Medicaid expansion places governors, tax payers and employers between a rock and hard place.
Arguably the only ‘good thing’ about U.S. Supreme Court Justice John Robert’s decision in July 2012 to not strike down the PPACA was his decision to provide governors a choice to expand their Medicaid rolls to the levels specified in the PPACA. In fact, this part of Robert’s ruling has been referred to by many as the only ‘silver lining’. In the end, however that perception depends upon who you ask. Many taxpayers are against the expansion because it will most certainly massively inflate state budgets all across the country. Many of which already point to Medicaid as their biggest line item.
Whether you use the Kaiser Family Foundation estimates, the Cato Institute estimates or the Congressional Budget Office. The expansion of Medicaid under the PPACA will put a significant new burden on the taxpayer. This is because the PPACA promises 100% matching federal Medicaid dollars for years 2014 through 2016 and 90% for years 2020 onward for states that elect to expand their Medicaid rolls.Even President Obama’s Medicare Actuary Charles Blahous doubts that promise. Most especially since the President’s own submitted budgets, as well as the bipartisan Simpson–Bowles Commission, and the budget resolution passed by the House of Representatives in 2012 already call for trimming Medicaid spending by a minimum of $100 billion.
And, unlike Supreme Court justice Elana Kagan who famously said during PPACA oral arguments: “It’s just a boatload of federal money to take and spend on poor people’s healthcare. It doesn’t sound very coercive to me.” We taxpayers realize that ‘a boatload of federal money‘ comes from taxpayers and taxes themselves are inherently coercive.
Whilst the Obama administration touts the fact that the PPACA calls for the aforementioned matching federal funding for those who will be newly eligible for Medicaid in 2014. It is far less vocal about the fact that it only provides the existingor Traditional FMAP percentage match rate for the millions of Americans who were always eligible for Medicaid but either never knew they were or never bothered to enroll. These ‘old eligibles’ will now be required by federal law to maintain ‘minimum essential coverage‘ via Medicaid. Which means that they will all be enrolling in 2014 in order to avoid problems with the IRS. How much will the Traditional FMAP federal percentage match be in 2014? In states like Illinois and others it will be only 50%.
Who picks up the other half? That’s right, the state tax payer. Keep in mind Illinois taxpayers that this new tax increase will be in addition to the 66.66% tax increaseGovernor Quinn already imposed upon you in January 2011 and the $350 million additional tax increase in May 2012. How much will picking up the other half of the cost to enroll ‘old eligibles’ cost Illinois taxpayers? See the chart below. I’ll bet it’s closer to the CATO institute’s estimate of $10.1 billion.
The Illinois Policy Institute predicts that 1 in 3 Illinois residents will be Medicaid recipients by 2019 if Governor Quinn’s desire to expand Medicaid under the PPACA becomes law in Illinois. Worse yet, on January 30, 2012, the Civic Federation released its “Budget Roadmap” for the coming fiscal year. In it, they highlight the fact that state officials now believe that the Illinois Medicaid program will have between $21 and $23 billion in UNPAID bills by 2017. ‘Forward’…. to bankruptcy.
However, that’s just the cost to Illinois taxpayers. How many people nationwideare ‘old eligibles’? This 2010 article in the New England Journal of Medicine estimates that number to be 9 million Americans. Total cost to the states to enroll all of these ‘old eligibles’ on to Medicaid nationwide will be $931 Billion according to the Congressional Budget Office’s latest assessment. Keep in mind that those CBO assessments are only for years 2014 through 2022. What many governors are concerned about is what such a new commitment will cost state tax payers after the first 8 years? Well, we know what will happen after the first 6 years because beginning in 2020 the 100% federal Medicaid match rate for newly eligible recipients drops to 90%. This means that state taxpayers will pick up the other 10%. That alone will add billions to state budgets. However, a far more important question governors should be asking is what happens after the first 2 years?
You see the PPACA’s answer to improving Medicaid is to raise the amount the federal government pays to doctors who take MedicAID patients to a level commensurate to what the federal government pays to doctors who takeMediCARE patients. Their thought process behind doing so is that more doctors will accept Medicaid under this arrangement because the reimbursement rate will be far higher. There’s only one problem. The federal government only provides funding for this massive increase in Medicaid reimbursement ratios for the first 2 years. Afterward, state tax payers are on the hook for the rest.
This, more than anything else related to Medicaid expansion is a fiscal ticking time bomb for state budgets and one that is not being discussed nearly enough. Furthermore, just wait until hospitals – who are forced to treat emergency patients under EMTALA – start pressuring states for reimbursement of more than $11 billion in annual federal payment cuts for uncompensated care. Hospitals are a powerful lobbying force and they will lobby hard for that money.
Click HERE Very comprehensive information regarding PPACA (Obamacare) after the Supreme Court Decision from TheTruthAboutObamacare.com
The TRUTH About Preexisting Conditions
Then there was the LIE the President told about his own mother. In 2008 and again in the film created for Barack Obama entitled “The Road We’ve Traveled” – narrated by Tom Hanks. Watch him tell this lie in the video below:
In the book “A Singular Woman: The Untold Story of Barack Obama’s mother.” by journalist Janny Scott. Scott reviewed letters from the President’s mother – Anne Dunham – to CIGNA (the insurance company), and revealed the dispute was over disability coverage, not health insurance coverage. Disability coverage helps replace lost wages due to an illness. This story had absolutely nothing to do with her health insurer refusing to pay her medical bills. In fact, she had excellent health insurance, the hospital billed her health insurer directly and her health insurer paid her medical bills, less her deductible and applicable co pays.
Worse yet, the President described his mother as an indigent woman who was ‘pretty much drained of her resources.’ The truth is Anne Dunham received a base pay in 1995 of $82,500, plus a housing allowance and a car, to work in Indonesia for Development Alternatives Inc. of Bethesda. Today, adjusting for inflation, that salary would be equivalent to $123,500. This is far from indigent. Today, the Washington Post rightfully gives this story ‘Three Pinocchios”
What about the women who the President said had her cancer treatment denied because of acne? Well, as you may have guessed by now. That too is a lie. According to ABC News, “President Obama’s description that Beaton’s ‘insurance company canceled her policy because she forgot to declare a case of acne’ is not accurate.
As Robin Lynn Beaton’s congressman, Rep. Joe Barton, R-Texas, testified, the Blue Cross/Blue Shield letter ‘informed Ms. Beaton that an investigation into her claims for benefits resulted in the company reviewing her medical records in which they discovered that she has misinformed them on several pieces of information. One of them was that she did not list her weight accurately, and the other, that she had failed to disclose some medication she had taken for a preexisting heart condition.”
Blue Cross discovered the previous condition after her visit to the dermatologist for acne but her insurance was not canceled because she didn’t declare a case of acne.”
By now, you may be asking. ‘Who are you to call the President of the United States a liar?’ Let me answer that. I have been a multi-state licensed health and life insurance Broker for more nearly 20 years now. I have also served as a Subject Matter Expert for multiple business journals around our great country. One of the biggest challenges I’ve had to deal with throughout the years has been trying to secure coverage for people with preexisting conditions who obtain their health insurance on the individual market. They represent 10% of the American insured.
I’ve never had to worry about preexisting conditions with the other 90% of American insured’s who get their health insurance through an Employer Sponsored Group plan. Why? Because A Federal law called HIPAA has protected them against being denied health insurance because of preexisting conditions for more than 17 years now.
Labor unions continued to receive the overwhelming majority of waivers from the president’s health care reform law since the Obama administration tightened application rules last summer.
Documents released in a classic Friday afternoon news dump show that labor unions representing 543,812 workers received waivers from President Barack Obama‘s signature legislation since June 17, 2011.