Tuesday, February 28, 2017

The Obamacare trap

Governors met in Washington, D.C. last week to discuss the repeal of Obamacare and the future of Medicaid expansion.  The meeting was rather sobering at times as they were presented with different proposals.  The financial blog Zero Hedge reported in a very good post: 



Click on image to expand

a presentation from Avalere Health and McKinsey warned that the policies proposed by Republican congressional leaders to repeal and replace Obama's signature healthcare law would lead millions of people to lose their health coverage, while states lose billions in Federal funding.

 The presentation, reproduced below, estimates that the number of people covered by Obamacare through the individual insurance market could be reduced by as much as 51% in states that chose not to expand Medicaid coverage under Obamacare and by 30% in those that did expand the federal-state health program for the poor. The governors’ meeting came at a pivotal moment in the debate over the future of the health law, which Republicans have pledged to overturn.

The Republican party controls the White House, the Senate, the House of Representatives and 33 state governorships; it is also getting cold feet about repealing, replacing or even overhauling Obamacare out of concerns what it would mean for existing coverage, which would lead to millions of Americans losing insurance, and potentially truncating the careers of many politicians. It would also mean the end of millions in Federal government handouts to states coming to an end.

Roughly 12 million people gained Medicaid coverage after Obamacare broadened eligibility for the program. From 2014 through the middle of 2015, states got $79 billion of extra funding from the Medicaid expansion, according to the Kaiser Family Foundation. Under the health law, the federal government paid 100 percent of the cost of the expansion from 2014 to 2016. The government’s share fell to 95 percent this year and was scheduled to fall to 90 percent by 2020.

On the other hand, Obamacare premiums for those paying into the program have soared in the past two years, sucking up a substantial portion of US household disposable income, and leading to widespread displeasure among the US middle-class with the existing format of the healthcare law....

 Republican governors in states that expanded Medicaid have been telling their congressional delegations for months that repealing the health-care law without an adequate replacement would cost their budgets and hurt hospitals. While many say they support repealing Obamacare, they’ve advised a heavy dose of caution. Republican leaders in Washington are considering ending the Medicaid expansion, as well as setting per-person caps on federal funding of the program. “Governors know about 50 times more about Medicaid than anyone in Congress,” said Haley Barbour, the former Republican governor of Mississippi. “The idea that we’re going to repeal, repair, replace, redundant, whatever -- the idea that we’re going to do that in a matter of weeks just ignores the difficulty of doing it,” Barbour said....

Kingfish note: Skyrocketing Obamacare premiums and high deductibles versus the cost of shutting down Medicaid expansion and possibly kicking people off of the rolls.  A lovely trap set up by the former President.  People shriek if cut off and people shriek when they can't afford Obamacare.  What to do, what to do, what to do, tis the question.



39 comments:

Anonymous said...

These Republicans need to act like conservatives and have the backbone to decrease the Medicaid rolls as required by their budgets. I'm not a TEA Party member nor McDanielite, but I am a conservative. IF WE CAN'T AFFORD IT, WE ARE FORCED TO MAKE TOUGH DECISIONS. Otherwise, we'd be Democrats. Quit being pansies and do your jobs. For those state's run by Republicans but expanded anyway, the chickens have come home to roost. You ran as conservatives, but didn't govern like them. Now you face the consequences.

Note: Mississipi won't be faced with such a tough decision because it didn't expand to begin with. Can you imagine if in the background of all the other fiscal issues right now at the Capitol you had the officials wanting to avoid pissing off people by reducing rolls or face a $200 million budget increase next year?

Anonymous said...

Fixit Oh The Great Trumpster, fix the armed services, fix the violence in the streets, fix the infrastructure...., fix it all. Oh and while you are at it, go awhead and spend millions on why you did not loose the popular vote. ALSO prove that Flynn didn't make illegal calls to your boy Putin regarding the Obama sanctions.

. We voted for you! Bad, very, very bad on our part. Mr. POTUS,

Anonymous said...

But but but...Trump said he had a plan already in place to replace the ACA when he was running for President!

What happened?????

Anonymous said...

Note to 2:34 PM
S#!t rolls down hill...

Anonymous said...

Why are there more than 60 legal actions pending against Peresident Trump pending at this time? I suppose that he is such a good business man, or not. Don't get me wrong, I hope he pulls through but I am having second thoughts. I am really concerned for my country, and am really uncertain about his knowledge of history and National Intelligence.

Anonymous said...

Once you giveth, it's hard to taketh away. It's been the same with every other entitlement program as well. Now you're faced with taking that extra money away not only from the individuals but also the States, both of whom have already become dependent on it.

Giving free or subsidized health coverage to every single person is/was a very noble idea, but yet also a very financially irresponsible idea for a country already with an unbalanced budget and tremendous deficit.

The feds agreed to pay the additional Medicaid cost....for a few years...but at some point all the States that expanded their rolls are going to have to face the piper and pay 100%, and it ain't gonna be pretty.

The Republicans voted, what was it, 52 times last year to repeal Obamacare, although they were meaningless votes since they didn't control both branches of Congress. Now that they do, let's see if they do it one more time and make it for real.

Anonymous said...

Right, and you are an expert on both.

Anonymous said...

The people who have filed 'legal actions' against Trump are the DC equivalent of Robert Shuler Smith in Hinds County. Anybody can file anything and waste their time and our money.

You should not be as concerned about his 'knowledge of history' and be comfortable about his knowledge of business. We do not live in a socialist republic. Get the fuck over it!

Anonymous said...

If tens of millions lose Obamacare and Medicaid the rest of us can expect much higher premiums on our healthcare insurance. Many who have coverage through an employer will soon find out what the term part time worker means. Those who lose coverage will once again run up hospitals bills which will be passed on to the rest of us through higher costs. Obamacare was not ideal but it did address some of the major problems.

Anonymous said...

Obomacare was never supposed to work. It cannot work. It was a way to get to socialized medicine because they could not get socialized medicine passed in congress. The insurance companies were given a set of rules that make it impossible form thew to survive under Obomacare.
It's like when an airplane crashes. First the grownups put their masks on, then the kids. In this case you first come up with a plan that works for the people who can pay. Have everyone purchase their own insurance, not their employer. The employer can take the money he used to spend on your insurance and give you a raise. If you are unhappy with your insurance company, fire them. You go to the hospital for a broken arm and they want to give you a chest x-ray - fine. Let them do it, but YOU are paying for it either now or with increased premiums. We must give the patient more role in the cost and savings associated with their medical care. You get lung cancer from smoking, OK. You can get insurance but you have to pay more. It's stupid to think that sick people pay the same for insurance as well people. Insurance cannot work like that. Oh, you cannot force people to buy health insurance. It's unconstitutional.
This could go on and on and on. Main point - less government. More capitalism. Fix the system for folks who pay, then worry about the one's who can't.

Anonymous said...

Yeah 4:21 pm, we are a hell of a lot closer to a DICTATORSHIP than we were less than 2 moths ago. Lie to get elected, close down legitimate investigations and shut out the media. Your analogy to RSS is not relevant to this conversation. RSS IS CHUMP CHANGE compared to the POTUS. Trump is a billionaire liar who knows nothing about American Govt.

Curse me all you wish. You are a fool! American Govt. is NOT even close to a business,

★★★ FALLACY ALERT ★★★ said...

If tens of millions lose Obamacare and Medicaid the rest of us can expect much higher premiums on our healthcare insurance. Many who have coverage through an employer will soon find out what the term part time worker means.

Fallacy. Slippery Slope.

Anonymous said...

Crybaby dimocrats... suck it up like we did for 8 years and stay out of the way.

Anonymous said...

The RSS analogy is right on. Nothing was said about Trump in comparison to Smith. What was said is those suing him are the local equivalent of RSS bringing Ben Allen up on charges and going off half cocked wanting to charge everybody and his brother for imaginary crimes. All of them are frivolous.

But, it matters not. You whiners are the local equivalent of the dejected Pelosi you just saw on television, sitting in the aisle seat, pouting and wishing she had a brandy.

Anonymous said...

I'm not sure which is more pathetic, Old Miss and MSUcks fans arguing about a couple of mediocre at best athletic programs or Dems and Repubs fighting over mediocre politicians that serve each party.

Anonymous said...

Yeah right like this is Trump's economy, this is Obama's. Screwing with Medicare and the ACA will destroy it too.

Anonymous said...

Many of the people who simply hate anything associated with Obama are going to gag on the ultimate realization that health care costs are not coming down in any event and that the trend started well before Obama and ain't stopping. In fact many who hate ObamaCare will find themselves embracing the premise of universal coverage inspiring the Affordable Care Act when they see what medical bills look like in the near future. But as long as they can still blame Obama they'll accept any Republican plan to put primary care for the poor and "uninsurable" back in the emergency rooms, so that the rest of us can pay those inflated costs "indirectly". They will also be surprised at how easy it will be to become "uninsurable". Hate "ObamaCare" but the Affordable Care Act...well maybe.......

Anonymous said...

If only I had one dollar for every simpleton who conflates opposition to Obama and/or his policies as hate.

Anonymous said...

@ 1:30, does anyone ever consider that that piece of crap law was pushed down our throats for just a small percentage of the population? It's sort of like sending money to Iran without us having a say so (Obama) or not funding your military so that another country or possibly The United Nations can send troops over here? I don't think it's fair that a person DOESNT want to work but can demand the same privileges that those who are a benefit to society receive and call the damn shots! Small businesses owners have been slammed to the ground and many put out of business due to Obamacare. Is that ok with most of you?

Spots Another One.. said...

1:30 a.m. is just another true-believer and reader of 'the talking points'. "Obamacare is not a driver of health care costs or a causal factor in the system's unfortunate failure". Right. IT ALL STARTED WITH BUSH. Repeat that until you believe it.

Anonymous said...

@ 4:35am

For the love of god, when will you Obama haters do your f*ckin' homework before you spin some sh*t!?

In the words of Joey Fillingane - its - not - our - moneeeeeeeeey!

What Obama returned was money the Iranians sent to America during the Carter Administration to acquire weapons from our military complex, and they arms were never sent. So anyway we had their money from a deal that never happened.

Add fuel to the fire, who the hell wants American soldiers going over and settling a damn 1,000 year dispute between Sunnis and Shiites muslims? That's like Baptist's vs Pentecostal's - it's all Christianity, except both have different views on how to worship! and that's what the problems are between the Sunnis and Shiites.

Obama wants the middle east to start policing their region on their own, we get out of your backyard and you show us that you can maintain the region. So it was more about getting our people out of there.

How the heck we get on this from the Affordable Care Act, is beyond me.

Anonymous said...

The result [of Obamacare] is lower-quality coverage—for MS, rheumatoid arthritis, infertility and other expensive conditions. The researchers find these patients face higher cost-sharing (even for inexpensive drugs), more prior-authorization requirements, more mandatory substitutions, and often no coverage for the drugs they need, so that consumers “cannot be adequately insured.”

Anonymous said...

What Obama returned was money the Iranians sent to America during the Carter Administration to acquire weapons from our military complex, and they arms were never sent

Link?

Anonymous said...

Trump's speech was the most tweeted- about presidential address to Congress, surpassing the previous record of 2.6 million for Obama's 2015 State of the Union speech, a Twitter spokesman said.

Anonymous said...

It is in our self interest to have a healthy nation. It is in our self interest that our future generations are born healthy and stay healthy .
We need a healthy workforce.
Making health care affordable for everyone is in our self-interest.
The larger the pool , the lower the costs and that's one reason insurance rates vary wildly from state to state. It's population!
The first thing Congress should do, is repeal the stupid bill a lame duck Congress passed just before Clinton went into office.
Insurance costs and profits shouldn't be proprietary any more. They used to have to give Congress access. Now all of us have to believe whatever they tell us.
Did you health care costs go down with tort reform? Had they not profited enough in years without hurricanes on a single dwelling not to have suffered the entire losses they claimed in Katrina?

The way an insurance company traditionally worked is to invest all the monies that don't suffer claims well so that when a claim occurs, the money is there to cover it. It's not to make sure their CEOs get richer. The CEOs used to only get what was available by keeping the reserve high enough to cover losses.

They sold you a bill of goods because in any year, they whined about a loss from a malpractice case and didn't tell you how many years they had no losses and should have had more than enough money invested from premiums paid to cover the loss. They didn't have to tell you that anymore.
They complained about the stock market losses without mentioning the years of gain or telling you that unlike in years past, they could and did engage high risk investments. Deregulation meant that they, bankers and brokers no longer had the same due diligence that existed when the system worked.
You should demand of your Congressman that they tell you what premiums , deductibles and co-pays they have and ask you why the hell they can't get you covered!
You cannot fix a car if you don't know the mechanics of how a car works and your mechanic can dupe you if you don't check the facts of what he's telling you.
The health insurance industry has made certain you can't get the facts. They tell you what they want you to know and omit what they don't!

Anonymous said...

Once they screw with the ACA, there will be so much butt hurt, Democrats will have a good chance of taking back congress.

Anonymous said...

1:30. There are parts of the ACA worth discussing. Obamacare, hell
No!!

Anonymous said...

4:21 PM, let's have you post a list of the cases pending against Trump. Don't omit the style of the case, please. Fact is, you have no idea of the merits of any case pending against the orange oaf and I suspect are a typical, angry, obese, sausage-fingered GOP half-witted loon flailing away and blaming everyone else for your sorry lot in life.Trump is a global disaster and he's only going to get worse until the GOP,in a last ditch effort to salvage the party,pushes him on the sword.
We are still waiting for his plan for ISIS and the ACA.

Anonymous said...

@9:37 AM must not have seen the CNN/ORC poll results. Donkeycrats and #NeverTrumpers = OUCH!

Anonymous said...

Quoting 9:37, two posts up:

"Anonymous said...
4:21 PM, let's have you post a list of the cases pending against Trump."

I'm 4:21. You're confused 9:37. It's not my responsibility to post a list of cases pending against Trump. I'm not the one who asserted that there are any. The person who moaned about the large number of people suing him should come up with that list for you.

As to 'my lot in life', I'd be willing to wager it's an octave or two above your life, sitting at Taco Bell, pretending you're in Fondren, sitting under a patio umbrella, swilling a warm craft beer, wondering if McDades has lentils and tofu on the menu today.

Plain ol' Catfish said...

@ 8:53am

"There are parts of the ACA worth discussing. Obamacare, hell
No!!"

Hey Genius, the Affordable Care Act is Obamacare, ROTFLMAO!!!!!!!!!!!

Boy these Republicans really have you believing the damn sky is red

Bless your heart

Anonymous said...

10:32 AM
Actually, fat boy, I'm having a new prop put on the A-36 Bonanza today and some more upgrades. That's a bump up from your 1998 Toyota I'll expect. Now I'm more that happy to exchange contact info or phone #'s and let's see how smart ass you are in person.

Methinks Bonanza Is Off Runway.. said...

12:39 - So, not only can you not follow the blog-conversation, you also pretend to be a pilot and you no doubt slept at a Holiday Hotel with your boyfriend last Saturday night.

Actually, it's you who is the smart ass for suggesting someone not party to the claim offer up a list of supposed plaintiffs who are suing the president. I know of none. Perhaps you will climb down from your imaginary prop-ladder and help with the list.

Anonymous said...

John Boehner even said trying to get Republicans to agree on how to repeal and replace the ACA won't happen. Chris Wallace from Fox News also said Trump has done nothing to fulfill any of his promises for his 100 day plan for America this past Sunday. Where's Mexico's payment for the wall? When is Trump going to tear up the Iran nuclear deal? Where's the new trade deal with China? Where's the replacement plan for the ACA? Trump has around 70 days left and all the American people have seen is a lot of big barking, tweeting, blaming others, jaw popping and window shopping. Trump's executive orders are weaker than Milquetoast and he can't cut it as President; watch, you'll see...

Anonymous said...

He is Crawfishing on Immigration already, and now we find out Sessions misled the Senate. It's time to get that headcount, raise your hand if you voted for President Trump...where are all the guys from last week?

Anonymous said...

Link to Sessions lying to the Senate?

Anonymous said...

I'm ready for the civil war to begin @10:41 AM. Come on by my place and try to take me out.

Anonymous said...

I doubt Trump will be in office by the end of the year. When a Special Prosecutor is named and the House and Senate investigations begin he will make a deal and exit like Nixon and not have to testify. Pence expanded Medicaid in Indiana and can probably put together a deal to either fix Obamacare or have a similar plan replace it.

Anonymous said...

In any situation, what happens when you save or spend less money? Someone has to agree to take less money or someone is forced to take less money. Who in the healthcare industry from insurance to nurse to doctor to hospital will agree to take less money? People act like prior to "Obamacare" that insurance and medical costs were not going up every year. So, regardless of what system anyone comes up with, including the Republicans and the deal making POTUS, unless people agree to take less or are forced to take less, insurance companies and the healthcare industry will find a way to make costs increase.....yearly.



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