No,,, Illegal Imigrants can not get Medicaid! (Pt 3)

There is really not much more I can add to this,

First off, health care is a public good, not a market commodity. It does not hold to the economic model of supply and demand, or consumer-driven market forces.  If it did, we would see the same productivity gains of the general market instead of the cost of care going through the roof on comparison.   Access and affordability is part of what enables everyone to become a full member of society. And when any of us lacks that access and affordability all of society suffers.

Consider this,

In 1993, before the Blues went for-profit, insurers spent 95 cents out of every dollar of premiums on medical care, which is called their “medical loss ratio.” To increase profits, all insurers, regardless of their tax status, have been spending less on care in recent years and more on activities like marketing, lobbying, administration and the paying out of dividends. The average medical loss ratio is now closer to 80 percent. Some of the Blues were spending far less than that a decade into the new century. The medical loss ratio at the Texas Blues, where the whole concept of health insurance started, was just 64.4 percent in 2010.

The framers of the Affordable Care Act tried to curb insurers’ profits and their executives’ salaries, which were some of the highest in the U.S. health care industry, by requiring them to spend 80 to 85 percent of every premium dollar on patient care. Insurers fought bitterly against this provision. Its inclusion in the ACA was hailed as a victory for consumers. But even that apparent “demand” was actually quite a generous gift when you consider that Medicare uses 98 percent of its funding for health care and only 2 percent for administration.

Let that sink in a minute, ",,,Medicare uses 98 percent of its funding for health care and only 2 percent for administration.

While I try and be nice at times, you are so stuck on the false notion of "welfare queen" that your ignorance is blinding.  Here is a bit of truth concern responsibility, (internal citations removed)

Among adults with Medicaid coverage—those most likely to be in the workforce—nearly 8 in 10 live in working families, and a majority are working themselves,,, Data show that among the 24 million non-SSI adults (ages 19-64) enrolled in Medicaid in 2015, 6 in 10 (59%) are working themselves. A larger share, nearly 8 in 10 (78%), are in families with at least one worker, with nearly two-thirds (64%) with a full-time worker and another 15% with a part-time worker; one of the adults in such families may not work, often due to caregiving or other non-work responsibilities. Because states that expanded Medicaid under the ACA cover adults with family incomes at higher levels than those that did not, adults in Medicaid expansion states are more likely to be in working families or working themselves than those in non-expansion states.

Most Medicaid enrollees who work are working full-time for the full year. Among adult Medicaid enrollees who work, the majority (51%) worked full-time for the entire year, and most (84%) worked at the same job for the entire year (data not shown). Many (59%) are working 40 hours a week or longer. By definition (that is, in order to meet Medicaid eligibility criteria), these individuals are working low-wage jobs,,,

Nearly half of working adult Medicaid enrollees are employed by small firms, and many work in industries with low ESI offer rates.  Working Medicaid enrollees work in firms and industries that often have limited employer-based coverage options. Four in ten workers in this group work for small firms with fewer than 50 employees that will not be subject to ACA penalties for not offering coverage. Further, many firms do not offer coverage to part-time workers. Four in ten workers in this group work in industries with historically low insurance rates, such as the agriculture and service industries. A closer look by specific industry shows that one-third of working Medicaid enrollees are employed in ten industries, with one in 10 enrollees working in restaurants or food services,,,

 As I noted, 26% of the 70 million+ Medicaid recipients qualify based on income alone.  Sixty percent of which ARE working.  I would say that is being responsible wouldn't you?

Just out curiosity, how much do you think a single-working age, welfare recipient receives in aid?  

Minus Medicaid, here in PA, it is a grand total of maximum $200 in SNAP.  That's it.  There is no cash assistance.  Again there may be caveats dependent upon circumstances such as housing, but "welfare" is generally considered food, cash assistance and medical.  A single able body adult gets next to nothing.  Like myself many live at or below poverty.

So let's take a look at your demonetization of addicts - YOUR WRONG!

 http://www.pcadv.org/Resources/welfare-08-appendixC.pdf

While it is understandable that people are unhappy with some aspects of the healthcare insurance debate, it would be helpful if these individuals learn the facts.  Take time to learn the policy governing Medicaid, who's eligible and who is not.  Leave your bias at the door and quit making assumptions.  Learn about the ACA, what it is responsible for and what it is not.  IOWs read the fucking bill.

Examine your insurance companies.  Should the CEOs of BC/BS be making $102 million a year collectively (per 2014 data)?  If Medicaide has a 2% administration cost, why don't industry leaders follow?

Are you comparing apples to oranges?  Do you even know what it is you are paying for?  Is your insurance plan better or worse?  Most people have no clue.  Prior to the ACA, one major hospital stay (ICU) could cap out your insurance for life.  You are now protected from that.

Is the ACA perfect?  Fuck no!  But it is better than what we had, which in my case was nothing!

No,,, Illegal Imigrants can not get Medicaid! (Pt 2)

My interest here is primarily the second statement concerning illegal immigrants; will deal with "the others" mentioned in a later posting.  As to the statement concerning cost, I will readily admit that making a purchase such as health insurance would overwhelm me as it does others.  Hence why I would rely on outside financial advice.

While I do not have a financial planner per se, I do have numerous connections whose advice I highly regard.  A purchase such as this would require much thought and not a willy nilly decision.  As I approach retirement age (haha) I have already started the process of determining the best course of action besides a bullet in the brain.

Sadly from some that I have spoken to, the effort put into maximizing insurance gains was/is very lacking.  Most took the first option offered without any forethought or planning, generally accepting Right Wing talking points as fact.  Hence the above - plain and simple, illegal immigrant do not qualify for Medicaid under the 1996 welfare reform act! (Notice my adversary moved the goal post to "all forms of government assistance" from just Medicaid when slightly pushed on the issue.)

Are there caveats?  Of course!  These are just two statuses I am familiar with. That is not to say there isn't an issue with fraud and improper enrollment of ineligible people, including aliens. But the list of who IS qualified among immigrants is long.

As noted, the one exception is according to Phil Galewitz of Kaiser Health News (via NPR),

,,,a little-known part of the state-federal health insurance program for the poor pays about $2 billion a year for emergency treatment for a group of patients who, according to hospitals, mostly comprise illegal immigrants. Most of it goes to reimburse hospitals for delivering babies for women who show up in their emergency rooms, according to interviews with hospital officials and studies.

The funding — which has been around since the late 1980s and is less than 1 percent of the cost of Medicaid — underscores the political and practical challenges of refusing to cover an entire class of people. Congress approved the program after lawmakers required hospitals to screen and stabilize all emergency patients regardless of their insurance or citizenship status.

From my understanding this "emergency Medicaid" reimburses hospitals when they provide emergency and/or maternity care for people who would otherwise be eligible for Medicaid if they were in the US legally. States also have funding.

One addition I would make to this point, EMTALA also requires hospitals to provide emergency health care for anyone who arrives needing it, regardless of immigration status.  Both "emergency Medicaid" and EMTALA predate the ACA.

I second point I mentioned is CHIPRA (2009),

This legislation marked a new era in children's coverage by providing states with significant new funding, new programmatic options, and a range of new incentives for covering children through Medicaid and the Children's Health Insurance Program (CHIP). One of the clear goals of the legislation is to support states in developing efficient and effective strategies to identify, enroll, and retain health coverage for uninsured children who are eligible for Medicaid or CHIP but are not enrolled. CHIPRA also provided flexibility to states to expand health care coverage to children who need it, and tasked the Secretary of Health and Human Services (HHS) with developing standards by which states can measure the quality of the care that children are receiving.

Please be advised that CHIPRA varies by state and there many nuances, while important, that may be beyond the general scope of the point I intended to make.

The complexity of federal eligibility provisions and states choices in extending or further restricting coverage for immigrants within the federal framework contribute to vast differences in the ease of access to and participation in public benefits of immigrants across the United States,,,

One such point being the coverage allotted to prenatal woman.  From my understanding it would fall under the "CHIP unborn child option".  I am not aware of how long postpartum care would extend to the mother.  This scenario would be one of those caveats.

As I noted CHIPRA is for the child, not the entire family and the first qualifier is income; without the Medicaid expansion it is generally set at poverty level.  Expansion's set point is 133%.

http://familiesusa.org/product/federal-poverty-guidelines

And FYI::  prior to my stroke and expansion of Medicaid, I made just over poverty level (about $12,300).  I didn't qualify.  Currently I make around $9K.  BUT,,, if the current health bill goes through, with the slashing of Medicaid over four years, I am in jeopardy.  The cutting of Medicaid funding would force states to slash income eligibility.  Granted there are many "if" scenarios in my case that I may wiggle through, it is too close for comfort.

Other factors taken into account include household size, family status, disability, age, utilities costs, rent/mortgage, etc.  Everything has to be documented.  No one walks into DPW and walks out with benefits.  It is a process that takes about 30-days and in some cases a PITA.  In my case a PITA but one that saved my life.

So again, illegal immigrants can not get Medicaide! As to "people who refuse too work", they are under the same guidelines.  More on that in a later post.

No,,, Illegal Imigrants can not get Medicaid!

 https://www.facebook.com/SenatorBobCasey/posts/1367477353305414

So the other day the following conversation happened surrounding this article.  For the sake of brevity I am going to edit out other responses but my own; hopefully highlighting the "cluelessness" of the adversary and how one sticks to uniformed talking points despite contrary information.

You will notice, not once did my adversary ask for citation. And while she did state she felt health insurance should be for all, she concentrated on herself ignoring the main focus of the article: to get her way, fuck the children.  So in essence, she is not for insurance for all - only if it benefits herself would she even consider it.

1]  The general consensus is the current debate surrounding the GOTP repeal and replace is being held in secret, with minimal insight as to what is being proposed.  Since the initial posting, some aspects have been leaked as well as, I believe, the full measure has been released. (Still developing, will update ASAP!)

[I am just beginning to read and digest the actual legislation.  HuffPo has provided this A Simple Guide To The GOP Health Care Bills for starters.  Can't vouch for accuracy or bias, although HP does lean left.]

The main thrust of my argument is that there was public discussion concerning the ACA with republican input unlike the current situation of 13 men "in secret".

The legislation is being written by 13 Republican senators — all of them men — in secret. No one has seen a draft of it. No public hearings have happened, and none are scheduled. Republicans briefly considered banning cameras from the halls of the Senate so they couldn’t be asked about the bill on television. Various Senate Republicans have condemned the process.

As I have stated prior, the ACA is a reformulation of the 1993 response to Hillarycare as well as Romneycare in MA.  It was well known what provisions where in the legislation, that is not the case currently. Golshan, Scott, and  Stein have amply highlighted that fact writing for Vox, We asked 8 Senate Republicans to explain what their health bill is trying to do. 

Senate Republicans can't answer simple and critical questions about the health care bill they're crafting in secret.

Some still can't say what it's trying to do — other than garner enough votes to pass the Senate — or how they believe it will improve the American health care system.

 

With the bill’s text still not released for public view, Vox asked GOP senators to explain their hopes for it. Who will benefit from the legislation? What problems is this bill trying to solve?

 ,,,

Over the course of the past week, Vox asked eight Republican senators to explain the affirmative case for the bill. They rarely answered directly, at least not on the bill’s policy merits.

Sometimes a senator could identify a desired outcome, like “lowering premiums” or “stabilizing marketplaces.” But they rarely could explain the mechanism through which they planned on achieving that outcome.

One caveat I will add, as this information is new to me, there was some secrecy or perceived secrecy to the ACA, but,,,

As we noted, Republicans have skipped the lengthy, open process of hearings and markups of legislation that characterized the Democrats’ march to passage of the ACA. Instead, they moved directly to floor votes. Moreover, Democrats at first tried to enlist some Republican support, while Republicans have not reached out to Democrats.

But recalling the second-longest Senate session obscures the fact that the floor debate was mostly for show, an exercise designed to allow the closed-door negotiations that shaped the final bill to take place. Once the deal was struck, Reid pushed the final draft forward with as much speed as possible. That’s what McConnell is doing now, having skipped the preliminaries.

For the most part, my position still stands.

2] The ACA is failing - is a subjective statement at best with many complexities not even considered.  Simply put, it boils down to this.

These Insurance companies argue they need to scale back because insuring the people who are selecting Obamacare plans is more costly than they expected. Too many sick people are buying plans, and not enough healthy people are making up the difference, according to the insurers.

 In other words profit.  Sick people are buying plans because they can now afford them and get the care they so desperately need. People like me, the underemployed (in my case compounded by health issues but not eligible for SSDI), now qualify for Medicaid via the expansion through the ACA.

For shits and giggles::  maybe the money spent ($2 million +) would be better invested in actually taking care of people.  As CommonDreams highlights,

"The lack of transparency and public information about the bill makes it impossible to analyze the impact on the insurance and pharmaceutical industries, but indications from stock prices earlier this year showed investors were betting GOP legislation would be a boon for pharmaceutical companies and health insurers."

Gee I wonder why that is?

Overall - the issues surrounding the ACA, repeal and replace, is it failing, and other minutiae - it is not that simple.  Yes, some "large insurance companies have been losing money on the marketplaces (and raising premium rates for their plans in order to compensate). And there’s broad agreement across health policy experts that there’s more work left to do to strengthen Obamacare’s marketplaces and continue attracting healthy consumers."

And that is my point.  We know the ACA needs some work as I stated later in the conversation.  It is a foundational piece that needs tweaked not destroyed; which is exactly what the GOTP intend to do.  (Seriously folks, take a look at what they are offering.  The latest incantation is one big ole fat tax cut for the rich.) What it does not need is some jack-ass companies threatening to de-stabilize the market-place to get their own way, as Culp-Ressler highlights.

Two issues that need strengthening, for example.

• Many under age 35 are opting out of buying insurance altogether, choosing to pay the penalty instead.  Encouraged to do so by adversaries of the ACA
• Gaming the system, waiting until they got sick to buy insurance, then canceling it once the bills were paid, because of the law's "guaranteed issue" mandate. 

Also bear in mind that the GOTP has not offered solutions to the above or any other perceived weakness.  Their goal for 8 yrs, was obstruction at all cost; including a gov't shutdown that cost billions of dollars.  This after failing to make President Obama a 1-term President.  Instead of strengthening, the GOTP chose to attack as witnessed by:

• NFIB v. Sebelius (the 2012 Supreme Court challenge that went after after Obamacare’s individual mandate)
• Beginning in 2014, House Republicans began challenging the way Treasury Department pays out cost-sharing subsidies to insurers so they can keep out-of-pocket costs down for low-income consumers. They say the payments are being made illegally because Congress never specifically appropriated them in the Obamacare law.
• 2015’s King v. Burwell (which targeted the subsidies many Americans receive when buying insurance on some ACA exchanges).

Please, tell me what is gained by this tactic?  How are we as US citizens and consumers helped?


This is why we need a socialized program similiar to what other nations have.  Everyone pays in, everyone gets the preventative and maintenance care needed.  (I know it's not that simple.)  As we have many examples to choose from, determining what works and what doesn't should be doable.  "Cadillac plans" can still be made available through private market if so desired, but I can guarantee, Joe Blow down the street ain't gonna be able to afford the "Cadillac plans" and neither will you.

Legislative panel approves special-language amendments to Private Option | Arkansas Blog | Arkansas news, politics, opinion, restaurants, music, movies and art

Well it's official, a Teapug admitted that they are doing everything possible to submarine the ACA,,,

Bell explicitly acknowledged that “without active marketing, you probably get declining enrollment.” That is, for Bell, a feature, not a bug: "We're trying to create a barrier to enrollment." Less enrollment means lower costs, he said. "In general, as a conservative," he said, "if I have the opportunity to reduce government spending in a program from what’s projected … I’m probably going to take that deal."

The other thing to bear in mind: the get here for Bell is not just taking the foot off the accelerator on private option enrollment; he's also continuing to block spending on outreach — and completely eliminating the guides program come July — for the Obamacare Marketplace (the non-private-option pool, above 138 percent of FPL). Technically, almost all of the outreach funding that his amendment would kill was only supposed to be directed at non-private-option consumers above 138 percent of FPL; thus, Bell's amendment would be landing a blow against the enrollment process in Obamacare wholly aside from the private option.

[,,,]
Several Democrats were visibly angry and frustrated, and were aggressively critical of the amendments during the committee hearing. (One asked, "You're saying we should keep our citizens ignorant?" Another asked, "what is next — should we stop the federal government from signing people up for Medicare?"). At least some said they would not vote for the private option with these amendments attached,,,

Legislative panel approves special-language amendments to Private Option | Arkansas Blog | Arkansas news, politics, opinion, restaurants, music, movies and art

How Texas Health Care Failed Israel, A Man With Terminal Cancer Who'd Worked His Whole Life | ThinkProgress

In 2013, Israel began to develop severe headaches. They soon turned into seizures. He went to the emergency room, where the neurologist diagnosed him with depression and sent him home. The seizures stopped for a while, but soon came back with a vengeance.

“Maybe if I did have some type of health insurance, I would’ve been able to afford to get a second opinion,” Israel said. But he was caught in a doughnut hole. The jobs he’d worked didn’t offer insurance and he was too poor to buy it on his own. Last year, his income was $13,334, but that was nearly $10,000 higher than Texas’s cutoff to qualify for Medicaid. So he went without.

After six months he finally went back to the hospital where he was diagnosed with terminal brain cancer. The doctors removed as much as they could, but it was too late to get it all. “So right now they’re just trying to work as far as extending the length of…time that I’ll have,” Israel told ThinkProgress, choking back tears. Doctors estimate Israel has 18 months to live. If he had been able to get a second opinion earlier, “Maybe the tumor would’ve been smaller, might have been able to treat it better,” his sister, Miriam Mora, added.

[,,,]
A new organization, Texas Left Me Out, has been launched in the state to collect stories from some of the 1.5 million Texans who would benefit if Gov. Rick Perry (R) and his legislative allies decided to accept the Medicaid expansion.

How Texas Health Care Failed Israel, A Man With Terminal Cancer Who'd Worked His Whole Life | ThinkProgress

Wal-Mart on Wal-Mart - Newsroom: Bernie Sanders - U.S. Senator for Vermont

A Wal-Mart spokesman on Monday told The Huffington Post that only 5 percent of the discount chain’s workers were on Medicaid. The spokesman was attempting to rebut Sen. Bernie Sanders’ assertion on MSNBC that the Walton family, the Wal-Mart owners, got to be the richest family in America by paying workers so poorly that they need Medicaid and food stamps to survive. What the spokesman may have forgotten to mention was that an internal memo to Wal-Mart’s board of directors (obtained by The New York Times) acknowledged that 46 percent of the children of Wal-Mart's 1.33 million U.S. employees were uninsured or on Medicaid. The 2005 memo by M. Susan Chambers, Wal-Mart's executive vice president for benefits, had more to say about how the company treats its workers:

• Wal-Mart's workers are getting sicker than the national population with preventable diseases such as obesity (p. 4). More than half of Wal-Mart's workers (p. 8) are not covered by its health insurance plans, meaning many do not have access to necessary preventative care and doctors' visits. "Our workers are getting sicker than the national population, particularly with obesity-related diseases" (p. 4).
• Wal-Mart's workers aren't using primary care because so many of them lack coverage. Instead, they opt to use taxpayer-subsidized emergency rooms. The Wal-Mart workforce "tends to over utilize emergency room and hospital services and underutilize prescriptions and doctor visits" (p. 4-5).
• In a survey, Wal-Mart workers scored the company "poorly" on the cost of healthcare coverage for employees (p. 6).

Wal-Mart on Wal-Mart - Newsroom: Bernie Sanders - U.S. Senator for Vermont

Thousands Of Women Forced To Find New Doctors Now That Texas Has Defunded Planned Parenthood | ThinkProgress

Why cant teapugs get it through their heads the PP is not JUST abortions,,,the thought of having to change doctors would have me running for the hills,,,

Still, agency officials say they will not turn clients away who cannot afford to pay, concerned that inconvenienced women will skip life-saving exams rather than search for new doctors.

Thousands Of Women Forced To Find New Doctors Now That Texas Has Defunded Planned Parenthood | ThinkProgress


,,,but Visiting Judge Gary Harger ruled that Texas may design a state-run Women’s Health Program that excludes qualified providers like Planned Parenthood — despite the fact that, on a federal level, states aren’t allowed to block qualified health providers from receiving Medicaid funds.

The new Women’s Health Program launches on Tuesday, and Monday’s ruling ensures that Planned Parenthood won’t be part of it. Before Texas Republicans began their crusade against Planned Parenthood, the organization provided preventative cancer screenings, contraceptive services, and family planning assistance to nearly half of the state’s 110,000 low-income women in the Medicaid program.

[,,,]
Since the Hyde Amendment already prevents Medicaid programs from covering abortion services, the Planned Parenthood affiliates in Texas don’t actually perform abortions for any of their patients in the Women’s Health Program.

http://thinkprogress.org/health/2012/12/31/1381181/texas-end-planned-parenthood/

The Hyde Amendment

After Roe v. Wade decriminalized abortion in 1973, Medicaid covered abortion care without restriction. In 1976, Representative Henry Hyde (R-IL) introduced an amendment that later passed to limit federal funding for abortion care. Effective in 1977, this provision, known as the Hyde Amendment, specifies what abortion services are covered under Medicaid.

Over the past two decades, Congress has debated the limited circumstances under which federal funding for abortion should be allowed. For a brief period of time, coverage included cases of rape, incest, life endangerment, and physical health damage to the woman. However, beginning in 1979, the physical health exception was excluded, and in 1981 rape and incest exceptions were also excluded.

In September 1993, Congress rewrote the provision to include Medicaid funding for abortions in cases where the pregnancy resulted from rape or incest. The present version of the Hyde Amendment requires coverage of abortion in cases of rape, incest, and life endangerment.

http://www.prochoice.org/about_abortion/facts/public_funding.html