Jackson Jambalaya

Could someone explain to me in an intelligent manner, why could we not require any and all 18-65 medicaid recipients to work for the State in a part time capacity (weekends? at nights?) for 20 hours (maybe less maybe more) a week for their Medicaid? If not for the State, then for charities and churches? Habitat for Humanity alone could wipe out urban blight with the new labor source. Of course, you would have a part time capacity if the person has a job and a full time capacity if they do not. You could even loan them to new industries like Georgia does in their unemployment program at a subsidized rate, so they could gain skills. For the kids, if they are on medicaid, if they have a 2.0 and play a sport or after school activity leave them alone. If not, require them to go to some tutoring. Poverty is not going to stop itself. To ultimately help someone you must teach them accountability and a work ethic. Is this not what every successful person was taught? Why are we not having this discussion and please don't tell me that well they will scream racism, the counter to that is this is how I was raised. I am treating you as if you were my family. Are we really afraid to address entitlement reform here in Miss.? and not expanding medicaid is not entitlement reform. It is status quo.

Yeah, tell that to the Katie Beckett program participants.

9:11, because of the way the Medicaid system is set up, the vast majority of current Medicaid recipients are either disabled or have young children. The former are on Medicaid precisely because they are unable to work, and child care is a significant financial obstacle for the latter (doubly so for nights/weekends, when most day cares are not open). You'd effectively be requiring them to pay $300-400 a month per child for Medicaid coverage.

The expansion of Medicaid would make it available to people with minimum-wage or part-time jobs. Their availability is obviously limited to the time period outside of their primary employment, which means nights, weekends, and irregular shift availability. State offices, churches, and charities simply aren't set up for that kind of operation. Are they going to staff supervisors 24/7 to manage these people according to irregular schedules?

Then you've got the demands of any business in adding a significant number of employees to its workforce. Even if the employees themselves aren't salaried or benefitted, you have to have additional supervisors to manage them, and work for them to do that's suited to their skills. You have to deal with the paperwork of reporting their work requirements to the state, and of "hiring" and "firing" and all that other good HR stuff.

Ask yourself what your employer would do if you were handed a few dozen high-school interns and told you had to keep them busy and supervised for 20 hours a week, fitted around their school and job and sports schedules. Think it would be more hassle for your business than it's worth? Then there's your answer.

Can someone give me a link or a citation that will explain the 9,000 new jobs? Are we just assuming that 310,000 people will make appointments for physicals the first month? How many current Medicaid recipients show up in the ER instead of going to a clinic for routine care? Is the expansion of Medicaid going to address that? I have no problem with expanding home and community based services, especially for mental health, but I also believe that there's a lot of gray area between mental illness and criminal activity. Finally, if the offset that Rep. Myers is talking about doesn't pan out, who's going to pay for it? Better still, are the courts going to allow us to remove people from the rolls if we can no longer afford them? We're 0 for 1 on that so far. This has the potential of not only bankrupting the state, but also of adding 310,000 people to a group that's already too large. We should be addressing ways to get people off Medicaid, not put more on. Bill Billingsley

An incremental new job for every 34 new Medicaid recipients? I think not. No one should ever count on Donkeycrats being good at math.

I, too, am very puzzled as to where these jobs are going to come from as a result of expanded Medicaid. If these are healthcare-related jobs to care for the new participants, good luck with that. Medicaid reimbursement for healthcare is the absolute lowest of any third-party payer. Many physicians and other providers don't even accept Medicaid patients, because the low reimbursement doesn't compensate for the administrative overhead and headache of seeing these patients. Plus, once you start taking Medicaid patients, many times your private-pay (insurance, cash) patients get crowded out. Expanding Medicaid coverage will NOT draw more healthcare providers into the market.

There is a lot of misinformation being spread by bloggers.

First, Medicaid is not insurance. It is a poor payment for charity care. There are no premiums and the benefits of Medicaid are lousy. A working person who makes minimum wage and is enrolled in Medicaid does not have good "coverage" for anything. Say it is July 2 ( dates are important with Medicaid) and the person is diagnosed with something awful like an acute leukemia. The odds are very good that all their Medicaid benefits would be used up by October. So from October until the next June 30, they have no benefits. That means no payment for a blood transfusion or a doctor visit or anything.

So what this debate is really about is funding some of the charity care that is currently not paid.

And DSH payments. Currently virtually all MS hospitals survive because of DSH payments. And the way Obamacare is funding Medicaid expansion is by decreasing and eliminating DSH payments.

So like it or not, there is no option and our moronic governor will eventually figure it out.

What are the variations on medicaid or entitlements? I havent seen publicity/analysis on the 4million or so unemployed and not paying social security, medicare and fica, let alone the employer's share, and the additional employer's unemployment taxes on wages. What about the implication of immigrants, legally and otherwise? What about the accuracy of the details spewed by the FEDS? I think Governor Bryant has it right. These medicaid recipients were receving care before Obama Care; what has changed? THE FEDS OR OBAMA WOULDN'T CHANGE THE ACCOUNTING METHOD TO SHIFT LIABILITY, OR WOULD THEY?? DO YOU BELIEVE EVERYTHING, IF ANYTHING, THE GUVMENT SEZ?? I sure as hell dont.

Please stop spreading misinformation 11:45 AM.

Absurd to me that folks have changed medicaid expansion into some type of 'jobs bill'. Balony. Expanding medicaid is expanding a government program. Nothing more, nothing less. Medcaid is important because it helps those who are in need. However, someone in the thread made a great point--we need to work at getting folks off medicaid, not expand it.

And pardon, 11:45 am, but if this statement was true--"virtually all MS hospitals survive because of DSH payments"--then I guess those with insurance don't need to go there anymore because that money just really isn't needed.

I don't fault the hospitals for wanting this. Hospitals are a business, just like all others, and they have to look at profit/loss statements. HOWEVER, its one thing when you tighten your own belt...its quite a different thing when you try to tighten my belt so you can make more money.

Child’s thinking: gimme gimme gimme NOW!
Grown up thinking: would be easy to give it to you now, but I have to look at the entire picture and the future.

Expanding an overburdened program with borrowed federal dollars that will dry up in part in a few short years…..that’s the definition of irresponsible. Lower income workers need real healthcare options, not short-term fake promises.

Does anybody supporting the Medicaid expansion want to talk about ‘provider taxes’? No? Now stop running away, we hear the shouts of---its for jobs, its for the children, its for (insert noun), and if you dont shut up and agree with me then you're a (insert noun such as racist, elitiest, meanie, evil, etc.)

Lets talk provider taxes, how the state is going to cover the costs, how this does not fix a broken system.

EAB,
First thank you for your post, but I think you are missing the point. The people on Medicaid would not have to pay for daycare, because due to the the new savings, the State could increase its pre-K (we are lacking in it anyway) programs and provide day care for their children. If these people had real full time jobs, where would their kids go? This is a process to get people off of entitlements and we are all addicted whether it is medicare, social security, student loans or medicaid. We can't spend $2.50 for every $1, so we have to be try something new. Why couldn't the State open day cares why these people worked? To provide their children the advance learning they will need?

People with part time jobs will by definition have additional time during the week. I am not asking for 40 hours, but they could work some hours. Second,for people with miminum wage jobs, if they want medical treatment they might have to work more than forty hours a week. Medical treatment is not a right but a privilege. I work sixty hours a week as it is and have to work nights weekends, why not work just every Saturday for full medical coverage? Is that too much to ask? and the important thing here is not just working to pay, because you will never be able to pay off the medical expense of a major illness. It is developing a skill set to allow you to improve your position in life. Should people on Medicaid work less than doctors or lawyers? Give me two saturdays a month for coverage. Is that too much?

As for the HR argument, I will again point to GA, http://money.cnn.com/2011/08/29/news/economy/georgia_jobs/index.htm

The state and other employers would become creative. The traditional 8 to five workweek is dying with each year. People could just data entry. Just take GED classes. Once again improve your position.

As to your finally point, I use college externs all the time for contract work. It is successful. We should implement the same for the student loan program. We cannot keep on doing the same thing and think it will have different results.

Rep. Myers first sentence says it all. Job growth has not occurred. Mechanization in the factory and on the farm have left the youth with no prospects. Gains in productivity has shrunk the national workforce. Rep Myers is from a medium-sized town, McComb. If shale gas production happens there, the needs might not be as urgent in his area. The soft labor market keeps wages low and sixteen years of no job growth should wake up our awareness. Public health and safety is symptomatic. The medical profession knows the value of work to psychological and physical health. Read Freud or other psychologists. St. Paul in the New Testament expresses the same understanding. Our political dilemma is 'what are humans for if there is no work available due to technological improvements in production?' Conservatives rubber stamp economic development subsidies but not a social development outlay.

It is absolutely NOT true that most "handicapped" people cannot work. Yes, if a person is over 65 and in poor health or suffering from some sort of physical incapacity, we should not be too concerned about whether they work to offset the cost of their benefits (whether medicaid, food stamps, whatever). THOSE people have, most likely, already paid their dues. But, for the rest of recipients aged 18 and up, most CAN and SHOULD work. It is very difficult to be MORE disabled than Stephen Hawking yet he worked. In my opinion, every government job should be filled by a disabled person. Only if the position requires a specific skill and no disabled person can be found with that particular skill should a fully functional person be eligible to fill that job. That's all it would take to eliminate our deficit and lower our taxes. If we reserve government jobs for the disabled, we remove them from the welfare rolls. By not having to pay for government employees out of one hand then turn around and pay out of the other to support the disabled, we could substantially reduce corporate taxes and divert that money into business expansion & creation of job for those displaced former government employees. By eliminating the duplicate spending, we could reduce personal taxes and individuals would have more income to spend which, in turn, increases demand for goods and services which leads to even more job creation. Yep, the answer to our problem is to (a)REQUIRE recipients of government financial assistance to WORK for it and (b)make work available for them via government jobs. And if some people don't want to work for assistance, then let them do without.

The bottom line is that the AHCA is now law. The governor should put aside the concern of the teaparty and do what's best for the people of the state of Mississippi. They're going to pay for it anyway so they may as well reap the benefits for its poor.

9:52 has some interesting ideas which to my knowledge have not been tried, however the mentally handicapped are a special category not include in his scheme. The educational system is not geared for certain employment or adult life skills. They should be an important component of a adult 'right to work' or direct government production of jobs and/or welfare supervision. No doubt the welfare system needs fundamental reform perhaps in the vein attempted by the Democrats under President Clinton or the scheme envisioned by the previous writer. It is a radical departure from the 'free market' ideas of the past.

The harpy with the woody for the Tea Party is back.

The legislature does not have a welfare reform bill before it. Its a bill for the working poor being sold as an economic development bill. How it turns out as an economic deal depends on how the state manages its general health difficulties with chronic diseases.

Medicaid expansion must be seen in its health context. Expansion does have a price tag which is considerable in the out years.

Health, education, and welfare are the state's constitutional responsibilities. The state must be a better manager of its health programs like medicaid.

State government needs to use its education dollars better to get a better handle on its health programs. Educators like physicians need to do better at teaching healthy lifestyles. Otherwise we will have larger health outlays.

Other states like Wisconsin that are refusing the Medicaid expansion have some alternative state healthcare plan. Mississippi has no such plan.

Until we have a comprehensive plan we should reconsider the expansion. We should take the money on the table and craft a plan while we utilize the federal dollars.

Governor Jindal has re-written his taxation policy and might have a health policy alternative up his sleeve as well. We are stick in the mud here in terms of state innovation and probably should just follow the federal healthcare mandates until we have some ideas of our own.

Mississippi has an idea. Its to spend money from the state treasury on the match for uncompensated care in hospitals. Brilliant. Lt. Gov. Tate Reeves estimates on the low end $1B for the state match on medicaid expansion. We spend a quarter of that amount each year on uncompensated care. Once state leaders sharpen their pencils they will add things up. Don't wait for the hospitals and docs to explain the better way forward. They get paid either way with state or federal dollars.

(1) How absurd is it that over a third of a state's population (approaching half) would be on a charity program?

(2) Please stop referring to and lumping in Social Security with entitlement programs. Although a worker reaches the point where he or she may be entitled to benefits, it is by no means an entitlement program like those some of you are lumping it with are entitlements.

I'm really not one to trust the opinion of a doctor when it comes to discussions like this one. Some of you seem to think they stand at a golden podium with the Hippocratic Oath in one hand and a plate of fresh, hot, Mom's Apple Pie in the other. Ain't so. They often write their opinion statements while standing in line at the teller's window.