Perry says no to exchanges, Medicaid expansion

[sonias]

Postcards from the Lege blog AAS 7/9/12

Perry says no to exchanges, Medicaid expansion

Gov. Rick Perry said today that he would not set up a state-run health insurance exchange or expand Medicaid, two key provisions in President Obama’s health care plan.

Emily Ramshaw of The Texas Tribune reported this morning that Perry would be sending a letter to U.S. Health and Human Services Secretary Kathleen Sebelius to advise her of Texas’ position.

“I stand proudly with the growing chorus of governors who reject the Obamacare power grab,” Perry said in a statement. “Neither a ‘state’ exchange nor the expansion of Medicaid under this program would result in better ‘patient protection’ or in more ‘affordable care.’ They would only make Texas a mere appendage of the federal government when it comes to health care.”

When the U.S. Supreme Court ruled last month that the federal health insurance overhaul was constitutional, the justices also said that states could not be punished for declining to expand Medicaid to cover more people.

Oh you knew that little ricky wasn't going to miss the crazy train. Once bobby jindal jumped on board, little ricky had to buy in too.

And Texas with the worst health care coverage in the country will let the situation just get worse.

[TexasTowelie]

1. He could care less about those little people.

His health care coverage is paid by you and me.

[sonias]

4. But of course he "works" for his health coverage

And the rest of Texas that doesn't have good government provided health care - well they should get a good job like him. Right?

[thucythucy]

2. Instead he'll probably book a stadium

and ask people to pray for better health.

I mean, considering how that strategy worked so well in putting out all those fires.

[sonias]

3. +100

Oh you know him so well. He is full of so much hot air and hair gel that he's a potential fire hazard.

[white cloud]

6. 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.

"I stand proudly with the growing chorus of governors who reject the Obamacare power grab," he said in a statement. "Neither a 'state' exchange nor the expansion of Medicaid under this program would result in better 'patient protection' or in more 'affordable care.' They would only make Texas a mere appendage of the federal government when it comes to health care."


http://www.texastribune.org/texas-health-resources/medicaid/perry-tx-wont-implement-key-elements-health-reform/?utm_source=texastribune.org&utm_medium=alerts&utm_campaign=News%20Alert:%20Subscriptions

[mbperrin]

5. AND he will soon reimburse Texans for his multi-MILLION dollar security bill during his EPIC failed

run for Prez, right?

Right?

[sonias]

9. Is that a Texas sized cricket

I mean it looks like the actual size too.

[onestepforward]

7. I'm waiting to hear what the hospital systems will say

about this. I haven't found anything yet.

If Howard Dean is right, they will fight this.

[sonias]

8. I hope so

I'd love as many groups and individuals to fight this as possible.

[onestepforward]

10. I did find this:

http://www.bizjournals.com/dallas/blog/2012/07/rejection-of-medicaid-expansion.html

Perry's rejection of Medicaid expansion called 'disappointing'

Gov. Rick Perry's rejection of health insurance exchanges and Medicaid expansion in Texas will hurt the state and result in a one-size-fits-all approach, the chief of the Dallas-Fort Worth Hospital Council said this morning.

"From an industry perspective we're certainly disappointed," Steve Love, the council's president and CEO, told me in a phone interview this morning. "The hospitals were very supportive of both the Medicaid expansion and the state health insurance exchanges."
-snip-

On the Medicaid issue, Love said it's a valid point that the state would have to sustain the expansion after it's put in place. However, he said, the federal government would cover 100 percent of the expansion in Medicaid costs through 2016, then 90 to 95 percent through 2020.

"Over the next eight years, it wasn't like a big price tag was going to be handed to Texas," Love said.
-snip-

[onestepforward]

11. From the Texas Hospital Association:

http://www.advisory.com/Daily-Briefing/2012/07/09/Battleground-Medicaid-Hospitals-prepare-state-by-state-fight-for-ACA-expansion

Hospitals prepare lobbying campaigns

Many GOP leaders have pledged to oppose the expansion, so advocates for providers and uninsured residents are developing state-level campaigns to pressure them into changing their minds, Modern Healthcare reports. "You're going to see a major intensification of lobbying at the state level by the hospitals and the doctors," says John Gorman, a consultant and former lobbyist.

For example, Gov. Rick Perry (R) over the weekend said he does not plan to have Texas participate in the ACA expansion. In response, the Texas Hospital Association (THA) and its 500 member hospitals plan to build "significant" political pressure on state leaders to participate in the expansion, according to THA lobbyist John Hawkins.
-snip-

[Ilsa]

27. Perry's wife is a nurse, but she appears

To be pretty lame when it comes to standing up for patients' rights.

I hope all of the hospitals bulldoze him out of office.

[Bolo Boffin]

12. It's not often you can tell over 6 million people to get lost.

Our problem here in Texas, you see, is not people without insurance. It's people making bad personal choices in staying healthy.

[sonias]

13. Those choices can be connected though

A person with insurance is probably more likely to have a health professional guide them to make better choices.

If you go see a doctor/nurse or have access to medical advice sooner, you may make better healthy lifestyle choices.

Sure peer pressure, self preservation interest and family nudging may be just as important. But it doesn't hurt to have your official numbers so a medical professional can tell it to you straight too.

I agree that prevention is so much cheaper than a cure.

[Bolo Boffin]

16. Exactly. Putting off your annual exam so your kids can have school shoes is "poor personal choice."

It's just the low meanness that gets me.

[Gothmog]

14. Ezra Klein has a good wonky reason why Perry may be forced to back down

Part of the Affordable Care Act involves the phasing out of payments to hospitals to compensate these hospitals for uninsured care. This reimbursement is not necessary if the state participates in the Medicaid expansion but if a state is stupid, then the hospitals in that state will be losing this reimbursement http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/07/08/the-super-wonky-reason-states-may-join-the-medicaid-expansion/

It all centers on something called DSH payments (pronounced “dish” payments, in health-wonk parlance). That stands for Disproportionate Share Payments, extra money that Medicaid sends to hospitals that provide a higher level of uncompensated care. Those payments, which totaled $11.3 billion in 2011, are meant to offset the bills of the uninsured.

The Affordable Care Act phases out these payments. If most Americans are covered under the Affordable Care Act, after all, hospitals would presumably see a reduction in unpaid bills. They wouldn’t need the supplemental payments anymore.

That was the thinking before the Supreme Court decision, at least. If a state opts out of the Medicaid expansion and does not extend coverage to those living below the poverty line, the math changes. The unpaid bills do not disappear, but the DSH dollars do. Barring an act of Congress, those supplemental funds will be largely phased out by 2020.

That’s a big deal for hospitals, who already spend about $39.3 billion a year on uncompensated care, which makes up 5.8 percent of all expenses. Add on another $11 billion and hospitals would find themselves spending 27 percent more covering unpaid bills. It especially matters in states with more uninsured residents. In Texas, for example, the hospitals received $957 million in DSH payments last year.

[onestepforward]

15. Good article.

This is what Howard Dean was betting on.

(added) He said it would push the hospital systems to fight back.

[white cloud]

17. more

http://www.forbes.com/sites/rickungar/2012/07/09/rick-perry-to-6-5-million-texans-with-no-healthcare-youre-on-your-own/


http://www.huffingtonpost.com/2012/07/09/rick-perry-obamacare_n_1658934.html


http://blogs.houstonpress.com/hairballs/2012/07/rick_perry.php



http://politicalticker.blogs.cnn.com/2012/07/09/perry-texas-will-stand-against-obamacare/

[onestepforward]

18. Thanks!

I loved the title from the Houston Press article:

"Rick Perry Stands Tall Against Socialism, Obamacare and Godless Federal Dollars"

[sonias]

20. Perry said that "every Texan has health care"

Culture Map Houston 7/9/12

FANTASYLAND?
Rick Perry claims all Texans already have health care: Defies belief in Fox News appearance on Obamacare rejection

(snip)
Talking about his decision on Fox News, Perry said that "every Texan has health care" adding "We don’t trust this administration and we don’t trust Washington, D.C."

While he couches his decision with references to "freedom" and "socialism," the practical effect is that the state will lose hundreds of millions of dollars provided by the federal government to offer Medicaid to needy adults, a Texas health insurance exchange will be run by the federal government and, presumably, Texas will continue to lead the nation in citizens lacking access to medical care.

ricky perry obviously does not understand the meaning of the word "insurance" or more accurately he just lies through those polished white teeth, every opportunity he gets to be on national tv!

[sonias]

23. Perry’s Titanic Blunder

Texas Observer 7/10/12

Perry’s Titanic Blunder

To expand Medicaid is “not unlike adding 1,000 people to the Titanic.”—Rick Perry on Fox News, July 9

(snip)

But where Perry really got it wrong in the Fox interview was his assertion that “every Texan has health care in this state from the standpoint of being able to have access to healthcare.” That’s like saying that every Texan has food in this state from the standpoint of being able to have access to the grocery store. It doesn’t mean the more than six million Texans who are uninsured can actually afford it. And who but our governor has access to experimental adult stem cell spinal infusions? According to a new study released by the Agency for Health Care Research and Quality, Texas ranks dead last in health care services and delivery. Texas Medicaid is also one of the most limited and strictest programs in the country. The Texas Health and Human Services Commission projects that the state would actually see a net gain of $70 billion over five years if it expanded its Medicaid program. That sounds like some sort of trick.

In the end it looks like Perry would rather go down with the ship than work with the federal government on health care. And he’s taking millions of uninsured Texans down with him.

And who but our governor has access to experimental adult stem cell spinal infusions?

Why yes I am already running for President in 2016 - rick perry

[Mayberry Machiavelli]

26. Excellent and informative post, you should make it its own thread.

No wonder the hospitals are lobbying against Perry's stand.

[Melissa G]

19. Doggett says there's a federal work around.

Last edited Tue Jul 17, 2012, 02:15 PM - Edit history (1)

Anyone know what it is?

A Message from Congressman Doggett:



Tomorrow morning at 7:30 a.m. Central, I will be on CNN's Starting Point talking about about President Obama's proposed extension of middle class tax cuts and House Republicans' scheduled vote on Wednesday to repeal the Affordable Health Care Act. If you are not watching the news then, you can also view our discussion by visiting my Facebook page later in the day. I welcome your thoughts on these important matters.



Earlier today, Governor Perry declared that Texas will neither establish a state health insurance exchange nor accept federal funds to expand Medicaid coverage. Having once talked about Texas' right to secede, perhaps Governor Perry's move to secede from health insurance reform is not surprising, but it is disgraceful. He is only trying to protect his Big Insurance buddies and deny millions of working Texans access to an insurance marketplace similar to the one through which he once obtained his own health insurance. And his refusal of billions of federal dollars is more of the same—a narrow-minded policy, which denies our most economically disadvantaged neighbors access to a family doctor and denies many employers a more healthy workforce. Fortunately, we have a federal path around his mean-spirited obstructionism.

Please keep me advised of federal matters with which I may be of assistance.


Sincerely,
Lloyd Doggett

[onestepforward]

21. This is very interesting.

There is a federal path around the exchanges. If states don't set their own up, the federal government will set it up for them.

I haven't heard of any way around the Medicaid part and I hoping that perhaps Doggett does? I'm looking forward to hearing what he has to say!

[hobbit709]

22. Another brilliant move by our illustrious governator.

TX ranks 51st in a field of 50 in healthcare and he wants to make it worse.

[Gothmog]

24. Perry is getting a great deal of pressure from Texas Hospitals and insurers to back down

This makes me smile http://maddowblog.msnbc.msn.com/_news/2012/07/24/12932553-perry-haley-face-hospital-pushback-on-healthcare?lite

As Jay Hancock reports today at Kaiser Health News, two groups of powerful interests are preparing to pressure Perry if, come next year, the state really does decide to opt out of the Medicaid expansion. One group is the hospitals that, absent the Medicaid expansion, will be bearing the cost of charity care even as they cope with declining revenue from other resources. The other group is private insurers, who see the growing Medicaid population as a huge profit opportunity and have been investing large amounts of money to prepare for it.

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."....

Here's the thing: Perry and Haley find it fairly easy to ignore a whole lot of voices when it comes to health care. Patients' advocates? Low-income families? Religious groups? Federal officials? Pundits and wonks? They shrug their shoulders and move on.

But for a sitting governor to ignore the needs and demands of their own hospitals is tougher, and probably unsustainable

[sonias]

25. Ruh roh

Wonder just how much power Amerigroup has with Petty Perry?

Let's hope they can get him to back down even if it's behind close doors to save his ugly face.

Good article by the Maddow crew of course.

[ajain31]

28. Medicaid Expansion under Obamacare in Texas

Hello Friends,

Governor Rick Perry millions of under-privileged poor Texans who do not have any Health Coverage will be covered under The Affordable Care ACT (ACA) expansion of MEDICAID!

My Physician wife's practice is partly dependent on MEDICAID and its viability. Please allow the expansion of MEDICAID to occur in Texas under The Affordable Care ACT.

FACT: If states choose to expand Medicaid, the federal government will cover 100 percent of the costs from 2014 to 2016. The feds' contribution will begin to decrease in 2017, but will never be less than 90 percent, under the ACA.

That's why I created a petition to Governor Rick Perry, Texas Governor, The Texas State House, The Texas State Senate, and Governor Rick Perry, which says:

"Please ACCEPT the FREE EXPANSION of MEDICAID under The Affordable Care ACT."

Will you sign this petition? Click here:
http://signon.org/sign/accept-free-expansion?source=c.em.cp&r_by=7268737

Thanks!

Ajay Jain
[email protected]
Twitter Handle ajain31
Mobile: [phone]

[DhhD]

29. I signed your petition when I read your earlier OP request today. Thanks for letting us know.