Tennessee Decides to Expand Medicaid
In my own state of Michigan, there was a battle in the Republican controlled state legislature to expand Medicaid for the 600,000 uninsured citizens. It did pass with some legislators such as Michigan State Senator Joseph Hune complaining loudly about how its passage made him “sick to his stomach.” Even with the passage, the state legislature delayed its implementation from January 1st to April 1 2014 costing the state $millions in aid. Republican Governor Rick Snyder supported the passage of the Medicaid Expansion after commissioning a study by the State Senate Fiscal Agency investigating his proposal of banking some of the savings to be used after the 100% federal funding ceased. Based upon medical cost inflation rate, case load, HICA Caps, etc.; the state would not have to dip into its coffers until 2022 considering worst case to potentially 2034 under the best case scenario.
It has been said of many of the holdout states in denying the expansion of Medicaid, they pass up quite a bit of $federal to expand Medicaid, lose $federal reimbursing hospital care for the uninsured, and would eventually come to the table and accept the expansion. August 28, The Tennessean quoted the Gov. Bill Haslam him “I think we’ll probably go to them sometime this fall with a plan … that we think makes sense for Tennessee.”
Not only is the expansion important for the uninsured, it is important for hospitals which were previously reimbursed for care to the uninsured through other federal programs. These programs would be discontinued under the Medicaid Expansion whether the state went forward with it or not. Many of these hospitals would be faced with bankruptcy or denying care to the uninsured.
Tennessee Justice Executive Director: “It’s urgent that the governor submit a serious plan to accept federal funds to expand health coverage for Tennesseans. The Consequences of delay are devastating for both the healthcare infrastructure we all rely upon as well as Tennesseans.”
The same as the delay in Michigan, the delay in Tennessee also costs the state aid at the rate of $2.7 million/day. Gotta love those Repubs.
Ht Tip: Crooks and Liars
I bet you would not see the implementation delay if the $2.7 million per day came out of their salaries or, even better, their campaign funds.
Jerry:
Very true or better yet; take away their life time healthcare benefit.
That’s an important point about the hospitals. If a state doesn’t
expand Medicaid hospitals will continue to have to spend
a huge amount of money providing free care for people who should
be on Medicaid. And they won’t be reimbursed for that care because
the ACA assumes that all states expand Medicaid.
And the problems currently being faced by ” the healthcare infrastructure we all rely upon” in these states show that there is no such thing as a free lunch.
That the uninsured being treated before the ACA were being subsidized by the entire covered population and the government, and that expanding coverage is much more efficient in terms of quality of healthcare and cost control.
EMichael:
Not sure if it is more efficient when one inserts a middleman in the fray such as an insurance company; but as one expert told me, private companies are more adept at designing healthcare polices than government. It does make sense to cover those who have no means of securing healthcare as the costs are typically more when they arrive at the ER for care. Yes we were subsidizing them through hospital payments having special requirements to meet and which will go away in the near term regardless of whether states expand Medicaid or not.
Keep in mind that it’s not about the money. It’s about denying health care to people who don’t deserve it, even if it is more expensive to do so.
Does anyone seriously think that the health care and other costs to society for unwanted children born to women who are unable to afford birth control is $0?
You can always tell a person’s values by what it is they are willing to spend more money on, regardless of what they are saying, or what they think they are communicating.
Katherine:
Is it your belief then to cut off your nose to spite your face?
i hear and see what you’re saying Katherine..and it makes me so angry to see this happening. I am sick. Very Sick with a chronic illness. However, i wasnt always sick, and with healthcare, i can probably do something about going back to work. I HAVE ALWAYS WORKED. usually 2 and 3 jobs at a time. Paid my taxes. State and Federal. Paid my insurances. Paid my bills. UNTIL I GOT SICK. then all of a sudden…i am not worthy of healthcare? REALLY??? WHY NOT? because i got sick and cannot work UNTIL I GET SURGERIES AND ONGOING HEALTHCARE? apparently, yes! so…guess who ended up running up hundreds of thousands of dollars in Emergency Room care. yep, me. and FYI – THEY DID DENY ME CARE IN THE E.R.! for years, not just recently. and now i have permanent damage to my kidney/s due to the denial of care. if they had given me even temporary healthcare, this may have all been headed off and i would have been back to work years ago, and my health issues would not have been anywhere near so dire, and so expensive to the state, etc. so, how stupid were they, to say i was NOT WORTH giving healthcare to? now, they face possibe/probable charges for denial of emergency care and permanent damage due to negligence, and put me in a situation where i could not work and support myself, thereby making me a burden to the state. idiots, im tellin ya, idiots!
Becky:
Sorry for your hard times.
“if they had given me even temporary healthcare, this may have all been headed off and i would have been back to work years ago, and my health issues would not have been anywhere near so dire, and so expensive to the state, etc. so, how stupid were they,”
Emergency rooms by law have to provide emergency care to stabilize patients. They do not have to go beyond stabilization. By law many states did not have to provide Medicaid and refused to provide Medicaid to single and married adults who could not get a job and over a certain percentage of the Federal Poverty Limit. If you did have a job and were below ~70% of FPL, the bar was lowered a tad to qualify for Medicaid. If you were at 100% of FPL; in most states, you were out of luck. States determined who was eligible for Medicaid and who was not.
The PPACA first mandated the expansion of Medicaid which was struck down by the activist Roberts SCOTUS allowing states again to decide who was worthy of receiving healthcare except this time hospitals would not be compensated for caring for the indigent. So now there is no fall back for stabilization care. The Medicaid expansion was meant to reimburse hospitals for all types of care through Medicaid for those below 138% FPL. That the expansion is not happening is the result of Republican and Tea-bagger politics denying care to those who have fallen on hard times or are indigent in states not expanding Medicaid. It is less costly to care for people coming through the front door with insurance than coming through the back door without insurance. The last statement is true whether Medicaid was expanded or not. Furthermore, healthcare should be accessible to all people.
Beyond that, I am not sure of your circumstance.
Ms Beck, it is not the government’s job to provide you with healthcare.
We have free clinics. We have charitable hospitals.
I people choose not to contribute to such organizations, well, it is their money. They earned it. If they are too stupid, ignorant, and selfish to decide where and how much to donate, then they are too stupid, ignorant, and selfish to vote for those who will decide for them.
Perhaps it should be part of the government’s job to provide healthcare. You know, provide for the general welfare…and all?