families of five, both of which the IRS expects in its assumptions to pay a minimum of $20,000 per year for a bronze plan.

“The annual national average bronze plan premium for a family of 5 (2 adults, 3 children) is $20,000,” the regulation says.

History has repeatedly shown the costs of many government healthcare programs far exceed early projections. Why does anyone expect the expansion of Medicaid would be any different? We don’t need Washington putting states on the hook for future budget obligations (which is what Washington is doing with Medicare). We don’t need to expand a big-government program to provide for everyone’s needs.

What we need is to shrink the cost of healthcare and expand opportunities for people to get a job so more people can afford it.


DISCLAIMER: The views and opinions expressed in these forums do not necessarily reflect those of Catholic Answers. For official apologetics resources please visit www.catholic.com.