The Intransigent Conservative: Medicaid

Showing posts with label Medicaid. Show all posts

Monday, February 25, 2013

Florida Medicaid Monday

View the story "Florida Medicaid Monday (2/25/13)" on Storify Florida Medicaid Monday (2/25/13) http://theintransigentconservative.blogspot.com Storified by Brian Empric· Mon, Feb 25 2013 11:42:45 James Madison Institute polled 600random registered Florida voters and found the following (margin of error +/-4%):

• 85% are either “very or somewhat” concerned about government healthcarespending as it drives our long-term debt problem
• Although the response was within the margin of error, more respondents wantto reform Medicare/Medicaid than preserve these government programs (264-257)
• About 56% were less likely to support extending Medicaid eligibilityrequirements once they understood that Medicaid spending ($21 billion) is about30% of Florida’s budget, and the Medicaid expansion will cause that program tobecome an even higher percentage of overall state spending
• Almost 60% were less likely to support the Medicaid expansion when told thatexperts predict it will cost the state an additional $3 billion to $20 billionover the next decade
• About 60% were less likely to support the Medicaid expansion when offered thechoice between expanding the program and either additional taxes or lessspending on other things (like education, roads, and law enforcement)
• About 59% thought that we should opt not to expand Medicaid and keeptaxes/spending on current trajectories, instead of having resultant taxhikes/spending cuts
• 65% opposed expanding Medicaid coverage if the effect would be to pull manyout of private coverage and into the taxpayer funded program
• Almost 56% believe that Florida should improve the private insurance marketto increase coverage to the uninsured instead of expanding Medicaid
• Almost 54% were less likely to support expanding Medicaid coverage once theyknew that the ObamaCare individual mandate will require Florida to spend moreon Medicaid
• About 63% are concerned that the federal government will eventually changethe Medicaid program, and reduce the amount it reimburses to Florida, whichwould add additional expenses to taxpayers

See also: Florida Statewide Medicaid Poll JMI NEWS Latest Poll of #Florida Voters Shows Majority Oppose #Medicaid Expansion http://bit.ly/15xse83 #sayfie #ssnslerts @newsserviceflaJames Madison Inst

Tia Mitchell and Steve Bousquet report that Florida GovernorRick Scott (a former health care executive at Columbia/HCA,@FLGovScott) has nevertheless decidedlast week to support expanding Medicaid, in “a significant policy reversal” and“a stunning about-face for a small-government Republican who was one of theloudest voices in an aggressive, and ultimately unsuccessful, legal strategy tokill a law he derided as ‘Obamacare.’”

“Whilethe federal government is committed to pay 100 percent of the cost, I cannot,in good conscience, deny Floridians the needed access to health care,” Scottsaid at a hastily called news conference at the Governor’s Mansion.

“Throughout his 2010 campaign for governor, as Scott sought support from teaparty members, he called the law a ‘job-killer’ that would hurt Florida.”

“Scott was careful to point out that the Republican-controlled FloridaLegislature will ultimately decide whether or not his proposal is worthimplementing. That is far from certain, particularly in the more partisanHouse.”

“Gov. Scott has made his decision and I certainly respect his thoughts,” saidHouse Speaker Will Weatherford, R-Wesley Chapel (@willweatherford). “However, theFlorida Legislature will make the ultimate decision. I am personally skepticalthat this inflexible law will improve the quality of health care in our stateand ensure our long-term financial stability.”

“Scott said he would support an initial three-year expansion of Medicaid butmade clear he would not twist legislators’ arms to make it happen… Under thegovernor’s proposal, the Legislature — after three years — would have to voteto reauthorize the program to keep it going.”

“For weeks, Scott has said the debate on expanding Medicaid was directly tiedto the state’s application for waivers it needs to allow private companies torun the program.

“His endorsement of the expansion came hours after the federal governmentagreed to grant Florida a conditional waiver to privatize Medicaid statewidefor the state’s more than 3 million current recipient, more than half of whomare children or people under age 21.”

“Medicaid, a joint state-federal, government-run health care program, isvoluntary for states… The federal government covers about 55 percent of allMedicaid costs in Florida and covered about 68 percent in recent years withadditional stimulus funding.”

“The health care law tried to entice states to expand eligibility to Medicaidby raising income eligibility limits. To do so, the federal government agreedto fund 100 percent of the cost for states to expand Medicaid for three budgetyears. The federal government would then cover 95 percent of the costs in 2017,94 percent of the costs in 2018, 93 percent of the costs in 2019 and 90 percentof the costs in 2020 and beyond.”

TALLAHASSEE: Florida Gov. Rick Scott supports Medicaid expansion - Florida - MiamiHerald.comWEB VOTE After getting a waiver from the federal government to privatize Medicaid, Gov. Rick Scott now says he will expand healthcare for...

Slade O’Brien,the state director of Americans for Prosperity-Florida, had the followingcomments after Governor Scott flip-flopped from his previous opposition toMedicaid expansion.

“GovernorScott’s announcement today is extremely disappointing. Scott had been anational leader in the fight against President Obama’s healthcare takeover. Hewas elected because of his principled conservative leadership againstObamaCare’s overreach, and led the charge, with Attorney General Pam Bondi, totake ObamaCare to the Supreme Court. But today he came out in support of theMedicaid expansion he vowed to oppose.”

“At every level of government, it is too easy for politicians to spend otherpeople’s money. For far too long, states have fallen for the promises of ‘free’federal money ignoring the insidious federal strings and the long-term effectson state budgets. Florida’s Medicaid program already costs the taxpayers more than$20 billion a year, and the financial burden will only grow if a million newpeople are added to the program. Hopefully our legislative leaders will notfollow in Governor Scott’s footsteps and will reject expansion of this brokensystem.” @SladeOBrien on Scott's announcement: Support of Expansion a huge threat to Florida’s financial future http://bit.ly/VLrOJH #sayfieAFP Florida

Adam C. Smith (@adamsmithtimes),political editor at the Tampa Bay Times, blames Obama’s victory in Florida lastNovember, abysmal poll numbers, a “diminished” tea party and twenty months oflooming re-election campaigning for Governor Scott’s change of heart.

“Twoyears ago nobody would have dreamed that Rick Scott, the multimillionairepolitical outsider crusading against Obamacare, would end up heading into are-election campaign looking like the sort of pragmatic, moderate Republicantea party activists loathe… But that's where Scott has awkwardly positionedhimself — as another politician without clear convictions.”

“With his Medicaid decision this week, Scott officially and forever cast offhis image as a tea party standard-bearer.”

“Scott is the seventh Republican governor to support the federal-drivenexpansion of Medicaid. But Scott also is a special case, having spent millionsof dollars of his own fortune fighting the Affordable Care Act and launchinghis own campaign for governor attacking Obamacare at every opportunity.”

“This is going to be devastating for patients, devastating for taxpayers. It'sgoing to be the biggest job-killer ever," Scott said on Fox News after the U.S. Supreme Court upheldthe law (see video below). "We're not going to implement Obamacare inFlorida. We're not going to expand Medicaid, because we're going to do theright thing.”

“Statewide elections in Florida are usually won in the moderate middle, not thehard right or left, and Scott is now lunging as fast as he can toward thecenter.”

“Only 38 percent of Florida voters approved of Scott's performance in a JanuaryQuinnipiac poll. His recent policy reversals may have burned bridges with thelast sliver of the electorate that had been enthusiastic about him.”

“Former Attorney General Bill McCollum, who launched the lawsuit to overturnthe health care law and whom Scott cast as too moderate in their 2010gubernatorial primary campaign, said he was ‘very disappointed’ by Scott'sdecision.” Rick Scott's new ideology? 'Getting re-elected,' some say | Tampa Bay TimesTwo years ago nobody would have dreamed that Rick Scott, the multimillionaire political outsider crusading against Obamacare, would end u... Gov. Rick Scott: We are not going to implement Obamacare in Floridafloridagop

The Associated Press reports that the Office of Economic and Demographic Researchmeets today in Tallahassee to discuss the cost of expanding Medicaid inFlorida.

“Medicaid expansion cost projections have varied widely, but the latestprojection would cost the state $3 billion over the next decade… Stateeconomists estimate about 80 percent of those eligible would apply.”

“A House committee meets Thursday to discuss the issue. A Senate committee isalso still weighing a decision and plans to have a recommendation in earlyMarch.” Fla. economists discuss cost of Medicaid expansionFORT LAUDERDALE, Fla. - Legislative economists will discuss the cost of expanding Medicaid days after Gov. Rick Scott signaled he wanted ...

Sunday, February 17, 2013

Weekend Potpourri

@AUG_RickMcKee

Joe Heller

View the story "Weekend Potpourri (2/16/13-2/17/13)" on StorifyWeekend Potpourri (2/16/13-2/17/13)http://theintransigentconservative.blogspot.comStorified by Brian Empric· Sun, Feb 17 2013 17:26:09Alex Burns reports on the pair of PR firms, CRC Public Relations and Shirley & Banister Public Affairs, who are working with their clients to advance the conservative grassroots uprising against the national GOP establishment.

“During almost any given controversy, there’s a barrage of indignant subject lines from both firms cementing the backbone of what the national press calls the ‘anti-establishment’ message of the day. Call them the anti-establishment establishment.”

“The founders of both firms are conservative true believers, whose biographies are intertwined with the rise of the modern activist right and with each other’s careers.

“In fact, the current leadership of CRC and S&B looks a bit like the Pat Buchanan alumni association: CRC founder Greg Mueller (@gregmcrc) worked with Banister on Buchanan’s insurgent 1996 campaign. Craig Shirley (@SBPublicAffairs), the S&B partner, worked for the Reagan-era Republican National Committee and for the National Conservative Political Action Committee in 1984, and has more recently become a kind of court historian for the Age of Reagan.”

“Over the past decade and a half, they’ve dived in — together or separately — to countless conservatives-versus-Washington fights and political campaigns… Indeed, choose at random a conservative activist, author or organization thundering against Washington, and there’s a decent chance you’ll come up with a client of one firm or both.”Fun note in that "anti-establishment establishment" story: both CRC and S&B are led by Buchanan '96 alums http://www.politico.com/story/2013/02/the-anti-establishment-establishment-87643.html?hp=t2_3Alex BurnsOn the website of the magazine founded by William F. Buckley, Jr., Neal B. Freeman explains what supporting “the rightwardmost viable candidate” meant in Buckley’s lexicon. Freeman was present at the formulation of the Buckley Rule in 1964, when National Review was deciding whether to support Barry Goldwater or Nelson Rockefeller.

“These intramural arguments, as I say, were protracted, begun in the winter and carrying on into the early spring. WFB sat at the head of the table, encouraging others to speak, keeping his own counsel. In early June, after Rockefeller had won the Oregon primary and Goldwater had won California, after all of us had had our say, after rumors had begun to creep out of 35th Street that NR might shift its support to Nelson Rockefeller — the equivalent, today, of word leaking out of 15th Street that the Washington Post might endorse Michele Bachmann — Bill, who rarely proposed, decided that it was time to dispose. With each of us in our assigned seat and with six pairs of eyeballs staring at him unblinkingly, Bill announced that ‘National Review will support the rightwardmost viable candidate.’

“Victory for Team Goldwater! We all knew what ‘viable’ meant in Bill’s lexicon. It meant somebody who saw the world as we did. Somebody who would bring credit to our cause. Somebody who, win or lose, would conservatize the Republican party and the country. It meant somebody like Barry Goldwater.”

“Bill Buckley was careful with words. If he had opted on that June day for the words ‘rightwardmost electable candidate,’ we would all have recognized it as a victory for Team Rockefeller. And life might look very different today. If there had been no Goldwater, National Review might not have become so influential, and if there had been no Goldwater, no National Review, there might have been no Reagan.”

“We all understand that it is Karl Rove’s mission to promote the Republican party. It was the mission of Bill Buckley to promote the conservative cause. There should be no confusion between the two.”The Buckley rule - an originalist interpretation: http://bit.ly/ZalLiHNational ReviewNate Cohn writes that the House Republican obstructionism “fever” did not break after Obama’s re-election, but safe, gerrymandered districts are not to blame like Obama has argued. The wide ideological divide between conservatives and liberals is why Obama has not been able to “break the fever.”

“It's not surprising that Obama holds this view, since much of the mainstream media does, too. But the president is wrong: Republicans aren't in safe districts because of gerrymandering; increasing the number of competitive districts wouldn't necessarily make Republicans more likely to support the president's agenda; and it's even possible that the number of moderate Republicans has been inflated by gerrymandering in blue states.”

“It's difficult to draw competitive districts in a deeply polarized country. Americans are geographically segregated along a variety of demographic lines, and most demographic groups side decidedly with one party or the other… Since ‘fair’ congressional districts preserve geographic integrity and tend to promote homogenous districts, even a fair redistricting process would leave Republicans in deeply conservative districts.”

“The combination of de facto segregation, extreme racial polarization, and the Voting Rights Act (which requires the creation of minority-majority districts) ensure that Republicans preside over extraordinarily red districts in the former Confederacy.”

“Even if a gerrymander created a modest number of artificially balanced districts, it might not moderate the House Republican caucus. In a useful if underreported piece, John Sides used data from political scientists Simon Jackman and Nolan McCarty to show that there is only a weak relationship between the partisanship of a district and the partisanship of its representative. Put differently: The Republicans from blue states just aren't much more moderate than their peers from blood-red districts.”

“Partisan gerrymandering works by piling your opponent's voters into a small number of deeply partisan districts, and then dividing the rest of the state into a larger number of less partisan districts that lean in the direction of the gerrymandering party. Because the party in charge is spreading its votes over a larger number of districts, their districts are relatively competitive.”Obama's got it all wrong: @electionate explains why gerrymandering doesn't explain the GOP fever http://on.tnr.com/XOMqwCThe New RepublicMike Murphy writes that Obama has great theatrical campaign skills, but “a strategy based on doing what is comfortable rather than what is difficult will doom his second term.”

“President Obama has started his second term as if his re-election campaign had never ended. That is a titanic mistake. White House aides are fundamentally misreading the political landscape if they think a barrage of fiery stump speeches and campaign-style advocacy will achieve anything in Washington. In reality, the it-is-always-a-campaign thinking will subvert any chance for a meaningful Obama success in his second term.”

“Unlike his congressional opponents, President Obama faces a merciless countdown clock. In about 18 months, the national political agenda will become hostage to the 2014 midterm elections. After that, a high-stakes 2016 presidential-nomination contest will shift into high gear inside both parties. The President has little time to waste.”

“Showing the hubris of all things Obama, the White House has forgotten that while he won re-election fair and square with about 66 million votes, 61 million (63 million) other Americans voted to fire the President. Many of those anti-Obama voters live and vote in the 232 (234) congressional districts firmly held by Republicans. It is terribly naive to think that stuffing e-mail inboxes and presidential hectoring on the stump will persuade those voters — and their members of Congress — to support the President’s decidedly left-tilting second-term agenda. When the President threatens the Republicans in Congress with ‘or else,’ they just roll their eyes and wonder ‘or else what?’ In their precincts, he is not even a paper tiger.”

“So the President must choose: Does he want a second term of rhetoric without results while the rest of us suffer under an exploding federal debt and endless recession? Or does he want to actually get big, important things like immigration and entitlement reform done?”"Organizing for Failure" - @MurphyMike on President Obama's second term this week in @TIME - http://ti.me/Y9eN6OTIME CommunicationsLydia Saad reports that federal government and private sector hiring has faltered the most in recent months. The Gallup Job Creation Index – the percentage of employers hiring new people minus percentage letting people go – averaged +16 last month, the lowest monthly index level in 11 months.

“January's results are based on 32% of U.S. adult workers saying their employers are hiring and expanding the size of their workforces, and 16% saying their employers are letting workers go and reducing the size of their workforces.”

“January also saw the continuation of a decline in hiring in the federal and nongovernment sectors of the economy, a trend that started in November. At the same time, hiring reported by state and local government employees has been fairly steady at the highest levels in more than four years.”

“As has been typical since late 2010, the Midwest continues to show slightly stronger hiring than the other regions. Net hiring is currently +18 in the Midwest, versus +17 in the West, +15 in the South, and +14 in the East.”

“Most of the decline in net hiring in the past few months is due to a weakening of reported hiring by employees working in the private sector as well as in the federal government, while reported hiring by employees of state and local government has held fairly steady.”U.S. Job Creation Index Dips to 11-Month Low in January... http://www.gallup.com/poll/160313/job-creation-index-dips-month-low-january.aspx?utm_source=twitter&utm_medium=gallupnews&utm_campaign=syndication #Jobs #JobCreationgallupnewsgallup job creation indexBrian_Empricgallup jci by employer typeBrian_EmpricPhil Galewitz reports that illegal immigrants are usually prohibited by federal law from being covered by Medicaid, but about $2 billion is spent each year on more than 100,000 patients for Emergency Medicaid. Primarily, this money is being spent to reimburse hospitals for delivering “anchor babies” in their emergency rooms, which encourages people to cross the border for care. In 2011, Florida spent $214 million on 31,000 Emergency Medicaid patients ($6,900/each).

“The funding -- which has been around since the late 1980s and is less than 1 percent of the cost of Medicaid -- underscores the political and practical challenges of refusing to cover an entire class of people. Congress approved the program after lawmakers required hospitals to screen and stabilize all emergency patients regardless of their insurance or citizenship status.”

“Hospitals can't ask patients whether they're illegal immigrants, but instead determine that after checking whether they have Social Security numbers, birth certificates or other documents.”

“A 2007 medical article in the Journal of the American Medical Association reported that 99 percent of those who used Emergency Medicaid during a four-year period in North Carolina were thought to be illegal immigrants.”

“The Federation for American Immigration Reform, which seeks to limit immigration, said the funding led more women to give birth in the United States, especially since they knew that children born here would be American citizens. The group believes that tens of thousands of ‘anchor babies’ are born each year to illegal immigrants who hope that giving birth to children recognized as citizens will help the women gain legal status themselves.”

“Last year, for instance, Florida changed its policy to pay for emergency services for eligible undocumented immigrants only until their conditions had been ‘stabilized.’ Previously, its policy was to pay for care that was ‘medically necessary to relieve or eliminate the emergency medical condition’… An administrative law judge ruled in December that Florida had enacted the change improperly because it didn't go through a public hearing process; the state is appealing.”$2 Billion Medicaid Program Helps Mostly Illegal Immigrants, @PhilGalewitz has the story: http://khne.ws/XB20xPKaiser Health NewsJonathan Weisman writes that Senator Ted Cruz (@SenTedCruz) is running counter to the Senate’s courtly ways. Cruz was instrumental in blocking the passage of a cloture motion to nominate Chuck Hagel for defense secretary, and the obstruction “was due in no small part to the very junior senator’s relentless pursuit of speeches, financial records or any other documents with Mr. Hagel’s name on them going back at least five years.”

“In just two months, Mr. Cruz, 42, has made his presence felt in an institution where new arrivals are usually not heard from for months, if not years. Besides suggesting that Mr. Hagel might have received compensation from foreign enemies, he has tangled with the mayor of Chicago, challenged the Senate’s third-ranking Democrat on national television, voted against virtually everything before him — including the confirmation of John Kerry as secretary of state — and raised the hackles of colleagues from both parties.

“He could not be more pleased. Washington’s new bad boy feels good.”

“Comity does not mean avoiding the truth,” Cruz said. “And it would be wrong to avoid speaking the truth about someone’s record and past policy positions, even if doing so inevitably subjects me to personal criticism from Democrats and the media.”

“Chris Chocola, the president of the Club for Growth, a conservative free-market political action committee that strongly backed Mr. Cruz in his victory last year against the establishment’s favorite, Lt. Gov. David Dewhurst, said the new senator was doing precisely what he had expected. The growing caucus of ardent conservatives — Mr. Cruz, Mr. (Rand) Paul, Marco Rubio of Florida, Patrick J. Toomey of Pennsylvania, Jeff Flake of Arizona, Mike Lee of Utah, Ron Johnson of Wisconsin and Tim Scott of South Carolina — has begun reshaping what it means to be a Republican in the Senate, he said.”

“’The last thing we need is another status quo senator or congressman who will go along to get along,’ said former Senator Jim DeMint of South Carolina, who pumped money into Mr. Cruz’s campaign, then left the Senate to lead the conservative Heritage Foundation.”Very Junior Senator’s Bomb-Throwing Debut; Shaking status quo "what I intend to do, have done in every way possible" http://nyti.ms/Vnb1fMJonathan WeismanRomina Boccia, a Research Coordinator in the Thomas A. Roe Institute for Economic Policy Studies at The Heritage Foundation, confirms that America is on a dangerous budget path, with high debt today and even higher debt projected in the future. Solutions include raising the Social Security and Medicare eligibility age, correcting the cost-of-living adjustment, and phasing out benefits for upper-income retirees.

“Current spending and debt are dangerously high, and future spending and debt are on track to rise even higher in large part due to increasing entitlement spending. Academic research shows that advanced economies like the United States are at risk of significant and prolonged reductions in economic growth when public debt reaches levels of 90 percent of GDP. High public debt threatens to drive interest rates up, to crowd out private investment, and to raise price inflation. The implications would be severe and pronounced for all Americans, but most especially for the poor, the elderly, and the middle class.”

“Recent economic research, especially the work of Carmen Reinhart, Vincent Reinhart, and Kenneth Rogoff, confirms that federal debt at such high levels puts the United States at risk for a number of harmful economic consequences, including slower economic growth, a weakened ability to respond to unexpected challenges, and quite possibly a debt-driven financial crisis.”

“The federal government is quickly exhausting its ability to manage its bills, with debt having already reached the statutory debt ceiling. The resulting debate should focus on the need to reduce federal spending immediately and over the long term by making necessary and prudent reforms to the nation’s major entitlement programs, and thus reduce the continued buildup of debt and the expected harmful consequences increasingly confirmed by academic research.”

“America’s entitlement programs, by definition, span generations. It is vital in assessing their sustainability to consider their long-term implications. Over the 75-year long-term horizon, the combined unfunded obligations arising from promised benefits in Medicare and Social Security alone exceed $48 trillion (net-present value).”

Debt overhang – where the debt exceeds the future capacity to repay it - reduces economic growth significantly and for a prolonged period with higher interest rates (which hurts middle-class borrowers), higher inflation (which hurts the poor and those on fixed incomes), and crowding out of private investment (which lowers innovation and productivity).

“Creditors may lose confidence in the country’s ability to service its debt and demand higher interest rates to offset the additional risk… Higher interest rates on government bonds also lead to higher rates for other domestic investments, including mortgages, credit cards, consumer loans, and business loans.”

“The government could, through the Federal Reserve, inflate the money supply. The resulting increase in the rate of price inflation would devalue the principal of the remaining public debt. The resulting inflation would also destabilize the private economy, increase uncertainty, increase real interest rates, and slow economic growth markedly.”

“Government deficit spending and its associated debt subtracts from the amount of private saving available for private investment, leading to slower economic growth. Unlike what staunch believers of government spending for economic stimulus claim, government stimulus spending does the opposite of growing the economy. Less economic growth caused by high government spending and debt results in fewer available jobs, lower wages and salaries, and fewer opportunities for career advancement.”

Boccia concludes with a clear message: “The Time to Act Is Now”

“By neglecting the regular budget order—the institutional schedule to assess government spending and allocate taxpayer dollars with prudence—Congress and the President are increasingly failing to govern… As U.S. debt is quickly approaching economically damaging debt levels, U.S. lawmakers should delay no more.”New paper just out: How the United States’ High Debt Will Weaken the Economy and Hurt Americans: http://tinyurl.com/bg3yktbRomina BocciaEntitlements and Interest Drive Future Spending SurgeBrian_EmpricHigh Public Debt Levels Depress Economic GrowthBrian_Empric