Mississippi, what a waste

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29 Oct 2014, 7:19 pm

Mississippi's dysfunctional politics are going to turn it into an even greater hellhole. By refusing to accept the Medicaid expansion and by keeping very restrictive Medicaid eligibility roles, they are keeping up the poor waiting till they're really really sick and end up in the emergency room. Only, unlike before 2014, hospitals won't be receiving as much federal cash as they were to make up for treating the uninsured in their emergency rooms, because all the states were supposed to have expanded Medicaid when the law was written. When that requirement for the states was struck down and it turned out those making less than 100% of the poverty level would receive no subsidies for buying insurance (because, again, all the states were supposed to expand Medicaid when the law was written to accommodate all the impoverished), a whole bunch of poor people got left out of the insurance pool and will have to pay a penalty.

What a waste that Mississippi is not expanding Medicaid, and many rural hospitals may have to end up closing, as the federal subsidies taper off, but with no concomitant decrease in the uninsured seeking emergency room care, putting them in the red.

http://www.politico.com/magazine/story/ ... FDuQ_TF_FS

Quote:

By the time the federal government offered the required coverage on its balky HealthCare.gov website, 70 percent of Mississippians confessed they knew almost nothing about it. ?We would talk to people who say, ?I don?t want anything about Obamacare. I want the Affordable Care Act,?? remembered Tineciaa Harris, one of the so-called navigators trained to help Mississippians sign up for health care. ?And we?d have to explain to them that it?s the same thing.?

Sad.

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beneficii
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29 Oct 2014, 7:39 pm

Quote:

The more significant drag on sign-ups, though, was Mississippi?s decision not to expand Medicaid. The state?s low standard of living means many people earn less than the federal poverty limit but too much for Medicaid; under the health law, they can?t buy insurance on the exchange, leaving 138,000 Mississippians who fall into what has come to be known as the Medicaid gap. For Minnie Wilkinson, it brought a sense of desperation to her church office. She recalls a man who returned there four or five times hoping to get a different answer about his coverage options?his wife had cancer. Surely, there was some help in the law? She could offer little more than prayer. Wilkinson dutifully referred people to a community clinic, where they could pay a sliding-scale fee to see a doctor. But the clinics aren?t equipped to treat serious maladies. ?It was heartbreaking for us and for them,? she said. The Medicaid gap also fueled a negative feedback loop about the law. As Wilkinson describes it, people felt deceived: ?They were under the impression that the less money you made, you get insurance for free.? It killed momentum even for those who could have bought heavily subsidized coverage on the exchange. Word spread quickly: This Obamacare is a waste of time, and Obama was to blame.

But the administration had few options. And the law was, after all, a federal-state partnership. If the state didn?t play, the feds were stuck. ?When we were designing the legislation, we were very aware that the states that, in many cases, benefited the most were poor and generally anti-Obama,? Bob Kocher, a special assistant to Obama in 2009 and 2010 who helped draft the ACA, told me. But ?you needed a state that at a minimum level is cooperative for this to work,? he said, which became more difficult after the Supreme Court?s Medicaid ruling in 2012. That meant even idealistic liberals had to turn their efforts away from needy states like Mississippi to more receptive regions. ?It broke the heart of some folks at HHS,? Kocher said. ?But I?m not sure they had another choice.?

The Medicaid gap hit hospitals hard, too. Without the cash infusion that a Medicaid expansion would have brought, Mississippi hospitals are being strained to a near breaking point, with a number of them shuttering entire departments and laying off staff. Poor people often flocked to the emergency room at Montfort Jones Memorial Hospital in Kosciusko, for instance. The central Mississippi town is best known as Oprah Winfrey?s birthplace, but that distinction has done little to change its fate. Earlier this year, the hospital shut down its intensive care unit and laid off 38 employees. Next, the psychiatric unit for seniors closed. One in five people who come to the hospital can?t pay their medical bills, and Montfort Jones had relied on supplemental Medicaid payments to defray the costs. But under the health law, federal aid for uncompensated care trails off. Without those payments, and with no softening in the demand for uncompensated care, Montfort Jones had been losing up to $3 million a year, and couldn?t meet payroll.

And of course, the reason why federal aid trails off is because those states are supposed to expand Medicaid. If states don't expand Medicaid, they are shooting themselves in the foot as far as the health industry is concerned in their states. There's nothing the Obama Administration can do for them, but regardless the dirty, smarmy politicians in those states who refuse to expand Medicaid will doubtless blame Obama for this. While Rome burns, they're playing the violin. It's on the states to expand Medicaid; if they don't, then there will be serious consequences for that state's health care industry. They have only themselves to blame.

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beneficii
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29 Oct 2014, 7:53 pm

Quote:

During state budget negotiations in the fall of 2013, Bryant proposed giving the state?s struggling hospitals $4.4 million to offset their losses. The association?s new chief executive officer, Tim Moore, responded politely to the gesture, but Democrats viewed the earmark as hush money. ?I?ve asked the [hospital association] a number of times what they got in exchange for their deciding to become mute on this issue,? state Senator Hob Bryan, the Democratic vice chairman of the health committee, told me. ?They said they got a seat at the table. I said, ?So, in other words, you sold your birthright. You didn?t even get a bowl of porridge. You just get to sit at the table and watch other people eat porridge???

Besides, Mississippi couldn?t come close to making hospitals whole. The state was facing eviscerating cuts in federal subsidies of $8.7 million in 2015 and 2016; $26 million in 2017; $72.3 million in 2018; $81 million in 2019, and $57.8 million in 2020, according to the Center for Mississippi Health Policy. Over breakfast one morning in Jackson, Ronnie Musgrove, a Democratic former governor of Mississippi, told me, ?It just defies logic.?

Of course, if they accepted the Medicaid expansion, they would have received full 100% federal subsidies for the Medicaid expansion for the first 2 years, which would taper down to 90% of the cost of the expansion in 2020 and stop tapering there. That has got to be a much better deal for the state than the crap they're trying to pull right now.

But, nope, ideology has to win over common sense.

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Kraichgauer
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29 Oct 2014, 8:19 pm

Ah, but conservatives will tell you that the poor need to stop getting a free ride, and that we should be enriching our most valuable citizens, the wealthy job creators!

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29 Oct 2014, 9:45 pm

[img][800:1087]http://teaminfocus.com.au/wp-content/uploads/2011/04/straw-man.jpg[/img]

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29 Oct 2014, 10:59 pm

Raptor seems a wee bit obsessed with these non-existent straw men he keeps referencing....

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30 Oct 2014, 12:13 am

Sweetleaf wrote:

Raptor seems a wee bit obsessed with these non-existent straw men he keeps referencing....

I suppose because he doesn't want to admit that that's the position of the conservative political philosophy.

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khaoz
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30 Oct 2014, 12:40 am

Kraichgauer wrote:

Sweetleaf wrote:

Raptor seems a wee bit obsessed with these non-existent straw men he keeps referencing....

I suppose because he doesn't want to admit that that's the position of the conservative political philosophy.

Eh, I don't think obsessiveness is in short supply on WP. At least he didn't hit you with 27 quotations in one reply this time.

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30 Oct 2014, 12:51 am

khaoz wrote:

Kraichgauer wrote:

Sweetleaf wrote:

Raptor seems a wee bit obsessed with these non-existent straw men he keeps referencing....

I suppose because he doesn't want to admit that that's the position of the conservative political philosophy.

Eh, I don't think obsessiveness is in short supply on WP. At least he didn't hit you with 27 quotations in one reply this time.

FOR GOD'S SAKE, DON'T TEMPT HIM!! !! !! :lol:

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khaoz
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30 Oct 2014, 1:04 am

Kraichgauer wrote:

khaoz wrote:

Kraichgauer wrote:

Sweetleaf wrote:

Raptor seems a wee bit obsessed with these non-existent straw men he keeps referencing....

I suppose because he doesn't want to admit that that's the position of the conservative political philosophy.

Eh, I don't think obsessiveness is in short supply on WP. At least he didn't hit you with 27 quotations in one reply this time.

FOR GOD'S SAKE, DON'T TEMPT HIM!! !! !! :lol:

I don't think they can help themselves. We all here have issues. We need to start admitting and recognizing the, Maybe we cancut down on some of this acrimony if we make an effort to understand and care. I know I got serious OCD, triggers, bipolar, and they all manifest here, which explains a lot. I am not the only one.

Kraichgauer
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30 Oct 2014, 1:27 am

khaoz wrote:

Kraichgauer wrote:

khaoz wrote:

Kraichgauer wrote:

Sweetleaf wrote:

Raptor seems a wee bit obsessed with these non-existent straw men he keeps referencing....

I suppose because he doesn't want to admit that that's the position of the conservative political philosophy.

Eh, I don't think obsessiveness is in short supply on WP. At least he didn't hit you with 27 quotations in one reply this time.

FOR GOD'S SAKE, DON'T TEMPT HIM!! !! !! :lol:

That is doubtlessly true.

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30 Oct 2014, 6:03 am

So the state should give everyone free health care, and pay 90% of the cost?

Mississippi is the poorest state, and that cost is likely larger than the state budget.

All along the delta is poor, black, and fat. Lowest education, income, it is a money pit.

State wide they have the highest obeasity rate, but white people are thin.

The rate through the black delta country is more like 70%, and all the smart ones bought a ticket to Chicago, Detroit, long ago.

This is just one of their self inflicted problems, and who ever freed the slaves should deal with it.

Spending a million on healthcare for some 400 pound person who will continue their ways, die at fifty, is insane.

Obamacare says the people, and the States, should pay for National Healthcare. The people should pay twice, for themselves, or else, and through higher taxes at the State level, for the poor.

In all other countries, healthcare is funded by the national government.

Between Vicksburg and Memphis, down both sides of the river is black, overweight, undereducated, non productive, and proud of it. It makes Detroit look progressive.

It is a National problem, and discrace. Freeing slaves is not enough, they need to be taken to Washington, and made equal.

National problems are why we have a national government.

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30 Oct 2014, 7:52 am

Inventor wrote:

You have such a caring, compassionate heart. I bet you mother brags to all her friends what a loving, saintly soul you are.

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30 Oct 2014, 9:45 am

khaoz wrote:

Kraichgauer wrote:

khaoz wrote:

Kraichgauer wrote:

Sweetleaf wrote:

Raptor seems a wee bit obsessed with these non-existent straw men he keeps referencing....

I suppose because he doesn't want to admit that that's the position of the conservative political philosophy.

Eh, I don't think obsessiveness is in short supply on WP. At least he didn't hit you with 27 quotations in one reply this time.

FOR GOD'S SAKE, DON'T TEMPT HIM!! !! !! :lol:

I don't think they can help themselves. We all here have issues. We need to start admitting and recognizing the, Maybe we cancut down on some of this acrimony if we make an effort to understand and care. I know I got serious OCD, triggers, bipolar, and they all manifest here, which explains a lot. I am not the only one.

As I recall, you rode in here with guns drawn and started blasting away at ANYONE with a different opinion on anything.

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Last edited by Raptor on 30 Oct 2014, 9:51 am, edited 1 time in total.

sonofghandi
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30 Oct 2014, 9:47 am

Inventor wrote:

^A complete lack of factual basis and a clear misunderstanding of the ACA and Medicaid expansion.

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Kraichgauer
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30 Oct 2014, 11:54 am

Inventor wrote:

With poor people in America today, it's not always a matter of not having enough food, but having healthy food. Poor people often can only afford junk food, which takes it's tole on them concerning weight, diabetes, high blood pressure, etc. It has nothing to do with them not being smart enough. And no human being is a money pit, or a waste of money, and all in fact are worthy of help.

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