• Welcome to OGBoards 10.0, keep in mind that we will be making LOTS of changes to smooth out the experience here and make it as close as possible functionally to the old software, but feel free to drop suggestions or requests in the Tech Support subforum!

ACA Running Thread

The more I read about NC opting out of the expansion the more it infuriates me. While the money isn't "free" it was certainly a no-brainer when this is the alternative. McCrory and the DHHS can eat a big fat bag of dicks.
 
It isn't free money at all. It's a nice monetary boom for a couple years that tapers off. In the meantime, it increases coverage, which means that even with a higher percentage of the costs covered by the feds, the states still have to cover more people. Moreover, the feds continue to cover under the old percentages for people who were eligible under the previous rules, and there were be plenty of those that the states are stuck with too. The states also have to hire more employees to account for the expansion.

The states not participating aren't just being kneejerk. They recognize that while it is tempting to take that money now and make any potential budget shortfalls look good in the short term, it's a long term expansion they have to worry about that and also more intrusion of the federal government into state affairs.
 
EatLeadCommie said:
It isn't free money at all. It's a nice monetary boom for a couple years that tapers off. In the meantime, it increases coverage, which means that even with a higher percentage of the costs covered by the feds, the states still have to cover more people. Moreover, the feds continue to cover under the old percentages for people who were eligible under the previous rules, and there were be plenty of those that the states are stuck with too. The states also have to hire more employees to account for the expansion.

The states not participating aren't just being kneejerk. They recognize that while it is tempting to take that money now and make any potential budget shortfalls look good in the short term, it's a long term expansion they have to worry about that and also more intrusion of the federal government into state affairs.
Click to expand...

the idea that politicians are making a sacrifice now for an investment in the future seems absurd to me.
 
EatLeadCommie said:
It isn't free money at all. It's a nice monetary boom for a couple years that tapers off. In the meantime, it increases coverage, which means that even with a higher percentage of the costs covered by the feds, the states still have to cover more people. Moreover, the feds continue to cover under the old percentages for people who were eligible under the previous rules, and there were be plenty of those that the states are stuck with too. The states also have to hire more employees to account for the expansion.

The states not participating aren't just being kneejerk. They recognize that while it is tempting to take that money now and make any potential budget shortfalls look good in the short term, it's a long term expansion they have to worry about that and also more intrusion of the federal government into state affairs.
Click to expand...

State affairs such as not helping hundreds of thousands of NC residents get health insurance? Yeah, i'd sure hate for NC to help it's own needy population, that's sure as hell not what we want the government doing.
 
myDeaconmyhand said:
State affairs such as not helping hundreds of thousands of NC residents get health insurance? Yeah, i'd sure hate for NC to help it's own needy population, that's sure as hell not what we want the government doing.
Click to expand...

I prefer $230,000 bathroom renovations for the governor's mansion.
 
dmcheatw said:
the idea that politicians are making a sacrifice now for an investment in the future seems absurd to me.
Click to expand...

Yeah I think they're probably just playing party politics.
 
myDeaconmyhand said:
State affairs such as not helping hundreds of thousands of NC residents get health insurance? Yeah, i'd sure hate for NC to help it's own needy population, that's sure as hell not what we want the government doing.
Click to expand...

It's a federal program that was agreed to in the first place because the states retained relative autonomy in determining the poverty level %s of those who were eligible. In allowing themselves to set those percentages, the states could control how fucking big the program was in the first place. They get to help their residents, the feds pitch in a good portion of the cost, and states control the bureaucracy on their end. In short, it was a good example of how the states and feds could cooperate. The expansion takes away much of that state control in favor of federal mandates-- something found unconstitutional in the ACA, by the way. ACA is an enormous expansion of Medicaid (I think it accounts for most of the anticipated increase in HC coverage), and that particular unconstitutional portion of it was thus a huge (and unwanted by many) expansion of state responsibility.
 
EatLeadCommie said:
It's a federal program that was agreed to in the first place because the states retained relative autonomy in determining the poverty level %s of those who were eligible. In allowing themselves to set those percentages, the states could control how fucking big the program was in the first place. They get to help their residents, the feds pitch in a good portion of the cost, and states control the bureaucracy on their end. In short, it was a good example of how the states and feds could cooperate. The expansion takes away much of that state control in favor of federal mandates-- something found unconstitutional in the ACA, by the way. ACA is an enormous expansion of Medicaid (I think it accounts for most of the anticipated increase in HC coverage), and that particular unconstitutional portion of it was thus a huge (and unwanted by many) expansion of state responsibility.
Click to expand...

Oh, I get that the state is controlling who gets health insurance and who doesn't.
 
It's about setting the poverty level eligibility requirements for Medicaid, not "depriving people" of some god given right. It is, in short, a huge entitlement expansion, as is the rest of the ACA with its subsidies.
 
EatLeadCommie said:
It's about setting the poverty level eligibility requirements for Medicaid, not "depriving people" of some god given right. It is, in short, a huge entitlement expansion, as is the rest of the ACA with its subsidies.
Click to expand...

And our poverty standards are bullshit. The world needs ditch diggers, but north carolina doesn't think they need health insurance. It's health care for those that need it, and an "entitlement expansion" for those that don't.
 
There's plenty of blame on this issue IMHO. Sure, many states played politics and declined Medicaid expansion. But the feds really messed up how they wrote the law. I was in inner city Raleigh today and had to explain to someone who just got kicked of of Medicaid that she couldn't get a subsidy because she made just $10,000/year. Meanwhile, I got to tell someone who makes 13,000 a year they are getting free coverage....Thats not good.

States screwed it up. I understand that they had legit covers over the 10% shift in '17 (and you can't grow out of this problem...the math just doesn't work). But so did the feds. How could they write a law with such a big loophole....
 
CHDeac said:
There's plenty of blame on this issue IMHO. Sure, many states played politics and declined Medicaid expansion. But the feds really messed up how they wrote the law. I was in inner city Raleigh today and had to explain to someone who just got kicked of of Medicaid that she couldn't get a subsidy because she made just $10,000/year. Meanwhile, I got to tell someone who makes 13,000 a year they are getting free coverage....Thats not good.
Click to expand...

Did the 13k/year have kids or are you distinguishing between subsidies and Medicaid? 10k is still well below the 100% poverty level for a household of 1, so why isn't she eligible?
 
EatLeadCommie said:
Did the 13k/year have kids or are you distinguishing between subsidies and Medicaid? 10k is still well below the 100% poverty level for a household of 1, so why isn't she eligible?
Click to expand...

You don't understand the gap do you? Non-disabled childless adults do not qualify for Medicaid, and if they are below the poverty line they don't qualify for subsidies or tax credits. We've had multiple threads about this, there was a NY Times article about it, it's what I thought you understood when you were defending this stupid shit.

http://www.healthcarereformdigest.com/low-income-adults-fall-into-ppacas-coverage-gap
"Currently, 100% of the Federal Poverty Level for 2013 is $11,490. A childless adult making less than $11,490 will not qualify for Medicaid because they do not meet the Medicaid eligibility requirements, at least in North Carolina. And, because the adult’s income is less than 100% of the Federal Poverty Level, they also will not qualify for premium tax credits or cost-sharing subsidies. An adult in this situation would be left with limited options: (1) going without coverage; (2) paying the full premium for a health plan through the Marketplace; or (3) enrolling in employer-sponsored coverage, if employed and eligible for the employer’s benefits. Although these options are not very appealing, the U.S. Department of Health and Human Services (HHS) has made an accomodation. In a final rule published on June 26, 2013, HHS provided an exemption from the individual mandate tax penalty for individuals ineligible for Medicaid solely because a state declined to expand Medicaid under PPACA."

Read More http://www.healthcarereformdigest.com/low-income-adults-fall-into-ppacas-coverage-gap
 
Last edited:
OK, fine. But she isn't crippled. Are you gonna defend somebody being a non-disabled childless adult making under $11,490?
 
All Im saying is its not good that the super poor get the shaft because of politics and a poorly designed law. This woman looked at me like I was crazy.
 
You must log in or register to reply here.
Back
Top