Waste and abuse? Just a little bit here and there. After a review of one-in-four Medicaid enrollees in Illinois, so far 25 percent of the total number of enrollees in the program were not eligible and have been kicked off.
In Ohio during an appearance yesterday, Vice President Joe Biden claimed the GOP Medicare plan would result in a bankrupt program by 2016 and become “vouchercare” where those on the plan would be on their own to use a voucher to find insurance.
As you know, because of the Supreme Court’s Obamacare decision, the Governor’s of Florida and Texas have said they will not expand Medicaid coverage as demanded by Obamacare. But, that is not the extent of what the states are pondering. Read more
Now that the Supreme Court has decided that the federal government, under Obamacare, can’t put a gun to the head of the states on Obamacare’s Medicaid expansion, the states are reacting. Prior to that ruling, if a state did not agree to greatly expand its Medicaid coverage, the federal government could withhold all Medicaid funding, not just the “expansion” funding. Read more
This afternoon the Supreme Court heard the last of four oral arguments dealing with Obamacare…the states’ argument that Obamacare’s new mandates concerning Medicaid are an unconstitutional intrusion into states’ rights. You can listen to the argument here, and read the transcript of the argument here.
The states can opt out of this expansion if they want to, but, they argue, if they do so, the law gives the Secretary of Health and Human Services the right to cut off all federal Medicaid funding, and, thus they are being coerced into going along. As a matter of law, if the Court finds that the Medicaid expansion is coercive, then the law is unconstitutional.
All seemed to be going well for the government when it was brought out that the Secretary had never cut off funding for a state’s refusal to go along with a new federally mandated program until we learned from the attorney representing the states that the Secretary had, in the past, threatened to cut off all Medicaid funding for the State of Arizona if they refused to implement a new program.
But it’s a letter in the record in this litigation, and it’s a letter from the secretary to Arizona, when Arizona floated the idea that it would like to withdraw from the CHIP program, which is a relatively small part of the whole program.
And what Arizona was told by the secretary is that if you withdraw from the CHIP program, you risk losing $7.8 billion, the entirety of your Medicaid participation. So this is not something that we’ve conjured up — [See page 16 of transcript]
That is the fear that the states have. Although we can “opt out” of the new mandates, if we do so, we could lose all Medicaid funding.
Although the Solicitor General argued that the Secretary would not be able to cut off all funding unless it was “reasonable”, at least two members were unpersuaded. All they wanted from the Solicitor General was some assurance that the Secretary would not do so. The Solicitor General refused to provide that assurance.
CHIEF JUSTICE ROBERTS: Could you give me some assurance? We heard the question about whether or not the Secretary would use this authority to the extent available. Is there circumstances where you are willing to say that that would not be permissible? I’m thinking of the Arizona letter, for example. I mean, if I had the authority and I was in that position, I would use it all the time. You might — you want some little change made? Well, guess what; I can take away all your money if you don’t make it. I win. Every time. It seems that that would be the case.
So why shouldn’t we be concerned about the extent of authority that the government is exercising, simply because they could do something less? We have to analyze the case on the assumption that that power will be exercised, don’t we?
GENERAL VERRILLI: Well, Mr. Chief Justice, it would not be responsible of me to stand here in advance of any particular situation becoming — coming before the Secretary of Health and Human Services and commit to how that would be resolved one way or another… [See pages 47-48]
And then, there was this,
JUSTICE KENNEDY: There’s no real — there’s no realistic choice. There’s no real choice. And Congress does not in effect allow for an out — opt out. We just know that.
And it’s –
GENERAL VERRILLI: No, I guess I –
JUSTICE KENNEDY: — it’s substantial. [See page 70]
Just from the questioning, I would say that the “conservative” members of the Court have problems with the reality that no state can opt our of this expansion.
The ironic part is that if the Solicitor General had just assured the Court that states would not be punished for failure to follow the new mandates, this issue would have gone away.
If you are interested in reading all of the briefs filed in the Supreme Court on this issue, you can find the links for that here.
The Washington Times actually has it wrong – using $350 billion instead of $350 million. But isn’t that telling? At some point, you have to just say what’s the real difference ya know?
From the Washington Times and – believe it or not – the Associated Press, we learn state cuts to Medicaid continue and more are planned in the future. No kidding?
Someone on the left will soon claim this is a positive result … imagine how bad it could be if we did not pass Obamacare! </sarc> From the Washington Times and AP writer Shannon McCaffrey.
Nearly every state has proposed or implemented a plan in its current budget to rein in costs, and many are considering additional cuts in the year ahead.
For the tens of millions of poor and disabled who rely on the program — approaching nearly one in five Americans — the cuts translate into longer waits for doctors, restrictions on prescription drugs, a halt to vision and dental care, staff cuts at nursing homes and dwindling access to home health care.
On top of that, the article notes some seniors in southern New Jersey are being “assigned” doctors in Philadelphia.
General practitioners do not have to participate in the Medicare or Medicaid programs, and if they are losing money on each patient they see, they can either demand higher fees from private health insurers (good luck) or just stop accepting seniors as they become eligible for the program.
Do you think mandates on physicians requiring them to ensure a minimum percentage of their patients are one one of these government programs could be around the corner? I’m almost certain of it.
A piece of the Stimulus Bill increased the amount of money that the federal government (actually, you and your children and grandchildren, etc., will somehow have to figure out where to get that money) gave to states to cover the cost of Medicaid. That money has now been spent, and we are beginning to see the consequences. Read more
Regardless of the state you live in, state budgets are a mess. Governors and legislators are reviewing every line item to find out where cuts can be made. But, one of the biggest costs facing any state is Medicaid. And under Obamacare those costs will rise dramatically as millions will be added to the rolls.
On Thursday, Secretary of Health and Human Services, Kathleen Sebelius, sent a letter to all governors offering sage advice on what could be done about this Medicaid problem. Her solution…cut benefits.
That’s correct, the same administration that, as we speak, is inventing new ways to drive up health costs (see: new taxes on insurance companies, medical device manufacturers, drug manufacturers, to name just a few), is now proposing that states solve their budgetary nightmare by cutting benefits.
Among the suggestions, cut some programs,
such as physical therapy, dental care, eyeglasses, and even some prescription drugs.
And, if all else fails, states should look into,
removal of some people from the program. [emphasis supplied]
Seems to me this group hasn’t a clue. First we’re told that everyone has to have “affordable health care”, and then we’re told that it’s ok to cut benefits, and drop folks from the health insurance rolls.
Gee, I can’t wait for Obamacare to be fully implemented. Does the word “rationing” come to mind?