It’s not just education. There’s an inter-connectedness of education, poverty, and the expansion of Medicaid in the Affordable Care Act (ACA).
The GOP members of The Lege have a mixed message on school finance. From an article by Peggy Fikac over the weekend, GOP waits and sees on school funding. When reading this keep in mind that schools talked to The Lege and lobbied hard to keep their funding in 2011.
A state judge is expected to rule next week on whether the school finance system is broken, but lawmakers aren’t anywhere near ready to launch repairs.
Instead, Republican leaders plan to wait for an appeal and a final Texas Supreme Court ruling so they know exactly what they are forced to do.
In a twist, some of their rhetoric seems to suggest school districts have only themselves to blame for the postponement of hopes of restoring funds cut back from education two years ago.
The delay in acting is business-as-usual for the Legislature, which as an institution typically waits as education funding problems get bad enough to prompt a lawsuit by school districts. Then lawmakers wait some more, until the state’s highest court outlines the parameters of the mess they must fix.
Senate Finance Chairman Tommy Williams, R-The Woodlands, said at a hearing last week that lawmakers should pay attention to those who want funding restored for key education programs.
But Williams also stressed the need to weigh that against other education-related funding demands, and he repeated his belief that the ongoing lawsuit makes it difficult for lawmakers to put in additional money for anything other than enrollment growth.
He also seemed to suggest that school districts used the courthouse as an alternative to discussion, odd to those who remember quite a school funding debate in the 2011 legislative session.
“I wish the school districts would sit down and talk to us,” Williams said. “It really ties our hands when they file a lawsuit.”
The reality is, and everyone involved knows it, is that The Lege will not act on school finance unless they’re forced to by the courts. One only has to go back to 2006, the last time they acted on this issue. It’s not in their political interest to act unless they can use the excuse that they were forced to by the courts.
And not taking care of education will just exacerbate the problem, Poorer Texas kids lead to higher education costs.
Texas’ high child poverty rate is beginning to make demands on the state’s budget, and experts warn the state needs to spend more on education or the state’s economy could slow.
About 60 percent of Texas children live in poverty, according to the U.S. Census, and many of those children are unprepared and need extra attention when they start school. If they do eventually get into college, the state’s Higher Education Coordinating Board says they are relying on a shrinking pool of financial aid.
Public schools and state universities are calling for more money as the state’s Republican leadership pledges to dramatically limit government spending. In 2011, the Legislature reduced funding for public education by $5.4 billion, cut pre-Kindergarten programs and cut funding for college scholarships.
Conservatives argue that low taxes and low government spending have helped the Texas economy grow by leaps and bounds since 2000, but the percentage of Texans living in poverty has grown also. According to 2010 Census data, 15.3 percent of Texans live in poverty and most are under 40 and Hispanic, the fastest growing segment of the Texas population. The poverty rate among Hispanics is 26.8 percent.
Hispanics account for 38 percent of the population and 48.3 percent of Texas children. This same group has the highest percentage of people aged 25 years or older without high school diplomas, at 40.4 percent. Between 2000 and 2010, the number of poor students has gone up 45.9 percent to 2.85 million children.
Poverty and education inextricably linked. There’s also a report out today on the positive effects Medicaid expansion would have in Texas, New Report Shows Local Tax Impacts from Offering Medicaid Coverage to Low-Income Adults.
A report issued today provides the most comprehensive analysis to date of the costs and benefits to local taxing authorities (including cities, counties and hospital districts) and state government if the Legislature chooses to extend Medicaid benefits to low-income adults under the Affordable Care Act (ACA). Click here to read the full report.
Billy Hamilton Consulting prepared the report, titled Smart, Affordable and Fair: Why Texas Should Extend Medicaid Coverage to Low-Income Adults, for Texas Impact and Methodist Healthcare Ministries of South Texas, Inc. An Executive Summary of the report is also available.
Texas Impact Executive Director Bee Moorhead said, “Our analysis shows conclusively that extending Medicaid to low-income adults is the smart, affordable and fair choice for the state–and that passing up this opportunity will place local taxpayers, low-income Texans, and the entire state health care system at a significant disadvantage going forward.”
The report demonstrates that local property taxpayers and hospital charity programs already spend about six times as much on low-income health care as it would cost the state to extend Medicaid coverage to adults who have incomes below 138 percent of the federal poverty level (FPL)–$15,415 for a single adult and $31,809 for a family of four. Under the Affordable Care Act, Texas could cover adults aged 18 to 64 whose incomes are below 138 percent FPL, with the federal government paying an average of 90 percent of the cost of coverage for low-income adults over the next ten years.
“For years, Texas has had the highest uninsured rate in the country, with 6 million Texans lacking health insurance. Now we have a chance to change that, and there is no excuse for any other course of action than extending Medicaid to low-income adults,” said Kevin C. Moriarty, President and CEO, Methodist Healthcare Ministries of South Texas, Inc.
Certainly bringing down the amount of children, and adults, without health care would lower the number of Texans in poverty. Which will in turn improve the education of Texas children. It’s time for Texas, for all it’s boasting of prosperity, to make sure that all Texans are prospering.
Looks like the GOP is trying to find a “face saving” way out of their decision not to take billions in federal money to expand Medicaid.
The Affordable Care Act is the federal law that Texas Republicans love to hate, but one top lawmaker says expanding health care for the working poor could happen if federal authorities are willing to strike a deal.
Republican Sen. Jane Nelson, chair of the Health and Human Services Committee, said she hopes the Centers for Medicare and Medicaid Services will allow Texas to receive $27 billion to expand Medicaid. But she said the key is to allow lawmakers to develop a Texas-specific program that will not blow the state’s budget.
“I am still open to anything that will allow us to have the flexibility that we need, and that will also give us the assurance that it’s not going to put us deeper in debt,” Nelson told The Associated Press in an interview.
Expanding Medicaid, the joint state-federal health care program for the poor and disabled, was a critical requirement under the Affordable Care Act designed to make sure 98 percent of Americans have health insurance. But the U.S. Supreme Court ruled that federal authorities cannot require states to expand Medicaid, and so far Texas and more than 20 other states have refused to do so.
Gov. Rick Perry has rejected the Affordable Care Act as an affront on state’s rights and said he wants the federal money with no strings attached in a block grant. The Perryman Group, an independent economic consulting company, estimated that Texas will miss out on $90 billion in increased economic activity and leave at least 1.5 million people uninsured if it does not expand Medicaid.
Nelson said a block grant was not the only way to reach a deal. She said a waiver that would allow the state to develop a tailor-made program within certain federal boundaries might be enough.
A spokesman for the Centers for Medicare and Medicaid Services on Thursday did not have an immediate comment on possible waivers for Texas. Under federal statute, waivers are generally only granted if they expand the number of people eligible, reduce costs or add additional services to the disabled, poor or elderly.
President Obama’s has said in the past his willing to work with states as long as certain conditions are met. But it’s the bidness types like Perryman that are probably leaning on the GOP to find a way to cave on expanding Medicaid. From Perryman’s report titled, Texas has only one rational choice: Expanding Medicaid under The Affordable Care Act.
According to an analysis by The Perryman Group, every $1 spent by the State of Texas to expand Medicaid coverage under the Affordable Care Act (ACA) returns $1.29 in dynamic State government revenue over the first 10 years of the expansion. Medicaid expenditures lead to substantial economic activity, federal funds inf low, reduction in costs for uncompensated care and insurance, and enhanced productivity from a healthier population. When these outcomes and the related multiplier effects are considered, the program actually far more than pays for itself and provides a notable economic stimulus.
“Neither the Affordable Care Act nor the Medicaid program is perfect, and there are many opportunities to provide needed health services in a more efficient and cost effective manner,” said Dr. Ray Perryman, “but if we don’t expand Medicaid coverage as envisioned under the Affordable Care Act, Texas loses an opportunity to enhance access to health care for about 1.5 million Texans and foregoes almost $90 billion in federal health care funds over the first 10 years.”
Free money, economic stimulus, and 1.5 million more uninsured Texans get insurance. That’s why the law was designed, to make Medicaid expansion a really good deal for states. At this point it doesn’t matter what the wing nuts have to do to justify this to themselves. It needs to get done for the benefit of our state. They can call it Perrycare for all I care, but get it done.
And this little tidbit from Arizona may add some fuel to the fire, Obamacare Medicaid Expansion Could Put GOP Governors In Awkward Position On Immigration.
Governors who reject health insurance for the poor under the federal health care overhaul could wind up in a politically awkward position on immigration: A quirk in the law means some U.S. citizens would be forced to go without coverage, while legal immigrants residing in the same state could still get it.
It’s an unintended consequence of how last year’s Supreme Court decision changed the Medicaid provisions of President Barack Obama’s health care law. The overhaul expanded the federal-state program for low-income and disabled people. The Supreme Court made the Medicaid expansion optional for states, which complicated things.
Arizona officials called attention to the problem last week, when Republican Gov. Jan Brewer opted to accept the Medicaid expansion.
Texas Health and Human Services Executive Commissioner Kyle Janek is bringing right wing ideology to the HHSC. A recent personnel move highlights this, Conservative health care expert is Janek’s ‘special adviser’.
The former vice president for health care policy at an Austin-based, conservative think tank has become Health and Human Services Executive Commissioner Kyle Janek’s “special adviser,” concentrating on two urgent and thorny social services issues.
Mary Katherine Stout, who also served as budget and policy director to Gov. Rick Perry in recent years, is working for Janek on ideas for overhauling the state-federal Medicaid health insurance program for the poor, elderly and disabled, Stephanie Goodman, a spokeswoman for the Health and Human Services Commission, said Thursday.
From Stout’s work history of the announcement about her joining Gov. Rick Perry’s staff in 2008.
Prior to joining the Foundation in February 2005, Stout worked for then-Chair Diane Rath at the Texas Workforce Commission (TWC), where Stout served as policy analyst and handled issues among the two-dozen TWC programs including TANF and child care.
Stout previously worked for the Texas Conservative Coalition and the Texas Conservative Coalition Research Institute (TCCRI), working closely with the TCCRI task forces on fiscal policy, health and human services, and school finance reform.
Additionally, Stout worked as a policy analyst at the Texas Legislative Council and in the office of former Louisiana Governor Mike Foster.
Stout received a bachelor’s degree in political science from Texas A&M University.
In other words she bounced back-and-forth between the government bureaucracy and the corporate bureaucracy of right-wing think tanks her whole career. Not that there’s anything wrong with that, per se. Her expertise is in gutting government as a ideological political hack. This Andrea Grimes post points out, referenced in the above DMN article, Stout’s boss Kyle Janek is trying to use his best political spin, in a misguided attempt to discredit the how many uninsured adults there are in Texas.
Because Kyle Janek doesn’t believe—despite credible, widely accepted evidence to the contrary—that one of Texas’ most pressing health problems, its high number of uninsured adults, is real.He doesn’t believe that more than a quarter of Texans are uninsured, as estimated by the U.S. Census Bureau. He told a Texas Tribune reporter in early October that he believed that number to be “inflated,” and then reiterated his point in an extended interview with Tribune editor Evan Smith on October 31st. (Through his press representatives, he refused an interview with RH Reality Check.) Here’s his most recent take via the Tribune:
“It’s not that I don’t believe those numbers. I don’t believe the reasoning for those numbers.”
Janek’s problem: he said the Census Bureau only takes a “snapshot” by asking people if they’re uninsured, and doesn’t ask them if they had insurance in the past or if they think they have a job lined up with insurance in the future. Janek must not be aware that for nearly 25 years, the Census Bureau’s “snapshot” has shown practically the same thing: since 1987, Texas repeatedly has one of the highest, or the very highest, number of uninsured adults in the country. That rate has not been below 1987′s 23 percent; it peaked at 26.8 percent in 2009 and is currently estimated at 26.2 percent.
That’s a remarkably consistent snapshot of something that Janek seems to believe changes for millions of people by the day. Janek says he isn’t sure why Texas “is different” when it comes to health care, but he told the Tribune it could be because the weather here is nice.
“Do we have so many people that are temporarily uninsured? Or is it the general climate of better weather and glorious place to live? Folks come here, and that attracts more folks with health care needs or disabilities?” he wondered during the interview. Surely our high uninsured numbers couldn’t be due to the fact that Texas jobs generally don’t provide health insurance, that Medicaid in the state is limited, that insurance rates are unregulated or that Texas has a large immigrant population, as the Washington Postreported last year. No, it’s probably just the purty weather.
I called Dr. John Holcomb, a pulmonologist who chairs the Texas Medical Association’s committee on Medicaid, to find out what he makes of Janek’s stance. (Spoiler alert: the TMA’s official position is that “Texas is the uninsured capital of the United States.”) Holcomb told me that Janek’s comments are “a perfect example of how Dr. Janek is not ready for prime time.”
Holcomb told me that while Janek is a “very good speaker” and “very articulate,” when it comes to uninsured rates in Texas, “everyone knows exactly what those numbers are.” They aren’t inflated. They’re real. They’re accepted by public health professionals all over the state, including Dr. Janet Realini, the president of unplanned pregnancy prevention group Healthy Futures of Texas. Realini has been a vocal supporter of maintaining the Medicaid Women’s Health Program and a critic of the state’s and the HHSC’s cuts and changes to money-saving family planning programs.
And Grimes goes on to say this about Stout’s new position.
Her name is Mary Katherine Stout, and for $150,000 per year, the former Perry staffer, Wal-Mart defender and far-right Texas Public Policy Foundation economics “expert” will act as a “special advisor,” “involved in a number of policy and planning issues,” according to HHSC spokesperson Stephanie Goodman. Goodman toldRH Reality Check that Stout will be “looking at ways [Texas HHSC] can work with medical schools to support their efforts to make sure Texas has enough health professionals.”
In the past, Stout has particularly focused her efforts on criticizing Medicaid and especially CHIP, the popular children’s Medicaid program, which she has said is rife with luxury car-driving freeloaders and should be closed to people who are verily rolling in cash and furs, like “those making as much as $40,000 annually for a family of four.” Stout’s coldness is unusual even for Texas right-wingers, and her cruel preoccupation with making sure as few Texas children as possible receive needed aid borders on the bizarre. To that end, this was her 2007 proposal for fighting “The Left” in the National Review:
Perhaps we should fight their strategy with our own campaign to tell stories of success, of people working hard and making good decisions for their family, of people who made something out of nothing, or who turned something into more. Yes, send me your stories of success, of personal responsibility, and of government’s depredations on a family trying to make ends meet.
These are the words of a “special advisor” on Texas public health care policy, who’ll be whispering in the ear of a man who believes the state has “inflated” uninsured numbers because hey, poor people can always go walk in and get some open heart surgery at a public hospital or amorphous medical school of dubious funding origin.
That’s all just the same 40 year old false right wing rhetoric regarding people in poverty. To see why that tired rhetoric is so wrong see this recent post, The tough choices families must make on a daily basis.
No one should fool themselves that the current leaders of our government in Texas, the far right of the Texas GOP, is going to use government to help the people of Texas. They want to privatize government and make sure their campaign donors can profit from taxpayers. That’s what their version of the “free market” ideology has become. This is just more of the same. People like this who think government is the problem, will never come up with government solutions to help people. And if we keep electing them nothing is going to change.
The one thing I’ve always admired and envied is Paul Krugman’s ability to make things simple and easy to understand. He’s done it again, Understanding Medicare “Cuts”.
Jackie Calmes has a very good piece about those Medicare “cuts” Romney promises to repeal. As she emphasizes, all of these involve reductions in payments to insurance companies and health providers, rather than reductions in patient benefits. So what are we talking about?
Sarah Kliff had a good summary. Most of the proposed savings come from reducing overpayments to Medicare Advantage and reducing reimbursement rates to hospitals.
What should you know about these changes?
Medicare Advantage is a 15-year failed experiment in privatization. Running Medicare through private insurance companies was supposed to save money through the magic of the marketplace; in reality, private insurers, with their extra overhead, have never been able to compete on a level playing field with conventional Medicare. But Congress refused to take no for an answer, and kept the program alive by paying the insurers substantially more than the costs per patient of regular Medicare. All the ACA does is end this overpayment.
As for the cuts in hospital reimbursement, the key thing to know is that the hospital industry itself negotiated those cuts. Here’s how John McDonough’sInside National Health Reform describes it:
The negotiation involved the White House and high-level Senate Finance staffers. The agreement involved two numbers: $155 billion in reductions over ten years, and health insurance coverage for 95 percent of all Americans. At these numbers, hospital leaders were convinced that the revenue from the added covered lives would more than make up for their losses on the Medicare side, and it was a deal they could embrace.
So, does any of this sound like a devastating blow to seniors’ health care?
The Romney/Ryan plan, on the other hand, actually does gut Medicare, Patients Would Pay More if Romney Restores Medicare Savings, Analysts Say.
False before, False now: John Carter says board could come between “you and your doctor” in determining treatmentshttp://www.politifact.com/texas/statements/2012/aug/21/john-carter/john-cornyn-says-board-comes-you-treatment-options/ …
The one thing about the Affordable Care Act (ACA), aka Obamacare, is if the law is as bad as the regressives make it out to be, then why to they and their shills in the media have to keep making stuff up and lying about it? It’s because the law is proving the GOP lies about it false. And the more people begin to understand it – free well checks, near universal coverage, no more “pre-existing” conditions, and coverage for children until 26 – the more they realized it includes very good things, and they’re warming to it.
But Rep. John Carter (R-Round Rock) is lying about the ACA as well.
Saying he’s committed to repealing Obamacare, U.S. Rep. John Carter, R-Round Rock, told constituents: “You may not be aware of one of the most frightening provisions in the president’s healthcare plan — the creation of the Independent Payment Advisory Board.”
Carter’s July 31, 2012, letter continues: “This board, comprised of 15 unelected, unaccountable people hand-picked by the president, will have the ability to come between you and your doctor in determining the best treatment options for you!”
After readers asked us to look into Carter’s claim about the board’s intrusive powers, we emailed Carter’s office for backup information — and didn’t hear back.
With Carter’s wording in mind, we read the relevant portion of the law.
Section 3403 indeed states that the board is to include 15 members appointed by the president. Each appointee also would face Senate confirmation.
As far as we can tell, the law does not give the board the power, or permission, to regulate any individual’s treatment options.
For an August 2011 Truth-O-Meter article, PolitiFact Georgia asked four health experts about a congressman’s claim that “a bunch of bureaucrats” would “decide whether you get care.” All four said that’s incorrect.
A scholar at the Cato Institute, a libertarian think tank usually at odds with Democratic positions, said the assertion that the board would be controlling patients’ health-care decisions is “not even close to correct.” Cato scholar Michael Tanne said the board “has nothing to do with individual care at all. It’s not making decisions on individuals.”
Carter’s claim has no factual foundation. We rate it False.
Dude, even Cato says you’re lying, that’s bad.
Via EOW on the retirement and likely replacement at Health and Human Services (HHS) and the Texas Education Agency (TEA), Here comes the next wave in the assault on health care & public education in Texas.
Perrys’ picks to replace Suehs (HHS) and Scott (TEA) will likely be right wing and pro-privatization. And it’s likely, no matter how the Speaker and US Senate/Lt. Gov. races turnout, that the committee chairs will be more right wing and pro-privatization. So cuts and privatization will likely be the proposed “fixes” for these two long-beloved public programs in our democracy.
As Progress Texas points out Perry’s pick for HHS – former GOP state Senator, turned lobbyist Kyle Janek – is right wing and pro-privatization. Perry’s Latest Appointment Jeopardizes Medicaid in Texas.
Kyle Janek’s previous record on health care is troublesome, however. As a senator in the Texas legislature, Kyle Janek’s top two contributors were both PACs relating to healthcare, one of them being the Texas Medical Association PAC and the other being the Greater Houston Anesthesiology PAC (Kyle Janek also works as an anesthesiologist). As a lobbyist in 2011, Kyle Janek was on the payroll
- The Health Care Compact Alliance, an alliance headed by Leo Linbeck III (the CEO and chairman of Linbeck Corporation, a Houston-based construction company, and a member of a powerful family that donates often to libertarian causes) This 501c(4) focuses on advocating for the interstate health care compact, which would strip Texas, among other states, of federal regulations on health care. Texas would receive block grants with no federal rules attached; the state government could do what it pleases. In the worst case scenario, Texas could remove Medicaid, Medicare, CHIP and other federal programs entirely. The interstate health care compact was seen by Republicans as a way to get out of the Affordable Care Act, no matter what the Supreme Court ruling turned out to be. Kyle Janek, along with top lobbyist Mike Toomey, led the lobbying effort onbehalf of the Health Care Compact Alliance. The health care compact was included in SB7, passed last year.
- Citizen Leader Alliance, the conservative 501(c)4 that Leo Linbeck III founded; its president, Jamie Story, was a featured speaker at the Texas Public Policy Foundation, a conservative think tank and ALEC’s arm in Texas.
- Eisai Inc., one of the top 25 pharmaceutical companies in the United States.
Janek, who lobbied to get rid of federal programs such as CHIP and Medicaid, is now at the head of the commission that is responsible for the administration of federal programs. As a former state senator and lobbyist who is now back in government, Janek personifies the revolving door in politics. His connections to ALEC, TPPF, and the Health Care Compact Alliance suggests that he will be no friend to Texas’ most vulnerable populations.
The AAS Ed Board has hope, for now, but that likely won’t make it through the legislative session. The regressives are in government to tear it down, not build up.
Kainser Health News published an article in which they surmise that Texas Gov. Rick Perry will eventually accept the expanded Medicaid funding from the Affordable Care Act (ACA). It may be the first one that really shows why he might actually wind up accepting the expansion. The first part of this article does a really good job of explaining how our government works, Businesses Will Push Perry to Rethink Medicaid Expansion.
Texas Gov. Rick Perry says he rejects the “Obamacare power grab” and will block measures expanding health insurance to millions in his state. The country’s second-biggest health insurer is betting he won’t succeed.
The same day last week that Perry said expanding Medicaid would be like “adding a thousand people to the Titanic,” WellPoint Inc. disclosed an agreement to buy Texas’s biggest Medicaid managed care company for $4.9 billion. The purchase of Amerigroup, which operates in 12 other states besides Texas, is WellPoint’s attempt to cash in on the health act’s addition of 17 million Americans to Medicaid, the state and federal program for the poor.
The Supreme Court decision allowing states to block Medicaid growth without a penalty, however, threatens the profits of companies hoping to manage care for the new beneficiaries. Perry is one of more than half a dozen Republican governors resisting the federal Medicaid windfall set to begin in 2014.
But if there’s one thing more powerful than Republican governors’ dislike of the Affordable Care Act, many believe, it may turn out to be the business interests in their own states. [Emphasis added]
It really doesn’t get more stark then that. This offers a glimpse of how our “republic” really works now. It’s a corporatocracy. Pay no mind to the fact that millions in Texas and across the US – the people – are without health care. The real issue is how is this law going to effect the corporate bottom line. In other words Perry won’t relent because it’s the right, or moral, thing to do. He’ll relent because those who finance his campaigns will profit from the expansion.
“Once the headlines die down, every hospital in Texas is going to look at Perry and say, ‘Please tell me why we’re not taking money from the federal government to offset my uncompensated care,’” said Thomas Carroll, who follows health insurance stocks for investment firm Stifel Nicolaus. “That is a question that Rick Perry absolutely cannot answer.”
A higher portion of Texans lack coverage than residents of any other state. A Texas Medicaid expansion would generate $100 billion in federal money for the state over a decade, according to the state Health and Human Services Commission, and furnish coverage to an estimated 2 million Texans.
At the same time it would generate nearly $1 billion in annual Texas revenue for Amerigroup and WellPoint, calculates Carroll.
Quiet for now, insurers are expected to join hospitals and patient advocates to fight for Medicaid expansion and what are enormous amounts of money, even by Washington standards. Nowhere are the dollars bigger than in Perry’s state, where one in four lacks health coverage.
“Fights seem to follow the money, and there is a lot of money at stake in Texas on this,” said Phil King, a Republican state representative from outside Fort Worth who opposes the Medicaid expansion. “Maybe you need to rename this ‘The Full-Employment Act for Lobbyists.’”
With world-renowned medical institutions such as the University of Texas and a large part of its Medicaid coverage handled by private insurers such as Amerigroup, the state’s health industry is “just behind oil and gas” in size and influence, said Vivian Ho, a health economist at Rice University. “Given how much Amerigroup has to gain from a Medicaid expansion in Texas, they may be one of the most effective organizations to lobby Perry and the state legislature to fund the expansion.”
In this day and age, when corporations have their own foreign policy, and only work with nation states when it benefits their bottom line, this should not surprise anyone. Our elected leaders true constituents are not the people, but those who profit from the decision our elected leaders make.
This is why efforts to attack our elected leaders – along moral, ethical, and logical lines – seem so futile often times. They’re obviously not worried about a backlash from voters, because it never comes. Our politicians are only worried about fueling their addiction. And until that’s fixed little will change.
While it’s starting to become obvious that many of the inflated,and false, claims the regressives, (see below), made about the Affordable Care Act, they’re still trying to go negative. Case in point, Texas slashes estimate of state’s ObamaCare tab.
Suehs testified to a House budget panel that he agrees with Perry that Texas shouldn’t opt into the federal law’s expansion of Medicaid to include childless adults until after the state-federal program’s problems are fixed.
If Texas opts in, the extra $15.6 billion in state spending through 2023 would draw down $100.1 billion in additional federal dollars, Suehs said
Not the $27 billion Suehs once thought. (Here’s the link from 2010 on Suehs prior inflated projection. It does look like he’s just trying to make things right before he’s out the door.) Of course, why we should care, or trust what Suehs says anymore is beyond comprehension.
What’s being lost in this discussion is what a good deal this is for Texas. If we will spend $15.6 billion over the next 10 years and get $100.1 billion back from the federal government. And insure almost two million uninsured Texans at a cost of $1.56 billion per year to taxpayers. (If my calculations are correct that around $800/per person, per year.) That may be the best economic development money this state has spent in decades.
Of course the wing nuts will freak out, because some wealthy people may have to pay more in taxes, but it’s better than the cruel alternative.
New Texas estimate for health care reform is $11 billion cheaper.
And another blast from the past, Feds, State Disagree on Cost of Health Reform.
HHSC Commissioner Tom Suehsestimates that health care reform’s top-dollar items — Medicaid expansion to roughly 2.1 million Texans, plus heightened reimbursement rates for primary care physicians — will cost the state more than $27 billion between 2014 and 2024, up $3 billion from his most recent estimate.
But the Congressional Budget Office’s numbers are far different. Between 2010 and 2019, the agency estimates, the reform will cost Texas $1.4 billion. A letter written last month by U.S. Rep. Henry Waxman, D-California, the chairman of the House Energy and Commerce Committee, notes that Texas’ estimate is more than the $20 billion the reform is expected to cost all state governments combined in the next decade.
“I don’t know where he went to school and got his math education. But it’s not right,” Suehs said of Waxman, speaking at a joint hearing of the Senate Health and Human Services and State Affairs committees. (The answer? UCLA.) “I can’t rationalize the CBO’s budget numbers when I know that I’ve got a higher population of uninsured than most states have total population.”
Some lawmakers said they’d understand a small cost differential, but that this difference looks enormous. “Glaring,” state Sen. Robert Duncan, R-Lubbock, called it. And they said that whatever the final cost is, it’s clear it will take a major bite out of Texas’ bottom line.
Suehs said the most obvious discrepancy between the state and federal numbers is that the federal estimate doesn’t include administrative costs. It also starts immediately, while the state estimate doesn’t begin until 2014. In the first three years of the reform program, the costs to the state are expected to be minimal, and Suehs said he wanted to give lawmakers a fleshed-out 10-year view.
“I felt I had an obligation to give a long-range [view] to the Legislature,” he said. “You need to have strategies for how you finance, how you fund it.”
But some Democratic lawmakers questioned that approach — particularly in light of staunch Republican opposition to the reform. “I don’t know of any time where I’ve had the financial years start out in 2014 and go out to 2023,” El Paso state Sen. Eliot Shapleighsaid skeptically. “We’re being presented with a sticker-shock number.”
Suehs took issue with that, and he vowed that the federal estimate will continue to rise. “In my 35 years of doing budget work, there’s never been a group of cost estimates that have had more cost analysis than our efforts on this reform bill,” he said.
Oops, as they say.
There are a few things to keep in mind regarding Gov. Rick Perry’s announcement yesterday that he would turn down the federal Medicaid expansion in Texas, as a result of the Affordable Care Act (ACA). The main thing is that nothing has actually been decided yet. And that a certain amount of this is just political posturing, his attempt to stay relevant, for the November election.
If President Obama is reelected there’s not chance the ACA will be repeal. And ever hard core GOP partisans acknowledge that, no matter who is elected in November, the ACA will be very hard to repeal. Likely GOP nominee Mitt Romney stated that he wants to keep what’s in it, he just doesn’t want to pay for it. The GOP will fight this, tooth and nail, as they’ve historically done with landmark legislation. It takes time, years even, to get controversial laws like this implemented. A few excepts from a Melissa Harris Perry show from July 1st.
Now, that`s three years after the Supreme Court ordered southern states to move with quote, “all deliberate speed” to desegregate public schools. Now, the affordable care act line is more specific. States have until January 1, 2013 to demonstrate by the department of health insurance services that their exchanges, the marketplace where is customers can shop around for insurance, will be up and running next year.
The governor`s threats of delays now as they did then, have very real implications for the lives and the liberty of American people. By 1964, for example, a full ten years after brown, less than two percent of black children in the south attended desegregated schools. And the health of individual Americans and the already astronomical cost of caring for the uninsured can`t afford the cost of that kind of delay today.
But there is a cruelty, in not just southern governors, but governors like Kasich, Walker, and the governor of Florida, Rick Scott, in turning down federal funds[...] But on this, it`s just putting lives on the balance for ideological reasons.
I also think this decision and I defer to the constitutional experts here, was crafted, the finesse, it still puts limits on the federal government and that relationship between the government and the states is still up for
grabs, though the immigration decision was interesting, because there was very clearly the federal government has the prerogative in the immigration area, so I think it`s a very fluid moment, and last point on the brown versus board, it will take movements, it will take movements, fused with court decisions, to bring about the real progress in this country. We saw it with the civil rights movement, having to push years after brown to make real the promise of that decision and I think that will be the case with this.
That’s the point, change doesn’t come easy, and this is just another step in a decades long process of making sure all Americans have health care. As FDR referred to it in his Economic Bill of Rights – The right to adequate medical care and the opportunity to achieve and enjoy good health.
What Perry and the wing nuts are screeching about it ideological, it must be kept in mind that Texans will pay, whether he takes the federal money or not, it’s just cheaper if Texas takes the federal money. Because Perry turning down the money hurts hospitals, and shifts the cost from federal and state government, to local governments, Perry’s rejection of Medicaid expansion could burden local taxpayers.
Many opponents had pinned their hopes on victory in the courts and now hope Republicans can sweep this fall’s elections and repeal the law.
“We’re just not going to be a part of … socializing health care in the state of Texas,” Perry told Fox News.
Parkland Memorial Hospital, which treats many of the North Texas region’s uninsured patients in its emergency room, said Perry’s resistance to the proposed Medicaid expansion won’t stop the flow of indigents seeking care at safety net hospitals.
“If our state is going to turn away hundreds of millions in federal funds, we are eager to see what our leaders will propose to replace them,” the Parkland Health & Hospital System said in a written statement. The system said that last year it provided $605 million in uncompensated care.
Dan Stultz, an internist who heads the Texas Hospital Association, said Medicaid offers only paltry payments to providers, but having uninsured people flock to emergency rooms for care simply shifts costs to those with insurance. It also places more burdens on the county property owners whose taxes support hospitals such as Parkland.
“With a strained state budget, it’s hard to imagine addressing the uninsured problem in Texas without leveraging federal funds, which will now go to other states that choose to expand their Medicaid program,” Stultz said.
Houston neonatologist Michael Speer, president of the Texas Medical Association, said he’s especially worried about uninsured adults under the poverty line who were intended to be added to Medicaid and may not qualify for subsidies to buy private plans.
That sets up a very good set of issues for Democrats to run on in Texas. To fight to make sure the almost 2 million uninsured Texans get insurance, and to keep the GOP from raising local property taxes, by accepting the federal Medicaid expansion.
Another issue to keep in mind is that the hospitals, the insurance corporations, and the drug corporations we’re all on board with the ACA. They know Medicaid is being expanded because it’s the least expensive way to get almost all Americans insured.
Unfortunately logical and sound fiscal arguments aren’t the most effective ways to sway enough people. But maybe the utter cruelty of rejecting health care coverage for so many that don’t have it. Especially those who need it the most.
The provision that Perry wants the state to reject would add to the state’s Medicaid rolls more than 1.5 million poor, childless adults who are currently ineligible, plus as many as 300,000 pregnant women, children and extremely poor parents who already qualify but aren’t enrolled.
Fortunately it’s not just up to Perry, but it will take many from the, “let him die!” Party to join with Democrats to keep this provision alive. The legislature can still “assert itself”, though unlikely, on this issue.
Legislators could attempt to buck Perry on the issue next year, though it’s unlikely enough other Republicans will want to do so.Either way, Medicaid — one of the largest parts of the state budget — will again be a major issue. Last year, lawmakers helped bridge a $27 billion shortfall by underfunding Medicaid between $4 billion and $5 billion of state funds. They’ll have to pay the tab in 2013, even though state finances are expected to again be tight.
Rep. Garnet Coleman, a Houston Democrat who is a leading health policy writer, said Perry “chose the policy that’s best for him politically” but ignored the plight of poor adults, many suffering from diabetes, cancer and mental illness.
“The governor said it’s better to follow his ideology and throw those folks under the bus than to provide health coverage that the state of Texas would pay zero for, at least for the first three years,” Coleman said.
House Speaker Joe Straus, R-San Antonio, said he agrees with Perry that the state could offer bare-bones health coverage more efficiently than the federal government.
However, Straus said the biggest problems in U.S. health care originate with the federal tax code. Federal income taxes encourage employer-provided coverage, which keeps consumers from having “skin in the game” and being prudent purchasers, he said.
“The Legislature will have a say in this once we know past November who is in the federal government making decisions,” the speaker said.
The reality is that it’s going to take a movement, sustained pressure, over the course of years to get all Texans the health care that is their right.
Kuff has a great rundown of the timeline and reaction across Texas to Perry’s decision, No Medicaid expansion for you!
Today GOP Texas Gov. Rick Perry has decided, by fiat it would seem, has decided he will deny health insurance for millions of Texans, Perry: TX Won’t Implement Key Elements of Health Reform.
Texas will not expand Medicaid or establish a health insurance exchange, two major tenets of the federal health reform that the U.S. Supreme Court upheld last month, Gov. Rick Perry said in an early morning announcement.
Perry’s office sent a letter to U.S. Health and Human Services Secretary Kathleen Sebelius on Monday morning asserting his opposition, both to accepting more than a hundred million federal dollars over the next several years to put more poor Texas adults onto Medicaid, and to creating an Orbitz-style online insurance marketplace for consumers.
“I look forward to implementing health care solutions that are right for the people of Texas,” Perry wrote in the letter to Sebelius. “I urge you to support me in that effort. In the meantime, [health reform's] unsound encroachments will find no foothold here.”
Just exactly what kind of fake free market, tax payer money for corporate greed scheme that would be is anyone’s guess. More on how many will not get insurance from BOR, Big, Bad News: Rick Perry Refuses to Establish Health Insurance Exchange, Blocks Medicaid Expansion.
While the Affordable Care Act will still increase the number of insured Texans by between 2 and 2.5 million individuals, the roughly 1.8 million Texans who were eligible per HHSC guidelines to gain coverage through the Medicaid expansion now will not.
This was pretty much expected. The only difference between Perry and the other GOP class warriors, is that Perry’s announcement isn’t as knee-jerk as the others. He’s trying to make it look like he actually took his time.
But as David Atkins points out, maybe most people still don’t believe it will happen, “They refused to believe any politician would do such a thing.”
Robert Draper describes the results of focus groups done a few months by Democratic groups attempting to define Mitt Romney:
Burton and his colleagues spent the early months of 2012 trying out the pitch that Romney was the most far-right presidential candidate since Barry Goldwater. It fell flat. The public did not view Romney as an extremist. For example, when Priorities informed a focus group that Romney supported the Ryan budget plan — and thus championed “ending Medicare as we know it” — while also advocating tax cuts for the wealthiest Americans, the respondents simply refused to believe any politician would do such a thing.
That’s really how bad the Ryan budget is: voters don’t believe that real politicians would actually do such a thing. The plan to gut Medicare in order to make room for tax cuts for the rich is egregious and embarrassing that groups like Politifact have to go out of their way to cover for them.
And then there’s Mitt Romney, a vulture capitalist responsible for mass layoffs and outsourcing, who supported the Ryan budget and continues to advocate for tax breaks for millionaires and austerity for everyone else. As Jonathan Chait says:
The basic theme of Romney as a super-rich guy who sees the world through the lens of his own class seems like a powerful and roughly accurate one. The attacks on Romney’s business career fit with the theme. I’m sure there will be more attacks on Romney’s secretive finances — Obama’s campaign keeps dropping the phrase “Swiss bank account” because, I would wager, focus groups find it a little suspicious.
Once they’ve established that frame for voters to understand Romney, then they have set the stage for a closing attack that focuses on the policy contrast. (Or so I have argued.)
One odd thing is that Romney has done so little to insulate himself against this line of attack. George W. Bush framed his entire campaign persona in 2000 so as to protect himself from charges of looking out for the rich — he called himself a compassionate conservative, he falsely claimed his tax cuts disproportionately benefitted the poor, he surrounded himself with cultural symbols of the middle class. Romney is a very rich man running on a platform of helping other rich people and doing almost nothing to deflect the most obvious political attack.
It’s almost as if the Republicans are planting gigantic targets on their backs, standing in the middle of the street and daring Democrats to hit them. It’s such openly flaunted evil that even the most jaded voters refuse to believe it’s actually real.
This has more to do with who would be receiving health care, then it does with the so-called federal strings that are attached. That’s just what Perry and the GOP hide behind when they don’t want to talk about the millions without health insurance in Texas. It’s extremely doubtful that this will be an issue where the , “..Legislature needs to assert itself..”. The only way this will stop is to change our elected officials.
Here’s the statement from the Texas Democratic Party:
Rick Perry’s announcement is both cruel and negligent. No person with a speck of intelligence would turn down billions in federal dollars that would be a boon to our economy and help Texans. But then again this is Rick Perry. Rick Perry could’ve brought billions in federal dollars to Texas, reduced the rate of the uninsured and improved the quality of life for Texans. Rick Perry’s Texas solution is to let Texans stay ill and uninsured. That is not a health care plan. Once again Perry is putting partisan political pandering in front of the interests of Texas.
« Previous Page — � Previous entries « Previous Page · Next Page » Next entries � — Next Page »