home

Federalize Medicaid

By Big Tent Democrat, Section Other Politics
Posted on Wed Dec 23, 2009 at 10:05:36 AM EST
Tags: (all tags)
Share This: Digg! StumbleUpon del.icio.us reddit reddit

Good post from Ezra:

Ben Nelson is getting a lot of blowback for the deal he struck exempting Nebraska from paying for its Medicaid expansion. But though it was his deal, it wasn't his preference. It was Harry Reid's. And Reid made the right decision. [. . .] That's created a few days of bad press, but as Tom Harkin points out, it could eventually lead to good policy. "When you look at it, I thought well, God, good, it is going to be the impetus for all the states to stay at 100 percent [federal funding]," Harkin told reporters. "So he might have done all of us a favor."

Harkin is right about this. One of the best things the bill could do would be to federalize Medicaid, and federalizing the Medicaid expansion is a good first step.

(Emphasis supplied.) If this bill serves as a camel's nose under the tent for federalizing Medicaid while expanding it, it would indeed be one of the most progressive pieces of legislation in some time. It would be ironic if Ben Nelson were the catalyst for that.

Speaking for me only

< College Football Bowl Game Predictions and Open Thread | Balloon Boy Parents Sentenced to County Jail Time >

  • The Online Magazine with Liberal coverage of crime-related political and injustice news

  • Contribute To TalkLeft


    • Display: Sort:
    Federalize Medicaid | 108 comments (108 topical)

    Readers Must Login or Create an Account to Comment

    I think Harry (5.00 / 1) (#1)
    by Capt Howdy on Wed Dec 23, 2009 at 10:12:11 AM EST
    is smarter than the credit he is being given

    It could be a shrewd move (5.00 / 1) (#87)
    by cawaltz on Wed Dec 23, 2009 at 01:59:35 PM EST
    if it gets the Republicans to do their dirty work with getting citizenry to ask that their states get the same sweet deal Nebraska is getting. It might even get budget neutrality tossed out if Reid were to point out he's only doing what they requested.

    Parent
    I have heard (5.00 / 1) (#2)
    by Steve M on Wed Dec 23, 2009 at 10:16:55 AM EST
    that some of the non-Nebraska states are exploring possible constitutional arguments over this unfair "special treatment."  Obviously a political stunt rather than a real legal theory, but I'm with ya, I hope all the states get the money!

    NY State better... (none / 0) (#34)
    by kdog on Wed Dec 23, 2009 at 11:02:15 AM EST
    get a deal closer to Nebraska's...the governor is saying the Senate bill could cost the state over a billion in new medicaid funding requirements...Bloomberg is saying it will close a ton of clinics in the city...they say the states that have done better by the poor providing access to care are being punished for their charity by the Senate bill.

    Statements from Schumer amounted too (imo) "there is good stuff too, don't worry, we'll get the best deal".  Not very inspiring.

    Parent

    Bloomberg is right when he says (5.00 / 3) (#48)
    by MO Blue on Wed Dec 23, 2009 at 11:15:05 AM EST
    states that have done better by the poor providing access to care are being punished for their charity by the Senate bill.


    Parent
    Full disclosure... (none / 0) (#49)
    by kdog on Wed Dec 23, 2009 at 11:16:37 AM EST
    not sure if that came from the Bloomy or Patterson camp...not that one is more credible than the other:)

    Parent
    I think the expression is (none / 0) (#72)
    by jimakaPPJ on Wed Dec 23, 2009 at 01:01:46 PM EST
    ....be careful what you ask for, you might get it..

    I'm gonna go back and restate.

    Kill this piece of pork, come forth with a single payer plan based on Medicare's example, show us how it will be paid for and then we will see who is actually concerned about the health care needs of the citizens.

    Anything done in the dark is always done there because the participants don't want others to see it!

    Parent

    What you say is true (none / 0) (#73)
    by Militarytracy on Wed Dec 23, 2009 at 01:09:42 PM EST
    but the only way you can do it and get it done is if every single one of them tells the lobbyists with all of their re-election funds to go eff off.

    Parent
    Obama had a 65% approval rating (5.00 / 1) (#76)
    by jimakaPPJ on Wed Dec 23, 2009 at 01:14:03 PM EST
    and a real mandate for change. That he didn't use it for something like this speaks volumes.

    Parent
    I don't know what it speaks of (5.00 / 2) (#83)
    by Militarytracy on Wed Dec 23, 2009 at 01:28:06 PM EST
    in its entirety.  I know what I would have used that mandate on.  I know what I wanted him to use it on.  Thing is Jim, I don't think Obama believes in single payer and I don't think he really wants a serious challenge to insurance companies in a public option.  I think he is at a point that one can be forced on him now, but I think Conservatives have too much dirt on the underhanded deals being used to attempt to get something passed.  And I think they are going to gnaw away at finding out about or exposing anything that was secret that discredits Obama and Democratic leadership.  And Barbara Boxer can talk all day about how the insurance companies told the Repubicans to not work with them or talk to them but first off......that's the Democrats own fault that that works so well.  Pass election finance reform then!  And secondly, the Republicans are not your friends Obama.  They take notes every single day, they document all of your dirt that they can and you are giving them plenty in your false belief that they can be your BFF.  There is no such thing as post partisan unity.

    Parent
    Obama believes in receiving campaign (5.00 / 1) (#86)
    by MO Blue on Wed Dec 23, 2009 at 01:47:01 PM EST
    contributions from the medical industries and that keeping them and their $$$ on his side is necessary to winning in 2012.

    Parent
    He has to have our money though (5.00 / 1) (#92)
    by Militarytracy on Wed Dec 23, 2009 at 02:07:27 PM EST
    to keep them in business.

    Parent
    "something like this" (none / 0) (#101)
    by Socraticsilence on Wed Dec 23, 2009 at 04:38:46 PM EST
    never would have flown-- our party has to many remaining deficit hawks- and federalizing Medicaid-- especially if that federalization included the most generous state eligibility requirements would have blown up the budget.

    Parent
    Hyde Amendment prohibits any abortion (5.00 / 1) (#104)
    by debcoop on Wed Dec 23, 2009 at 11:21:27 PM EST
    with federal funds. There are 17 states which pay for Medicaid with their portion of the ratio.

    I am not positive but if there was 100% funding then those states may lose the right to provide abortions to women in those states with their own money.

    Millions of women could lost their rights.

    This health care bill has become nothing but a vehicle to deprive women of the right to make decisions about their bodies and their lives.

    Parent

    That's years down the road (none / 0) (#36)
    by andgarden on Wed Dec 23, 2009 at 11:03:43 AM EST
    in the meantime, there is no increased expense for the state. I really wonder whom Paterson is playing to.

    Parent
    What really bothers me is... (none / 0) (#38)
    by kdog on Wed Dec 23, 2009 at 11:05:48 AM EST
    the closing of clinics statement by Bloomy...if health care reform leaves us with less places providing actual health care to the less fortunate...wtf are we doing?

    Parent
    10 billion (none / 0) (#63)
    by waldenpond on Wed Dec 23, 2009 at 11:44:44 AM EST
    Bernie Sanders got 10 billion for community health clinics in exchange for his vote.

    Parent
    Yes, for a small state (5.00 / 2) (#82)
    by BackFromOhio on Wed Dec 23, 2009 at 01:25:03 PM EST
    with small population, especially compared to NY's overall population and pop that relies on publicly-funded health care.

    Parent
    Oh, now you're in for it, as I was (5.00 / 2) (#88)
    by Cream City on Wed Dec 23, 2009 at 02:01:57 PM EST
    when I was attacked for my disgust that the bribe to Bernie Sanders was for so much for so few, in one of the least-populated states.  Of course, every American is as deserving as every other one.  But it really speaks to the problem of the Senate.

    Parent
    FYI (5.00 / 6) (#91)
    by CST on Wed Dec 23, 2009 at 02:06:21 PM EST
    that's not what it is at all.

    It's 10 Billion for health clinics NATIONWIDE.

    Not for VT.

    Maybe that's where the problem was.  That wasn't a "bribe" for his state, it's something he cares about for all Americans.

    Parent

    The irony being for my area (5.00 / 1) (#96)
    by cawaltz on Wed Dec 23, 2009 at 02:22:35 PM EST
    that they will get money and if this passes won't really have many people to treat. In order to utilize our free clinic you can not have health insurance(even if you have junk insurance you don't qualify). Considering health insurance will be mandated the pool of people they will treat is going to be smaller. Meanwhile the people they used to treat won't be getting care because they can't afford the deductible.

    Parent
    I have a feeling (none / 0) (#97)
    by CST on Wed Dec 23, 2009 at 02:25:32 PM EST
    A lot of these rules may be changing in the future.

    Many states/areas will have to rethink their healthcare approach in light of the new bill.

    I sure hope my state rethinks their mandate policy.  People do not need to be fined twice.

    Parent

    Federal program (5.00 / 2) (#94)
    by waldenpond on Wed Dec 23, 2009 at 02:10:21 PM EST
    This is for federal clinics, not just his state.

    [As for the community health centers--officially named federally qualified health centers--they were spearheaded in the 1960s through legislation authored by Senator Edward Kennedy. There are now 1200 of them across the country with over 7500 satellites. 20 million Americans utilize these facilities, including 1 out of 6 Vermonters, giving the state the highest rate of participation in the nation.]

    Also, from the article.....

    [Also critical, the funding would expand the National Health Service Corps which provides loan repayments and scholarships for primary care doctors, dentists, nurse practitioners, physician assistants and mental health professionals. Sanders points out that currently there is a "primary healthcare crisis" with "tens of millions of people"--even people who have insurance--unable to find a primary healthcare doctor or dentist.]

    Parent

    I just saw this too (none / 0) (#95)
    by Militarytracy on Wed Dec 23, 2009 at 02:14:31 PM EST
    This sounds wonderful.  I have a bad feeling though about where we are.  I suppose we are in the danger zone now.  I hope there isn't any dirt out there worse than a pheasant hunt.

    Parent
    Ditto (none / 0) (#107)
    by BackFromOhio on Thu Dec 24, 2009 at 11:02:08 AM EST
    glad to learn this

    Parent
    I'm confused (none / 0) (#90)
    by Steve M on Wed Dec 23, 2009 at 02:05:22 PM EST
    surely all 10 billion is not earmarked for Vermont?

    Parent
    Yes it does (none / 0) (#93)
    by Militarytracy on Wed Dec 23, 2009 at 02:08:21 PM EST


    Parent
    Did you consider that he is playing to the truth? (none / 0) (#70)
    by jimakaPPJ on Wed Dec 23, 2009 at 12:51:36 PM EST


    Parent
    Don't know who Paterson is ... (none / 0) (#98)
    by Robot Porter on Wed Dec 23, 2009 at 03:34:31 PM EST
    playing too either, but worry not, Gillibrand is offering t-shirts!  Designed by Nanette Lepore!

    Is it any wonder that NY is near the bottom on the happiness scale?

    Parent

    I'd love to see Maine lead the way (none / 0) (#42)
    by ruffian on Wed Dec 23, 2009 at 11:10:29 AM EST


    Parent
    Question (none / 0) (#71)
    by jimakaPPJ on Wed Dec 23, 2009 at 12:57:06 PM EST
    Article IV - The States

    Section 2 - State citizens, Extradition

    The Citizens of each State shall be entitled to all Privileges and Immunities of Citizens in the several States.

    Is the above a "theory?" And if so, could we have some free legal advice?

    Parent

    Heh (5.00 / 1) (#74)
    by Steve M on Wed Dec 23, 2009 at 01:11:07 PM EST
    No, the idea that each state has a constitutional right to receive the same level of benefits as every other state doesn't seem to have any constitutional validity.

    Parent
    If it did surely we'd have had (5.00 / 3) (#78)
    by Militarytracy on Wed Dec 23, 2009 at 01:16:06 PM EST
    problems before now.

    Parent
    "Sorry LA, (5.00 / 2) (#81)
    by lilburro on Wed Dec 23, 2009 at 01:24:22 PM EST
    I realize Katrina is going to be expensive and all, but you get the same amount of dinero as Montana."

    Parent
    Has it ever been tested? (none / 0) (#75)
    by jimakaPPJ on Wed Dec 23, 2009 at 01:12:01 PM EST


    Parent
    too bad (5.00 / 2) (#79)
    by mollypitcher on Wed Dec 23, 2009 at 01:19:05 PM EST
    that "The Citizens of each State shall be entitled to all Privileges and Immunities of Citizens in the several States" does not apply to LGBT issues.

    Parent
    Funding is not a privilege (none / 0) (#89)
    by Cream City on Wed Dec 23, 2009 at 02:03:34 PM EST
    nor is it an immunity.  Definitions are key, and these definitions long have been determined.

    Parent
    Federalizing Medicaid (5.00 / 1) (#29)
    by KeysDan on Wed Dec 23, 2009 at 10:53:07 AM EST
    is something that needs to be effected, in any event, to relieve financially troubled states and to assure more standardized benefits.  Moreover, it does offer great potential  It will be necessary, however, to work against the notion that health care reform is a new welfare program with its associated political vulnerabilities.  Lowering the Medicare ages, for example to 55 would not present the same issues, but we need to move-on to health care that we are getting rather than the health care we want.

    Indeed, that's what's most dangerous (5.00 / 3) (#31)
    by andgarden on Wed Dec 23, 2009 at 10:55:56 AM EST
    about the "subsidy" formulation. If it looks like Welfare, they can kill it later.

    Parent
    If we have a medicaid buy-in (5.00 / 1) (#41)
    by Militarytracy on Wed Dec 23, 2009 at 11:09:57 AM EST
    though, that could be expanded.  The ONLY thing about having the whole country insured at this point at any cost that would be a benefit (though not enough of one in my opinion to just push any ole thing through that could break everyone) is the change of expectations that people will have about having health coverage.  In every single nation that has universal coverage, you cannot wrestle that away from the people now.  It is the norm.  If you attempted to you could not get elected or re-elected unless there was some kind enormous extreme giant circumstance.  If being covered is the norm, and medicaid can be expanded and has a buy-in.....anybody who wanted to get elected or re-elected would have to champion any way possible for everyone to continue to be covered and an accesible way to do that would already exist.

    Parent
    Exactly, Militarytracy (none / 0) (#103)
    by christinep on Wed Dec 23, 2009 at 07:10:21 PM EST
    The expectation and reality of "coverage" will change the values norm. Inherent in the legislation is the assumption that healthcare is a right, not a privilege. (Granted, it needs work--but, thats a major step from where we have been.) Likewise, Sen. Sanders inclusion of the nationwide $$$ increase for community clinics follows that same track.

    Parent
    The trick is getting enough folks in the net (none / 0) (#100)
    by cawaltz on Wed Dec 23, 2009 at 04:34:29 PM EST
    that it makes it difficult to cut or kill without looking like the Grinch who stole Christmas.

    Parent
    There must be enough funding to make sure (5.00 / 1) (#62)
    by esmense on Wed Dec 23, 2009 at 11:42:27 AM EST
    people can be enrolled quickly, without hassle. Earlier in the year I tried to help an unemployed friend, too young for Medicare, too old for affordable insurance, get medicaid coverage for a prescription (only $22 a month). It was more than 2 months before she got coverage for a drug she needed to take daily (for a hyper-thyroid condition that, in addition to having caused severe weight loss, was causing paranoia, extreme anxiety, extreme sensitivity to sound, sleeplessness, etc. -- and severely interfering with her ability to find work.) A big part of the problem was understaffing -- the people assigned to her case were rarely in the office. I presume this was because the hours state employees worked had been cut back out of budget concerns. Fortunately, the prescription was cheap and I was able to help her out until she got coverage, but not everyone who will need this coverage will be as fortunate in terms of the affordability of the prescriptions or other care they need.

    Untreated hyperthyroid (none / 0) (#99)
    by cal1942 on Wed Dec 23, 2009 at 04:13:52 PM EST
    shortens life span.

    Serious condition.

    Parent

    I know. The whole experience was very eye-opening (none / 0) (#102)
    by esmense on Wed Dec 23, 2009 at 05:26:03 PM EST
    and discouraging -- and humiliating and life threatening for my friend. It has made me a bit skeptical about "expanding Medicaid" and using a welfare model for reform.

    Parent
    I was taking a shower and my cell phone (5.00 / 3) (#68)
    by Militarytracy on Wed Dec 23, 2009 at 12:16:43 PM EST
    beeped.  When I got out it said that someone had sent me some recorded media so I played it.

    I think I can get him to offer me 80%, he already offered me 75% yesterday before we recessed.

    No Ben! I told you he has to offer to pay 100% of your State's Medicaid.  It is all or nothing, why can't you understand this?  Anything less makes us look like jerks when we investigate.

    Okay, and when I get a 100% I have it put in the bill.

    Oh Jesus, NO BEN!  They have to put it in.  Just tell them you can't.  That's all you have to say.

    Okay, but I can't find my camera

    Oh for God's sake, you can't take the photo.  I need a photo of both of you together.  You have your driver take the photo.  He has to be sneaky though you know.  Sit in the vehicle and then as you guys approach to leave he jumps out and says "Cheese" real quick and snaps.  Then you need to lose the camera fast in a pocket or something and be real calm and happy for Christ sake.......oh forget it.....I'm sending my driver to you.  He'll know what to do.

    Okay Karl

    I would be 100% federalizing Medicaid (5.00 / 2) (#84)
    by cawaltz on Wed Dec 23, 2009 at 01:28:09 PM EST
    Personally love the idea and would love to see it happen. Then perhaps there could be federal guidelines on things like what constitutes assets and what level of income you need to qualify.

    I am waiting to see what my senators (5.00 / 1) (#85)
    by BrassTacks on Wed Dec 23, 2009 at 01:33:08 PM EST
    Are bringing home to us.  They both voted for cloture.  I do not expect to get stuck paying for Nebraska's medicaid unless my Senators get the feds to pay our medicaid bills too.  Medicaid is killing our state budget.  We can't afford our own medicaid bills, much less Nebraska's!  There had better be something for Virginia in this bill!  

    A very conservative poster... (none / 0) (#3)
    by MileHi Hawkeye on Wed Dec 23, 2009 at 10:18:52 AM EST
    ...at my second favorite blog views the full Federal funding of Medicaid as a pathway to  single payer.  He might have a point.

    I hope he has a point (none / 0) (#4)
    by Big Tent Democrat on Wed Dec 23, 2009 at 10:20:49 AM EST


    Parent
    I have been wondering (none / 0) (#14)
    by Capt Howdy on Wed Dec 23, 2009 at 10:35:03 AM EST
    other than the "no changes" language you said yesterday was crap is there any reason the could not come back to some of these things as individual issues and force an up or down vote on them?

    for instance Nelson forced language that would make insurance companies obey anti trust laws to be removed from the bill, yes?
    could they come back to that and force people to vote up or down and in public on such a no brainer?


    Parent

    they could (5.00 / 1) (#20)
    by Big Tent Democrat on Wed Dec 23, 2009 at 10:41:28 AM EST
    But they won't.

    Without the mandates, the health insurance companies have nothing to gain.

    Parent

    you are probably right (none / 0) (#24)
    by Capt Howdy on Wed Dec 23, 2009 at 10:46:21 AM EST
    but it seems like such an easy and smart thing to do.  go with the flow to get this monstrous piece of legislation passed and come back to some of the important stuff, like the one I mentioned but there are several, and force an up or down vote.

    let them explain why they are voting to exempt insurance companies from the laws everyone else in the country has to obey.

    its what I would do.


    Parent

    It won;t be easy (none / 0) (#27)
    by Big Tent Democrat on Wed Dec 23, 2009 at 10:49:08 AM EST
    because the insurance companies will oppose it.

    Parent
    of course they would (none / 0) (#30)
    by Capt Howdy on Wed Dec 23, 2009 at 10:53:28 AM EST
    but going into the 2010 elections doing something that would reeeeeeally pi$$ off the insurance companies, and yank they 52 year high wall street rug right out from under them, seems like such a smart thing to do.

    probably why it wont happen I guess.


    Parent

    My reading of the "No Changes" language (none / 0) (#33)
    by MO Blue on Wed Dec 23, 2009 at 10:59:36 AM EST
    (section 3403) you referred to is that it applies only to decisions made by the Independent Medicare Advisory Boards.  Recommendations for changes to Medicare as decided by that board will become law without amendment or change during conference unless overturned by a super majority (67%).

    Not a good thing.

    Parent

    Not an enforceable thing (none / 0) (#61)
    by Big Tent Democrat on Wed Dec 23, 2009 at 11:36:38 AM EST
    It is a waste of time to even discuss it.

    Parent
    Please, as a kindness to me, (none / 0) (#64)
    by MO Blue on Wed Dec 23, 2009 at 11:48:41 AM EST
    briefly explain why it is not enforceable. I'm not a lawyer and this provisions concerns me a great deal.  

    Parent
    the nexrt Congress (none / 0) (#66)
    by Big Tent Democrat on Wed Dec 23, 2009 at 11:59:21 AM EST
    is not bound by the provision.

    They can do whatever they want.

    Parent

    Thanks for the explanation (none / 0) (#69)
    by MO Blue on Wed Dec 23, 2009 at 12:17:56 PM EST
    Not sure that it makes me feel warm and fuzzy since IMO a Republican Congress would love this provision. I will defer to you and not discuss it further in your threads.

    Parent
    Boxer said this morning on Morning Joe (none / 0) (#5)
    by Militarytracy on Wed Dec 23, 2009 at 10:22:26 AM EST
    that Medicaid is the public option.  So do we get a Medicaid buy in if we make them really really uncomfortable right now?  I mean, I'm not just going to heave a sigh of relief over one Ezra write-up and one Boxer comment on Morning Joe.  Fork it over fools!  And I'm not kidding! I was the fool last time, now it's your turn!

    Nice try Sen. Boxer (5.00 / 2) (#8)
    by andgarden on Wed Dec 23, 2009 at 10:27:28 AM EST
    but we all know that states are free to (and usually do) contract with private ins. companies to implement Medicaid.

    Parent
    So is Tricare (5.00 / 1) (#15)
    by Militarytracy on Wed Dec 23, 2009 at 10:36:38 AM EST
    They sit at the table and they bargain.  They bargain a lot harder when their money is involved than they do when it is mine.

    Parent
    Not agreeing with you on this one (none / 0) (#10)
    by Big Tent Democrat on Wed Dec 23, 2009 at 10:30:38 AM EST
    Contracting with private insurance when the government cuts the deal is not a bad thing.

    Offering the Medicaid option on the exchanges would provide a public option imo.

    Parent

    Medicaid has some cost controls right now (none / 0) (#13)
    by Militarytracy on Wed Dec 23, 2009 at 10:35:00 AM EST
    That's for sure.

    Parent
    Then I would suggest you stay tuned, (none / 0) (#17)
    by andgarden on Wed Dec 23, 2009 at 10:38:01 AM EST
    because if the OPM national plan is implemented smartly, it has the potential to do that for everyone else.

    That means that the 2012 election is critical, because Presidential appointees will be setting it up.

    Parent

    "implemented smartly" (none / 0) (#19)
    by Big Tent Democrat on Wed Dec 23, 2009 at 10:40:25 AM EST
    As I understand the exchanges, the OPM will not be involved except in a peripheral way.

    Parent
    I want to be very specific about what I mean (none / 0) (#22)
    by andgarden on Wed Dec 23, 2009 at 10:44:22 AM EST
    Under the Senate bill, the OPM will attempt to engage 1-2 national insurance plans, at least one with a non-profit. It will be the same plan nationally. Now, the Government isn't exactly paying the bill, but arguably paying the subsidies would give it considerable leverage.

    Parent
    Paying is not what gives it leverage (none / 0) (#26)
    by Big Tent Democrat on Wed Dec 23, 2009 at 10:48:23 AM EST
    Negotiating is the leverage.

    Most of the subsidies will go to private insurance not subject to OPM negotiation.

    Parent

    We don't know that yet (none / 0) (#28)
    by andgarden on Wed Dec 23, 2009 at 10:49:23 AM EST
    What if the Administration really gets behind the OPM plan and encourages people to join?

    Parent
    I do know this (none / 0) (#32)
    by Militarytracy on Wed Dec 23, 2009 at 10:56:20 AM EST
    In the past the companies like a certainty.  You come to them with X amount of those to insure.  You bargain on what they can accept and you would be shocked if you saw some of what can be accepted!  You bargain and if you get that deal, you get that certainty that is very important in the world of corporations.  The worth of your stock and your insurance company is greatly affected by these "certainties" that are YOURS.

    Parent
    How would they do that exactly? (none / 0) (#35)
    by Big Tent Democrat on Wed Dec 23, 2009 at 11:03:43 AM EST


    Parent
    Do your level best to create (none / 0) (#37)
    by andgarden on Wed Dec 23, 2009 at 11:05:08 AM EST
    a national pool. Have the President stump for it. Make a point of it in the next election.

    Parent
    The Senate bill (5.00 / 1) (#39)
    by Big Tent Democrat on Wed Dec 23, 2009 at 11:06:55 AM EST
    is state based exchanges, so the pools are going to be pretty small.

    It would be cheaper and BETTER if we junked the exchanges and the subsidies and just auto-enrolled people into a federalized Medicaid.

    Parent

    The OPM plan would be NATIONAL (none / 0) (#40)
    by andgarden on Wed Dec 23, 2009 at 11:08:59 AM EST
    That's why Republican Senators are calling it a public option. The HHS secretary and the OPM administrator seem to have the discretion under the act to come pretty close to that.

    Parent
    With the legislation that we have now? (none / 0) (#43)
    by Militarytracy on Wed Dec 23, 2009 at 11:12:36 AM EST


    Parent
    Senate bill (none / 0) (#45)
    by andgarden on Wed Dec 23, 2009 at 11:13:22 AM EST


    Parent
    I think it has possibilities (none / 0) (#60)
    by Militarytracy on Wed Dec 23, 2009 at 11:33:35 AM EST
    But it's expensive.  Medicaid has already implemented high cost controls and the ability to apply them in place :(  We could have increased payment to providers in State's that don't pay well enough for doctors to universally accept it.  Not that that matters now.  Dumba$$e$

    Parent
    Sure (none / 0) (#46)
    by Big Tent Democrat on Wed Dec 23, 2009 at 11:14:16 AM EST
    Assume then by 2019, it captures the 2 million that the public option was going to get.

    Are we assuming then that the OPM will cut a better deal for that 2 million than the private insurance offerings give? And if so, then why wouldn't more people move to it? IS the CBO wrong?

    Parent

    I think it's possible (none / 0) (#50)
    by andgarden on Wed Dec 23, 2009 at 11:19:09 AM EST
    What I do know is that there's no other chance to do anything like this.

    I think the OPM plan has the potential to be the "level playing field" public option, if the people who implement it have that model in mind.

    Parent

    If it is the public option (none / 0) (#7)
    by Big Tent Democrat on Wed Dec 23, 2009 at 10:25:03 AM EST
    then it should be offered on the exchanges.

    I think that is possible. At least giving states that option on state based exchanges.

    Parent

    If they do that (5.00 / 1) (#12)
    by Militarytracy on Wed Dec 23, 2009 at 10:34:03 AM EST
    the legislation could have some impact.  We have a way of dealing with insurance companies.  It is much harder for a change of regulating administrations to screw us all over on premiums and coverage.  It changes up the paradigm, makes having to have good solutions more of a must have.  I could easily do this.  They will eff the whole country in a heartbeat though right now.  If they are heading in this direction people need to pressure.....Now.  I think Jane started blowing this thing open enough for this to perhaps become a reality.  I think Obama started to panic a hair too.....and LIED.  That was priceless.  Morning Joe had a field day and I don't think the Dems want him to have another one tomorrow with their base cheering him on if they can help it :)

    Parent
    Hey, I made that point as soon (none / 0) (#6)
    by andgarden on Wed Dec 23, 2009 at 10:25:01 AM EST
    as I heard about the deal Nelson got!


    I know (5.00 / 1) (#9)
    by Big Tent Democrat on Wed Dec 23, 2009 at 10:29:23 AM EST
    I was just looking for a chance to be nice to Ezra.

    Parent
    Ha. (none / 0) (#105)
    by oculus on Wed Dec 23, 2009 at 11:31:03 PM EST


    Parent
    Nelson got the Public Option (5.00 / 1) (#16)
    by Militarytracy on Wed Dec 23, 2009 at 10:37:39 AM EST
    fully paid for for the state of Nebraska. That part is very funny.

    Parent
    Didn't some Republican (none / 0) (#11)
    by CST on Wed Dec 23, 2009 at 10:32:49 AM EST
    senator offer this as an amendment?  Unfortunately it was voted down.  But remarkable that it was offered... and by a Republican.

    At least, I think that's what CNN told me.

    For every state, it would probably (5.00 / 1) (#18)
    by andgarden on Wed Dec 23, 2009 at 10:38:51 AM EST
    kill the "deficit neutral" nature of the bill.

    Parent
    Shhhhhh...... (none / 0) (#21)
    by ruffian on Wed Dec 23, 2009 at 10:43:40 AM EST
    Prepare to get it stripped out in conference if we get too happy about it.

    There's no constituency for that (none / 0) (#23)
    by andgarden on Wed Dec 23, 2009 at 10:45:01 AM EST
    Unless the House Blue Dogs really intend to blow up healthcare, which they still could.

    Parent
    Considering the things that do have (none / 0) (#47)
    by ruffian on Wed Dec 23, 2009 at 11:14:24 AM EST
    a constituency that are not in the bill...I'm not ruling anything out from this crew.

    Parent
    Ruh Ro....the SUPER ugly begins (none / 0) (#25)
    by Militarytracy on Wed Dec 23, 2009 at 10:48:18 AM EST
    I remember a recent Schumer vote that did not compute for me.  They have a photo of Schumer and Nelson in Nebraska on the news right now, they are on a pheasant hunt together ironing this healthcare legislation out.  They are so happy side by side holding dead birds with big ole smiles on their faces.  This is going to be BAD today!  Very very bad!

    Barring someone getting shot in the face (none / 0) (#44)
    by ruffian on Wed Dec 23, 2009 at 11:12:39 AM EST
    I'm not sure how it can get much worse.

    Parent
    I think with investigating (5.00 / 2) (#51)
    by Militarytracy on Wed Dec 23, 2009 at 11:22:04 AM EST
    what went down in the deal making.....didn't they say seven separate attorneys were looking into this?  It is going to.  Those who care about this issue already know that both the Republicans and Democrats sold us out to their lobbyists.  That began to be made very clear to the whole country yesterday.  Nobody is going to like this confirmation and the filthy details because we were talking mandates here.  In the eyes of the people, these two filthy pigs went hunting to negotiate how they were going to force everyone possible except Nebraska to buy for profit insurance.  This is going to get much much worse.  Why are our legislators so stupid?  All of them.  And the Dems never turn the Republicans in for how bought they are because they don't want to talk about how bought everyone is.....and liberals at Orange don't want to talk about it because that could endanger the legislation.  But hey you dummies.....all the independents and the conservatives in this country really really really care about who has bought who and today is going to get ugly.

    Parent
    yes (5.00 / 1) (#53)
    by jedimom on Wed Dec 23, 2009 at 11:23:18 AM EST
    yes MT TheHill reports a GOP atty IIRC is suing to get the closed door meeting info released

    our very own Haliburton, aint it grand to have a majority?

    Parent

    Well it is when the Democrats (5.00 / 2) (#58)
    by Militarytracy on Wed Dec 23, 2009 at 11:29:40 AM EST
    are that majority because the Republicans can't wait to expose them and all their dirt.

    Parent
    Secret sitdowns with insurance companies (5.00 / 1) (#54)
    by Militarytracy on Wed Dec 23, 2009 at 11:24:08 AM EST
    and Big Pharma......how stupid could Obama have been?  You campaign on transparency, then one of the first things you do is that? And now here we are and nobody has even begun to be ticked at him in large numbers yet for his "secrets".

    Parent
    I'll give this call to oculus when (none / 0) (#59)
    by Militarytracy on Wed Dec 23, 2009 at 11:30:18 AM EST
    that gets shaken down too.

    Parent
    GOP is requesting the documents (none / 0) (#106)
    by oculus on Wed Dec 23, 2009 at 11:33:07 PM EST
    pertaining to WH secret deals with big Pharma and health insurance industry.  Hope they succeed.  But probably "state secrets" or something.

    Parent
    The only adjective that comes (none / 0) (#108)
    by Militarytracy on Sat Dec 26, 2009 at 08:52:18 PM EST
    to mind is Bushesque.  I've had zero sleep though.  

    Parent
    pushed back to Feb? (none / 0) (#52)
    by jedimom on Wed Dec 23, 2009 at 11:22:13 AM EST
    everyone see Politico reporting the final HCR package is being pushed back top February after the rush rush rush so Obama can pivot hard to jobs...

    BWAAAAHAAAAA

    ahh man, the Medicaid federalization will be institutinalizing the horrendous care instead of bringing everyone UP to private care levels they plan to push us all DOWN to the worst...I have been on it and it is a nightmare.

    I love HRC for getting SCHIp done so my kids didnt have to be in 'regular' Medicaid which no doctors would take outside of the 'ghettoes' of NYC

    At least! (5.00 / 2) (#56)
    by Militarytracy on Wed Dec 23, 2009 at 11:25:50 AM EST
    Such fools!  They have lied and cheated so bad to get this done.....it's so hopeless.  Can post partisan unity be over now?  It seems to include nothing more than mafia deals!  And now everybody knows!

    Parent
    We could have improved Medicaid (5.00 / 2) (#57)
    by Militarytracy on Wed Dec 23, 2009 at 11:27:25 AM EST
    in all states.  In fact we were going to have to.  This is a huge loss for the country unfortunately.

    Parent
    "Everyone" being (none / 0) (#55)
    by Big Tent Democrat on Wed Dec 23, 2009 at 11:25:01 AM EST
    those who have no insurance now you mean.

    Just ridiculous.

    Parent

    the camel's nose (none / 0) (#65)
    by Dadler on Wed Dec 23, 2009 at 11:55:00 AM EST
    every time i start to feel like that nose could possibly get under there and make a difference, i am reminded of gay marriage and how many laws have been overturned by referendum in states.

    the camel's nose is equally capable of being stabbed and shoved back out of the tent. granted, with time, gay marriage will probably become accepted, but is that really the argument we want to make with the healthcare issue? just wait?

    also, unless we address our ridiculous medical paradigms, our addiction to pills-for-every-condition-real-and-imgagined, until we accept and deal with the brain's vital role in disease and illness, until we stop thinking of ourselves merely as engines with broken parts, well, I do not think any real "reform" of actual healthCARE is going to take place.  

    I was thinking about that too (5.00 / 2) (#77)
    by Militarytracy on Wed Dec 23, 2009 at 01:15:06 PM EST
    But nobody gets to make big money from preventing anyone from getting to be gay and having full rights.  We lose all that wedding money.  We lose all that divorce revenue.  Drag queens often have enough clothes for two people.  But no, we want to stiffle the economy

    Parent
    More than he asked for (none / 0) (#67)
    by waldenpond on Wed Dec 23, 2009 at 12:02:05 PM EST
    Nelson said Reid gave him more than he asked for and may drop this.

    I read that yesterday (none / 0) (#80)
    by Capt Howdy on Wed Dec 23, 2009 at 01:23:26 PM EST
    which is why I said Harry is smarter than people give him credit for.

    Parent
    Federalize Medicaid | 108 comments (108 topical)

    Readers Must Login or Create an Account to Comment