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Archive for Monday, November 5, 2012

GOP raises specter of Medicaid expansion as campaign issue

November 5, 2012

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TOPEKA — Gov. Sam Brownback’s allies have raised the potential expansion of the state’s Medicaid program as a campaign issue in the days before Tuesday’s election decides races for the Kansas Legislature, with conservative Republicans seeking to bind Democrats to President Barack Obama and the federal health care overhaul.

The federal law enacted in 2010 contemplates an expansion of Medicaid to cover millions of uninsured Americans, and it promises that the federal government will pick up the full cost until 2016 and most of it afterward. A U.S. Supreme Court’s decision in June said states could refuse to expand their programs, which provide health coverage for the poor, the disabled and elderly.

Many Kansas Republicans are skeptical of the funding promises, noting the federal government’s ongoing budget problems. Officials assume Brownback will declare after the election whether Kansas will opt in or out of the expansion, but retiring House Speaker Mike O’Neal, a conservative Hutchinson Republican who’s also chief executive officer of the powerful Kansas Chamber of Commerce, said last week that voters need to know whether legislators and candidates would support an expansion.

The chamber already has attacked Democrats for opposing a proposed health care “freedom” provision for the state constitution, protesting the federal law’s mandate that most Americans buy health insurance starting in 2014. O’Neal issued his statements as Democrats were pointing out that the measure was largely symbolic, countering the chamber’s assertions in mailings that the proposal would “stop the Obama agenda at the Kansas border.”

But the Medicaid issue also ties into longstanding Republican themes portraying Democrats as advocates of big government. A report in July from the nonpartisan Kaiser Family Foundation said an expansion would cover nearly 264,000 adults in Kansas — where 393,000 residents now receive health coverage through the state.

“The simple fact is, we can’t afford it,” said House Majority Leader Arlen Siegfreid, a conservative Olathe Republican, adding that if Obama is re-elected, “We’re going to be watching that very closely.”

Democrats aren’t openly embracing a Medicaid expansion, even if they believe it would reduce the number of uninsured Kansans. They contend the state can’t seriously contemplate any additional spending because of massive income tax cuts enacted this year.

Kansas Democratic Party Chairwoman Joan Wagnon said any discussion of expanding Medicaid was “rendered moot” when Brownback signed the tax cuts in May. Legislative researchers estimate that the cuts are worth $4.5 billion over the next six years and project that the reductions — meant to stimulate the economy — will produce collective budget shortfalls approaching $2.5 billion during the same period.

“He’s dug a hole as big as the Grand Canyon in the budget,” Wagnon said.

Comments

Mike Wasikowski 2 years, 1 month ago

Hold on a minute. Hasn't the GOP been complaining about the federal government making unfunded mandates on the states for years now? So now that the federal government is rather generously funding a mandate on the states, the complaint is that the federal government can't afford to fund it? It almost sounds like they just don't want the federal government to tell the states to do anything regardless of whether it's funded or not. Why don't they just say that instead of moving the goalposts?

volunteer 2 years, 1 month ago

I'm not sure why this writer lumped in the elderly with the poor and the disabled as the three groups eligible for Medicaid. My 91-yr-old mother relies on railroad retirement Medicare and the supplemental Blue Cross for which she pays $240 monthly. Her eldercare specialist attorney has not mentioned the possibility of Medicaid assistance. Either sloppy journalism or sloppy lawyering.

globehead 2 years, 1 month ago

Actually, good journalism. You cite your grandmother. That is fine and good for her. A huge amount of Medicaid goes toward the elderly. Many have Social Security amounts far below poverty level and receive the balance in partial SSI which automatically qualifies them for medicaid. Likewise, many disabled who never were able to work rely on medicaid as their only source of medical assistance. These folks simply cannot pull themselves up by their bootstraps. The elderly make up about 10% of medicaid recipients and has consistently totaled about 5 million per year each of the past 10 years or so.

Carol Bowen 2 years, 1 month ago

Seniors in poor health are forced to spend down their assets to qualify for Medicaid. Medicaid pays for nursing homes and other over the top healthcare costs. These seniors receive social security and Medicare, but this does not cover healthcare. Our support system for seniors is demoralizing. Imagine trading everything you have for healthcare to live.

Currahee 2 years, 1 month ago

Actually this is not true. Medicaid rates are really... really..... well, crap. I've learned that a lot of providers won't accept medicare rates because they pay so low. The problem with medicare mostly is medicare fraud. A shady physician can say I did x, y, and z exams when he only did x and bill Medicare for x, y, and z and the government would have almost no way of finding out what exams actually took place. The same goes for medical supplies. Although your statement about seniors in poor health is certainly true.

Carol Bowen 2 years, 1 month ago

I was not referring to rates. Medicare limits the number of days a patient can stay in a hospital and in a nursing home. Once a patient has maxed out Medicare stays, they must qualify for Medicaid or pay out of pocket.

Cliff Sperry 2 years, 1 month ago

Medicaid has income restrictions for eligibility. It may be your mother's income exceeds the limit.

Cait McKnelly 2 years, 1 month ago

Not everybody has RR retirement (which is more generous than SS). If Social Security retirement is all of the retirement funds a person gets, then frequently Medicaid picks up what Medicare doesn't cover. I suggest you research this thing called SHIP (state health insurance assistance programs). You can find it at medicare.gov.

Cait McKnelly 2 years, 1 month ago

Republicans; government so small it fits in your uterus.
(This isn't off topic. Any discussion of Medicaid must include it's impact on the healthcare of women. Especially poor women.)

Dan Eyler 2 years, 1 month ago

I want to thank the legislature and the governor for walling off any state funded Medicaid expansion. I am a big proponent of communities and cities paying more of the cost to run government. Lawrence for example needs to pay its own way. If we want to expand local government spending we the citizens Lawrence need to foot the bill. If cities want more money for social services and schools they should raise their own taxes. This will force a serious discussion and increase transparency on local spending and priorities. Cutting the income tax will be a tax raising firewall in Topeka and communities across our state. Now we can start deciding on our priorities and how we pay for them.

just_another_bozo_on_this_bus 2 years, 1 month ago

Translation-- screw the poor, especially those who live in poor areas that lack the resources to take care of the most vulnerable in their communities.

Liberty275 2 years, 1 month ago

That sounds like a community issue.

If you want to be helpful, be my guest. Use your own money.

just_another_bozo_on_this_bus 2 years, 1 month ago

"50% of the population not pay into the system which then supports them."

This makes no sense. If you want the bottom 50% to pay more in the way of taxes, then they need to see their incomes rise. And in an economy run by and for plutocrats whose wealth is fed by the ability to exploit that bottom 50%, it's a catch-22 situation.

jhawkinsf 2 years, 1 month ago

Average income and standard of living are not synonymous. If a typical Kansan with an income 20% lower than the national average were to move to somewhere like New York City, where housing costs might be 200% higher (just a guess), then raising their income to the national average won't offset the housing costs. Their standard of living, even with the income raise, will actually go down.

globehead 2 years, 1 month ago

But, only if the standard of living is measured in dollars. Otherwise, it seems these New Yorkers would be knocking our doors down to live here. The trend seems to be to get out of Kansas, not in.

jhawkinsf 2 years, 1 month ago

Yes, it's all in how you define "standard of living". If it's peace and quite, one place might suit you well. If going to Broadway shows weekly is how you define your standards, then another place might suit you better. But it does go to show that Larry's "20% lower income" might be a meaningless comment as there are so many other personal factors that come into play.

Carol Bowen 2 years, 1 month ago

Will you take care of the seniors in your family? Nursing homes are not cheap. Most seniors rely on Medicaid to pay for them.

Dan Eyler 2 years, 1 month ago

I haven't been made any promise. Who expects or believes promises from government? Fewer the promises the better.

just_another_bozo_on_this_bus 2 years, 1 month ago

"The simple fact is, we can’t afford it,” said House Majority Leader Arlen Siegfreid,"

No, as a committed class warrior, you choose not to "afford" it.

jhawkinsf 2 years, 1 month ago

Translation: Take more money from those who earned it and give it to people who didn't earn it, with the government taking it's vig.

jhawkinsf 2 years, 1 month ago

Says the tax paying, law abiding, citizen. And after nearly five decades of such, I know I've earned my right to express my opinion freely.

Fred Whitehead Jr. 2 years, 1 month ago

Hmmmm.. Another day where there is an article in the print edition that does not appear here in the digital edition. I am referring to the news article in today's JW parint edition that the president is leading barely in many of the so-called "swing sttes".

I am told that this is not indicative of anything, but come on, people! This election is one of the most contentious and debated elections in many years, lying and disingenious politicians ripping their opponants to shreds in misleading and down right fraudulant television ads. Now we hear that the Republican Gestapo is sending agents out to the polls to "assure voting rights". this will be, of course,. to those that Kris Kobach has enfranchised with his voter i.d. laws while shirking his duties as Kansas Secretary of State. Some of you dismiss me when I compare things that happened in 1930's Germany to present current events, but to those of you who are ignorant of history, Hittler DID NOT TAKE OVER GERMANY....THE CLUELESS CITIZENS OF GERMANY GAVE IT TO HOM!!!! Keep that in mind as your Social Security, Medicare, Medicaid, free speech rights, voting rights, civil rights and other rights we presently enjoy are flushed down the toilet with the rise of the facist right. in the United States of America.

jhawkinsf 2 years, 1 month ago

Seems to me that if we were anywhere near where you think we are, your letter would have been censored and you would have been arrested. Perhaps we're not as near the calamity you describe as you think we are.

jafs 2 years, 1 month ago

How close would we have to get before you think something should be done?

Kathy Getto 2 years, 1 month ago

Rest assured we will be some of the first to go to the internment camps.

jhawkinsf 2 years, 1 month ago

It depends upon how you define "how close" and "what should be done".

Drawing an analogy to the Nazi takeover in Germany is so much hyperbole that it's hardly worth the effort to think "what should be done" as anything but a flight of fantasy. And just in case you need evidence of that, the comment is still there, for all to see.

jafs 2 years, 1 month ago

Not at all.

My question is and was "How close do we have to get before you think we should do something?"

You seem to have a much greater tolerance for problems and issues in our society than I do - I see many ways and places which should be improved, in my opinion.

I'm curious about how bad things have to get before you would agree.

jhawkinsf 2 years, 1 month ago

You're going to have to get a lot more specific before I can answer a question like that. It is so overly broad that, really, really, I don't understand the question.

jafs 2 years, 1 month ago

The nature of our conversations seems to follow a general pattern.

I identify a problem or issue that I think needs attention, and offer a possible solution or way to proceed.

You then criticize that by calling it "idealistic" or "superficial" or "not implementable", but fail to offer any of your own suggestions for how to improve things. And, when asked, you say something like "Well, it's not perfect, but nothing is", or "The cure will be worse than the disease", etc.

It's happened with many issues, so it's not confined to one issue.

So, it looks as if you're rather content with the "status quo" in many ways, and don't see things as needing to be improved. Which leads me to wonder how imperfect things have to get before you might think that way.

jhawkinsf 2 years, 1 month ago

The problem you identified here is "how bad do things have to get". Doesn't that seem pretty broad to you?

If we're seriously discussing our slide towards Nazi Germany, then I would reply we need do nothing because we're not sliding into anything resembling Nazi Germany. If you're talking about other things that are getting bad, you're going to have to get specific.

jafs 2 years, 1 month ago

Pick an issue, any issue at all.

And, you don't find things like the Patriot Act and other government intrusions into our privacy and rights problematic?

jhawkinsf 2 years, 1 month ago

No, I don't have a problem with the Patriot Act. I've spoken many times about compromises we've always made, even with our most fundamental rights. I don't have a problem with fighting words not being covered by freedom of speech. I don't have a problem with limits made on our freedom of religion. And I've yet to see major problems with the Patriot Act. Then again, should problems arise, that's what we have courts for. Might there be abuses happening now or in the future, maybe. Let the courts decide. I trust them, even if I don't always agree.

The major issues of the day that I do have problems with are just the sort of problems that don't have solutions. I think the number one problem in government is the inability of Democrats and Republicans to work together for the public good. Yet we keep electing them. If there's a solution out there, I don't see it. So if you, jafs, propose some solution that has zero chance of being implemented, sure, I might call you on it, not so much because I don't think there is a problem, but because I don't think your solution is plausible. That doesn't mean my solution is better, I don't have one.

For each of us, our reality is often based on our experiences. If I have different experiences than you, I'm going to have a different reality. I'll tell you a story I experienced a couple of decades ago, in Ca. I was sitting in a bar next to a very large Black man I knew well. He was complaining about the new seat belt law and said because of his size and his heart condition, seat belts were very uncomfortable. Then he asked rhetorically, if he and I were both driving down the road without our seat belts, who would the police stop? I then pulled out my ticket that I received earlier that day, for driving without a seat belt. His experience framed his reality, even though my experience contradicted his. Does that mean racism is dead in this country? Of course not. But I do frame my reality based on my experience. I've never carried box cutters into an airport, nor joked about bombs being in my suitcase. If a policeman asked to look inside my trunk, I'd say sure. I know there's nothing there. I don't sacrifice animals in the name of any religion. I don't commit any crimes more serious than driving without a seat belt. I work hard, pay my taxes and have moved from the bottom 25% at birth to the top 25% now. So I guess I'm not going to see as many problems with the system as other people. Not only is my reality just as real as their reality, to me, it's more real.

jafs 2 years, 1 month ago

A long way of saying what I said.

You're fine with the "status quo" in many ways, and don't have suggestions for solving the few problems you do find.

By the way, I'm also a law abiding citizen, and my personal life is working splendidly - for me, that doesn't mean that I can't see problems in our country that I think should be improved/fixed.

jhawkinsf 2 years, 1 month ago

Remember, Jafs, I've never said there are zero problems and therefore we need zero remedies. I've called for measured responses to the relatively small problems we do have.

FlintHawk 2 years, 1 month ago

Found this yesterday. When my thoughts were taking me to the same place:

http://rense.com/general37/char.htm

jhawkinsf 2 years, 1 month ago

So let me get this straight. Republicans are fascists and Democrats are socialists. And 100% of posters here are hyperbolists. Except me, of course, I'm merely an exaggerist. :-)

Wednesday morning can't come quick enough.

Kathy Getto 2 years, 1 month ago

Exaggeration is a great tool! I do agree, Wednesday or however long it takes won't happen soon enough.

jhawkinsf 2 years, 1 month ago

Exaggeration is a great tool, yes, but it comes at the expense of honesty, an even better tool.

Kathy Getto 2 years, 1 month ago

So true, however there is no honesty in politics,

“An honest politician is regarded as a sort of marvel, like a calf with five legs, and the news that one has appeared is commonly received with derision.” Mencken

lucky_guy 2 years, 1 month ago

I don't see any problem. We cut taxes to stimulate the economy, remember Laffer said so and he must be right, cuz he told Reagan about cutting taxes. So we get t the poor and disabled to work for rich people and all the Medicaiders to go away. The old people on medicaid are just magically going to go away too, cuz we only worry about job creators in Kansas. I don't see anything but blue skies and unicorns.

George_Braziller 2 years, 1 month ago

The Kansas Department for Aging and Disability Services Secretary's office announced just this afternoon that 1,500 people on the Medicaid Physical Disability Waiver waiting list have been been dropped. Some have been waiting for months or years.

Richard Heckler 2 years, 1 month ago

Brownback and his puppets just want to pay more tax dollars the insurance industry. No money will be saved. And service will go straight to hell.

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