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Subscribe to RSSVirginia Republican Gov. Robert McDonnell said that even at 90 percent federal funding, the Medicaid expansion would be a "crushing" burden on many states.
Updated at 3:20 p.m. ET: While it upheld most of President Barack Obama's health care reform program Thursday, the Supreme Court took away the stick the White House had hoped to use to force states to expand Medicaid coverage for millions of poor Americans.
The court, in an opinion by Chief Justice John Roberts, said states can't be penalized for refusing to join the Medicaid expansion by losing all of their federal Medicaid funds. That leaves cash-poor states in the position of deciding during an election year whether the benefits of the expansion outweigh the potential downsides — both financial and political.
First, some background. Medicaid currently covers many families that are at or below about 63 percent of the poverty line, with some categories — such as children under age 6 — covered up to 133 percent. But most states don't cover lower-income adults.
The Patient Protection and Affordable Care Act sought to compel states to expand coverage to nearly everyone up to the 133 percent threshold — income of about $30,000 a year for a family of four — which would add about 17 million people to the Medicaid rolls.
The carrot was the federal government's promise to cover all of the states' Medicaid expenses for the new enrollees through 2016, gradually dropping to 90 percent by 2019. The stick was that states that refused to sign on would lose all of their federal Medicaid funding.
Christina S. Ho of the Rutgers University School of Law told msnbc.com that the decision could leave the poorest residents of states that decline the money in a particularly vulnerable situation.
Another provision of the law the so-called state health insurance exchanges, extends subsidies to people between 100 percent and 400 percent of the poverty line to buy coverage. But if you're below the poverty line, you're not eligible — because the law assumes you'll get the new Medicaid benefit.
So if a state rejects the expansion of Medicaid, "there are some people that may not be able to get coverage at all," said Ho, who was a member of President Bill Clinton's Domestic Policy Council. "They may not get Medicaid, and they may not be eligible to purchase insurance through the exchange."
States charge plan was blackmail
Twenty-six states filed a petition with the court arguing that the provision was unconstitutional, saying it amounted to blackmail: Either they accept the added funding for a few years, with its increased burden on state coffers in later years, or they lose all of their billions of dollars of federal Medicaid distributions.
That would be a crippling financial blow, because states can't opt out of Medicaid itself. Currently they pay about 40 percent of those expenses; without any federal funding, they would have to come up with the remaining 60 percent themselves.
Supreme Court upholds health care mandate
Obama calls ruling victory for US; Romney vows to repeal
Roberts upheld the constitutionality of the expansion itself, in essence saying the carrot was fine but the stick was illegal.
"Nothing in our opinion precludes Congress from offering funds under the Affordable Care Act to expand the availability of health care, and requiring that States accepting such funds comply with the conditions on their use," he wrote. "What Congress is not free to do is to penalize states that choose not to participate in that new program by taking away their existing Medicaid funding."
Twitter reactions to the ruling
"The states claim that this threat serves no purpose other than to force unwilling states to sign up for the dramatic expansion in the health care coverage effected by the act," he added. "Given the nature of the threat and the programs at issue here, we must agree.”
While it might be fair to say the ruling turned a virtually mandatory program into a voluntary one, few if any states are likely to reject the increased coverage for so many more of their residents, said Katherine Hayes, a lawyer who is an associate research professor for the George Washington University School of Public Health and Health Services.
"I think, to the extent that they do, it will be largely for political reasons rather than financial or policy reasons," Hayes told msnbc.com. In an election year, it might be useful for some conservative lawmakers "to say you oppose quote-unquote Obamacare," she said.
Jay Bhattacharya, a physician and economist at the Stanford University Center for Health Policy, disagreed, saying some state budgets are so stretched that state officials might "consider this option since they will ultimately be on the hook for financing at least a portion of this expansion."
"If enough states decide to deny the Medicaid expansion, this may substantially reduce the ability of ACA to expand insurance coverage," Bhattacharya wrote on the center's health policy blog.
Virginia Gov. Robert McDonnell predicted that would happen, saying that once the federal contribution begins dropping, states will still be left with a large "unfunded mandate" — $2.2 billion over 10 years in his state, he said.
"We've already had Medicaid grow from 5 percent to 21 percent of our budget in the last 30 years, and for every governor, these mandates are crushing expenditures to endure," McDonnell, chairman of the Republican Governors Association, said in an interview on MSNBC-TV. "So this is a real hardship."
But Hayes said that in practical terms, the incentives for states to sign on are too big to turn down: They can provide hundreds of thousands of residents with health care coverage at no cost for a few years, and even in the outlying years (when the federal government will pick up only 90 percent of the bill), they can work on strategies to mitigate the reduction, such as seeking waivers from the Department of Health and Human Services.
"I don't know what more the federal government or (Health and Human Services) could do" to bring reluctant states on board, she said.
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Get over it Repubs.
We won. Fair and square.
True, but can you tell me if Best Buy is hiring? I think I need a second job now.
Di you even know what you won rustyboy? or what its going to cost you?
you did... today.
the question is... will it be a Pyrrhic victory
November will answer that
@ RustyBoy-FL
Not all Democrat's like this law. I am a democrat and this law sucks. You are right, the law passed and it was a fair process, but that does not mean it is right !
Every (repeat, every) other industrialized nation provides health coverage for its citizens.
And the all do it for less than 1/2 the cost per capita of our system.
Yes, we won. Finally.
No, you lost. Now we are on the fast track to EU style economic collapse. The EU does have this and it's one of the reason they are imploding. This victory just moves up our date.
Im not too thrilled with this law either, and I too consider myself pretty derned liberal. Its the individual mandate I dislike. This is not an apportioned tax. This has very little to do with interstate commerce, no matter how much the supreme court twists and contorts to call it so. The individual mandate is a boon for the insurance companies. I see how rates could not possibly rise even more with this, expecially now that private insurance companies have a captive audience. This government should not be able to force every american, just due to the fact that they simply draw breath, to have to buy a product from any entity, ESPECIALLY, a private one.
If this were entirely government provided, and funded by actual tax increases - to FICA, or SSI, and the SSI tax cap removed for those that earn over a certain amount, then I could accpet this. But the individual mandate - on people who are already struggling - is most bothersome. At the end of the day, I think insurance companies are snickering...
I agree this isn't the greatest health care reform law, but with the repug-nut-ones screaming socialized medicine at the hint of a public (not-for-profit) option during the debates, the private exchange was the only thing that would fly. The mandate was necessary (a GOP idea) to get insurance companies to expand coverage for preexisting condition and eliminate limits. So here we are, with a flawed system to shore up an outta-control-costs system. All we can do is try to make it work and tweak it as best we can. All the repeal and replace BS is just cheap talk when the replace part is missing. But that's the way the teabaggers role; no follow through. Just like them wanting to cut spending while cutting taxes to reduce the debt. The responsible thing to do is raise taxes across the board as we should have done to pay for the two Bush's wars and his Medicare drug program. Teabaggers are happy to leave it to our children and grandkids. It’s time to step up repug-nut-ones and be part of the solution instead of thumping your chest, wrapping yourselves in the flag, while crying socialist and communist at anyone who disagrees with your myopic point of view.
The we won part is that those on the right called this law unconstitutional. Whether you believe it's a good or not, the fact is that it is now law and can be worked out to benefit everyone. Maybe if the Republican members of congress would got off their NO BS it could have been a much better bipartisan law but they were so set on trying to make the other party look bad they screwed the American people...temporary. Now that the SCOTUS has shot down their argument and talking points, maybe the Republicans will sit down with their "enemy" to iron out the bugs in the plan.
I have medical coverage and have had it since I started working as a teenager so my problem always has been the freeloaders on the system that when they have a medical emergency they run up a big bill and refuse to pay it even if it means taking bankruptcy. That drives up my insurance cost because in order to make up the loss the medical industry has to charge my insurance company more which raises my insurance premium. That is worse than a tax increase because it's not a fair equable amount based on income because those that refuse to pay their medical bills many times are not poverty. They're just greedy con artist that abuse the system.
Come on people! If you already have health insurance, you have nothing to worry about concerning the ruling. If you're poor, you may or may not be able to benefit from the ruling depending on which state you currently reside in. Nothing more, nothing less. Don't get caught up in all the other BS commentary.
Why?? Are you saying you've been freeloading on the medical system without coverage? If so you're the kind of people we want to force insurance on. You would be costing me more money if/when you go to the hospital for treatment.
@StrengthInNumbers
It's not a boon for the insurance companies since they have to pay 80% of the money they collect on medical payments otherwise refund the money. That they never did before since they would pay their CEOs huge bonuses if they could deny coverage to someone that suddenly got very sick. I was involved in the insurance claim business for a while and it was sickening how they tried to deny coverage for items that are covered under the plan. If the patient complained as I did to the state board of insurance they would pay the bill other wise they would keep the money as profit and raise your premium.
Of course for those that are really upset with the ACA there is always Canada and I hear it's pretty nice this time of the year. Just leave your passport and citizenship at the border.
This part of the ruling just allows the local Republicans to keep their promise to kill off the poor rather than help them.
The ruling will not reign in premium costs. The new tax is cheaper than paying for an insurance policy for both, employers and individuals. In fact, the new tax is actually cheaper than what some employees pay as their share for employer subsidized plan. Small employers and large employers alike, will increase the number of part time employees in order to circumvent paying for insurance without penalty of taxation.
The medicaid ruling is based on the federal poverty level. In many states, the federal poverty level will encompass the middle class. Any state who participates in the medicaid expansion will have to increase taxes to cover the undunded federal portion. Federal taxes will have to be increased to cover the federal government's outlay or deficits will increase.
Mark my words, in less than 10 years, this will be a funding topic of discussion far beyond the debate of raising the social security age.
Yep, States like California, Illinois, New York, Oregon, and Washington will certainly get on the band wagon since they are BILLIONS in debt and have Democratic Governors. I am so sure they will be able to pay for the skyrocketing costs of Medicaid after 2019 because of the number of Illegal Aliens on medicaid.
That "carrot" is going to turn into a "bankruptcy" for most of the Democratic States.
Hard for me to understand repubs hatred of this program. 40% of Americans health care costs are currently paid by the government by Medicaid, Medicare and veterans. 40% have their own coverage through work or self purchased which leaves 20% or so. For a party that complains about the 50% who pay no federal taxes but reject a bill that mandates insurance or a penalty that would help cover care for those irresponsible enough to not have insurance and would fall mainly on that very 50% who pay no fed taxes. This bill might increase those on Medicaid but most of the costs would be paid by those without insurance who figure if they get seriously ill thay'll just go bankrupt.
It's sad how democracy has become "Our side won, suck it!"
At least we KNOW that no one cares to compromise so we don't have to waste the time trying...just continue enacting and repealing in a never-ending useless cycle...awesome
Well said. The EU is collapsing because no one payed taxes but received the services. Keep cutting taxes and we will get there without having any services.
Single payer will reduce medical costs. Think of the millions saved in CEO salaries alone.
"We won"
Was it a partisan contest or a Health Insurance Act to make Health Insurance affordable and available to everyone?
Clearly, a partisan contest by the reaction of Rustyboy there.
Winning is a lot more fun.
Those that did not learn from 2010 are doomed to repeat it. What part of shellacking do you not understand?
Oh darn!!! Now people are going to have to be responsible for their own medical coverage. Wait, isn't that what the Republicans have been saying all alone.
Many of us already have been responsible for our own Health Insurance. It's the subsidies and high risk pools that will require funding. Who will fund that? US of course, unless this is just another line item to be added to the deficit. In that case, our grandchildren will pay for it.
Those who will pay is mostly the millions who go without insurance and get medicaid or go bankrupt on huge medical bills if they have a catastrophic medical problem. We that have health insurance already pay for those that don't bother. Time they paid into the system prior to getting sick and sticking us with the bill.
Interesting... I wonder how this now impacts bills like Transportation funding... "do it or else?".....
or the failing postal service. Surely everyone uses, will use, or has used the postal service and so, it would just be a tax to force us all to donate to ensure it's survival....
"We've already had Medicaid grow from 5 percent to 21 percent of our budget in the last 30 years, and for every governor, these mandates are crushing expenditures to endure," McDonnell, chairman of the Republican Governors Association, said in an interview on MSNBC-TV. "So this is a real hardship."
Greece = USA
tick tock... tick tock... we will be joining Europe
Those statistics mean absolutely nothing without further clarification, anyone who's had even one statistics class knows that. For example how has their budget changed? Has it remained the same or grown in the last 30 years?
What you fail to notice is that McDonnell spent ALL his time on ABORTION bills and FORCED ULTRA SOUND Exams instead of fighting Medicaid Fraud in his own state!!!
It doesn't take a rocket scientist -- it just takes someone who's NOT a partisan hypocrite looking for a VP nomination!!
True.
I know that cities all over this country are collapsing.
I know that 15 Trillion is a big number.
I know Europe is about the collapse.
If a line item is a percentage of a budget...with an increase or decrease in the entire budget, wouldn't that line item show slight variations over the years due to variations in that particular line item?
OR, do you think an increase in the budget automatically increases percentage factors for line item totals from 100% to 100% + budget increase?
cms5, I understand statistics and percentages quite well. Over the past 30 years the cost of healthcare has risen DRAMATICALLY, so if your budget hasn't changed at all or at the near the rate of the inflation of healthcare it will continue to increase the percent of your budget that you are spending on it. What I'm saying it that you can't keep revenue the same when inflation is out-pacing it. Furthermore, the ACA is aimed at curbing the rising costs of medical care and it's based on firm principles which should net the results that are intended.
@KellinMN
So, you're saying the cost of health care is rising faster than income? It took you long enough to get there.
Yes and no DingleB(erry). That is just one of the many reasons why giving a flat statistic like that means absolutely nothing without further information.
"There are three kinds of lies: lies, damned lies, and statistics" - Mark Twain
Ah, budgets are based on projected revenues. The Medicaid line item would be an expense factored into the budget. More than likely, they have accounted for the steady increase in their budgets.
You're suggesting that the state increase it's taxes to help pay for the added expense? That will go over well with the residents! Here...the ACA will cost you this much and we'll call it a federal TAX, AND as a bonus...your states are going to tax you more too! What's funny is, the average working person's income probably hasn't seen an inflationary increase in quite some time!
Growing from 5% to 21% isn't because medicaid is easier to get it's because more people qualify. If we continue on our path to force american workers to compete with people making a dollar an hour or less because we no longer protect our manufacturing base as we did 30 years ago Greece will look prosperous. China has high tarriffs that protects key industires, they manipulate their currency, force foreign companies that want to sell there to produce there and force some companies to partner with a Chinese company and share trade secrets to sell there. That's why we're declining and they're prospering.
It was clearly a partisan contest. A republican POTUS would take credit for inventing and passing it if they were currently in office. Too bad we can't elect a congress that is above politics. We had a problem that needed fixing and its on the way to being fixed, in spite of ourselves.
The republican bill was entirely different. It actually lowered health care costs. Nothing in Obamacare does that, it merely taxes the hell out of the middle class and further suppresses new hiring by business.
There is no free lunch. "Free health care" isn't free. While the rich get the tax cut the middle class are stuck paying for the freeloaders.
End result, the rich get first class care, the rest get rationing. Illegals will also flood the system since, although they aren't supposed to be elegible, all attempts to validate citizenship were killed by democrats.
You nailed that one on the head. I voted for this idiot and so far he was a lame duck now he just wants back in office. No better than Bush.
The republican plan to cut the amount the federal government reimburses states isn't cutting health care costs it's merely forcing the states to pay more or allowing people to die for lack of care.
Hypocritical how Boehner and Cantor talk about keeping government out of health care; then why do they persist on having these discussion about women's health and how government is going to make their choices?
+1
Of course every one remembers when Mitch McConnell said that the only way Republicans could agree to the Presidents plan is if it contained an individual mandate. Don't we? The President compromised and included it and of course the Republicans voted against it anyway. It's time to quit screwing around. It's time for the Republicans to offer something other than more of the same.
The ACA will eventually be a historical lesson in the law of unintended consequences.
Skup - Blah, blah, blah, say something new. All you're doing is repeating the same propaganda that was said when Medicare was enacted, now those same people who whined about and railed against Medicare get their feathers all ruffled when anyone talks about limiting their precious Medicare. I think Medicare is a great program, ensure healthcare for our aging population is what's morally the right thing to do. The ACA act aims at doing the right thing for all of our population, making healthcare affordable and accessible by everyone.
It will do neither, it will not be affordable and millions will still not be covered. It is accessible by everyone now.
Yeah look at 45% of the population. You don't get hooked on prescription drugs off the street, its from a Doctor FeelGood getting kickbacks from the same pharm companies Odumba just sold us all to. You know, like slaves. I'm not proud to be a slave in the united states of phizer.
KellinMN - I couldn't have summed it up better. They aimed, unfortunately they missed.
Skup - You can't even speak to what it's done since it hasn't really taken effect. All you can speak of is your paranoid fears just like people had paranoid fears when Medicare was enacted.
@KellinMN--you speak of medicare as if it is such a successful fully funded program. The concept of medicare was good, but in practice, it is a debacle. There is so much fraud and it is terribly underfunded.
The problem with healthcare in America and the ambitions of the Affordable Healthcare Act is the lack of doctors to service the program. We do not have enough general practitioners to provide the services for the additional 20 million people covered under this program. Only 50% of doctors accept medicaid now. By forcing people to buy private insurance increases the pool meaning an even lower percentage of doctors will accept medicaid. This will lead to rationing of care since, mathematically, the number of doctors providing care under medicaid will be reduced.
Medicare was enacted a short 57 years ago...and it is broke. Again, simple mathematics using projected inflation rates, growing retirement base (baby boomers retiring), decreasing labor base (less medicare taxes) and a stagnating wage.
To me, it isn't about politics...it is simple math. The majority of college grads in our country have liberal arts degrees...very little math background. The numbers don't add up for the AHA, medicaid or medicare.
The solution is to increase the number of doctors. Develop a program in order for those doctors to become general practitioners. Develop a program where these doctors will set up practices in rural areas as well as urban areas. Short of that, in less than 10 years, we will be debating these very issues.
This could have been avoided by the right if they would have during the debate helped by engaging the left rather than my way or the highway. I don't think it will be fix right until we have a single payer provision, then and only then we we get the health care in this country fixed. I believe that there should never profit from another's misery.
Agreed. Much of their current complaints could have been prevented by the public option that they blocked
This is a great post, Ed. Because the right stood obstinately in the way, we have a politically carved half-a-loaf.
Another option could have been government supported hospitals. Simply open up hospitals to provide basic care for all US citizens. If people want better care they can buy their own insurance.
Obama's healt care law seems very complicated and expensive. I don't understand most of it and it's confusing = expensive and decrease in service.
You can not possibly believe that Republicans would have gone for that. That obviously would have been socialism at its finest and government trying to take over the hospital industry and @!$%#ting on free enterprise.
alan_static - Reagan's law that hospitals can't turn acutely ill patients away (EMTALA) already more or less put hospitals on the government payroll. While I don't disagree with the law what you are suggesting isn't really any different from what we already have. Additionally, providing health care that is basically for emergency's and/or has long wait times (like a hospital would) would only perpetuate the problem we already have of people waiting until they are so ill that they need some of the most expensive services.
So Ed...what do the sick on the single payer system do when the Doctors go on strike? Alan_Static..that is what County and State Hospital Systems are supposed to provide and did for decades. So why aren't these systems thriving? Could be because of abuse at every level...they just can't afford to keep their doors open because of abuse.
Frugal Democrat...Our Government, Obama, Pelosi etc. are far too busy #$%^ing on the American people to burn their cash cow buddies in free enterprise. No tax increase for any family making under $250,000 a year....After all Pelosi, wearing her lucky shoes today, basically told America to suck it up the Dems accomplished their goal.
txmom32, what a single payer system would bring to the table would be to force these big health care corporations to stop sucking all the money off and into their pockets and back into the health market. I'm not saying get rid of the private health care I'm saying make them compete for their dollars, if they want to keep charging out the butt for their polices then let them it just won't be long before they price themselves out of the market. Isn't this what everyone wants to pay a far amount for their health care.
Ed...I don;t think you understand what a sigle payer system really is....The NHS is a single payer system for the UK. It is a way to ration health care and again what do people do when their health care professionals go on strike? Of course they also allow those who can afford to purchase health insurance. It is very expensive but the care, private hospitals and Physicians are exceptional. It promotes and have and have not system of care. Yes it is expenive to have and use private health care but from personal experience it is very, well worth the cost.
Virginia Gov. Robert McDonnell predicted that would happen, saying that once the federal contribution begins dropping, states will still be left with a large "unfunded mandate" — $2.2 billion over 10 years in his state, he said.
we are running out of cash for these socialist programs.
take a quick glance across the pond, you wanted Europe... now you got it.
James, this is the same stuff you post all the time. Socialist this. Europe that. Here's where we agree -- we have serious problems. The President is seriously trying to solve them. Calling people socialists (incorrectly using the term) and predicting that we are going to end up like Greece (inane, and unlikely anyway) doesn't add to the discussion.
Let's have some solutions. Let's identify common ground.
cut the debt.
check out the debt clock... today's fireworks will add a couple more trill
who's paying?
the only idea i have for healthcare is the free market
i don't have all the answers but letting thousands of Mexicans cross the boarder and handing out free healthcare surely wont' work.
and you are correct... maybe not Greece but Spain.
The free market obviously wasn't working. Also, illegal immigration is a completely separate topic with a negligible impact on the healthcare industry.
Finally, i am tired of people comparing us to spain or greece. We are not them. I am all for reducing the deficit, but not cutting programs in a time of stagnation.
We are the world's biggest economy. The world can not afford to let us default
say what?????????????????
who's going to bail us out?
James -- just curious, where were you and the Republicans for the past 30 years while YOU were running up the debt with TRILLION DOLLAR wars and UNFUNDED TRILLION DOLLAR Taxcuts?
Where were you then, calling for fiscal responsibility??
Well, as Ben Franklin said to the opponents of Fire Departments and public libraries -- just bite me..
Bush's entire war effort was $877 billion and the tax cuts paid for themselves. Check the treasury web site, revenue went up after the tax cuts.
40% of Americans already have their medical costs paid by the government by Veterans, Medicaid and Medicare. 40% have insurance. Making the 20% of the population who don't have insurance buy it or pay a penalty doesn't make it more socialistic. Anyone still has the right to buy as much or as little insurance as they want.
let me tell you who won today... i did and my other rich friends.
the middle class will become the poor.
the good news... you voted for this fuk up
Don't blame me, I voted for Ross Perot.
Do you own a health care company?
lol
No... I don't own a healthcare company... but I'm well off... and that's what I meant.
James. If what you say is true you should be thrilled. Right?
No surprise there...
I have enough to do my own thing also, but I did grow up lower middle class so I know what it's like.
When will lemmings learn, the only source for money is the middle class. There aren't enough rich to help and the poor can't. That means all these socialist programs are funded by the middle class, making them poor as well.
If you were rich you wouldn't care. The only people this will cost money is those without insurance who'll have to buy some or pay a penalty. Other than the mandate most people support other provisions in the bill.
Valhalla: No one "Well off" would ever admit the middle class pays most of the taxes they're too busy pointing at income taxes as the only ones that count. Did your nose grow as you posted?
Thanks kaden! Your message will self distruct in 4, 3, 2....
I wonder how many more democrats will be laid off now if they even working? The rest of the small bussinesses will have to shut down now.
Time to take your meds Joe66. Look at the red states...notice how darn poor those states are? That's because a large majority of Republicans are people who can't get jobs or refuse to. They are uneducated and ignorant. The reason they continue to vote for the party that wants to hurt them by taking away their welfare and health care is because of the GOP scare tactics.
Yea, that's why TX and WI are stealing high tech firms from socialist CA. And AL not only has Boeing, but AirBus as well. The list goes on and on. Oh, and Caterpillar has had it with IL, they're headed down south as well.
Facts trump liberal lies every time.
Yeah big thanks from us ignorant folks in Alabama. Oh yeah I forgot uneducated also, I am ignorant though and you'll have to overlook it. Maybe you have a program I can join and get free food and housing. Oh that's right! I'm a single white male we're expected to give our money to you.
Crybabies...my comment was no more harsh than Joe66 and was made to point out what a lame comment he made. Now if you're so insecure as to have to whine about that, then go ahead whine and cry like little over-grown babies.
OMG! Would someone please explain that the correct idiom is "carrot ON a stick" not "carrot AND a stick"?!?! From the old idea that if you put a carrot on a stick and hold it in front of the donkey you're trying to ride, the donkey will continue to move forward in an effort to get the carrot! This is so frequently used incorrectly and it sets my teeth on edge. DO NOT make the mistake of blending it with "Speak softly and carry a big stick." PLEASE!
And, YAY! for Obamacare!
it all adds up to leading the masses to poverty
Seems to me that the medicare expansion part was the only real benefit to anyone.
Medicaid expansion...Medicare and Medicaid are VERY different programs, I know they sound similar but they aren't interchangeable.
States can opt out if they like the idea of using their own money to pay for those who use the emergency rooms as their only health care plan. That won't last long.
Ah, okay medicaid. Never used it, never had to learn about it.
Sorry, that might have been a bit harsh. I work in health care and the number of people who confuse them and subsequently make erroneous statements about how they work is incredibly high...especially among those who have either or them.
Sick people will die, so let it be written, so let it be done! The quality of care will crash to that of a third world country, want to see your doctor, you will have to wait until he is done seeing all the illegal aliens, in 3 months time! No incentive for sacrifice for student doctors when everything will be fixed. Oh, fat people and smokers, .. look out, you will now become enemy #1. If I (as a healthy person) have to pay for your healthcosts you can damn well bet I'm going to have something to say about your lifestyle, especially if its unhealthy. No more sympathy, you can't have both worlds. If healthy people pay for unhealthy people through a 'tax' then the unhealthy people are going to hear it!
KSC, where do you get your information? From the fear-mongers, that's where. Ask anyone in Europe who has universal health care: they don't wait 3 months for a doctor's appointment! Where do you come up with this crap?
really?
you're going to use Europe as a role model.
Have you read any new lately about the European Union?
Yes, because their economy is just BOOMING.
Someday you will be unhealthy. It's called getting old. If you have a good lifestyle that means there is a reduced probability of getting certain ailments and thats all. But you will get others. Aging is a bitch.
If you don't like Europe, how about Canada or Australia? Taiwan is supposed to have pretty good health care.
K>S>C> = Just another believer of the GOP fear mongering who clearly lacks the ability to think for them self...all you do is regurgitate what the teabaggers told you, USE YOUR OWN BRAIN, that is if you can.
It was democrat fear mongering that tried to sell this POS. Again, there is no free lunch. Just as socialist programs have bankrupted the EU, this will hasten our bankruptcy and there will be no one to bail us out.
It really sickens me when the G-nO-P is so concerned about their almighty dollar, that they are willing to let people starve or die rather than spend any of "their" money. Good lord, you call yourselves Christians?? Ask WWJD. He'd feed the poor and heal the sick.
The Federal Government should not be in the business of keeping people alive. The Constitution does not require it.
No? What about "life, liberty, and the pursuit of happiness"? You can't be happy if you're dead.
It really sickens me that the only reason you think people oppose this is because they "are willing to let people starve or die rather than spend "their" money."
That's a completely blind assessment of the argument. There are so many things this effects including people who can't afford to pay for what will be required...and the people who are going to now pay more (me) due to the mandate and that they already have insurance. Helping people get the care they need is great...but if it bankrupts a country and the people who it intends to get that care to, then it doesn't make sense and doesn't help.
You could also argue that giving an apple tree to every family in Africa would be a good idea as it would give them a renewable source of food...until you realize that they now need 6 times as much water a day to help it grow, get barely any food from it due to bad growing conditions, and realize that no one is educating people how to properly grow the thing, so all the water is a waste anyways as all the trees die. Wasteful help doesn't end up helping all that much.
Marionic- you don't pay the mandate if you have insurance.
marionc - you clearly don't understand what the mandate is going to do for people who are already insured. It will curb your rising premiums, which have been rising at an incredible rate for a number of years. By mandating people to have insurance to cover if they get sick rather than those people only having insurance once they get sick we are spreading the risk out and essentially having those people start paying for their enormous health care costs prior to incurring them therefore paying more into they system rather than bankrupting it when they get gravely ill. I work in health care and I can't tell you how many times I see patients that have no insurance so they didn't get preventative care and now they have an advanced disease, such as prostate cancer, which could have been treated with less expensive care and better outcomes had they had the preventative care. Now they have a rampant illness that's progressed so far that it requires a great deal more care and more care is more cost. These people AREN'T paying for their services out of pocket, they are relying on Medicaid programs and EMTALA.
No, i don't pay the mandate, but the chances my work keeps our current insurance over the mandate is small...considering the fine is far cheaper than continuing to pay what they do.
So as long as my work decides to keep our current, more-expensive-for-them insurance, instead of a smaller fine to the gov., as long as my premiums don't rise to cover the newly covered preventative costs which I wasn't getting to begin with, and as long as I don't have to buy the mandate when my work cancels our insurance (since it is cheaper for them), it saves me money...(in case you didn't catch the sarcasm...I won't save money with this)
and check out these stories...they seem to contradict a whole lot of your points, including that premiums will be lower...direct quote...
To put it bluntly, the mandate costs more than I pay now, and my work will NOT extend the current insurance offered. I can either pay more than I currently pay for things I do not use with the mandate, or pay a fine and receive nothing, basically wasting a rent check...awesome.
marionc, do you really know how much you'd have to pay if you didn't have insurance or are you just running off at the mouth. I have a hunch you don't have the faintest idea of what you're talking about. If you do, what's your cost and/or how is it calculated????
Alan_static..........Oh really?
``We the People of the United States, in Order to form a more perfect Union,
establish Justice, insure domestic Tranquility, provide for the common Defense,
promote the general Welfare, and secure the Blessings of Liberty to ourselves
and our Posterity, do ordain and establish this Constitution for the United
States of America.''
marionc - Everything you are spouting off is basically your assumption. You know the saying about assuming, right? I'm sure we won't see you come and retract your uninformed rants when you don't lose your medical insurance over the Affordable Care Act.
from marketticker.com:
The USSC upheld Obamacare by, basically, twisting the Constitution into a pretzel, crapping on it, whizzing on that and then eating it.
Finding first that the Commerce Clause bars the government from compelling one to enter into commerce, the analysis then turned to whether there was any way to save the constitutionality of the act.
The justices found one.
They re-interpreted the penalty clause as a tax.
And of course, Congress can levy taxes.
That's the path taken by this tortured process -- a path that could only be dreamed up if someone had already determined the outcome they sought instead of being an independent jurist.
What little was left of The Constitution died today, June 28th, 2012.
RIP US Constitution
bingo
that's the best synopsis of the day
Interesting you say that the Constitution died today. It seems the GOP's precious, unfettered, right to bear arms (second amendment) among many other amendments to our Constitution couldn't possibly be directly affected by what you perceive as violations of the Constitution by the Affordable Care Act.
Please explain Kellin.
alan_static, What exactly do you not understand? It was pretty clear that the Constitution didn't die yesterday and that you are being overly dramatic.
OK now what???
What we really need is to get the FOR PROFIT completely out of health care. If the government pays any part of anyone's health care, it should be mandated to be NOT FOR PROFIT. If you have the money for a PRIVATE FOR PROFIT health care system and doctors that want to rape you, you have every right to pay for it out of your own pocket, not mine. Single payer system is the only way to remove the graft and corruption in the health care system.
Lol, some of the worst doctors I know are ones that are in large systems. The better ones don't even accept medicare... This is because the larger systems stifle critical thinking and don't reimburse for treatments that aren't considered mainstream. Current polls show doctors wanting to get out of healthcare or go to private pay only.
Idiot liberals. Competition is the only method that lowers costs and increases quality. The reason health care is so expensive is because there is no competition. Obamacare institutionalizes monopolies, guaranteeing higher prices going forward.
Medicare is 10X what it was sold at, this will be worse. They lied, cheated and stole to get it passed and the middle class will foot the bill.
I think I'm starting to see the pattern Phil. The only people who want this know nothing of the outcome or even how it works.
This medicaid loss explanation is very telling. States like Texas, Oklahoma, Alabama, etc... would rather the poorest of the poor get no coverage than approve anything Obama has done. The unemployed in red states lost big in this decision.
Right? So here is my question: If your state chooses not to expand medicare, you don't qualify for medicare but your employer doesn't provide health insurance, then what is the point of paying a penalty/tax for something you don't get anyway? Does that tax penalty just fall on your employer? Am I reading this right?
Medicaid, not medicare. Two different things. There is a problem here with this ruling. Most states may expand because the federal government is paying about 95% of the cost of the expansion and would be stupid not too. But right wing state governments don't care, they will attack anything Obama related. I don't know how this will be resolved or if it will. I can see red states using this to get poor people to move out of their state.
Okay, thank you for clarification. I see what you are getting at, now it is a political weapon.
Explanation of how the Law affects Medicaid:
Information for You
The Affordable Care Act provides you with strong
consumer protections, more coverage options, and lower costs. In this section,
you can learn how the health care law meets the unique needs of specific
audiences.
Families with Children
The law expands your family’s options for health coverage and makes health
care more affordable.
Individuals
Whether you are healthy or have a health condition, the law includes strong
new protections that include allowing you to appeal denied claims and providing
help with your insurance through the Consumer Assistance
Program.
People with Disabilities
Find out about programs that cover pre-existing conditions, eligibility for
Medicaid, and options for long-term care.
Pregnant Women
Learn about coverage options that are available now for you and your child.
Seniors
The law gives seniors new preventive benefits, prescription drug discounts
and more options for long-term care.
Small Businesses
Your business may be eligible for tax credits to help offset the cost of
health insurance.
Women
The law provides women with important health benefits and features
comprehensive new guidelines for
women’s preventive services.
Young Adults
You may be eligible for coverage on your parent’s plan if you are under age
26.
Use our interactive FAQ tool at answers.healthcare.gov to
find answers to your questions about health care and insurance.
All for the small cost of American bankruptcy. Sweet deal isn't it. Guess what, when we become Greece ALL this and more goes away. Enjoy it while it lasts.
valhalla, who's Kool Aid are you drinking these days? What an uneducated fluffball!
Well I was planning on applying for med school. Screw it, not anymore...too much risk for too little benefit.
Good, because with that type of attitude you wouldn't have made a good or ethical physician.
So now we can go after a foreign country that is violating human rights with all kinds of sanctions, but we can't force our own states to treat their people like human beings. The state of Texas is going to be a third world country, nestled inside of a second world country.
Thanks to ILLEGAL IMMIGRANTS.
The dems will pop a short-term chubby on their small victory. The congress will now begin plans to de-fund anything related to obozocare like the addl. 10,000+ IRS slime ball agents who will strong arm those who refuse to pay the now called "tax" Vs the "fee" the liar and chief and demoslugs called it back in 2009.
One question: how does obozo dance around the tax issues now? Since it's a tax and ALL eligible people will be taxed if they don't opt-in, he is now taxing the very same people he promised WOULD NOT BE taxed i.e. "anyone making under $250K."
Remember that lie? Just add it to his long list. Good thing is, we're going bounce this EPIC ONE-TERM LOSER of a clown out of office in Nov. and with him eric (obama scrotum) holder along with him. The clown is going down.
Every liberal out there keeps yammering on about how they want the "Single payer" system. What they are really asking for is the "Someone else payer" system. Who do they think they are kidding? Obamacare accomplished what they want. The responsible people of society will still be the single payer as they have always been.....
Another brick in the wall, another nail in the coffin. For the love of God, Montresor...
This is going to be more fun than watching a monkey f*ck a football.
as some have suggested, the issue is who will pay? say not "the government" for it obtains its cash from others; tell us who these others will be.
If you have your own health insurance now. That is what responsible people call the "single payer" system. When you pay for the Liberals insurance they also refer to this as the "Single payer" system..... I hope that answers your question...
This is NOT a single payer system and your comments show how uniformed you are about this law!
The middle class will pay. Obamacare is a tax cut for the rich and the freeloaders won't pay a dime. That leaves it to all you working stiffs out there.
Man, where are you getting this fear-mongering drivel from, Fox News? Glenn Beck? Boehner? McConnell? Hannity? O'Reilly? Ryan? Matlin? Coulter? SHEESH!