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Opinion

Opinion

Editorial: Too poor?

Kansas officials could use some help explaining their decision to reject expanded Medicaid and leave tens of thousands of state residents without any health insurance help.

August 9, 2013

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Kansas Insurance Commissioner Sandy Praeger says it will be hard to explain to thousands of Kansas residents why they are too poor to qualify for health insurance benefits under the Affordable Care Act.

Because Kansas has refused to accept the federal expansion of Medicaid benefits, a big gap in insurance coverage will open up in the state starting in January 2014. The federal ACA provides tax credits to help people pay for health insurance, but the act provides those credits only to people with incomes equal to 100 percent to 400 percent of the federal poverty level. That’s because the act assumes that people below that income level would be covered by expanded Medicaid benefits offered at the state level.

However, Kansas has refused to participate in the Medicaid expansion, even though the federal government would have paid 100 percent of the cost for that expansion for three years and 90 percent after that. Instead, Kansas is maintaining its existing Medicaid eligibility standards, which are some of the most restrictive in the country. Adults at any income level don’t qualify for the Kansas Medicaid program, known as KanCare, unless they are disabled. Families with children qualify for KanCare only if their incomes are below 35 percent of the federal poverty level. That’s $6,000 to $8,000 a year for a family of four.

That leaves tens of thousands of Kansans in a gap in which they are” too rich” to qualify for KanCare but too poor to qualify for tax credits to help them buy health insurance.

“The message that they’re too poor to qualify is not one they’re going to understand,” Praeger said in a recent radio interview. “They’re going to say, ‘What do you mean I’m too poor? You mean I make too much money?’ No, you’re too poor, because if you don’t make at least 100 percent of the federal poverty level, you’re not eligible because Kansas didn’t do the Medicaid expansion.”

An analysis released last month by the Kaiser Commission on Medicaid and the Uninsured says about 58,000 Kansans will fall into the coverage gap; a Kansas Health Institute brief released in January puts the estimate at about 88,000.

The Kaiser Commission estimates that expanded Medicaid in Kansas would provide insurance coverage to 144,000 additional Kansans and bring $5.3 billion in additional federal Medicaid funding to the state between 2013 and 2022.

It’s not a lot of comfort, but, according to the Kaiser Commission, Kansas is one of 21 states that aren’t currently moving forward with expanded Medicaid and will experience similar large gaps in medical coverage. Perhaps those other states have some advice for Kansas on how to explain to people that they are “too poor” to qualify for health insurance assistance.

Comments

overthemoon 1 year, 4 months ago

Perhaps Brownback can explain yet another decision that was not thoroughly thought out before he decided to do what he thought was good for his party and his donors instead of what is good for Kansans.

bad_dog 1 year, 4 months ago

Oh I think it was quite thoroughly thought out to the extent a knee jerk constitutes "thought".

grammaddy 1 year, 4 months ago

What has he ever done that was "good for Kansas"? Everything he does is aimed towards pleasing his puppeteers-the Koch Brothers and ALEC.

IreneAdler84 1 year, 4 months ago

I hope that those 58,000 Kansans will remember who they have to thank for their predicament when it comes time to vote in 2014.

Ron Holzwarth 1 year, 4 months ago

Out of Kansas' population of 2,886,000, those 58,000 votes won't be nearly enough to swing an election. Of course, not all of those 2,886,000 are of voting age, and many of them don't vote anyway. And of those who do vote, many don't vote wisely.

scott3460 1 year, 4 months ago

58,000 people have family and friends who will see what is happening.

The cruelness of brownback's decision will not go without notice.

Michael LoBurgio 1 year, 4 months ago

Insurance gaps Analysis of uninsured in Kansas shows need for Medicaid expansion, mandate

Gov. Sam Brownback are balking at raising Medicaid eligibility to 138 percent of the federal poverty level – about $30,000 a year for a family of four – a move that would expand coverage to 315,000 low-income Kansans, according to the KHI report. The federal government would pay for most of the cost of the expansion, but the governor and legislators are considering denying the federal money for this, primarily out of political spite for “Obamacare.”

That would be a huge disservice to low-income Kansans. Moreover, the KHI data paints a picture of a health insurance coverage problem that needs to be fixed. Insuring more low-income people is one fix. The other is the mandate that all Americans have health insurance,

http://www.hutchnews.com/Editorialblogs/edit-kansas-health-insurance

http://www2.ljworld.com/users/photos/2013/aug/09/259638/

rbwaa 1 year, 4 months ago

another reason to be embarrassed about living in Kansas

skinny 1 year, 4 months ago

Health care is not free! Who do you think is going to pay for it?? If it is an emergency they can go to the ER!

Orwell 1 year, 4 months ago

We're paying for it. We pay increased medical charges to make up for those who show up at the ER – the most expensive and inefficient way to provide health care. We're also paying for it by paying federal taxers that ail go to the states that have more sense and elect to participate in the program. Right now Kansans are paying plenty and getting nothing.

tomatogrower 1 year, 4 months ago

Wouldn't it be more efficient to go to a doctor's office before it became something that the ER needed to handle? Doctors visits are less expensive, and the ER is the emergency room, you know, for emergencies. And do you really think that the rest of us don't pay for it? Do we pay for the husband who waits until it it's too late and dies? Yes, there is a wife and children in a poorer place than they were before. If the person can't pay for the ER, then the hospitals have to cover their costs somehow, so they raise their prices on the rest of us. I would rather pay taxes to ensure that the husband or wife get the real care they need in a timely fashion, so they can continue to be a productive, although poor, part of our community. If not for the humane reasons, at least I know this person is paying taxes too and helping the whole.

orbiter 1 year, 4 months ago

skinny- I hope you are kidding. If not, you should really quit having opinions about anything reality based. Good God, how ignorant.

Cai 1 year, 4 months ago

... I'm assuming I'm missing sarcasm here. You can't really think unpaid for ER visits don't cost us anything.

JohnBrown 1 year, 4 months ago

The answer is simple and straight forward: the so-called 'Republican' Party's strategy is to deny O'Bama ANYTHING he seeks.

If it was a Republican goal or idea yesterday, and O'Bama asks for it today, the so-called republicans will oppose it today. This is their one strategy; it explains everything the Tea Party has done since O'Bama was first elected.

JohnBrown

jafs 1 year, 4 months ago

This points to a fundamental problem with Medicaid. Even though lots of federal money goes to states, the states are allowed to set up their Medicaid programs with virtually no federal involvement or oversight.

Seems to me that a federally funded program should come with guidelines that states must follow.

What exactly are those folks not covered by Medicaid in KS supposed to do for health care?

Patricia Davis 1 year, 4 months ago

They are supposed to die or move to another state with better benefits.

tomatogrower 1 year, 4 months ago

This is why a doctor in Texas was able to get away with millions. He hobnobbed with elite of Texas, and they just overlooked his ripoff.

jafs 1 year, 4 months ago

How so?

Why should we have the federal government paying for a program and letting the states decide how to run it?

Shelley Bock 1 year, 4 months ago

Concept of federalism when the various States demand control over money coming into their coffers. I suppose it has been a way to get legislation past Congress.

jafs 1 year, 4 months ago

Not sure I understand that.

If it's state money, then they can run the programs (if they're not infringing on anybody's constitutional rights), but if it's federal money, then federal guidelines seem appropriate.

jhawkinsf 1 year, 4 months ago

The money the federal government gets, comes from people living in the various states. May we put limitations on how or when that will be used by the feds., or is the power to impose regulations and/or restrictions a power reserved for the federal government only?

When the federal government gives out highway money, but only if you set your speed limits at a certain number and only if you raise your drinking age to 21 AND the federal government gives out education money, but only if you implement things like testing that conforms to No Child Left Behind AND the federal government gives out money for health care but only if it's done in a way that conforms to ACA AND states begin to feel like the federal government is becoming too much of an unchecked super sized bureaucracy that dictates more and more and more THEN states may say it's time to question a system where the the federal government mandates and mandates and mandates, all the while taking more and more money from the states. Maybe.

jafs 1 year, 4 months ago

Yes, and we do it all the time, by voting for federal legislators and presidents. That's how we express our preferences for a variety of policy decisions at the federal level.

Why should the feds give any money to states without federal guidelines?

Perhaps one might argue that instead of taking a bunch in taxes, and then distributing it to the states, that the feds should just take less in taxes. That would make a little more sense to me. But, as long as we have federal tax revenue that comes from all over, and programs that distribute that money to the states in a variety of ways, I think it makes sense to have federal guidelines for how that money is spent.

All of your examples make sense to me - they show how and why the feds have a legitimate interest in how states spend money they're given, based on policy.

It wouldn't make any sense for the feds to give states a bunch of money for education without guidelines, if we have the idea that people in all states should be getting an equivalent education, for example.

It's like Medicaid - the way it is now, the feds pay for a bit more than half of all Medicaid spending, but leave the decisions about eligibility to the states. That means that people in different states may be eligible for it in one state but not another. Seems to me that sort of defeats part of the point of having a federally funded program like Medicaid.

If states want the freedom to spend money how they like, then they can spend their own money that way, and institute their own programs.

Also, the feds don't take money "from the states", they take it "from the people", who are American citizens as well as state residents. And, our system is set up at both levels, so that states have latitude, but we also have nationwide rights and regulations.

jhawkinsf 1 year, 4 months ago

My point is, Jafs, that we have two legitimate points of view that are in competition with each other. Look at the Constitution. We have both the Supremacy Clause as well as the Tenth Amendment. On the face of it, they seem to contradict each other, or maybe compete with each other. My opinion is that there is an attempt to balance each other. Both are correct, it's the balance that needs to be maintained. Our founding fathers distrusted a too strong federal government, yet they lived through a too weak federal government during the years of the Articles of Confederation.

Go back 100 years and you wouldn't recognize the size and scope of the federal government compared to that of today. The same is true with the states. And it's especially true when we compare the two. Are we maintaining that balance I suggest?

You argue that as long as it's federal money, it makes sense that it comes with guidelines as to how that money is spent. Right, because we all believe that 50 members of Congress from Los Angeles, New York and Miami know better about spending highway funds in Kansas that do the 4 members of the Kansas delegation. Actually, the reason we have so many depts. of education and so many school boards is because there is the assumption that locals, wherever they are, are in a better position to make local decisions. In fact, an argument can be made that too much federal intervention has historically not produced better results. Think No Child Left Behind.

I'm not arguing whether Obamacare is good or bad. Or whether the feds should dictate one specific policy vs. another when it comes to highway funds, education, etc. But I am suggesting that whenever the federal government pushes specific guidelines on states, states pushing back is part of that balancing act.

jafs 1 year, 4 months ago

I don't see it as two legitimately competing views.

The states have latitude, but we also have a federal government. That's not competition, it's a combination of two ideas. The supremacy clause and the 10th amendment aren't in conflict, because the supremacy clause explicitly gives the federal government the power to create laws that apply throughout the entire country. The 10th amendment says that power not given to the feds goes to the states, or the people.

Those on the right often argue that decisions should be left to local entities, but I'm not convinced that they're right. Especially if we have the desire to ensure equality throughout the country.

No Child Left Behind is flawed, but the idea behind it is sound, in my opinion.

I seriously doubt that all states, whenever the federal government gets involved, "push back". However, conservative states that seem to misunderstand the role of the federal government, and the supremacy clause, certainly do.

As I said a couple of times, if they're using their own money, it's one thing, but if they're getting federal money it's another. Like your argument - when you reach into my pocket, I get to have a say.

jhawkinsf 1 year, 4 months ago

You keep saying it's their money. Who is they? Isn't it more precisely, our money, as in collectively all of our money? To be used as we collectively decide.

We elect representatives to represent our interests, at the federal level, state, county and city. If those entities are in conflict, say, as how to spend certain monies, deferring to the federal government seems appropriate if you're coming from the position that's it's their money. But it's not. They are holding it for us, the real owners.

jafs 1 year, 4 months ago

Yes and no.

It comes from us, but taxes become the government's money. That's what taxes are - a transfer of money from individuals to government.

If I'm paying federal taxes, I expect those to be used by the federal government, or given to states with federal guidelines. I'm not interested in paying federal taxes that are just distributed to states. What's the point of that?

It would be simpler to let the states tax their own residents for that sort of money - then local residents can choose how much they want to be taxed, and what kinds of programs they want to support in their state.

The whole point of a federal government is to have an entity that is focused on the good of the whole country, and acts accordingly, rather than what's good for an individual state. Giving money without guidelines defeats that purpose.

And states that want federal money, but not federal involvement want to eat their cake and have it too. Even worse are the ones that argue strenuously against federal spending, and then get federal dollars and take credit for the positive effects of that in their state.

jhawkinsf 1 year, 4 months ago

At no time is the money the federal government's money. It always belongs to "us".

It would be simpler if the federal government simply didn't tax the states. But nothing about our form of government is designed to make things simpler. If that were the case, all states would be eliminated and we'd have one dept. of education, one dept. of health, etc.

Remember, I'm not saying the federal government can't impose guidelines. But there is no reason to think that it must do so always. It should do so judicially, so as to not intrude on the areas of states rights. Just as states must be judicious in how it deals with counties and counties with cities. We in Lawrence have seen in the past couple of years a state that has run roughshod over our city. And we haven't liked it. Just because you may or may not agree with one policy or many policies, the judicious use of power is warranted, at all levels.

jafs 1 year, 4 months ago

That's simply not true.

The government taxes us, and the money is transferred to them. It's similar to when I go into your restaurant and buy something - my money becomes yours. In a sense, the government is a non profit service business.

That would eliminate one of the pillars of our system, which I wouldn't agree with.

I said "when federal money is transferred to states, guidelines should go with it" - that's not the same thing as saying it should "always" impose guidelines.

In my view, states don't have the right to take federal money and do whatever they like with it.

Let's remember, this started with Medicaid - a program to help low income people, funded about 1/2 by the federal government with money to the states. I think it makes no sense to do that without including guidelines for eligibility, etc. We can see the results in KS, where you have to be ridiculously poor to qualify.

jhawkinsf 1 year, 4 months ago

No, Jafs. The government is not like my restaurant. I own my restaurant. You may patronize it or not. If you do, there will be an exchange of my services for your money. But with the government, whether or not it taxes me, whether or not it taxes you, whether or not the amount we pay is the same or different, you and I own the government equally. The federal government is not the private property of those we elect or of those who happen to work there at any given time. It belongs to us all equally. Every park under government jurisdiction, every building, and yes, every dollar, belongs to us all equally while in the possession of the government. They are no more than caretakers of our collective wealth, deciding what to do with that wealth only upon the instructions of our duly elected representatives.

They may see wisdom in coercing states to behave in certain ways, say, by offering 50% of the money for something if the state provides the other 50%. That may be wise at times. There may be other times when the state is in a better position to know what certain monies are needed for. Which road are in more need of repairs, as an example. So the feds collect a uniform tax on gas, then distribute it to the states for them to use as needed. True wisdom is knowing when to defer the power of the purse to those in the best position to know what is best. Variously, that will be the federal government, states, counties or cities. Hopefully, we elect leaders who exercise that wisdom, though I fear that wisdom is a rare commodity.

Joe Hyde 1 year, 4 months ago

Republican "conservatives" and Tea Partiers justify the cruelty of their position on Medicaid expansion by claiming they're only trying to motivate lower income people to "pick themselves up by their bootstraps and become success stories"...while simultaneously they keep cutting education funding and passing tax laws that benefit the wealthy. The cumulative impact (and intent) is to cripple for eternity whatever chance lower income citizens and families have to better themselves.

What our current legislature and governor have been doing isn't politics. It's an organized anti-social pathology masquerading as politics.

james bush 1 year, 4 months ago

The federal government seems bent upon making everyone contribute to expanding federal bureaucracy. Accepting federal dollars to install their programs. Then the feds withdraw leaving the state saddled with the cost. Federal bureaucrats are appointed/placed by the party in power to administer to the state bureaucrats that had to be hired for program upkeep but the feds make the rules. The more fed programs the more rules and regs............IRS comes to mind!

tomatogrower 1 year, 4 months ago

Then what is the Republican plan to make sure people get healthcare? And don't say vouchers. Vouchers are the stupidest idea yet, and will lead to even more abuse and bureaucracy. Do you really not care if people die, so you can live high off the hog? If you do, don't call yourself a Christian, please.

tomatogrower 1 year, 4 months ago

What are you doing to, Pheps, to help the poor get health care?

voevoda 1 year, 4 months ago

If the Kansas ultra-right Republicans' objection to Obamacare lay solely with its intrusion into states' rights and the risk of cost overruns in a centrally-administered program, then they could instead set up a state-based, fully-funded program to cover the health care of all Kansans who live in poverty. Why haven't they done it? Because it is too expensive? No. We are already paying the costs through higher fees for medical care--especially hospital care--and disability payments and lost productivity. We have enough money in this state to give a giant tax break to the wealthiest Kansans and to all business owners. So what's the reason not to set up a system to pay for the health care expenses of poor adults? Maybe it's just an un-Christian lack of sympathy for the poor and the sick.

jafs 1 year, 4 months ago

Sure.

They want the money, without having to use it as intended. Federal money should always come with federal guidelines.

There's no good reason to give federal money and let states determine eligibility.

voevoda 1 year, 4 months ago

Actually, itsjustme, I don't agree that the federal government will inevitably not pay. I think that it's much more likely that the federal government will convert the current "Obamacare" program to something more affordable in the future, such as a Canadian-style single-payer plan, a Swiss-style limited selection plan, or a New Zealand-style single--payer with backup private insurance plan.

I repeat: if the state of Kansas doesn't want federal "strings" on the money, it should come up with funds of its own to cover the health care costs of poor adults who don't make enough money to qualify for the Federal insurance subsidy program. If the Kansas government doesn't want them to get medical care through the Federal Medicaid program, then it should set up a program of its own, drawing solely on Kansas financial resources, to cover poor adults' health care costs. Sloughing those costs off onto hospital emergency rooms (and thus ultimately onto uninsured consumers who pay for health care out-of-pocket and onto insurance companies) is cowardly and cost-ineffective. Hoping that poor and sick adults just won't seek medical care because they can't afford to pay for it is inhumane. So what's your solution, itsjusme, if it's not Obamacare?

Cait McKnelly 1 year, 4 months ago

It goes way beyond Brownback refusing to expand Medicaid (something for which no state funds would even be spent). Tim Huelskamp is stonewalling the ACA to the extent that he's refusing to even let his office answer any questions his own constituents may have about it.
How do these people even call themselves "Christians" and sleep with themselves at night?

jafs 1 year, 4 months ago

I called about the ACA with some questions.

The first two places I was referred to were the KS and PA insurance commissioners, both of whom said they couldn't answer my questions, which were very simple and direct ones.

I think it's no surprise that states which have chosen not to participate in creating the exchanges also don't want to help anybody find out about them, even though the federal employee I spoke with said they had gotten the information to the states.

Catalano 1 year, 4 months ago

That's interesting. I spoke with Praeger's office this morning and they were most helpful. What was your question they couldn't answer?

jafs 1 year, 4 months ago

It was a very basic one, about eligibility for the subsidies, and whether or not there was means testing involved, or just income.

I got the answer from a federal employee eventually.

Perhaps I jumped the gun, and the offices got the information later - this was a little while back that I called.

But there was a clear attitude, at least from PA, that they didn't want anything to do with the ACA.

oldexbeat 1 year, 4 months ago

Ask anyone in Meade County, Kansas and Christian isn't a word that leaps out about Dr. Timmy Huelskamp. Fake. That's one word for him. Fraud. There's another.

Sad but true -- and when the ER is backed up due to non-emergency visitors, and you or I have a real emergency -- say, a heart attack -- then we'll understand why using ERs for poor people's primary care isn't a good idea. Yup. Lots of sick fat white politicos coming up, and no space for them.

Sparko 1 year, 4 months ago

and this is exactly what parroting right wing vapid talking points leads to---sock puppets who post caustic fact-free posts about the size of government while bolstering the size of personal fortunes for people who have begun to dismantle the American Dream because it might cost them a few percentage points on the taxes they don't evade. Nice.

oldvet 1 year, 4 months ago

Oh the consequences of obummercare...

"We have to pass it to find out what's in it!"

Sparko 1 year, 4 months ago

Since they are simply Koch Brother front people, they don't have to explain. They'll just switch the conversation to fetal gun rights and parrot right wing talking points about socialism.
Many Kansans have never chosen theor "own" doctor because they can't afford to. Too many Kansans die of preventable diseases after voting for clowns like Brownback. This paper needs to do a better job of vetting lies. Too many astroturf organizations control the agenda, from fake tea partiers to "Freedom" works. Getting late in world history for the LJW to finally show a spine.

George Lippencott 1 year, 4 months ago

There are many single individuals or married couples without children with low income who have no medical care and for whom the ACA is not the current answer.

Expanding Medicaid could address this group. The one challenge is that there is no money to pay for this initiative. The Federal Government is already running a half trillion to a trillion dollar deficit without this benefit.

Just exactly who will we tax to fund this initiative? We settled for a mere 4% from the really rich. We do not tax the lower income half of our country. We tax the middle at upwards of 33% direct and close to 15% indirect..

Is it not about time for a serious discussion of just how much we can take from the middle class to redistribute? Is it not about time that we prioritized all the "progressive" things we want to do? Do we really think it is appropriate and reasonable to take over half of the income of the middle class to redistribute to those with lower income.

We already provide about 20 to 30K for each "poor" person. If we add more we will soon be providing almost as much to the "poor" as we are leaving to the middle class.

Alyosha 1 year, 4 months ago

Where's your source for providing 20-30K for each "poor" person?

Also, do you understand that it's not the middle class whose taxes have been cut for the last 30 years — leading us directly to the federal government not having sufficient resources — but rather the already very wealthy?

The continuous budget crises and social dislocations we are seeing today — local, state and national government in crisis after crisis, public services being cut, what used to be paid for by broadly based taxes now being devolved onto strapped families as "fees" — is a direct result of tax cuts on the already very, very rich.

It's time to clearly see what run-away tax cuts have done to the commonweal, the public good, and the social fabric of our country and communities: nothing but harm for the many, and gilded age excessive profit for the very few. Which history clearly (and bloodily) shows is hardly good for a democratic republic.

George Lippencott 1 year, 4 months ago

You will get no rgument from me on the "pass" we have given the really rich. But two points

  1. They really rich contribute a lot of money to both parties and both parties protect them. When the Democrats has full control of the government they did nothing to tax the rich. They could have if they could have held their members.

  2. There are too few of the really rich for even a confiscatory rate to achieve enough resources to pay for what is unfunded today let along new desires such as the above.

I am not heartless but I do believe we must pay for what we want.

George Lippencott 1 year, 4 months ago

I added up the funding for as many of the safety net programs as I could find government data and then divided by the number of federally defined poor. There is a range because I know I did not get all the funds because some of them are buried in of all places the defense budget as well as other unlikely places.

What was fascinating is that the government does not add these funds up for us. They exist in the budgets of a number of cabinet departments and are approved by a number of different congressional committees.

We add up the defense budget but not the safety net budget. Wonder why?

deec 1 year, 4 months ago

"We already provide about 20 to 30K for each "poor" person. If we add more we will soon be providing almost as much to the "poor" as we are leaving to the middle class."

That is an unusual and flawed method. "Poor people" don't necessarily receive aid from every program offered. There are overhead costs included in agency budgets like wages, utilities, etc. The clients don't receive those funds. A woman whom I know recently went on TANF. She has 2 minor children and lives with her parents. She receives $375 in cash monthly, about $500 in SNAP benefits and all 3 qualify for medicaid. They receive $4500 in cash,$6000 in food aid annually plus whatever medicaid deems covered. That's nowhere near $20-$30K.

Incidentally defense funds are scattered all over the budget, too.

George Lippencott 1 year, 4 months ago

Yes but the money is subtracted from the taxpayer to address poverty regardless of where it goes. Arguing you need more because the system is inefficient or poorly directed is a very poor way to approach taxpayers. It might be better to first reform the system to make sure it is "lean and mean" before demanding that the half of the people that pay for this should pay substantially more.

chootspa 1 year, 4 months ago

So are you suggesting we just hand people money with no oversight or administration or means to process the claims?

George Lippencott 1 year, 4 months ago

No but the cost to administer is not free. The taxpayers pay for ":the poor" to the tune of 25 to 30K per year per poor person per year. Fix the system so more gets to those that need it and the freeloaders like "surfer dude" get dropped.

My question remains - you take between a third and a half from the taxpayers in the upper half of the middle class. How much more do you want??

George Lippencott 1 year, 4 months ago

Yes Defense fund are all over the budget but they are totaled and presented as part of the "National Defense Budget". There is no equivalent "Social Safety Net Budget" that sums all of the pieces in that pot.

Armstrong 1 year, 4 months ago

Speaking of numbers let's put this in prospective. Kansas population is roughly 3 million of that roughly 58000 are supposedly going to "fall through the cracks" That equates to .0193 of the state population. Really Sandy? Find something to occupy your time like serving the .9807 of the State.

Shelley Bock 1 year, 4 months ago

Now there you go again, Armstrong, as you write off the equivalent of one-half of Douglas County. I see that you focus only on your self survival and care far less for the community well being. Wasn't that Marie Antoinette's "let them eat cake" comment.

A rising tide should lift all boats.

Orwell 1 year, 4 months ago

In Kansas the Brownback plan is for a selective "rising tide" that lifts all yachts.

George Lippencott 1 year, 4 months ago

Where does the one half come from?? There was a recent article that opined that about half of Douglas County's population receive "food stamps". I am not sure that food stamps and extended medicaid equate. Many receiving food stamps already receive Medicaid.

Shelley Bock 1 year, 3 months ago

58,000 Kansans as stated by Armstrong is approximately 1/2 of Douglas County population.

kevingray 1 year, 4 months ago

In regards to Skinny's comment, here's what I've tried telling/akding Obamacare naysayers for year. If you have an health insurance policy do you know how much of your own policy goes to prop up the uninsured? Just read the following at USA Today or google for other locations. So many naysayers continue to turn away from this information.

http://usatoday30.usatoday.com/money/industries/insurance/2009-05-28-hiddentax_N.htm

George Lippencott 1 year, 4 months ago

A lot of unsubstantiated assumptions in that study. I would argue that a substantial part of the costs for the uninsured is ultimately paid by the tax payers and only a bit by the otherwise insured. Your implied argument that insuring the poor will eliminate that is at best unsubstantiated. But the real issue is the source of the funding for the subsidy on the insurance for families with incomes up to 400% of the poverty level (about $80K). That will be in addition to the premiums paid by all of us for our insurance. It may reduce the actual cost of the premiums for those who meet the criteria for the subsidy but somebody will have to pay the bill - the taxpayers

markgreene69 1 year, 4 months ago

No wonder people are asking "where do I belong"? Imagine how one feels when they are told that they are too rich for regular Medicaid, BUT, not poor enough to qualify for insurance under the Affordable Care Act? I just hope that I can remain in good health so that I don't have to decide between my health and other things I need to live!

jafs 1 year, 4 months ago

That would be not "rich enough" for ACA subsidies.

The hole is between Medicaid eligibility and the point at which ACA subsidies kick in. Of course, that only holds true for states with very low income levels for Medicaid eligibility, since the ACA subsidies start at 100% of the poverty level.

grammaddy 1 year, 4 months ago

The more the GOP screw with Medicare/medicaid and the ACA, the closer we get to single payer.

deskboy04 1 year, 4 months ago

The people in the "gap" should vote for someone else in the next election. They should vote for a candidate who will support their interests. But, many of them won't vote. That's sad.

Richard Heckler 1 year, 4 months ago

Neither women,republicans nor democrats can afford this ALEC Right Wing party that controls the Kansas State government.

Sam Brownback and his associates are dedicated to The ALEC Right Wing party not the republican party.

Armstrong 1 year, 4 months ago

In real numbers this issue applies to less than 2% of the states population.

jafs 1 year, 4 months ago

I said "similar" not "identical".

Not sure why it's a big issue for you - for me, once taxes are paid, that money is the government's money. Of course, we have elected officials who are supposed to represent our interests, like how much money the government should take in taxes and how it should spend it.

I also don't see it as "coercion" if federal money comes with federal guidelines. If states don't like the guidelines they don't have to take the money.

We disagree here, and I think our disagreement is clear by now.

Wisdom is sorely lacking in government these days - we can certainly agree on that part.

jhawkinsf 1 year, 4 months ago

Apparently, Jafs, you believe the government is "them", an entity separate and apart from "us". I don't see it that way. Government is us. The parks they own, as you would have it, I see those parks as our parks. Government buildings are our buildings. The institutions of government aren't their institutions, they're our institutions. And if we intrust some of our wealth with the government to be used as our elected leaders see fit, it never stopped being our wealth.

Sure it's coercion. If you do this, I'll do that. If you drive 90 MPH, I'll give you a ticket. If you don't want a ticket, don't speed. It happens all the time. But it doesn't have to happen with each and every incident. Wisdom is knowing that if I do drive 66 in a 65 zone, and that if you give me that ticket, then the resources needed to do that will overwhelm the system, allowing those going 90 to escape. So the coercion must be measured, used judicially.

jafs 1 year, 4 months ago

Ok - that's your view. The government is both "us" and "not us" - it's composed of elected officials who are supposed to represent us, but like any other subgroup, it's not identical to the whole, in my opinion.

You're conflating speed limits with guidelines that come with federal money, which seems a bit off to me.

Laws like that are in fact coercive, and intended to be just that. The idea is to encourage people to drive slower, and thus more safely.

That's different from my examples. Let's use another analogy - let's say you tell me that you need money for food, and I want to help. Is it coercive if I give you money, but say it's for food, not for other things? Would it be better to just give money without strings? You've argued strenuously against that sort of giving numerous times when discussing social programs.

I see no good reason for the federal government to just give money to states without guidelines. If states don't want the guidelines, they can decline the money. If they (their residents) feel that they ought to be able to keep the money in their state, they can vote for elected officials that advocate for that.

The whole point of a federal government is that it's one for the whole country, while states simply exist in large part for their own interests. Clearly, the founders intended for us to have both of those, so I'd like them to work as intended.

chootspa 1 year, 4 months ago

Those guidelines were in place. You can thank the Roberts court for throwing them out. At least they didn't throw out the whole ACA.

jafs 1 year, 4 months ago

I'm not sure what you mean.

jhf and I were discussing federal guidelines for Medicaid - as far as I know, the federal government has been giving Medicaid money to states for a long time with virtually no guidelines - states are free to determine eligibility, etc. for Medicaid as they like.

whats_going_on 1 year, 4 months ago

So, these working poor who are "too rich" to qualify are now going to be forced to STOP WORKING in order to be eligible.

Nice work, dumb*ss, nice work.

bevy 1 year, 4 months ago

Just so we're clear, the dumb donkey you refer to is actually an elephant - Gov. Sam Brownback.

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