Squandering $2 billion dollars in essentially free money is not what anyone would call “fiscal conservatism.” But that’s exactly what the phony fiscal conservatives in Republican-dominated state legislatures have done this year, according to Kevin Drum, of Mother Jones. This spectacular hypocrisy is the result of their obstinate, obstructionist, nihilistic, knee-jerk hate for all things Obama–and their utter disregard for the well-being of their economically disadvantaged constituents–which in this case comes in the form of not expanding Medicaid in their states.

Drum explains:

In 2015, according to a survey by the Kaiser Foundation, spending by states that refused to expand Medicaid grew by 6.9 percent. That’s pretty close to the historical average. However, spending by states that accepted Medicaid expansion grew by only 3.4 percent. Obamacare may have increased total Medicaid enrollment and spending, but the feds picked up most of the tab. At the state level, it actually reined in the rate of growth.

In other words, the states that have refused the expansion…are actually willing to shell out money just to demonstrate their implacable hatred of Obamacare. How much money? Well, the expansion-refusing states spent $61 billion of their own money on Medicaid in 2014. If that had grown at 3.4 percent, instead of 6.9 percent, they would have saved about $2 billion this year.

So, Drum concludes, “states that refuse to expand Medicaid [like Missouri] are denying health care to the needy and paying about $2 billion for the privilege.”

And there’s even more:

The residents of every state pay taxes to fund Obamacare, whether they like it or not. Residents of states that refuse to expand Medicaid are paying about $50 billion in Obamacare taxes each year, and about $20 billion of that is for Medicaid expansion. Instead of flowing back into their states, this money is going straight to Washington DC, never to be seen again.

So, the bogus fiscal conservatives running state legislatures hate Washington so much that they are sending it $50 billion per year with no expectation of return on investment. [Note to self-proclaimed “free-market-capitalism” Republicans: Please review your notes from Capitalism 101 on ROI.]

This is what passes for “governance” in America today.

The post Screw the poor: Not expanding Medicaid cost red states $2 billion in 2015 appeared first on Occasional Planet.

I live in a state whose Republican-controlled legislature decided to opt-out of Medicaid expansion. As you probably remember, expanding Medicaid was a key provision of the Affordable Care Act—a way to enable more uninsured people to gain access to healthcare services. Unfortunately, the U.S. Supreme Court made it possible for backward-thinking, Obama-hating state legislators to exclude the lowest-income people from getting health insurance, by allowing states to opt out of Medicaid expansion.

Remember: States like mine are doing this even though 90 percent of monetary costs associated with Medicaid expansion under the Affordable Care Act would be paid for by the federal government. Why would they do that? You can’t argue that it costs too much, when the federal government is offering to pay for it.  According to a new study by the Commonwealth Fund, foregoing Medicaid expansion will cost Missouri $2.2 billion per year in federal funds by 2022. There’s only one explanation for leaving that much money on the table: Protesting “Obamacare” and punishing poor people is a higher priority than trying to make things better for people in the state.

A new study [January 2014]  shows the price that will be paid for this irrational and mean-spirited move by state legislatures. The study relates the human toll that will be taken by untreated diabetes, skipped mammograms and pap smears, and lack of medical treatment in those states opting out of Medicaid expansion. You can read the report in detail at Health Affairs, where you’ll find statistics for every state. Here is a summary of some of the findings that pertain to mine.

In Missouri:

• 238,427 Missourians, who could have been insured under expanded Medicaid, will remain uninsured.
• Between 218 and 700 Missourians will die each year for lack of proper medical care
• 4,086 women will not get a mammogram this year
• 14,134 women will not get an annual pap smear
• 12,947 people with diabetes won’t get their medications
• 21,816 people will not get their depression recognized and treated
• 7,770 people will have catastrophic medical expenses

I have health insurance. So do most of my friends. So does every Missouri state legislator. What kind of world are we living in, when lawmakers can so callously and spitefully inflict this pain on the citizens they supposedly represent?

The post Opting out of Medicaid expansion: Here’s how many people it hurts appeared first on Occasional Planet.

After the St. Louis Cardinals won the [2013] National League Championship Series, it was reported that a rookie player, Seth Maness, said, “It’s a team concept. … Putting the team first is expected of you.” I am optimistic that “the Cardinal Way” will be the attitude in our Legislature with regard to expanding/transforming our Missouri Medicaid program.

What is my basis for optimism?  This summer and fall, three interim committees composed of Republicans, Democrats and ordinary citizens met frequently and heard a wide range of testimony concerning Medicaid eligibility, transformation and reform.

These three committees didn’t leave anyone out. As the management team, they sought information from the veteran players but gave the rookies a chance, too. Everyone was given an opportunity to be heard. Now they have to consider next year. Whom will they keep and whom will they trade? What contracts will they offer?

There are 34 senators and 163 representatives in the Missouri Legislature who are major participants in our league. We say it is time to play the Cardinal Way; put the team first.  Reform Medicaid to resolve some of the issues the committee members heard about. Expand Medicaid to provide care for our uninsured, low income Missourians. The stakes are high. As many as 168,000 Missouri adults will remain without health insurance unless you act.  We are counting on you to bring home a winner!

Reprinted, with permission of the author,  from the St. Louis Post-Dispatch

The post The “Cardinal Way”: A model for MO legislature, and others, too appeared first on Occasional Planet.

Recently, Ron Pollack, executive director of Families USA, wrote about the “practical effects of the Affordable Care Act. His remarks clarified for me that Missouri legislators are readying themselves for a role as a Greek chorus, where they can affirm, “Yes, we were right, Obamacare is a disaster! It just doesn’t work.”  But what isn’t working effectively is our legislature, which is passing laws that hinder the implementation of the Affordable Care Act. For details on how obstruction of Medicaid expansion promises to affect poverty-level citizens in Missouri, check out the St. Louis Post-Dispatch article, “A Big Medicaid Gap Looms in Obama Healthcare Law.”

Pollack suggests that “states that accept generous federal funding to expand Medicaid coverage for low-income families will show remarkable improvements in reducing uninsured rates.” Our Missouri legislature has chosen to not expand Medicaid.  Up to 300,000 low income Missourians will remain uninsured. When they need care we will bear the expense and our legislators will be in the chorus chanting, “We were right!  Obamacare, government takeover of our health system, didn’t reduce our health care costs!”

Beginning October 1, 2013, more than 500,000 Missourians will begin purchasing health insurance through online exchanges. Pollack says that “states with larger numbers of on-the-ground helpers, sometimes called navigators or assisters, will help their citizens much more effectively secure premium subsidies to obtain coverage that is most responsive to their families’ needs.”  But Missouri has created barriers, imposing unnecessary fees and regulations to make it difficult and even prevent social services agencies from giving assistance to their clients who are eligible to purchase health insurance in the new marketplaces. If SB262 is signed into law, individuals and small businesses purchasing policies will only receive information on coverage from insurance brokers and our legislators will thunder, “We were right!  Health insurance exchanges are too burdensome for our citizens.”

And what of the Missourians who try to purchase insurance under the exchange and learn they are not eligible for insurance subsidies because their income is too low?  They fall into a black hole, not allowed on Medicaid and unable to receive subsidies in the exchanges.  In our play, they fall off the stage into the orchestra pit, where the legislators are drumming to the tune of “It doesn’t work!”

Pollack says that “states that implement active oversights of their insurance marketplaces will do appreciably better in decelerating decades of premium increases.” In Missouri, our insurance commissioner has been given minimal authority to enforce the federal law and protect the consumer. If SB262 is enacted, our legislators will have created the set for a scene where consumers purchase policies that have high deductibles and that do not meet the needs of their families. And, yes, our legislators will be in the wings with an aside, “We were right!  Obamacare does not work.”

Pollack comments that when the states that have not expanded Medicaid see the improvements in care and costs being made in states that have fully implemented the Affordable Care Act, they too will want to the follow the lead of Arizona, New Jersey, New Mexico, Nevada, North Dakota et al and do the right thing for their citizens.

I am not a health policy expert.  I am just a concerned citizen who urges our legislators to read the reviews and acknowledge the critics are giving Missouri a thumbs down.

To our legislators:  Go back, edit the script, and write a play which will have a happy ending with a standing ovation from your grateful constituents for moving us closer to affordable, quality health coverage and care for all Missourians.

The post Legislators against Medicaid expansion wait in the wings to say, “I told you so.” appeared first on Occasional Planet.

Dear Governor Nixon: During the debate over the Affordable Care Act (ACA), we learned many things as a country. Chief among them, in my mind, is that a citizenship without medical coverage is a growing problem, both for the health of our people and for our finances. People should never go bankrupt because they or their children get sick or seriously injured, but every day they do. Every day thousands of Missourians go without necessary health care. Some of them lose their livelihoods and, unable to provide for their families, they turn to the state for help.

Health care is widely regarded as a human right in developed nations, Mr. Governor, and every facet of our society reflects that. Our health care professionals take oaths to practice medicine ethically and put the patient first, to aspire to prevention before cure. All of those ideals are acknowledged in the ACA via free preventative care, rescission bans, and coverage for pre-existing conditions, among other things.

We also have laws that require hospitals to provide medical treatment to everyone who needs it, regardless of citizenship or ability to pay. Every single taxpayer chips in to programs like the VA, Medicare, and Medicaid so that the people who need health care the most–but in most cases are least able to afford it–are able to get the care they need. Responsible employers share the cost of employee health care because they know a healthy worker is a productive one. Good health is necessary to a life in the pursuit of happiness, liberty, and the American dream.

The Affordable Care Act is simply an addendum to this societal norm, this very basic right. A right we all recognize and accept, whether we gain from it politically or not, whether we will admit to it publicly or not.

This is why I’m asking you to take the first step in extending Medicaid to cover hard-working Missourians earning up to 133% of the federal poverty line by including it in your budget. Please sign this state on to the Medicaid expansion so that more Missourians in need of something as basic as medical care can live in good health, keep their jobs and their homes, and provide for their families with dignity. Health care is a human right and Missourians are people too.

The post Dear Governor Nixon: Extend Medicaid coverage in Missouri appeared first on Occasional Planet.