Jackson Jambalaya

Good timing. The black caucus is so tied up with Paula Deen and Gay Marriage, they don't have time to get bogged down with a discussion of what's literally going on in Mississippi. Therefore the measure passed. If we see Horne and crew on the capitol steps on tonite's news, they'll be opposing voter ID or celebrating gay marriage or passing a half-staff flag measure in anticipation of Mandella's demise. No time for Medicaid.

Good for Speaker Gunn. He's right about that. Now what is doing to do for the working poor? Many hard working citizens have a few teeth missing and need to see a doctor. They aren't going to quit working just so they can get Medicaid. Our state needs a medical program for this segment or Medicaid expansion. Which does the Speaker prefer? Neither.

People with missing teeth need a dentist, not a doctor. What we need is a better economy so people can pay for their own medical care. That starts with good education and low crime.

Subsidizing poverty just gets you more poverty.

Democrats didn't "cave" on this. Everyone knows that they were only trying to force a vote on expansion (which they said all along).

Oh well, guess it makes for a good headline.

You guys will be eating crow when hospitals start hurting and jobs are lost.

Help me understand why my tax dollars are needed to replace the missing teeth of the working poor. That makes absolutely no sense. A few years ago, we realized medicaid pays for Viagra. No private insurance program policy pays for Viagra. Maybe the Dems think a man on Viagra with no teeth is better at sex and therefore contributes to the vitality of the community.

Is there another explanation?

I consider myself a conservative, but I do not blindly follow the soup of the day views of many of you. I am a cancer survivor, I was very lucky that mine was removed by surgery after early detection. I have a good job and pretty good medical insurance, but was advised shortly after diagnosis to start preparing for bankruptcy if I survived. Most of you are one major disease or injury away from bankruptcy. Working class, minimum wage earners cannot afford to pay more than sniffles and bruises medical problems. I don't know the solution, don't know if medicaid expansion is the answer, but you head is up some politican's arse if you blindly profess that the poor should get a better job and pay without assistance. How many of you have, or had, a grandparent or parent in a nursing home with medicaid paying the tab? How many of you helped with medicaid fraud by moving their assets before putting them in there? I hate a friggin hypocrite.

Well said, 5:30pm

And, there are more than a few very wealthy folks who sign up immediately for part B at 65 because they know in the event of a catastrophic illness, what they have paid into the medicare pot won't come close to what their co-pays would be on any private plan.

And, they sure as heck aren't paying all the costs for their elderly parents either!


Here's a news flash, once upon a time, any monies you got from the government had to be paid back out of your estate. All the rich who want that to happen again, please raise your hand

What we need is a better economy so people can pay for their own medical care.

I think you seriously fail to understand just how expensive medical care is, and how impossible it is for many working people to afford health insurance.

A better economy isn't going to help the people who are already working full-time in low-wage jobs. Regardless of the state of the overall economy, they're not going to pay very much more than they do now. The people who work in them can't afford an individual policy of $250 on a monthly gross of $1167, which is what you make if you work 40 hours/week at $7/hour.

Any given person can get a better job, but someone will always have those jobs, because we need nursing home aides and waitresses and cashiers and janitors. Should we just say "too bad for them" and accept that a good chunk of the population is doomed to be vulnerable to medical catastrophe?

The fat Tater better do as good as the Speaker

6:17; You win the dunce contest. I turned 65 and took out a supplemental policy myself. Newsflash! I pay monthly for the damned thing. I don't expect the government or you to cover the cost of my illnesses. I paid into the medicare system since the day it began and pay the monthly premium for supplemental insurance. What else do you suggest I do? Well, other than paying for others' coverage.

And his 'estate claim' is bullshit.

How about if we start working driving down the cost of medical care instead of trying to figure out how to transfer that ever increasing cost to somebody else??? Maybe...just MAYBE...if it didn't cost $250 to see a doctor for a cold, health care insurance wouldn't be so important. And let's no forget for even one second that NOBODY gets turned away for NECESSARY medical care, regardless of ability to pay. And, finally, I submit that maybe, just MAYBE, a person who is earning only $7.50 an hour really should think twice before giving birth even ONCE, much less 4, 5, & 6 times...as was the case in an articleI read earlier today on this subject. Woman in Texas didn't qualify for medicaid because she was working..at $7.50 an hour, husband "disabled"...and 6 kids at home. Far too common a story.

8:48 nobody is turned away from an emergency room. you don't get anything more than critical care. people die every day because they can't afford health care and medicine. get your head out of Phil's arse.

Many people get turned down for necessary non-emergency medical care. The ER has to treat you for emergencies, but they can release you as soon as you're clinically stable (i.e. not threatening to die). If you break a bone, they will take X-rays, put on a temporary splint, give you pain meds, and send you home with a referral to the orthopedist. The ortho doesn't have to and will not treat you if you can't pay.

I had outpatient ankle surgery this morning, and they wanted their $794 deductible up front. My ankle wasn't going to kill me, and the ER docs don't perform complex orthopedic surgeries anyway. Without insurance, I wouldn't have been able to get my ankle fixed and hopefully be able to walk again.

Oh, one more thing for 8:48: "thinking twice before giving birth" doesn't help you if you had an unplanned pregnancy, as half of all pregnancies are. It is even more useless if you already gave birth at a time when your finances were in better order.

8:19, people die every day because they decided to smoke two packs a day for thirty years. Where do you draw the line on the people die every day reasoning? How much death are the taxpayers responsible for preventing?

"Where do you draw the line on the people die every day reasoning? How much death are the taxpayers responsible for preventing?"

Bill, you've fallen victim to the continuum fallacy (I think. It's been a long time since philosophy 101). Just because it's hard to draw the line doesn't mean we *shouldn't* draw it.

Just because some of our state's citizens, for example, over-eat and are obese, doesn't mean we should just say f*** everyone who needs healthcare just because X% of these people have brought it on themselves.

Elliot, Anonymous at 8:48 suggested that people die every day from lack of health insurance, and I presume his subsequent comment meant that he believes the state should expand Medicaid. There are really two "how far do we go" questions. How far do we expand Medicaid? The proposal will put a third of our population on it. Where do we stop? Half? Three quarters? I imagine everyone would like to receive free health care. At some point the number of taxpayers who aren't on Medicaid will be insufficient to support the ones who are. The second is the one you commented on. How much responsibility should society - the taxpayers - assume in preventing the untimely death of its citizens? If providing health insurance to the working poor is going to prevent some of them from an untimely death, then why not try to prevent more? By now you are certain to have seen my point, but I'll make it anyway. Health care costs money, and that money has to be provided by someone. Absent reductions in other areas of government or health care costs, tax revenue will have to increase in order to pay for the additional health care that will be given away. I know it's up to each of us to do what we can to prevent our untimely death, but it is also government's role to protect and care for its citizens, right? So, once again, where to we draw the line? I would genuinely like to see how people feel about this.

Bill, I think the strongest argument for the expansion of Medicaid to 138% of poverty is that we already have expansion of Medicaid to 138% for a specific group: pregnant women.

People who can afford health insurance should pay for it. That's why the premium subsidies kick in after you pass 138% of the poverty line, and phase out at higher income levels. However, that 138% is where we already recognize that health insurance takes up too large a share of income to be fiscally possible.

I'm sure you probably know women who have delivered on Medicaid. If we believe in covering pregnancy costs (which run about 10K for an uncomplicated vaginal delivery, and often higher if you need a C-section or NICU), what makes that different from breast cancer? That's been a pretty good place to draw the line for a lot of years, so it seems reasonable to me to keep the line there for other health conditions.

Good argument, and you're right - I know people who receive Medicaid benefits. I think the higher threshold for pregnant women is to produce more healthy babies, and pregnancy is the only medical condition that produces babies. That said, the line I'm asking about is the percentage of the population that the rest of us can afford to support. 138% of the poverty line - by the way, who decided what the poverty line was going to be in the first place? - still puts a third of our population on the program - over a million people. Although I don't know when or how the poverty line is adjusted, what happens when that inevitably occurs? I realize that people without enough money need help, but the number of people who can help is going down. My concern remains that eventually we'll run short of taxpayers and either services will have to be cut or people will have to be removed from the rolls. That's when the real fun will begin...

Bill, the reason Medicaid coverage produces healthy babies is because childbirth is such an expensive medical procedure that poor families cannot cover the costs. From that perspective, it's no different from treatment for any other serious illness or injury.

There's ultimately no way to get around the costs of medical care. Poor people either go un-treated and wind up dead or on disability, or they get medical care that they can't pay for. In the latter case, those costs are financed by higher taxes for DSH payments and higher hospital costs being charged to the insured population. Plus, by the time those uninsured people are sick enough to seek out services through the ER, it usually winds up being far more expensive. If you have asthma and can't pay for the $200 doctor visit or the $50/month inhaled steroids, you'll be looking at a $5000 ER visit when you have a serious asthma attack.

Either way, the taxpayers and insured people are already footing the bills of the uninsured. That's why the ACA was scored as cost-neutral by the Congressional Budget Office. I recognize that not everyone accepts those numbers, but they're the best estimates we have.

Why did Tate cave? He was barreling toward a one year repealer on the authorization bill. Then suddenly he wasn't.
You know he wants the expansion money.

EAB, I know how the system works. I worked in it in one capacity or another all my adult life. Health care costs can be reduced. So much money is dedicated to administration and CYA BS that it's no surprise that a hospital aspirin costs twenty bucks. My question still remains: Where do we draw the line? What percentage of the population has to be taken care of by the taxpayers before it becomes too expensive? We need to be working on keeping that percentage as low as we can, while at the same time reworking our health care delivery model to save money.

The ACA being scored cost neutral was ridiculous, but even if it's accurate it happened because it contains deep cuts to Medicare, which was missed by the elderly who weren't paying attention.