Relevant and even prescient commentary on news, politics and the economy.

ACA Medicaid expansion growth is 25% in 2020

The Good Part of Medicaid

Originally, Medicaid filled the gap if Americans could not afford healthcare insurance.

Today, Medicaid is filling the gap if people lost income and/or healthcare insurance during the pandemic. If below FPL or 138% FPL, people qualify for Medicaid. Others who were already in the ACA healthcare exchanges qualify for larger subsidies. Those not qualified for either were left stranded by president trump. in 2020

Newly elected President Biden is creating an opportunity for those not qualifying for Medicaid and lost their insurance to enroll in the ACA. Biden will open up healthcare exchanges so those who lost their jobs can enroll in new healthcare plans.

Meanwhile, Medicaid enrollment increased ~4 million from February 2020 due to Covid.

What Happens if You are 55 and Using Medicaid

First, lets answer a question. “Does the Affordable Care Act allow states to confiscate the estates of seniors on Medicaid when they die?”

The opponents of the ACA coined a commentary taking things out of context and citing, The Affordable Care Act confiscates the estates of seniors who were on Medicaid when they die.

History has it that all states had an option since Medicaid began in 1965 to recover some Medicaid costs from recipients after they died as Health and Human Services explained in a 2005 policy brief.

– In 1965, it was optional and states could only recoup Medicaid costs spent on those 65 years or older.

– It changed in 1993, when Congress passed the Omnibus Budget Reconciliation Act of 1993 budget bill   requiring states to recover the expense of long-term care and related costs for deceased Medicaid recipients 55 or older.

The 1993 Omnibus Budget Reconciliation Act also gave states the option to recover all other Medicaid expenses.

Biden Promises to Help Fix the Student Loan Crisis

There are those who always raise the issue of “I paid for mine, you pay for yours. I know of no other debt created by borrowing money where the penalty is a life time of servitude and the means of retirement in Social Security is also attached too.

Principal remains untouched and whatever money paid goes to interest atop of interest and penalties. By the time salary catches up and if it does, the interest and penalties have grown.

Allen Collinge of Student Loan Justice is finally getting national Coverage on TV.


Biden expected to tackle student loan debt crisis, what the impact would be, “Rebound,” January 25, 2020

President Joe Biden campaigned on a promise to help solve the student loan debt crisis, and many are expecting him to tackle that soon. On the campaign trail, he spoke about favoring some student loan debt forgiveness but was hesitant on the idea of wiping out the debt completely.

Student loan debt forgiveness, in any form, is very controversial. While some believe it is necessary for millions of Americans who are unable to pay these loans back. Others worry it will raise the national debt to help those who are unable to repay their loans.

Neal McCluskey, with the Cato Institute

The Less Than Supreme Court

How Recent Supreme Court Decisions Have

Damaged Both the Court and the Constitution

There’s a pattern:

In November of 2000, immediately following the very close, highly contested, presidential contest between George W. Bush and Al Gore, John Roberts, a lawyer in private practice who had clerked for Chief Justice Rehnquist, rushed to Florida to be legal adviser to then Governor Jeb Bush during the to be decisive Florida recount; a recount decided not by the counting of ballots but by Reagan Appointee Justice Scalia’s bullying the court into its halting. Six months later, now President George W. Bush nominated the aforementioned John Roberts for the D.C. Circuit Court of Appeals only to be rebuffed by a Democratic Senate Majority. When Republicans regained Senate Majority in January 2003, Bush renominated Roberts; this time, he was confirmed. In 2005, President Bush successfully nominated John Roberts for Chief Justice of the Supreme Court. After all, he owed him.

Justice Thomas was chosen by George H. W. Bush to replace the retiring civil rights icon, Justice Thurgood Marshall. Clarence Thomas was chosen because of his ultra-conservative republican bona fides, his being black, and the unlikeliness of his being another Justice David Souter.

Justice Alito was chosen by George W. Bush because of his ultra-conservative republican bona fides; and the unlikeliness of his being another Justice David Souter.

Tennessee’s Block Grant Is Approved by H.H.S.

Restoring Medicaid,” What happens when states switch to Block Grants? I came across a NYT article citing Seema Verma’s approval of the Tennessee’s Block Grant recently. The Tennessee Block Grant is mentioned in section ” Revoke The Block Grant Initiative” of my post Restoring Medicaid.

What Are Block Grants?

Government funded normal Medicaid has established rules for coverage and benefits. In an exchange for greater freedom offered to states and an open-ended payment commitment, states pay a share of Medicaid. Using the Block Grant initiative and capped federal funding , states can decide what services to provide.

If the Block Grant spending is less, Tennessee can keep 55% of any savings. Savings can be used for anything related to healthcare and not just Medicaid. If the spending increases beyond the Cap, Tennessee makes up the difference. Program limitations can change to allow the spending cap to grow if enrollment increases such as what is happening during the Pandemic.

Medicaid pays for a wide variety of pharmaceuticals and pays the lowest price “today” of any pharmaceutical purchase in the United States. Under a Block Grant, Tennessee negotiates the drug pricing. One danger is if a drug is too expensive, Tennessee can reject covering it in its formulary.

Why Can Block Grants Be Bad?

“insurrections, treason, and the pardon power”

The Federalist Papers #74 on insurrections, treason, and the pardon power: an argument that such pardons would be invalid as “arising in a case of impeachment”

The Insurrectionists from January 6 are already asking Trump for pardons. Probably the only thing that would hold him back from doing so is his innate selfishness: what would be the benefit to *him*?

The thought that Trump could issue Got Out of Jail Free cards to the very people he incited to riot is mind boggling.

But it’s at least possible that he might not have the right to do so. 

Article III, Section 2 of the Constitution provides that “The President … shall have the power to grant] reprieves and pardons for offenses against the United States, EXCEPT IN CASES OF IMPEACHMENT.” 

That last bit isn’t just my emphasis. It’s also the emphasis placed on the quote in the discussion of the President’s pardoning power in The Federalist No. 74, which also discusses the right of the President to issue pardons in the cases of sedition and treason. Below is the entirety of the relevant discussion: 

Restore Medicaid to Its Former Self Quickly

Me – Talk: Recent article on Health Affairs I tapped into and decided to present here at AB. The topic? As expressed in the title, return Medicaid to its former self and improved upon by the new Biden Administration. I also have been working on additional posts touching upon the history of the opioid epidemic by the numbers, single payer, and a comparison to the a European healthcare model.


“In Its First 100 Days, The Biden Administration Must Restore The Soul Of Medicaid, Health Affairs,” Nicole Hubereld, Paul Shafer

Some Purpose . . .

The new administration should turn things around quickly and fix the damage trump and his administration did as sponsored by Republicans and supporters. This is as vital as getting stimulus money to people.

With the pandemic and many out of work, one of the top priorities for President Biden in his first 100 days should be: repeal the changes to Medicaid over the last 4 years by Republicans driving the Trump administration – bus. Medicaid provides a safety-net covering nearly one-quarter of the population today and will also cover those who have recently lost income and insurance. Nothing could be more vital during a pandemic than people needing healthcare.

The PPACA is not perfect but with the implementation of it, the expansion of Medicaid in 38 states and Washington D.C. came to be. It was “only” Republican opposition which stymied it in the other 12 states.

Post-Putsch: Why There Should Be Consequences for Enablers of the Capitol Invasion

Post-Putsch: Why There Should Be Consequences for Enablers of the Capitol Invasion

 I usually find myself agreeing with Glenn Greenwald, but not today.  GG has posted a heartfelt warning against overreaction to the attempted fur-and-horn putsch at the Capitol Building Wednesday.  He says the mob trampled on symbols of state power but otherwise did little of consequence, and vilifying them and their supporters will lead to repressive overreach, just like we saw after 9/11.  Cool it, says Glen.

Actually, I agree with one piece of this, the use of the “t” word, terrorism.  No the mob was not a terrorist brigade; it was mostly unarmed and did not commit mass or random violence to induce passive cowering from the rest of us.  There was minimal effort to locate and assault politicians; the intent was mostly to physically prevent the certification of the electoral college votes that would legally end any opposition to the replacement of Trump by Biden.

Tort

When Fox News and Newsmax recently accused voting machine manufacturer Dominion Voting Systems of rigging the 2020 election results, Dominion quickly and vigorously struck back at the two with a threat of civil lawsuit; a suit claiming that they, Dominion, had been harmed by the actions of Fox News and Newsmax. Consequent Dominion’s filing, Fox and Newsmax began to quickly and forthwith profusely apologize for and correct their ‘misstatements’.

For years and years, and years, tobacco companies were, with political immunity and lots of good lawyers, allowed to sicken and kill Americans by the tens of thousands with their products every year. In the mid 1990s, more than 40 states commenced litigation against the tobacco industry, seeking monetary, equitable, and injunctive relief, and, as they say, the rest is history.

Unfit

For eight years Mitch McConnell did everything in his power to block any initiative by President Obama; no matter the cost to the nation. It simply wouldn’t do to have the Democrats governing, to have a Democrat in the White House; especially not a popular black President. He never was much on democracy. McConnell couldn’t thwart the will of the people in the 2008 presidential election, but, from the start, it was ‘whatever it takes’ to ensure that Obama was a one-term president. Things didn’t get any better; Throughout the eight years. whenever Obama reached out his hand, McConnell spat in it.

In Obama’s last year in office, the year before Trump took-over, McConnell, single-handedly, unconstitutionally, denied him an appointment to the Supreme Court after Justice Scalia died in February of 2016. But one of many appointments denied during those last four years, this was the most egregious. One he bragged about for years.

In 2016, when the Obama Administration briefed McConnell on Russian interference in the election, McConnell threatened to accuse Obama of trying to tilt the election in Hillary Clinton’s favor if the Administration went public with the confirmed information. This after he had approved the expenditure of thousands of hours of the Senate’s time and millions of taxpayer dollars on an investigation into the Benghazi Incident, one that McConnell knew was a sham, an investigation meant to harm Clinton’s chances if she ran in 2016. Mitch could never find a good reason to do the right thing.

Impeachment now?

What about impeachment?  There is no question that Congress can impeach Trump for his role in encouraging today’s assault on Congress.  What are the arguments for and against? 

For impeachment:

There is a real possibility that Trump will do something dangerous in the final days of his presidency.

If he is impeached and convicted, he could be barred from running for President again. 

Presumably impeaching him would have some precedential / deterrent value going forward.

Against impeachment:

A politically divisive impeachment would divert attention from Trump’s now oh-so-evident wrongdoing and breath new life into the grievance narrative that motivates him and his base.  It could bolster his political support.  It could also fail.

So what to do?  Removal under the 25th amendment would avoid charges of partisanship (since it would be done by Pence and Trump’s cabinet).  It would hasten Trump’s fall from power within the GOP.  If removal under the 25th amendment is not in the cards, I think Democrats should only impeach if Republican Senators commit to removing him from office and if McConnell agrees to bring the matter to a timely vote.  Arguably, Democrats should insist that some reasonable number of Republicans (say, 50%) agree in advance to removal, to kill the partisan grievance narrative and keep the focus on Trump’s wrongdoing.  If Democrats challenge Republicans to commit to remove Trump from office and they refuse then the failure to impeach and remove would make them complicit in yesterday’s thuggish attack on democracy.  But proceeding with a doomed, democratic impeachment without Senate removal would have no precedential or deterrence value and it would be a political gift to Trump and his base.