In a dramatic break from a long-standing norm of defending federal laws, Attorney General Jeff Session has announced that the Department of Justice will not defend the Affordable Care Act in a lawsuit filed in Texas by 20 Republican-governed states. The lawsuit seeks to declare all of ACA [aka “Obamacare”] unconstitutional and, therefore, invalid. In other words, the Trump administration is attempting to do in the courts what Republicans in Congress failed to do in 2017.

The decision was approved by [if not ordered by] Donald Trump, said Sessions, in the opening paragraphs of a three-page letter he sent to the court. [For what it’s worth—meaning not much—Trump is on the record as promising to protect coverage for pre-existing health conditions—one of the most popular aspects of the ACA. If the court invalidates the ACA, with Trump’s support, those protections would be gone. An estimated 130 million adults under the age of 65 in the U.S. have a pre-existing health condition.]

The Washington Post calls the lawsuit and the Department of Justice’s position in favor of it…

…a bold swipe at the ACA, a Republican whipping post since its 2010 passage…[the lawsuit] does not immediately affect any of its provision. But it puts the law on far more wobbly legal footing in the case, which is being heard by a GOP-appointed judge who has in other recent cases ruled against more minor aspects

In a telling twist, three career DOJ lawyers quit shortly before Sessions submitted his brief. According to AP, they were replaced with political appointees.

Defense of the law now falls to Attorneys General from 16 other states. In a press release issued yesterday upon the filing of the states’ brief in opposition, Attorney General Xavier Becerra of California said of the lawsuit,

The lawsuit initiated by Texas is dangerous and reckless and would destroy the ACA as we know it. It would leave millions of Americans without access to affordable, quality healthcare. It is irresponsible and puts politics ahead of working families. We won’t sit back as Texas and others try yet again to dismantle our healthcare system. Our coalition of states and partners across the country will fight any effort to strip families of their health insurance.”

It’s anyone’s guess as to whether this latest assault will be approved by a judge. Some legal scholars have called the arguments “ludicrous.” [Also ludicrous would be any attempt by me—a non-lawyer—to explain why they describe it that way. For an actual explanation, please check out this link. ]

So, the fight to preserve a good idea—ACA—that is very popular and has benefited millions of Americans—is not over. In their vindictive battle against all things Obama, Republicans are using every ploy they can conceive of to take away access to health care from the 11.2 million people who have enrolled for 2018.  [That  figure was slightly lower than in 2017, but it was seen by ACA advocates as “robust,” because so many people signed up, despite the Trump administration doing everything it could depress enrollment by making it more difficult.]

Unfortunately, this assault is too easily buried under the daily deluge of shiny- object distractions flashed by the Trump Administration, and by the tsunami of revelations about corruption that dominate the daily news cycle. We need to stay vigilant.

The post The latest assault on ACA [Obamacare]: DOJ won’t defend it in court appeared first on Occasional Planet.

Donald Trump’s recent statements and tweets have created confusion and chaos in the health insurance market, just as open enrollment for ACA/Obamacare is about to begin, on November 1. He’s making it sound like he has killed Obamacare for good. He’s saying things like “Obamacare is dead. It’s over. You might as well not even mention it. There is no Obamacare.” But that is not true.

You can get health insurance for 2018 on the ACA/Obamacare exchanges. The program is still alive. The exchanges are still alive. You can still get health insurance with subsidized premiums. Trump would love for you to be confused and to just not even try. That would depress enrollment and help him sink the program that he hates—not because he understands its purpose, its workings, or how it affects individual people and the overall economy, but simply because it bears the name “Obama.”

So, do not be confused. Do not give up. Trump is doing everything he can to make you think that you can’t get health insurance for next year. And he’s not just talking: He has taken administrative action to make it harder for you to enroll. But you definitely can still enroll and get health coverage for 2018.

He has shortened the enrollment period from the customary three months to only six weeks. [Enrollment opens on Wednesday, November 1, 2017. It ends on December 15, 2017.] Pay attention to those dates. Don’t wake up on January 2 and say, “Gee, I should get healthcare insurance now. Oh, oops, I missed the deadline.” Trump would love for that to happen. Don’t let him fool you.

He has reduced—by 91 percent– the amount of money that will be spent on advertising the open enrollment period. So, you won’t be hearing as much about it, seeing as many ads, or getting much snail mail, email or social media contact about open enrollment. But you can still get health insurance for 2018 through the ACA.

He has reduced—by 41 percent overall—the amount of money that the government will pay to the non-government organizations who are most likely to reach out to people eligible for ACA/Obamacare enrollment — especially low-income people. Some of these groups have had their ACA/Obamacare outreach budgets slashed by as much as 90 percent. So you won’t be hearing as much from community organizations who used to remind you about open enrollment. But you can still get health insurance for 2018 through the ACA.

This vast reduction in funds has reduced the number of navigators who answer the ACA/Obamacare phones and help you work through the enrollment documents. You’re going to have to wait longer to connect with a navigator, and the person you talk with may not be as knowledgeable as those who had the job in previous years. But you can still get health insurance for 2018 through the ACA.

The big news last week was that Trump announced that he would immediately stop supporting the cost-sharing subsidies [CSR’s] that reimburse insurers for reducing deductibles and co-pays for lower income Obamacare enrollees. Until then, the administration had been paying these subsidies on a month-to-month basis.

But this huge act of Trumpian sabotage does not let insurer off the hook entirely. “Insurers must continue providing these cost-sharing discounts—even though they won’t be paid for them,” notes CNN. “That’s because the subsidies are required by the Affordable Care Act.”

So, if you qualify for premium subsidies—which are separate and unaffected by the CSR payments—you won’t have to pay much more, although you may need to switch plans to keep your rates steady. But you can still get health insurance for 2018 through ACA/Obamacare.

Trump’s moves will undoubtedly result in rate increases next year. So, your ACA/Obamacare insurance plan could cost more. But you can still get health insurance for 2018 through ACA/Obamacare, despite what Donald Trump would like you to think. ACA/Obamacare is not dead. If this is the year when you have decided to sign up,or if you need to look into a new plan, you should definitely explore your options at healthcare.gov.

The post Can you still get health insurance for 2018 via ACA/Obamacare? Yes, you can appeared first on Occasional Planet.

This year’s open enrollment period for ACA/Obamacare is from November 1, 2017 to December 15, 2017. That is a mere six weeks, compared to the three-month enrollment period available in all previous ACA years. Anyone — in any state — needing to sign up for ACA/Obamacare for 2018 needs to pay attention to the deadline. The Trump administration has:

• Cut the enrollment period in half
• Slashed advertising and outreach by 90%
• Chopped by 41% the dollars allocated to non-governmental groups who reach out to likely ACA enrollees
• Severely cut the number of ACA navigators available to help people enroll
• Is shutting down healthcare.gov “for maintenance” for 12 hours during all but one Sunday in the upcoming open enrollment season. Kaiser Health News reports that not only will the shutdowns occur from 12 a.m. to 12 p.m. ET every Sunday except December 10, but the Department of Health and Human Services will also shut down healthcare.gov overnight on the first day of open enrollment, November 1.

There’s only one way to describe these tactics: sabotage.

Having failed to kill ACA/Obamacare legislatively [more than 50 times], the Trump administration has embarked on a cynical scheme to undermine the program by making it harder to enroll. It’s a nasty plan that is gratuitously mean and vengeful. It in no way reflects what people actually want: A Pew Research poll shows that favorable views of ACA/Obamacare hit a new high in 2017. [It’s telling, isn’t it, that, essentially, all it took for ACA/Obamacare to reach its highest approval rating was for Barack Obama to leave office.]

People want ACA/Obamacare to stay. People who don’t get health insurance through their employers want it through the ACA’s state exchanges. And even the 56% of Americans who get their health insurance via work—want the provisions enacted in the Affordable Care Act [coverage for pre-existing conditions, essential health benefits, no lifetime limits, kids on the plan until age 26, etc.] Whether they admit it or not. Whether or not they realize that the Affordable Care Act [ACA] IS Obamacare. Even if they live in Mitch McConnell-land [Kentucky], where Obama-hating state legislators renamed ACA “Kynect Care” just so that people getting desirable Obamacare benefits would think that they were getting something else. [In 2016, Kentucky Governor Matt Bevin killed Kynect Care, not because it wasn’t working, but because it was working too well. Kentuckians now get their health insurance via healthcare.gov.]

Making enrollment more difficult is a Republican dirty trick.

Potentially hundreds of thousands of people could wake up in January—having waited until close to the longer deadline they thought was in effect—to find that they’ve missed their chance to get health insurance through the Affordable Care Act. Thousands more, encountering long waits on the phone, a shut-down healthcare.gov on the Sunday they chose to do their enrollment, or being assisted by less experienced, less informed navigators, may just give up out of frustration. And that’s exactly what the Trump administration and its Congressional-Republican enablers are hoping will happen. They want enrollment to be a hassle. They want people to miss the deadline. They are eager for people to quit the enrollment process because it’s slow and frustrating. Their goal is to shrink enrollment and thereby initiate the long-hoped for Obamacare death spiral, in which the program self-destructs.

These tactics dovetail beautifully with what many Republican legislators want — while obviating the need for them to actually vote on repeal. Newly resigned Director of Health and Human Services Tom Price, who is most certainly one of the plotters behind this Obamacare-sinking plan, can now just sit back and watch his hoped-for disaster unfold, while not having to take responsibility for it. It’s a perfect storm, if you are a soulless Republican meanie who enjoys full health insurance coverage paid for by the government.

It is hard to imagine a more perverse strategy.

We don’t want repeal/replace. We like the provisions of ACA/Obamacare. People have called, written, facebooked, texted, IM’d, sat-in, demonstrated, marched, protested, pleaded, and campaigned—again and again—to prevent the derailment of a program—imperfect as it may be in some of its provisions—that has made healthcare insurance possible for tens of millions who didn’t have it before, and that has dramatically improved coverage for people already insured through their employers. These are the people Congressional representatives and Senators are supposed to be representing. Instead, they are ignoring the human needs in their districts, elevating their own political needs, and kowtowing to financial blackmail by their fat-cat campaign donors.

This is sick.

Please remind everyone you know that ACA enrollment is different this year. The clock is ticking. Those of us who have health insurance cannot be complacent. If Republicans succeed in undermining ACA/Obamacare with this irresponsible, immature, immoral trickery, we will all suffer.

The post Signing up for ACA Obamacare? Republican sabotage makes it harder to enroll appeared first on Occasional Planet.

There are two key reasons why mainstream media must be talking about Medicare-for-All. First, it is sound policy, something that all Americans should hope for in truly finding affordable and accessible health care for all. Second, it is the Democrats’ position (though often muted) which stands in opposition to the Republicans’ “Repeal and Replace” Obamacare, or even simply “Repeal.”

Democrats acknowledge that the Affordable Care Act requires fixing. Most of what needs fixing is what was initially left out if the bill in 2009-2010 because (a) President Obama did not think that he could ask for that much, and (b) Republicans stood in firm opposition to it. The first step would be a public option, a proposal to create a government-run health insurance agency that would compete with other private health insurance companies within the United States. Because the public exchange would not need to charge consumers (taxpayers) the twenty percent overhead for private insurers’’ profit, it would immediately reduce costs and by its very nature, apply to everyone.

Presidents Harry Truman and Lyndon Johnson both supported some form of Medicare-for-All. But without presidential leadership, it took until 2003 for Representatives John Conyers (D-MI) and Dennis Kucinich (D-OH) and others to introduce H.R. 676, a simple six-page bill which would establish a single-payer or Medicare-for-All system. But as we have previously reported, the media paid scant attention to the proposal when Dennis Kucinich ran for president in 2008 against the likes of Barack Obama and Hillary Clinton, both of whom were offering “universal-lite” coverage.

In the 2016 presidential campaign, Bernie Sanders forced the media to cover what was the linchpin to his health-care program. Unfortunately, for many in the media Sanders has become “yesterday’s news,” and along with his partial black-out is a silencing of many of the progressive proposals that he advocated. In fairness, very few Democrats in office have taken up his mantle, even though it was clearly more popular with voters than Hillary Clinton’s milquetoast.

An example of neither the media nor a mainstream Democrat adding Medicare-for-All to a conversation was on CNN’s “New Day” on Monday, July 3. Guest host John Berman was interviewing Maryland Senator Ben Cardin about the question of whether Democrats were willing to work with Republicans on health care reform. [I wish that I could give you a link to this interview, but CNN is notoriously bad in providing access to recently-aired clips or interviews.]. Berman asked Cardin whether Senate Democrats were willing to work with Republicans and the Maryland senator gave the requisite answer that in theory Democrats would collaborate, but it did not seem realistic presently because of the huge gulf that separates the two parties on health care. But what Cardin did not say, and what Berman did not ask about was exactly what Democrats stand for. Had he been asked that, I am not sure whether Cardin would have proposed first aid for ACA, or even mentioned that government subsidies needed to be greater to meet escalating medical costs.

All of that is confusing. Medicare-for-All is not. It is something that should be asked about and talked about.

When the main issue before us was gay marriage, members of the mainstream media did not hesitate to ask politicians whether they were for marriage equality. That was a clear question which lent itself to clear and precise answers.

The media has not done so with Medicare-for-All. It is time they do so because (a) it is good journalism to do so, and (b) their personal lives and that of the society in which they live will be better off with it.

UPDATE: On Sunday, July 9, 2019,”The Hill” reported “Single-payer healthcare gains traction with Dems”

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 “One Paragraph of Obamacare Saved this Boy’s Life,” tells the story of Timmy, a thriving, happy six-year-old who lives in Maryland with his sister and parents. Timmy was born seven weeks before his due date and spent the first five months of his life in a neonatal care unit. Timmy was born with a rare condition that requires him to breathe through a tube in his throat and receive most of his food through a tube in his abdomen.

Timmy’s daily routine of medical care, lovingly administered at home by his parents, is complicated and expensive. Without one life-saving paragraph in the Affordable Care Act that outlawed lifetime limits on insurance payments, Timmy’s parents would not have been able to afford his care. The truth is that without the Affordable Care Act Timmy would not be alive today.

Timmy’s medical condition may be rare but the tragic consequences he and his family might face if insurance-policy lifetime limits are re-imposed would be shared by countless other families and individuals across America.

The post VIDEO: THE HUMAN COST OF Replacing Obamacare appeared first on Occasional Planet.

Ok, ladies. Listen up. Maybe you voted in the 2016 election. Maybe you didn’t bother. Maybe you voted Hillary. Or maybe you wrote in for Bernie or gave your support to Trump. I’m not here to criticize or chastise. I just want to remind you – especially if you’re a woman still of child-bearing age – about exactly what was at stake concerning your health and the American health-care system in this election. I hate to say it but it’s looking increasingly like a miracle just isn’t going to materialize out of the ether and save us from the electoral college doing the dirty work of anointing the most unqualified, uninformed, impulsive, and temperamentally and intellectually unsuited individual to the presidency in our lifetimes..

I don’t like to be negative. But. What looks like an almost certain effort to repeal the Affordable Care Act by Republicans is looming just over the horizon. And contrary to the spin from Fox News and conservative talking heads, repeal is really, truly not going to yield anything good. Quite the contrary. As women, repeal is going to affect us disproportionately in profound and destructive ways. (What’s new about that? This is the oldest story there is.)

If you didn’t realize before November 8 just what’s on the line, at least pay attention now. This is about how the election of Trump and a Republican-dominated Congress and the expectation of an increasingly right-leaning Supreme Court might affect you and your body and the most important of your life and work choices for perhaps the next few decades.

But don’t listen to me. Ignore, if you like, my particular brand of seething anger and unhinged anxiety. Do yourselves a favor now and take a few moments to watch and learn from this video put together by the National Women’s Law Center.

Narrator Gretchen Borchelt is going to gently remind you that before the Affordable Care Act

Being a woman was a pre-existing condition and insurance companies could either deny you coverage or require you to pay more for your coverage

92% of insurance plans used a process called gender rating that meant that collectively women paid $1 billion more than men for coverage

19 million women were uninsured

Just 12% of insurance policies covered maternity care (family values, anyone?)

Full coverage of women’s preventive services, such as cancer screenings, was not required

Full coverage of birth control – considered health preventive services under the ACA – was non-existent

Just think of this one statistic if you want to understand what’s on the line for your lifestyle and financial security:

In one year alone, since enactment of the Affordable Care Act, women (hey, millennials, are you listening?) have saved $1.4 billion on the cost of birth-control pills alone.

Like I said. Listen and watch. Then decide. Are you going to sit this fight out? Or are you going to get involved and do something to protect yourself?

The post A must-see video: What ACA repeal will mean for women’s health appeared first on Occasional Planet.

I know people who have blasted Obamacare from the beginning, and refused to even acknowledge that there is anything good about it.

When I would mention all the positive things, like a ban on exclusion for pre-existing conditions, no lifetime limits, no more being kicked off your plan because you get sick, children staying on the plan until 26, an expansion of Medicaid, a prohibition on charging women more than men, free preventive healthcare, and millions of people getting insurance for the first time with the uninsured rate dropping to the lowest ever, they would brush off the importance of those and complain about increased deductibles and rising costs– which in most (not all) cases have been less than before Obamacare went in to effect.

To those of you who kept complaining about wanting the “free market” to rule, you are getting your wish. Here’s the rundown, via the Washington Post:  “Obamacare is probably toast. And a lot of poor, white Trump voters will get hurt by it.”

..the likely end result (again, at best) is that a lot of the 20 million people who would lose coverage due to repeal will remain without coverage, and protections for those with bad medical conditions will be eroded.

And if you are lucky enough to have insurance through work or can afford it on your own, enjoy watching others lose theirs. If you have any decency, I assume you will strongly support increasing taxes to pay for the rising cost of health care for poor and working class people.

The post Obamacare is probably toast: Trump voters will get hurt appeared first on Occasional Planet.

Hillary Clinton has just released a plan would treat mental health care with the same priority as physical health care. It’s a well-thought-out, comprehensive policy that deserves attention and support. And, according to some observers, it actually has a chance of becoming a reality. Unfortunately, the announcement of the plan came in the midst of the media clamor over Donald Trump’s bogus trip to Mexico and his hate-fueled immigration speech.

Clinton’s plan calls for some very important changes to the way mental health care is currently addressed in the American healthcare system, where it has long been a neglected stepchild.

In broad terms, according to the Clinton website, the plan would

Promote early diagnosis and intervention, including launching a national initiative for suicide prevention.

Integrate our nation’s mental and physical health care systems so that health care delivery focuses on the “whole person,” and significantly enhance community-based treatment

Improve criminal justice outcomes by training law enforcement officers in crisis intervention, and prioritizing treatment over jail for non-violent, low-level offenders.

Enforce mental health parity to the full extent of the law.

Improve access to housing and job opportunities.

Invest in brain and behavioral research and developing safe and effective treatments.

More specifically, the big-ticket item in Clinton’s plan is, according to the Washington Post,

…$5 billion for community health centers providing substance abuse and mental-health treatment as well as traditional medical care…To address a shortage of mental-health professionals, meanwhile, she would encourage telemedicine, among other things. Clinton also proposed pumping up the budget for basic scientific research, some of which would be diverted into studying the brain.

There’s no doubt that these priorities merit attention. According to a government study, about 1 in 5 adults — or 43.6 million people — had a mental illness in 2014, with nearly 10 million of those experiencing a serious condition, such as schizophrenia or bipolar disorder. The same study said that 2.8 million adolescents had a major depressive episode during the past year.

Unfortunately, conventional payment systems have shortchanged mental-health care. While the Affordable Care Act [Obamacare] made some significant changes in requirements for mental health coverage,  there is much room for improvement. The good news, for example is that,since 2014, health insurance companies offering individual and small-group plans can no longer deny enrollment or charge higher premiums to people with medical histories of behavioral/mental health disorders. Also under the ACA, individual and small–group plans  are required to cover ten essential health benefits with no annual or lifetime dollar limits. Mental health and addiction treatment are among the essential health benefits. Nor can these plans offer mental-health benefits that are less favorable than the benefits for medical/surgical care.

But the National Alliance on Mental Illness published a report in 2015 detailing problems with access to behavioral health providers, and limited coverage for some brand-name drugs, particularly anti-psychotics, says healthinsurance.org. .The report also notes that health insurance companies are still more than twice as likely to deny authorization for mental health care, compared with authorization for general medical care.

Clinton’s plan, says the Washington Post, “emphasizes using the federal government’s role as a major payer in the health industry to encourage the integration of mental-health care into medical practices.”

As for practicality, Clinton’s plan is not just another pie-in-the-sky idea with no hope of implementation. The Washington Post notes that…

Congress has over the past several years put serious effort into reforming the federal government’s mental-health efforts, producing — but not yet passing — a slew of bills with bipartisan backing. This is one of the few issues on which lawmakers may be able to agree, even in a severely divided Washington, over the coming months. The House, in fact, has already passed a bill. Ideally, the Senate would pass its own reform before next year. But, if lawmakers fail to send a bill to President Obama — always a high likelihood given Congress’s slow pace — the next president should enter the policy debate, pressing for lawmakers to finally pass something.

As far as I can tell, there’s no parallel proposal from the Republican nominee, whose candidacy has been, essentially, a policy-free zone [until recently, when he doubled-down on an outrageously hateful, xenophobic immigration “plan.”]

For those of us seeking a President who has actual policy ideas designed to help people, and who is willing to do the work necessary to bring them to life, Hillary Clinton’s mental healthcare plan is very reassuring. I’m voting for the policy wonk.

The post Hillary Clinton speaks up for mental health care equality appeared first on Occasional Planet.

A Medicare for All health system [aka “single-payer”] would be a great step forward for the US. But how difficult will it be to get from here to there?

A recent analysis by Charles Gaba yields important insights into the difficulties of making that transition. Gaba’s article focuses on one state—Texas. Using Texas as an example, Gaba shows that the logistics will be extremely touchy—and not just in a political way.

The biggest obstacle to transitioning from our current mix of employer-based and healthcare-exchange-based system, says Gaba, is “that at least a half a million people currently work directly for health insurance carriers, plus (I’m guessing) another couple million in directly related services.”

To illustrate this point, Gaba lists every company that offered private health insurance policies in the state of Texas as of 2014. There are 163 of them.

…The point is that moving to single payer (again, assuming that included replacing all private policies for everyone and assuming that it would be a comprehensive policy which didn’t leave room for supplemental coverage) would mean that every one of these companies would go out of business…or at least shut down a major division of their operations in the cases of companies which also sell life/auto/homeowners/etc.

Gaba says that, in the long run, he has no problem with the ultimate shutdown of these companies, because he sees “the very concept of profit-based health insurance as troubling and unnecessary.”

At the same time, however, these are real people working for real companies, and very few of them are the Fat Cat Multi-Million Dollar CEOs that we all despise.

If the idea is that the federal government would hire these 500,000 people (that’s nationally; I assume it’s more like 50K or so in Texas specifically) to handle the government-run equivalent of their current job, that’s fine, but we’d better make sure to take that into consideration. What happens to multi-year legal contracts between these companies and the healthcare providers? What’s the economic impact of 160 companies being shut down in one state alone? How much transition time would be needed to do all of this? Then multiply that by 50.

Then we need to add in the political realities and the still-unanswered question of whether moving to Medicare for All would be more cost-effective/ less expensive, notes Gaba.

It’s not impossible, he says. But we have to factor in…

“…the sheer logistics and real-world impact that making this move would have. I simply see no way of it happening over the course of a few years even if all of the political and economic winds were all lined up perfectly for that entire period of time.”

That bit about putting all those health-insurance workers out of jobs is very compelling. It’s an argument that often gets lost in the political shuffle. I’m in full sympathy with Bernie Sanders’ desire to get the profit motive out of something that–as he said on Fox TV’s Town Hall last night–is a human right. But Sanders–and all of us who want Medicare for All–need to talk about it in a much more pragmatic way.

The post From Obamacare to Medicare for All: Easier said than done appeared first on Occasional Planet.

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.