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House gop Trying To Slash Medicaid By About $1Trillion-Guess Who Will Suffer?

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babylonsister Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 08:39 AM
Original message
House gop Trying To Slash Medicaid By About $1Trillion-Guess Who Will Suffer?
Posted with permission.

http://www.washingtonmonthly.com/archives/individual/20...

THE GOP PLAN FOR MEDICAID.... While the details are still coming together, reports indicate that House Republicans hope to slash Medicaid, which largely benefits low-income families, by about $1 trillion.

And how, pray tell, would the GOP pursue such savings? Jonathan Cohn reports that the proposal intends to eliminate the Medicaid expansion under the Affordable Care Act, and then "convert the entire program into a system of block grants."

(F)or now, I hope that anybody writing on these proposals mentions, prominently, that rolling back the Affordable Care Act's Medicaid expansion would mean taking health insurance away from about 15 million people. That's the official, Congressional Budget Office projection of how many people will get coverage under Medicaid once the Act is fully in place.

As for turning Medicaid into a block grant, here's a quick refresher on what that entails. Right now, Medicaid is an entitlement program. That means the federal government, in partnership with the states, must enroll everybody who meets the program's guidelines. In other words, if millions of additional people become eligible because, say, they lost their job-based insurance in the recession, then the feds and the states have to provide them with coverage and find some way to pay for it. And it can't be spotty coverage, either. By law, Medicaid coverage must be comprehensive.

At least, that's the way it works now. If the law changes and Medicaid becomes a block grant, then every year the federal government would simply give the states a lump sum, set by a fixed formula, and let the states make the most of it. Conservatives claim block grants will give states the flexibility they need to make their programs more efficient. But, as Harold Pollack has noted in these pages, states already have some flexibility. And because demand for Medicaid tends to peak during economic downturns, when state tax revenues fall, the likely impact of a block grant scheme is to make Medicaid even less affordable at the time it is most necessary.


The Center on Budget and Policy Priorities' Paul Van de Water added, "The risks would likely be greatest for poor people with severe disabilities, who often need an extensive array of health services. Indeed, states would likely curtail benefits such as mental health services and therapies, many of which are critically needed by people with disabilities and children with special health care needs."

One assumes GOP leaders will say a brutal plan like this is somehow necessary, because of widespread fiscal problems at the federal and state level. But that's nonsense. For one thing, Republicans have wanted to do this anyway, and using the Great Recession as a justification for an existing agenda is absurd.

For another, if GOP officials were serious about fiscal responsibility, they could allow the expiration of ineffective Bush-era tax breaks for the wealthy, long before they started taking health care benefits away from families in poverty.


Steve Benen
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jaxx Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 08:45 AM
Response to Original message
1. One more reason to vote for Democrats in 2012.
The senate will hold this off but the bums will be trying to gut everything in sight that helps the people. There is nothing sacred to them but money.
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CTyankee Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 08:47 AM
Response to Reply #1
2. What do you think Obama will do in response to the GOP plan? nt
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NV Whino Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 08:51 AM
Response to Reply #2
3. Cave
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daa Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 09:20 AM
Response to Reply #3
10. +1
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Lorien Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 10:30 PM
Response to Reply #3
25. No doubt. nt
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NorthCarolina Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 08:53 AM
Response to Reply #2
5. Help facilitate it. nt
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roguevalley Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 09:33 AM
Response to Reply #5
12. + two trillion
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n2doc Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 09:10 AM
Response to Reply #2
7. If he is smart he will oppose it
We shall see how far to the right he is willing to go. He can only lose votes by supporting this, no "independent' is going to suddenly start voting for him because he cuts the deficit while giving the rich even more tax cuts.
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jaxx Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 09:17 AM
Response to Reply #2
9. Compromise on some things, say no to others.
As much as people think compromise is caving, it's how the process has worked for 200+ years. It didn't suddenly happen when PBO was elected. He will get what he can and keep moving forward. Same as any sane man would do. Sitting in his ivory tower acting like a jerk by refusing to keep the country running won't be happening. Much to the rightwings chagrin.
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Safetykitten Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 11:06 PM
Response to Reply #2
27. Give in....after lowering expectations incrementally.
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dkf Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 08:51 AM
Response to Original message
4. Medicare and Medicaid are the biggest drivers of US insolvency.
I say single payer is the only solution with the idea that it will cut costs, probably through rationing end of life care.

Opponents of social security cuts say social security isn't the problem. They are right that social security is a smaller problem than Medicaid and Medicare.
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CTyankee Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 09:02 AM
Response to Reply #4
6. What about ending tax loopholes, raising taxes (including estate tax) on the rich
and cutting the defense budget before we start sounding like we're saying "death panels"?
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dkf Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 09:44 AM
Response to Reply #6
13. The problem is beyond tax receipts but simply in looking at spending.
Government's immediate priority is to continue to foster economic recovery, there are longer term fiscal challenges that must ultimately be addressed. Persistent growth of health care costs and the aging of the population due to the retirement of the baby boom generation and increasing longevity will make it increasingly difficult to fund critical social programs, including notably Medicare, Medicaid, and Social Security.

This Guide highlights important information contained in the 2010 Financial Report of the United States Government. The Secretary of the Treasury, Director of the Office of Management and Budget (OMB), and Acting Comptroller General of the United States believe that the information discussed in this Guide is important to all Americans.

The projected increase in non-interest spending as a percent of GDP is principally due to growth in spending for Medicare, Medicaid, and Social Security. Between 2017 when the projected primary deficit is about zero and 2035 when the non-interest spending share of GDP plateaus, these expenditure categories account for essentially all of the increase in the ratio of non-interest spending to GDP. These spending increases reflect rapid aging of the population as the baby boom generations retire, as well as rising health care costs. After 2035, it is projected that continued increases in longevity will cause the population to become still older, but at a very gradual pace. The primary deficit projections in Chart 7, along with those for interest rates and GDP, determine the projections for the ratio of debt held by the public to GDP that are shown in Chart 8. That ratio was 62 percent at the end of fiscal year 2010, and under current policy is projected to exceed 70 percent in 2020, 130 percent in 2040, and 350 percent in 2085. Continued aging of the population due to increasing longevity will place upward pressure on the debt-to-GDP ratio beyond 75 years if there is no change in policy.

http://www.fms.treas.gov/frsummary/frsummary2010.pdf

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CTyankee Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 10:10 AM
Response to Reply #13
16. I don't disagree with you but it seems to me that many countries have our essential problem of a
growing aging population and all of the costs that inflicts on a society. What we DO have going for us in this country is population growth due primarily to immigration. Canada is now encouraging more immigrants because I suspect they've seen the handwriting on the wall. How we handle it is a different story...
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dkf Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 01:19 PM
Response to Reply #16
17. They all have some sort of national health care that I am sure looks at cost benefit ratios.
We spend so much more for our healthcare and concentrate it at the last two months of life.

And immigration won't solve problems in an age of increasing resource scarcity (water, food, oil, etc). The luxury of having so many workers supporting a small population of retirees is past. We are going to have to figure something else out.


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CTyankee Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 01:44 PM
Response to Reply #17
18. Maybe figuring something out is past, too. Maybe it's been past for a while now.
The die was cast when this country elected Reagan and threw Carter, with his plans for solar and other forms of renewable energy, out of office.

sounds to me like it's all over and we're just pretending not to notice...
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dkf Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 01:56 PM
Response to Reply #18
19. Probably so. Depressing I know.
Edited on Mon Apr-04-11 02:02 PM by dkf
For an aging population, take a look at Japan. Their GDP growth has been pretty abysmal.

I think people wonder why I am constantly harping on this issue of Medicare and Medicaid and social security...it's because I am scared they won't have anything else to back them up when what I see as inevitable happens. So I keep chugging on.

I live my life so that government funding is gravy because I don't think the safety net is guaranteed to be there.
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CTyankee Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 07:48 PM
Response to Reply #19
20. Germany now offers the most hope. They are exporters and they have a socialist state economically.
They actually train their workers in professions where they are needed to produce actual goods. I think this is great. Why can't we do this? I don't understand...
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golfguru Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 10:59 PM
Response to Reply #20
26. American corp's are run by accountants & lawyers, German
manufacturing corporations are usually headed by Engineers with a PhD.
The difference is astounding. We make short term decisions, they make
long term decisions.
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CTyankee Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Apr-05-11 06:59 AM
Response to Reply #26
28. I think also that German corps are required to have equal representation of workers at
the corporation on their Boards of Directors...
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Donnachaidh Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 09:12 AM
Response to Reply #4
8. and the three wars are just a field trip, right?
yeah, let's blame the poor for the 58% of our budget going to warmongering... :eyes:
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dkf Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 09:47 AM
Response to Reply #8
14. It's not the fault of the poor, it's our demographics which will get older necessitating more
And more spending.
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dflprincess Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 09:48 PM
Response to Reply #4
23. The biggest drivers of US insolvency
are Iraq & Afghanistan along with any other military "adventures" the administration might decide we need to engage in.

Social Security in not a problem at all as it has its own funding. The fact that that fund has been raided for the benefit of the MIC still does not make SS any part of the problem.
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daa Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 09:23 AM
Response to Original message
11. Paul Ryan wants to privatize your Medicare
what are you going to do to make Obama stop him????????????????????????????????

Do you want you 80 year old mother or 85 year old aunt to have $15,000 to go "buy insurance?" Are you kidding me. Just fucking shoot me know.
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dkf Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 09:52 AM
Response to Reply #11
15. Well that is obviously a stupid idea.
Single payer with cost controls is the only solution.
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dflprincess Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 09:49 PM
Response to Reply #15
24. Exactly
Leave it to a Republican to think we can save money on Medicare by turning it over the very crooks that are pricing everyone out of the health care market.
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spinbaby Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 07:54 PM
Response to Original message
21. Here are the real death panels
I just shudder at the thought of being in my 80s and having a for-profit insurance company deciding what kind of medical treatment I can have.

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Mojeoux Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Apr-04-11 08:15 PM
Response to Reply #21
22. Where do I line up for my Death Panel?
Will we have Port-a-Potties as we wait on line? I hope.
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