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Monday, October 24, 2016

A new study by the Rand Corporation of 14 states planning to reject Medicaid is getting a lot of attention because it points out what a “good deal” Medicaid expansion is for state governments.

As part of the Affordable Care Act, all 50 states can expand their Medicaid programs to cover anyone earning up to 133 percent of the poverty level. At first the federal government funds 100 percent of this expansion, after which its contribution decreases to the still-extraordinarily-generous level of 90 percent. Currently states receive 50-73 percent of Medicaid funding from the federal government.

This expansion pushes billions of dollars into state governments and will lower the reliance of the working poor on emergency rooms, which will eventually bring down rates for all residents. Basically, it’s a great f*cking deal and turning it down will cost these states $8.4 billion annually in federal payments and leave 3.6 million people uninsured.

And those uninsured would be working families who currently earn too much to qualify for Medicaid, but not enough to afford health insurance.

Still at least two dozen Republican-led states are planning on turning it down for the most obvious reason — their goal is to make Obamacare, and the president it was named after, fail.

And this recalcitrance will have a cost in dollars and lives, Rand found in its study of 14 of the states who are about to reject Medicaid expansion: “Based on earlier research showing that past expansions of Medicaid have led to decreases in deaths, the study estimates that an additional 19,000 deaths could occur annually if the 14 states studied do not expand Medicaid.”

It’s estimated that between 26,000 and 45,000 Americans die each year for a lack of insurance, a fact Mitt Romney refused to acknowledge during last year’s election.

And the states that turn down expansion will still be paying for the Affordable Care Act anyway, while letting their residents needlessly suffer and possibly die.

That’s why even Arizona’s Republican governor Jan Brewer — who is no fan of the president — is fighting to expand the program, as you can see in the video above. She may be partisan, but even she recognizes that the fiscal conservative and compassionate thing to do is to just say “Yes.”

(h/t @TheDailyEdge)


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  • docb

    Republican Congressional DEATH PANEL= DIE QUICKLY!

    • DurdyDawg

      Here’s the GOPs humanitarian proposal..

  • dtgraham

    When you find a doctor or hospital who accepts Medicaid, presumably you’ll get treated for everything or virtually everything. I understand that if you show up at a hospital without insurance or Medicaid or cash you’ll still be treated in an ER. However, that can’t be just a more expensive form of Medicaid or this wouldn’t be a big deal and there would be no talk of 19,000 extra people dying. If you arrive at an ER without insurance, Medicare, or Medicaid, and can’t pay…what won’t they do? What won’t they treat that they would have if you would’ve had Medicaid?

    • TZToronto

      What about long-term care? An emergency room is OK for something that needs immediate attention, but there are things–like cancer–that aren’t treated by emergency rooms. Oh, they’ll treat sudden consequences of cancer, but as far as ongoing treatment, well, forget it.

      • dtgraham

        Yes, I guess something requiring longer term treatment would be out of the question in such a situation. This would be just for on the spot care. Even if your longer term treatment was for something that was life threatening if the treatment was not received, your “care” would probably still involve little more than getting sent home with a pain killer.

        To think that the same Republican politicians who support such a system also fight tooth and nail to make sure that women don’t have access to the morning after pill, because that’s murdering a baby.

        I don’t explain this planet. I just live on it.

      • You are right. Reagan’s socialized solution, is designed to help uninsured citizens involved in an accident, or victims of a heart attack and sudden illnesses, it does not address the needs and benefits of preventive care and the positive impact that has on our well being and cost effectiveness.

    • gmccpa

      In my admittedly very limited experience, some hospitals wont do much more than they have to…unless they know they will be getting paid. I have a high deductible insurance plan, and went for a stress test at the end of last year. The hospital asked for my insurance info and approval…to which I replied dont bother, I will pay for it myself, as I would not have met the deductible in any case. They STILL would not perform the test, unless I put up $12,000 upfront….which was more than double the cost of the stress test. Ironically, once they had the insurance company approval…even though the test was less than the deductible, they performed the stress test… and did not bill me until my insurance company said I did not yet meet my deductible. (which I already knew)

      Anyway, the point is, I quickly discovered that its not so easy to have non emergency type procedure/treatment without some form of insurance. And my guess is that some – or many – of those procedures do actually save lives.

      • Lynda Groom

        Most in our small town have some kind of health care coverage, but of course not all. Our local hospital has a great policy that perhaps others should consider. When you drop into the emergency room you are not asked questions regarding your insurance until after you’ve been given the care required. They found from their own study that when that process is reversed the level of care drops for those with little or insurance. What do you think of their new policy?

        • johninPCFL

          The ERs in Florida now charge $50 to $150 before they assign a physiian. No money? The nurses handle your care.

    • ralphkr

      You are correct, dtgraham, that under Reagan’s socialist medical reform that the ERs are required to treat every one whether or not the patient has the ability to pay BUT…this ignores the fact that ER care is absolutely the most expensive care available (and the forfeited charges are picked up by local taxpayers). For example: during a routine appointment I happened to mention that I was really out of shape now and had to stop and get my breath 3 times when walking the 94 feet to the road to get the mail. He immediately sent me to the hospital a block away & set up sonogram & scans where the hospital ascertained that I had DVT in my calf and a pulmonary thrombosis at which point I was wheeled to the ER (they would no longer allow me to walk). As well as the shots to my belly I was given 2 Warfarin pills (Yep, rat poison. I sometimes wonder just how they feel about me) with my co-pay cost of $17 each pill. When I filled the prescription at WalMart (right on the way out of town to home) my co-pay was $1.08 for 100 pills. I also noticed that the sonogram of my leg cost much more than a cat scan of my entire spine 20 years previously.

      The hospitals also transport non-paying patients to other areas while patients with money or insurance with the same problem are admitted to the hospital. I ran into a particularly egregious case of this in the 1980s when a distraught woman called our office and wanted advice about this elderly woman who had shown up at her door. After talking to the very elderly woman I ascertained that she had been treated in an emergency room in a hospital about 140 miles away, loaded into a car, told that she lived here now, and pointed her to the now distraught woman’s home. No one was able to explain how the offending hospital chose that person’s place (for that matter, the offending hospital tried to claim no knowledge of the patient).

      So in answer to your question as to what won’t they do? They shall treat you about the same as a medic treats some one on the battle field, i.e., patch you up as best they can and send you on with the difference being that the ER shall admit you to the hospital if you have insurance or other proof of ability to pay otherwise the ER shall admit you to the outdoors to fend for yourself.

      • dtgraham

        Yowza. That experience you had of the woman transported 140 miles away reminds me of a scene from Michael Moore’s movie Sicko. The part where that hospital drops off seriously ill and disoriented patients on a random street corner because “skid row provides the best bed in town” according to the Doctor in the film. These would be patients who couldn’t pay. I suppose the idea is to get them away from the hospital for PR reasons. It wouldn’t look good to have a bunch of sick and dying former patients just lying around the facility’s grounds. That’s the only reason I can think of because driving them somewhere costs more money than just kicking them out the front door.

        • ralphkr

          I never saw Michael Moore’s “Sicko” but that sure sounds like Los Angeles to me. The LA hospitals were infamous for dumping patients on Main Street (That skid row street where they taped the “Hill Street Blues” series). I am sure that it was not just for clearing the hospital grounds but also in hopes that the patients would not find their way back. I remember seeing the LA hospital expose on “60 Minutes”. One particularly poignant scene was when a couple burly orderlies hauled a white haired woman out of the van and left standing there with only one shoe (the other had fallen off in the van as they were getting her out) and peering around hopelessly lost. Another elderly patient was filmed being dumped in her bathrobe and those paper slippers the hospital sells you. That one almost immediately collapsed to the sidewalk so she looked just like all the passed out winos.

          • dtgraham

            I think it may have been Los Angeles ralph. Street cameras from local businesses showed one older woman being forced out of a van with that same flimsy hospital gown and paper slippers. She was completely out of it and just slowly walked back and forth on the sidewalk, to the end of the block and then back again. She continued doing this until someone from one of the local establishments took pity on her and brought her in. Local area businesses report this as a common occurrence in the movie. It didn’t go into what happened to her after that.

            I guess the political right is ok with this as long as those poor souls don’t somehow manage to survive and then later get gay married or have an abortion. As one of our Republican posters told me not long ago, as long as I advocate for a woman’s right to choose, then “you’re just another demon.” Yes that’s quote, unquote. So, who’s dtdemon to criticize anything?

    • DurdyDawg

      Simple .. They will treat the emergency only.. Any short or long term care is not their function or responsibility as those will be treated by others ONLY with insurance.. Look it up.

  • charleo1

    These Governors know full well, and have for years known people are dying
    unnecessarily, due to lack of care. Because, so many of the maladies that wind
    up killing us, are easily, and more to the point here, less expensively treated,
    when caught early. And, I’m sorry. But to say, well, I’m aganist it, because my
    ideology tells me, that people shouldn’t be looking to the government to solve
    their problems. Or, I believe in the free market approach to solving such matters.
    Well, that’s not acceptable. How could it be acceptable? When did ideology
    become more important than people’s lives? If my ideology told me that, I
    believe I’d find me a different ideology. Or check to see if my conscience had
    died, and I had been operating, and making decisions about other people’s
    lives without one. I mean, how else could a person come to the conclusion,
    that, yes, 10, or 20 thousand people will die unnecessarily each year, for my
    ideology. That, however unfortunate that may be. At the end of the day, a small
    price to pay. Because this is not about saving lives or, improving the quality of
    life for my constituents. It is about me, holding fast to my principals.

    • dtgraham

      “If my ideology told me that, I believe I’d find me a different ideology.” I believe you’re channeling your inner Mark Twain or Will Rogers again charleo1. Thanks for the chuckle.

      • charleo1

        I wish! And, you’re welcome!

  • amphiox

    The modern GOP is now the BOH party.

    Blood On Hands.

  • Lynda Groom

    It is obvious now that the citizens of those states with obstructionist governments must demand to be part of the law of the land. Depending on people out to delay and obstruct the implementation of the law of the and is not way to go through life. Push for the improvement of your health care if you must. I happen to live in a more progressive state and I feel for those stuck in this ideological no-mans-land.

  • Many Republican governors, including Florida’s Rick Scott, have turned around on this issue and expressed their willingness to expand MEDICAID and embrace ACA. The only roadblock left is caused by Republican-controlled state legislatures trying to figure out ways to benefit their financial sponsors by adopting ACA.

  • Phyllis Cuming Des Jardins

    I am ashamed to say I live in a state where they are going to refuse the Medicaid money and let the peope die.
    Furthermore, since people with cancer are being denied the money for thier cancer drugs because of the Sequester, I have decided that if a I get an expensive cancer they will deny coverage for, I will just skip the whole mess and let myself die. I will never be able to pay for drugs that cost $15,000 a month or more.
    Unfortunately, there are some people in America who will cry for a dead dog or bird, but count human life of no value unless it is in-utero!.

  • howa4x

    These states and governors are negligent and the Attn. general should prosecute them for homicide. These are the same governors that thank Jesus every chance they get. I never heard of such a people that got their own religion so wrong. Maybe they will have carts going through town yelling bring out your dead

  • ArchiesBoy

    The Repubs have become a lost cause. The only hope is for the electorate to wake up and vote them out of office. And let’s start with the voters in states where Medicaid is going to be refused.

  • Alvaro

    All is Because The Name Of The Health Care Program is OBAMACARE,and is Forever and this name Remind The GOP,The First Black President in United State of America . The Gop Want to Change The Name Romney care or Brushcare.