Today's USA TODAY had a front page story on how the states are splitting along a purely political Republican-Democrat divide on whether to expand Medicaid in the way it was designed in the now legal ObamaCare. At this point, fourteen states with Democratic governors are moving forward with adoption; seven more are waiting. None of the states with GOP governors have adopted the changes, with seven saying they definitely will not and twenty-two others waiting.

So who's going to suffer? The 'GOP states' have more than 10 million people who will have no healthcare other than hospital emergency rooms who will provide care without being paid. Without broad action by the states, millions of Americans will remain uninsured, hospitals will face continued demands for uncompensated care, and private health insurance companies will certainly announce major hikes in premiums.

So other than the people in the Republican-governed states who will continue to have no health insurance, who will suffer? Who will pay?

The health insurance companies set up insurance programs by creating individual companies in each state. They do that because insurance is normally regulated by state insurance commissioners on a state-by-state basis. The terms of policies issued in each state and the premiums charged result from the insurers submitting their experience in each state to the state commissioners. They can't use high claim experience in New York as an example, to justify premium increases in Mississippi.

So who's going to pay for those millions of uninsured people? The other residents of those GOP-governed states who for mostly political reasons are refusing to let their state participate in the newly-designed Medicaid program...that's who!

What about Florida? Governor Rick Scott has already announced that Florida will not participate in the "new Medicaid". He's also said he would block the creation of an insurance exchange to encourage more private companies to compete for the business of Florida residents. Pretty much a party-line position. (Maybe it's even a personally-driven position. Scott had a felonious Medicare fraud experience when he was CEO of Hospital Corporation of America. And he still owns Solantic, a company trying to be an alternative to hospital emergency rooms. Might Scott personally have a "dog in this fight", making decisions for Florida residents for personal gain? Just wondering.)

The cost of Medicaid in Florida is growing at a rate 3-1/2 time faster than the state's general revenue. You can read the "fix" to that problem only two ways--increased taxes or elimination of service. Its reasonable to expect that a large number if the 3.19 million currently on Florida Medicaid will be kicked out as the result if the state's inability to fund the program. Where will they get care? Back to those hospital emergency rooms, who don't get paid for the care they provide. Or maybe the families of those with no money and no Medicaid will be required to pay. Increasingly, states are "reaching out" to demand payment from sons, daughters and other family members of indigent Medicaid patients to require payment.

Then the next step, obviously, is the insurance companies (really only one major one in Florida--United Healthcare) seeking major premium hikes, which almost certainly will be approved. So who's going to pay for the politically-driven recalcitrance? Why those of us with private insurance policies, obviously. Expect your premiums to skyrocket.

This is better than a single payer system? This will provide for better health results of the tens of millions of Americans with no insurance? This is affordable by the people who are paying for insurance?

In the meantime all that our feckless Congress has found time to do is pass a bill to repeal ALL of the ACA...and hold hearings on the problems of medication of racehorses!

C'mon all you small government conservatives out there...tell me how this is good for America...good for Americans...or affordable by Americans? Other than just saying, "repeal ObamaCare" and asserting that "we already have the best healthcare system in the world", what's the answer to this problem? What candidates from either party for any office is proposing a fix? C'mon tell me how and why politicizing the health of tens of millions of Americans is a good thing? Get your head out of the sand...or some other dark place.

Once again, VK, a very good posting from you. Once again, you have me wondering and scratching my head of why in the world do you keep repeating that you will not vote for Pres. Obama.

Originally Posted by buggyone

Once again, VK, a very good posting from you. Once again, you have me wondering and scratching my head of why in the world do you keep repeating that you will not vote for Pres. Obama.

He's shown no willingness or ability to lead either the Congress or the country. His re-election would almost certainly cause more divisiveness in the country than currently exists--if that's possible. And he's an incumbent. It's no more complicated that that, Buggy.

I'll be voting for whoever runs against Rick Scott as well.

Originally Posted by Villages Kahuna

Today's USA TODAY had a front page story on how the states are splitting along a purely political Republican-Democrat divide on whether to expand Medicaid in the way it was designed in the now legal ObamaCare. At this point, fourteen states with Democratic governors are moving forward with adoption; seven more are waiting. None of the states with GOP governors have adopted the changes, with seven saying they definitely will not and twenty-two others waiting.

So who's going to suffer? The 'GOP states' have more than 10 million people who will have no healthcare other than hospital emergency rooms who will provide care without being paid. Without broad action by the states, millions of Americans will remain uninsured, hospitals will face continued demands for uncompensated care, and private health insurance companies will certainly announce major hikes in premiums.

So other than the people in the Republican-governed states who will continue to have no health insurance, who will suffer? Who will pay?

The health insurance companies set up insurance programs by creating individual companies in each state. They do that because insurance is normally regulated by state insurance commissioners on a state-by-state basis. The terms of policies issued in each state and the premiums charged result from the insurers submitting their experience in each state to the state commissioners. They can't use high claim experience in New York as an example, to justify premium increases in Mississippi.

So who's going to pay for those millions of uninsured people? The other residents of those GOP-governed states who for mostly political reasons are refusing to let their state participate in the newly-designed Medicaid program...that's who!

What about Florida? Governor Rick Scott has already announced that Florida will not participate in the "new Medicaid". He's also said he would block the creation of an insurance exchange to encourage more private companies to compete for the business of Florida residents. Pretty much a party-line position. (Maybe it's even a personally-driven position. Scott had a felonious Medicare fraud experience when he was CEO of Hospital Corporation of America. And he still owns Solantic, a company trying to be an alternative to hospital emergency rooms. Might Scott personally have a "dog in this fight", making decisions for Florida residents for personal gain? Just wondering.)

The cost of Medicaid in Florida is growing at a rate 3-1/2 time faster than the state's general revenue. You can read the "fix" to that problem only two ways--increased taxes or elimination of service. Its reasonable to expect that a large number if the 3.19 million currently on Florida Medicaid will be kicked out as the result if the state's inability to fund the program. Where will they get care? Back to those hospital emergency rooms, who don't get paid for the care they provide. Or maybe the families of those with no money and no Medicaid will be required to pay. Increasingly, states are "reaching out" to demand payment from sons, daughters and other family members of indigent Medicaid patients to require payment.

Then the next step, obviously, is the insurance companies (really only one major one in Florida--United Healthcare) seeking major premium hikes, which almost certainly will be approved. So who's going to pay for the politically-driven recalcitrance? Why those of us with private insurance policies, obviously. Expect your premiums to skyrocket.

This is better than a single payer system? This will provide for better health results of the tens of millions of Americans with no insurance? This is affordable by the people who are paying for insurance?

In the meantime all that our feckless Congress has found time to do is pass a bill to repeal ALL of the ACA...and hold hearings on the problems of medication if racehorses!

C'mon all you small government conservatives out there...tell me how this is good for America...good for Americans...or affordable by Americans? Other than just saying, "repeal ObamaCare" and asserting that "we already have the best healthcare system in the world", what's the answer to this problem? What candidates from either party for any office is proposing a fix? C'mon tell me how and why politicizing the health of tens of millions of Americans is a good thing? Get your head out of the sand...or some other dark place.

I said on here a number of times....first of all, this is an election year and the states will certainly go down the political party path. I will predict a number of more "Wisconsin's" happening as a result of states being FORCED by the new health care act to do this.

To your other point, I am really being sold on the merits of what Romney did in Ma. Dismantle the new law and allow the states fo put into force their own response to the problem. I have found out that there are in fact other states, not quite as pronounced as MA, but Maryland for example where you can have existing coverage and you can remain on your parent insurance, but it is NOT automatic. It can be done but this was forced on the states at a time they cannot afford it.

Repeal the health care law...begin to build laws to help the states handle this on their own, as in MA an MD and others. Make provisions and put timetables on any affected by the repeal. Any new provisions must address COST of health care, Tort reform

You can say I have my head in the sand all you want....where was our congress when they FORCED this on us as part of a political plot. Latest polls suggest the unpopularity of it is growing. Wait until the payday arrives...we have not even begun the payment part yet.

The criticism belongs in this WH for doing what it did in the manner that it did it. You will not make me feel guilty with your "C'mon tell me how and why politicizing the health of tens of millions of Americans is a good thing? Get your head out of the sand...or some other dark place"

The man who did this to us....caused all this grief because he had to find ways to pay for it for his own legacy and forgot completely about what the entire idea was.

yes, we must be realistic...it is the law, and that is why this election is so important, not only to reverse this monstrosity but to prevent any more of the shenanigans he used in getting us here.

I am thinking that the initial bluster and rejection of Medicaid by the Republican governors is designed to stir up and solidify their base. Later they will try to quietly opt in cuz it is very hard to turn down the financial deal offered to them.

Originally Posted by DaleMN

I am thinking that the initial bluster and rejection of Medicaid by the Republican governors is designed to stir up and solidify their base. Later they will try to quietly opt in cuz it is very hard to turn down the financial deal offered to them.

I think that is what I was trying to say...this year is all about politics. What you say is so true if it is not repealed ! The states cannot afford to pick up that tab !!!

I will look but one of the problems with the cost of this law is that they used this particular piece as a savings and a cost when they presented it to the CBO !!

Originally Posted by Bucco

I said on here a number of times....first of all, this is an election year and the states will certainly go down the political party path. I will predict a number of more "Wisconsin's" happening as a result of states being FORCED by the new health care act to do this.

To your other point, I am really being sold on the merits of what Romney did in Ma. Dismantle the new law and allow the states fo put into force their own response to the problem. I have found out that there are in fact other states, not quite as pronounced as MA, but Maryland for example where you can have existing coverage and you can remain on your parent insurance, but it is NOT automatic. It can be done but this was forced on the states at a time they cannot afford it.

Repeal the health care law...begin to build laws to help the states handle this on their own, as in MA an MD and others. Make provisions and put timetables on any affected by the repeal. Any new provisions must address COST of health care, Tort reform

You can say I have my head in the sand all you want....where was our congress when they FORCED this on us as part of a political plot. Latest polls suggest the unpopularity of it is growing. Wait until the payday arrives...we have not even begun the payment part yet.

The criticism belongs in this WH for doing what it did in the manner that it did it. You will not make me feel guilty with your "C'mon tell me how and why politicizing the health of tens of millions of Americans is a good thing? Get your head out of the sand...or some other dark place"

The man who did this to us....caused all this grief because he had to find ways to pay for it for his own legacy and forgot completely about what the entire idea was.

yes, we must be realistic...it is the law, and that is why this election is so important, not only to reverse this monstrosity but to prevent any more of the shenanigans he used in getting us here.

Your "state's rights" idea is a good one, I think. Maybe the federal government should provide some guidelines to assure that what each state designs meets some minimum national standards. That is, there should be some minimum standards for individual states' healthcare insurance programs. I believe that should include a requirement that every citizen have health insurance.

Maybe the feds should provide a basic program of insurance--not as complicated as ObamaCare--that would be required for use in each state that has not enacted their own health insurance program, or adoptable by those states who choose not to spend the time and money to develop their own program. Kind of similar to "no child left behind" in the education sector. The feds don't tell the states of municipalities specifically how to accomplish things, but they do measure the results and establish penalties or results-based requirements for states whose programs fall short of national standards.

Same singers different song. whether its the fiscal cliff or healthcare or....these guys in Congress will stand on their hinds quarters beat their chest and growl but when the time comes they will compromise and kick the can down the road again. I question whether we will ever again have a majority of intestinal fotituded statesmen. Blame it on lobbyist, blame it on our educational system or blame it on voters poor choices.. it is a fact.

Try and settle it by never voting for an incumbent will not work. The only proper way is to fix our broken political system because we continue to vote in unqualified and weak people.

Originally Posted by Villages Kahuna

Your "state's rights" idea is a good one, I think. Maybe the federal government should provide some guidelines to assure that what each state designs meets some minimum national standards. That is, there should be some minimum standards for individual states' healthcare insurance programs. I believe that should include a requirement that every citizen have health insurance.

Maybe the feds should provide a basic program of insurance--not as complicated as ObamaCare--that would be required for use in each state that has not enacted their own health insurance program, or adoptable by those states who choose not to spend the time and money to develop their own program. Kind of similar to "no child left behind" in the education sector. The feds don't tell the states of municipalities specifically how to accomplish things, but they do measure the results and establish penalties or results-based requirements for states whose programs fall short of national standards.

VK, you sounded much more reasoned on this post than you did in the one that started this thread - another ad hominem attack on Republicans. This is an issue that is not split upon party lines. Seven Democrat governors are lying back until after the election before they roil the water. Medicaid expansion a tough sell to governors of both parties - The Washington Post

In another post that attacked Rick Scott for his stance against the expansion of Medicaid, I detailed the data that showed Florida simply cannot afford to implement this. The money simply is not there. Given your background as a banker would you recommend someone or some entity commit to a project that they cannot afford?

As much as I do not want to sound like a nag, please go to mittromney.com and look at what he has to say on the issue. In the spirit of compliance with forum rules, I provide only the link and do not post his bullet points or the full reasoning why the Unaffordable Healthcare Act, aka Obamacare, does not work. Do I agree with him on everything? Of course not. I strongly favor severe tightening on malpractice lawsuits. Any law firm that brings a malpractice action, must be held to pay opposing legal costs and expenses unless they can show that the client has reimbursed them in full for their own legal fees and expenses and is capable of paying the defending party’s legal fees and expenses. In addition, to encourage full disclosure, the law firm must reveal to the jury before verdict is rendered the amount they will collect in legal fees and expenses together with their share of the verdict. I’m tired about hearing this or that lawyer is ‘for us’. They are not. They are for themselves. The cost of the bar in these United States is now approaching the cost of the Defense budget. Who to we need protection from – the infamous military/industrial complex or our lawyer system?

All this talk about Florida can't afford to expand medicaid makes me wonder where were all these folks when Governor Rick Scott approved Florida's 12th university at the end of the last legislative session. This is the same university that has no students, no faculty, no building, no charter. There wasn't much interest in it except for the legislator who lives in that area and is a big land owner. I don't remember much discussion about who was going to pay for it. Now they want to build a new highway to the university that doesn't exist. Where is the outrage?


http://www.palmbeachpost.com/news/ne...da-poly/nN3KB/


http://www.tampabay.com/news/transpo...budget/1217976

Originally Posted by BBQMan;521***

...In another post that attacked Rick Scott for his stance against the expansion of Medicaid, I detailed the data that showed Florida simply cannot afford to implement this. The money simply is not there. Given your background as a banker would you recommend someone or some entity commit to a project that they cannot afford?...

As a retired banker, I'd frame the choice as follows...

Adopt the Medicaid provisions contained in the Affordable Healhcare Act and either modify provisions of the state program to reduce costs or raise taxes to pay for the program, or both.

OR...

Permit the state Medicaid program to expire or be so constrained in size that millions of Floridians would lose any healthcare insurance and be forced to use emergency rooms for their sole source of care. That option would not be free to Floridians, of course. Insurance companies will increase the premiums for those who are insured to pay for the newly uninsured former Medicaid patients. In essence, that's a hidden tax on those who can afford to pay

.A decision not to insure millions of indigent Floridians, mostly elderly, is not only inhumane in my opinion, but also far more costly in the long run, and certainly erodes the quality and length of life for millions of people. Then there's that "hidden tax", wherein those with insurance will wind up paying for care provided to the uninsured.

To answer your question, yes I think the governor should adopt the Medicare provisions of ACA, even though taxes would have to be increased to pay for it. Certainly the fundamental health of Florida citizens is a more important priority than many of the other expenditures at the state level.

Originally Posted by Villages Kahuna

As a retired banker, I'd frame the choice as follows...

Adopt the Medicaid provisions contained in the Affordable Healhcare Act and either modify provisions of the state program to reduce costs or raise taxes to pay for the program, or both.

OR...

Permit the state Medicaid program to expire or be so constrained in size that millions of Floridians would lose any healthcare insurance and be forced to use emergency rooms for their sole source of care. That option would not be free to Floridians, of course. Insurance companies will increase the premiums for those who are insured to pay for the newly uninsured former Medicaid patients. In essence, that's a hidden tax on those who can afford to pay

.A decision not to insure millions of indigent Floridians, mostly elderly, is not only inhumane in my opinion, but also far more costly in the long run, and certainly erodes the quality and length of life for millions of people. Then there's that "hidden tax", wherein those with insurance will wind up paying for care provided to the uninsured.

To answer your question, yes I think the governor should adopt the Medicare provisions of ACA, even though taxes would have to be increased to pay for it. Certainly the fundamental health of Florida citizens is a more important priority than many of the other expenditures at the state level.

My Friends:

The above post is IT IN A NUTSHELL!

And it's why the governors and congressmen in "We hate Obama" states need to stop their purely political posturing and do what is fairest and right for their constituents.

It's interesting that Gov Rick Scott's company Solantic Inc doesn't accept medicaid, but provides urgent care to walk-in customers. Coincidence? You decide.


Gov. Rick Scott, Solantic and conflict of interest: What's the deal? - Tampa Bay Times



Five GOP governors said yesterday they would accept the medicaid expansion if they could get it in block grants, which has been their goal all along. Gov Rick Scott was not one of them.



http://www.politico.com/news/stories/0712/78499.html

Originally Posted by Villages Kahuna

As a retired banker, I'd frame the choice as follows...

Adopt the Medicaid provisions contained in the Affordable Healhcare Act and either modify provisions of the state program to reduce costs or raise taxes to pay for the program, or both.

OR...

Permit the state Medicaid program to expire or be so constrained in size that millions of Floridians would lose any healthcare insurance and be forced to use emergency rooms for their sole source of care. That option would not be free to Floridians, of course. Insurance companies will increase the premiums for those who are insured to pay for the newly uninsured former Medicaid patients. In essence, that's a hidden tax on those who can afford to pay

.A decision not to insure millions of indigent Floridians, mostly elderly, is not only inhumane in my opinion, but also far more costly in the long run, and certainly erodes the quality and length of life for millions of people. Then there's that "hidden tax", wherein those with insurance will wind up paying for care provided to the uninsured.

To answer your question, yes I think the governor should adopt the Medicare provisions of ACA, even though taxes would have to be increased to pay for it. Certainly the fundamental health of Florida citizens is a more important priority than many of the other expenditures at the state level.

OR

Repeal this monstrosity of a law, which will financially bring this country to its knees in a few short years when the bill comes do. Allow the states to manage health care at their level as in MA and MD.

We are going to have so many Wisconsin's if this stays....The cost, if anyone has even taken the time to check instead of playing the political game) is so prohibitive as to be crazy. This should never have gotten this far...and you folks who want to play politics ought to think about COSTS to do all of this.

The politics of it, as taught to us by Obama, is by hook or crook get this stuff done...health care bill, take the work rule out of welfare, etc and then when someone wants to right that ship, you call them insensitive or inhumane as a matter of fact. This country cannot afford this...not sure how old you folks are but if you are young enough to be around when the bill comes in, you will rue the day. States cannot afford this, and lest you think that it is only Republicans, think again and do some research. This is a cost that will bring most states to their knees and services will be cut to such a degree......always nice to do things,BUT you have to pay for them.

This never should have happened and Obama who had to ...well, we all know what he did to get this passed, even though he had complete control of both house and senate...he is the one to blame.

Originally Posted by Bucco

OR

Repeal this monstrosity of a law, which will financially bring this country to its knees in a few short years when the bill comes do. Allow the states to manage health care at their level as in MA and MD.

We are going to have so many Wisconsin's if this stays....The cost, if anyone has even taken the time to check instead of playing the political game) is so prohibitive as to be crazy. This should never have gotten this far...and you folks who want to play politics ought to think about COSTS to do all of this.

The politics of it, as taught to us by Obama, is by hook or crook get this stuff done...health care bill, take the work rule out of welfare, etc and then when someone wants to right that ship, you call them insensitive or inhumane as a matter of fact. This country cannot afford this...not sure how old you folks are but if you are young enough to be around when the bill comes in, you will rue the day. States cannot afford this, and lest you think that it is only Republicans, think again and do some research. This is a cost that will bring most states to their knees and services will be cut to such a degree......always nice to do things,BUT you have to pay for them.

This never should have happened and Obama who had to ...well, we all know what he did to get this passed, even though he had complete control of both house and senate...he is the one to blame.

Bucco, Why would 49 states suddenly decide to set up health care systems which have the positive features of ACA? Your suggestion simply begs the question. Didn't happen in over 200 years, wouldn't happen in another 200. Before the ACA was passed and reaffirmed by the Court, EVERYONE agreed the states were not interested in putting in the effort to set up a decent health care system. Just imagine Texas doing it. The state with the most uninsured. Impossible! Your argument is just as just as much an impossibility today as it has always been.

I have read your many comments about ACA. You have been rather focused on criticizing many of it's features and your general solution is to repeal the entire law. However, despite repeated requests I have yet to read your specifying even a single element of the law which you can DEMONSTRATE needs to be changed, and for which you can offer a constructive revision.

Anyone can SAY that stuff is wrong, unaffordable or unconstitutional. But I'm waiting for you or ANYONE else to show exactly WHAT the problems are, WHY they are, and HOW to fix them, including removing them if there is no alternative.

This is what bothers me most about the current Republican platform. There is only negative talk, not constructive, FEASIBLE suggestions. OK, maybe the candidates can't be constructive because they might lose political points.
But what's stopping you?