While the Supreme Court upheld the Affordable Care Act's individual mandate, the justices altered its biggest component.
The most important yet under-reported aspect of the ruling deals with Medicaid. Most people who will get health care coverage under the law will get it from an expansion of the program. But, the Supreme Court switched the expansion of Medicaid from being mandatory in all states to being optional in all states.
As MSNBC’s Lawrence O’Donnell explained on Monday’s show, it may turn out that more people will lose coverage because of the Medicaid rewrite than would have lost coverage if the individual mandate had been thrown out.
Leave a Comment:
Worth watching.
1994 Mitt Romney Debates Ted Kennedy on Healthcare on youtube
When did it become the job of the press to lobby and preasure states to go into sure bankruptcy for an expensive social cause like the massive extension of Medicaid that was envisioned by the "DC" legislators that designed the (Un)affordable Care Act. What State services are they supposed to drop in order to put this expansion in place,especially as in California's case, they are fighting to see their way thru a $16 billion deficit now? Sure the promise of 90% financing with "federal dollars" for 10 years only is in that bill, but with the experience of watching the federal government wrestle with the quickly growing deficits themselves, how can officials in the states trust that Congress will continue to make those transfers annually?
Medicaid was meant to provide state health insurance to the temporary or permanently impoverished. This program as it was designed by the fools in DC that have shown they have no ability or desire to balance the books wished to compell the states to make this program something else, a "free" medical insurance program for folks earning past 133% of the DC measured "poverty level". In other words, for the individuals that have earnings enough to shop at Wallmarts, frequent fast food franchises regularly, use cell phones, buy theit weekly supplies of soft drinks and beers and cigarettes, watch wide screen cable service or TVs, and buy their scratch, daily lotto, and megabucks lottery tickets, but can't put away a few dollars weekly to pay for out of pocket routine medical expenses like a case of flue or a twisted ankle, and buy inexpensive catastrophic health insurance and/or learn where the public health clinics will serve them on an income based fee for service basis. Give me a break!
And how long exactly does it take you to save $20,000 to $30,000 dollars to cover that broken ankle? You figure the emergency room has a fee, the contracted doctor has a fee, the radiologist (x-ray) has a fee plus the charge for the x-ray itself, the nurse and orderly have their fees, and then you pay for the cast. And, maybe you wrecked your car, causing that broken ankle, so now you have the Take a look at your Statement of Benefits sometime and see just what it costs (or rather, what is charged) to see a doctor these days.
Mcrobrain that is why you buy insurance, you totally missed Keith's point. I'll say it in 2nd grade language so you can understand.
When you get a pay check pay for your insurance first, if you have money left over then go by your big screen TV or go out to eat, or buy you lottery tickets. There are way to many people that buy their toys first and then expect those of use that did spend wisely to pay for their needs.
Don't believe those medical billing statements. Insurance companies don't pay those charges at anywhere near the 100% level, nor do Medicaid or Medicare pay at 100%. The game is overcharge, and if you get a few suckers to pony up out of pocket, your better off for it. If you have to accept lesser payments, you get a tax writeoff for your "business losses".
"That's the way we do it! That's the way we do it! Money for nothing! Chicks for free!" (Dire Straits). Also, if the broken ankle came by way of an auto accident, the state mandated auto insurance personal injury coverage is the primary insureror you know, mcrochip!
Absolutely. Buy your insurance first. Don't eat. Don't buy clothes for your kids. Don't have a bit of entertainment so you're relaxed enough to be an effective parent...
Chemmd, my television is a 32" old style that I paid $25 for at a thrift store (same place I'm headed to buy some shorts to get through this hot summer you ostriches claim isn't related to anthropogenic global warming). My computer--surplus property--cost less than a hundred dollars total, and it should last two or three more years, sufficient time for me to fact check lots of delusional right wingnuts for the foreseeable future.
And lots of us wouldn't be able to buy insurance because of the "pre-existing" barriers; my little term life insurance cost four times what it would for someone else. They tracked down that I'd received alcoholism treatment over 30 years ago, and the fact I've been continuously sober was immaterial, as was the objective reality that I'm statistically less likely to die from drinking related causes than the average citizen.
Nice to see you passed second grade, but we deal in stuff for more educated sorts here... I have a friend--a very successful sort who has juvenile diabetes--and he pays nearly as much a year for his health insurance as I earn in that time.
Go study up on what happened to Marie Antoinette. There's a lesson there for you...
Your booze addiction led you to your lifestyle Cab Driver. And when you were in the position to feed and cloth your child and support your wife, you were lying in the gutter with a bottle clutched to your skrawny chest, and then relied on charity to get over your heebie jeebies. Hardly the life lessons from which you can take to the podium to lecture others on how to live their lives.
What weird program do you use for these videos? I've got almost every program out there, and they never play.
Keith- It' sad that you have chosen to believe the lies that the news media and television have offered you as truth. Do your research...you have been bamboozled into believing exactly as they want you to. Think for yourself, look for the TRUTH! Shopping at Walmart and eating unhealthy food from fast food restaurants isn't something that poor people would brag about...it is simply what they are able to afford. Let me educate you...the working poor are people that work 2 and 3 minimum wage jobs in order to maintain their rent/mortgage, etc. Many times these same people must CHOOSE between healthy food and fast food because of the high costs. The working poor have to rely on safety nets such as food stamps in order to feed themselves and their families. The fact is you are mis-informed about just how hard it is for the working poor. Businesses benefit from paying the minimum wage and therefore the safety nets have to pick up the slack. Many social programs are providing basic needs to the working poor that you don't ever have to think twice about. Wake up...the reality is America's busines is about providing more and more benefits to corporations and the wealthy and could give a rip about the people who actually do work hard in this country. Sounds like you should investigate the TRUTH and understand that you have been fed a line of BS that you believe as truth. I'm sorry for you!
After a career in social services working to help disabled individuals to return to the work force as a vocational rehabilitation specialist I think I know what the poor have for living conditions. In the early 2000s the kind of freebies provided by our Social Net for a single mother with two children amounted to over $48,000 a year if it was to be replaced by a like family with income from employment. That's Section 8 housing or other housing cash assistance programs, food stamps, medical care, clothing allowances, education and job training programs, free child care, and even (as in Massachusetts) a program that was known as the MARS program, a cash subsidy for the Man Assuming Role of Spouse in the household, infamously known as "The Boyfriend's Beer Allowance." It was hard work to encourage and keep encouraging individuals to accept job training, education, and job seeking and maintenance assistance, but for those that took that route, the gains they made in life to self sufficiency were very gratifying, Leslie.
After a career in social services working to help disabled individuals to return to the work force as a vocational rehabilitation specialist I think I know what the poor have for living conditions. In the early 2000s the kind of freebies provided by our Social Safety Net for a single mother with two children amounted to over $48,000 a year if it was to be replaced by a like family with income from employment. That's Section 8 housing or other housing cash assistance programs, food stamps, medical care, clothing allowances, furniture assistance, heat, air conditioning and electrical and phone assistance, education and job training programs, free child care, and even (as in Massachusetts) a program that was known as the MARS program, a cash subsidy for the Man Assuming Role of Spouse in the household, infamously known as "The Boyfriend's Beer Allowance." It was hard work to encourage and keep encouraging individuals to accept job training, education, and job seeking and maintenance assistance, but for those that took that route, the gains they made in life to self sufficiency were very gratifying, Leslie.
Bob Beckel of 'The Five'chimed in with something disturbing. When mentioned that the Obamacare mandate now was revenue legislation, it could be defeated forever by a majority vote, he grinned a crocodile grin and said, "We have ways of getting around that." It occurred to me then that there was only one justice that said the mandate WAS a tax, Roberts. The four leberal judges hid inside the Commerce Clause, while the conservatives allowed neither. The vote on whether the mandate was a tax was actually 8-1 against, which sets up a possible surreal scenario if Romney wins. Yes, he can give waivers to all 50 states, but Obamacare doesn't cease to exist. It goes zombie until the next Dem mad scientist revives it like a ghastly ghoul. It takes legislation to remove it forever. That can be done with just a majority vote IF it is a tax. But if done, one can easily see the Dems right back before SCOTUS, arguing this time that it is NOT a tax.
The generation that fought WWII is called 'The Greated Generation' and rightly so.
This generation will be known as 'The Handout Generation' willing to give up personnal freedoms for goverment handouts!
Leslie - I grew up in the 60's before LBJ's 'The Great Society' (Welfare) started to effect the econmy in it's negative way.
The majority of families I knew (middle class) back then only had the husband working, earning enough so that the wife could stay at home.
Look where we are now! It takes both parents working full-time to afford a home (barely) I believe in a tempoarary safety net but not generational welfare. And let me tell you what poor people can afford. In my state and I am sure many others, women on Welfare and WIC have bought there own homes whith their Section 8 money, they have new vehicles, cell phone, flat screen TV's etc., etc., etc. Also when you see them is the supermarket they have two carriages stuffed with food. You know who they are when they pull out their food stamp card.
This is something I have seen first hand, not read.
The reason the working poor have such a hard time paying their rent is that Section 8 has artificially inflated the prices on apartments and Dodd/Frank has artificially inflated the prices on homes.
You need a serious reality check! The Welfare state you are so in love with hurts everyone. The reason there are so few jobs let alone decent paying jobs is that corporations are overtaxed and overregulated! It's more eocnomical to send production overseas.
Why do you think Hong Kong is so rich? Untill 1999 the British Governors of that island fought tooth and nail against the English goverments attempt to increase the taxes and regulations on Hong Kong.
Sigh - I know I'm wasteing my breath. Being a liberal you won't be willing to listen to facts that are contrary to your opinion and I'm sure you will continue to beleve the lies put out by MSNBC! You're the sorry one!
Sillyman, you're writing a bit of romantic fiction with those idyllic claims about the 50's and 60's (I was living back then, too; a moment of silence, BTW, for Sheriff Andy).
The inflation you speak of was the result of deficit spending and the money supply "adjusting" itself to market realities. That deficit was largely the result of the Vietnam War, Reagan's "Spend the Soviets into Bankruptcy tactics" (they worked, but at a cost), and the idiot 43's two wars while cutting taxes...
The real comparison in why the "working poor"--and indeed most of the middle class--are struggling has to do with wages... Minimum wage in 1969 was $1.60 an hour, and a family making, say five times that was smack in the middle class...
Five times today's minimum wage (which is about twice what I make in a "good" week) now means both parents must work...
Rents vary widely, but in 1969 $150 a month would get one a nice three bedroom place here... Now something similar will run eight to ten times as much... The evil is not high property values, but wages that have not kept pace with inflation.
Food: Bread: 25¢ a loaf... Today: $2.00
Gasoline: 25¢ a gallon; $3.50 today...
That "Welfare State" was a Reagan concoction from his last Alzheimer-addled years; thankfully he alienated enough minorities--and women--to give someone like President Obama a chance.
Sorry to correct your "reality" with some objective facts and history of my own...
Man, that was a silly Freudian typo, wasn't it... ;-)
Uhh...Cab Driver, in the late 60s I was an undergraduate student with a fulltime job and a wife in nursing school with two children to raise, and I got by on that low income just fine, in a two bedroom apartment that cost $140 a month and paid my health and auto and life insurance policies. Early 1970s I was a graduate student with some income from substitute teaching, and my wife was working part time as an LPN while she went on to gain her RN degree. My children were both in grammar school, and I rented a 5 bedroom, 2 bath central chimney colonial with a living room and a parlor with working fireplaces in lovely condition on a full acre of land (for a garden) with maple trees I could tap for syrup. I paid $200 a month and gave sweat labor for maintenance and repairs for the privelege of living there in West Central Massachusetts for 4 years. And I paid my and my family's way, and managed to keep sound levels of insurance. That was a life that was about to disappear after Jimmie Carter came to office, with policies that ushered in STAGFLATION in our economy, and while my wife and I were both employed in social services regularly, we bought a 3 bedroom home with two baths, a family room, dining room, and living room and two car garage (for our two cars), did some labor with that on improvements, made some money when we sold it 5years later, and remained fully self sufficient paying all our bills and maintaning financial security thru savings and insurance. Later, in the 80s we were to take up residence in a beautiful location leasing a 200 acre farm with a stunning doric collumned New England farmhouse, two garages, chicken barns, and lots of lovely garden spaces and apple and pear trees and small fruits galore, nestled in a lumber holding acreage and abutting a state forest filled with grouse, turkey, and deer (some cayotes and black bears too, but that's another story ,LOL!), with a beautiful lake full of trout and bass and perch for the catching. I paid $400 a month and sweat labor while I lived there with my family for four years, and provided a lot of food stuffs and cordwood as a supplement heating fuel. You see, my foolish man, life is what you make of it...if you have the gumption, which I know you don't.
Note that Grandpa never mentioned the G.I. Bill Income in this "I walked 40 miles to school, uphill both ways" account...
LBJ's and Nixon's underwriting the Vietnam War were the cause of the "Stagflation," Grandpa, a "delayed effect" but you don't understand cause-and-effect any better than you do the biology of birth control.
The GI Bill paid me $80 a month in the late 60s while I was in undergraduate school, and I had to pay tuition and fees. It didn't cover my graduate school expenses, as the ability to use left over years of the GI bill for graduate courses after matriculation didn't become law until the late 70s.
I'm the one with the degree in Public Administration with Economics and Business Administration as minors, Cab Driver. I know what was behind the stagflation of the 70s, and the precipitating event that pushed the economy over the edge was the Oil Embargo by the folks willing to take advantage of weak kneeded president! Commodity spikes and real estate mini bubbles and bizarre Federal Reserve money policies were what put the nation into an unhealthy round of stagflation that Ron Reagan and Paul Volker finally wrestled us out of, and with a boom of Defense Spending under that president that told the Oil Cartel not to screw with us anymore, and drove the Soviet Empire (so active in the Middle East) into bankruptcy and dissolution trying to match us.
After skimming through all these posts, I now understand why Americans do not believe in health insurance for all. One person said - why not just buy catastrophic care health insurance? Because poor people do not have 10,000 dollars to spend on medical bills before the catastrophic care health insurance will kick in. Another post talks about how terrible it is that poor working people get food stamps and can feed themselves with good food from a grocery store. Another post was saying how terrible these people are for buying fast food (as if that is a luxury). So seems as these poor working class people are damned if they do and damned if they don't in regards to food. Why not just let them starve to death or how about we all just toss them our scraps? Will that satisfy your sense of fairness and fiscal responsibility? The medicaid expansion would boost a state's GDP, it would provide access to health care services to many who go without, and it would provide a safety net to the self-righteous posters here in case they ever lost their job and health insurance that goes with it.
I think you are exactly right Marina!
Mariana and Leslie. Catastophic Health Insurance pays for the very large expenses if one is seriously ill or injured, and the amount that one has to pay out of pocket before that comes in includes the value of free care or inexpensive care on a fee for service basis from public and nonprofit clinics.
We don't have a scarcity of health care for people in our country, we have, if anything, to much health care for those who do not take responsibility for themselves, like taking their child to the ER for a 100 degree fever instead of giving them a child strength aspirin or tylenol, fluids (preferrably orange juice instead of coca cola), and taking them to a clinic in the AM if they haven't improved.
And if you ever spent anytime in an ER in a metro area, you would be amazed at the number of individuals there with pain, pain, pain...that are simply there trying their best to have a overworked resident with no sleep to ascertain after numerous expensive tests are run that oxycontin or some other pain medication to get high on for the next few days when they repeat the cycle all over again.
The truth of the matter is that we have a lot of health care provided in our country, and it is expensive. For those that are willing to pay their fair share, to use a phrase that the liberals are happy to pass around when it comes to their tax policies, but not when it comes to health insurance.
Marina it seem's to me that a couple of commenter's on this page were in the audience when Ron Paul was asked if he would just let a person die if they were'nt covered by insurance.They must be the ones that screamed yeah.
Joca - My posts and I'm sure Kieth's as well are not about letting poor people starve as much as you, Marina and Leslie would love to believe.
The point of my posts (most on other topics on this website) was to point out that if you cut American corporate tax rates from 35% to 20 or 25% that most other counties charge and reduce the insane anount of regulations that companies in America have to put up with and pay for (fees and man-hours), a lot of jobs would stay in America and a lot jobs would be created. When there are more jobs then people to fill them (the case in China right now) wages go up and all the working people do better.
In the past if you wanted to improve you lot in life you worked and went to school. Today people just go to the goverment for handouts.
I make a good living because I was trained in Telecommuncations by serving four years in the military (a sacrifice most people refuse to make) and graduated with honors from two Technical schools to increase my knowledge in my field and to make myself more valuable to companies seeking skilled workers.
As Keith said: life is what you make it'
Sullyman: It's good that you have a talent that you put to good use I'm happy for you.I had an artist friend when I was young,one time I asked him where all that talent came from.He said it's easy anyone can do it,so I showed him my art ability,he told me well maybe not everyone can do it.And that's the point,not everyone is as talented as you or my artist friend.Sometime's no matter how hard a person tries they are just spinning their wheel's because they are not quite as smart as the other guy,so they end up in a low paying dead end job.It does'nt mean that this person has less value than you or I does it?Someone has to do the grunt work.
I agree with you to an extent on your view of people on welfare that game the system and create generation's of welfare recipients.But I do'nt judge everyone on welfare & food stamps the same.You see I have a daughter in law that has a master's in nursing.After our son died some year's ago she was left with nothing because he had just started a new job and had no insurance.Instead of mooching off the family as she called it.She went on welfare & food stamps to feed and clothe herself an their two kid's.Well anyway welfare paid her way through nursing school.She got a job and continued her education to where she is now.So you see some people just need a hand up and not a hand out or maybe just some temporary help to get through a rough stretch.But republicans in congress lump them all together and call them lazy no good's.Just because there are some bad apple's you do'nt throw the whole sack away.