Why does there have to be a reason that makes sense?
Anyway, I fully support all of these Republican headed states contributing their constituents Federal tax dollars to the expansion of Medicaid in my state. Thank you for the gift, 'tis much appreciated.
Ah, you want us to fall for the prisoners’ dilemma. More evidence that illegal coercion was intended.
Coercion is not illegal.
It is when the federal government tries to do it to the states.
No it isn’t. Because if it were illegal, the states could appeal it to the Supreme Court, which is the final arbiter of what is or isn’t illegal. It isn’t illegal just because you say so.
Follow the money - look at how many campaign contributors have ‘health’ in their title:
http://www.followthemoney.org/database/uniquecandidate.phtml?uc=132328
Um, the states did, and the federal government lost the Medicaid expansion case 7-2.
Because darkie McPresident supported it. There may be some fears that down the line the states will have to pay more of the medicaid share but a lot is just partisan spite. Plus a lot of conservatives have ideological objections to both social programs for the poor as well as government healthcare, and medicaid is both.
Really? If Medicaid is such a bad deal, then why does every state accept the money now? They are not required to have it at all, yet all of them have opted to adopt it. Currently, they only get reimbursed by the federal government 57% of costs on average. Why would they reject an expansion covered at 100% initially, then 90% later on when they currently accept a deal that only nets them 57%? Especially given that changing those reimbursement rates would require representatives of their own state (and similarly situated states) to vote against their own interests? How does rejecting this make sense to you at all?
This is doubly stupid because of two other hugely important factors: hospital Medicaid reimbursment rates will deline as part of the ACA, which means revenues will fall while costs increase, and because states ALREADY PAY INDIRECTLY FOR THE UNINSURED. Uninsured people generally don’t have the curtousy to die in the street. They use expensive resoucres they cannot afford. Not only does that hurt every citizen in the state who has insurance, but it also means the states missing out on LOTS of tax revenue. Obamacare may make a state’s finances look different, but it probably won’t make them look worse. Even if these states needed to raise taxes to cover costs later on, the system should be more efficient as a whole.
But like I said, within 5 years, the vast majority of these states will expand because the pressure from health care providers will be too great. No one is gonna leave tens of billions of dollars on the table on the off chance that it will be slightly less than that later on.
I am asking this a second time.
Except that Medicaid is not an Unfunded Mandate and never has been one. Duties that arise from conditions of federal assistance or that are tied to participating in voluntary federal programs generally are not considered mandates. And thanks to the Unfunded Mandates Reform Act, signed into law by Bill Clinton in 1995, it would be exceedingly difficult to make any changes.
Anything else, or just paranoid as usual?
Well, I know the answer to that one. So do the Republican governors have anything else, or are *they *just paranoid too? (Or, um, being dishonest about their reasons.)
Your question reminds me of the Real ID Act of 2005 that is still being resisted by a handful of states. Needs it’s own thread, but still worth bringing up as to how stubborn states can be:Real ID deadlines looms | Homeland Security Newswire
Good Lord, that is a Who’s Who of sleazy and barely-legal players in the For-Profit “healthcare” industry.
And I’m not in the business - if I recognize a name, it is because they made the news - and none of these were written up for being nice or fair or legal.
And those sleazy players don’t want the government to give them money to care for people?
Oh, they are perfectly willing to let the government give them money!
Medicaid pays providers a pittance compared to commercial providers, or even Medicare. (I’ve worked with claims for all three, and providers that can sometimes refuse Medicaid patients). If some of the people find a way to get Medicare or a commercial policy (including Obamacare) rather than an expanded Medicaid than the hospitals and insurance companies come out ahead.
As for the original question, maybe people are thinking about this too much. Maybe Republicans just think of it as income redistribution so are ideologically opposed to it whether it’s a “good deal” or not.
Let’s be fair about this, comrades. Come the Revolution, and we put them up to the Wall, let them take their money with them.
Considering that the state can then drop the extra coverage, you’re saying that states will have political problems doing so because it will be popular…right? That all this extra medical care is like crystal meth, once they get hooked on it they won’t want to give it up?:dubious:
Its unconstitutional and I don’t think you can point to very many cases where states were forced to take on unfunded mandates.
Thats the thing about our federal government… they is us.
The prisoner’s dilemma posits a negative result for the non-cooperating prisoner. What is the negative result here (other than less medicaid, which seems to be the result you want).
Again, if so, why do they enact Medicaid at all? It’s forcing them to have to do all the redistribution themselves instead of getting more money from the feds.
Heck, are the feds even required to keep paying if these states keep with their track record of reducing coverage for the people who already have it?
The thing with programs that give away money is that once they are started they are hard to do away with. For example tobacco subsidies, the government paid 188 million dollars in subsidies to farmers growing tobacco in 2012. The Senate just voted this May to keep paying the subsidies even though the same government is spending about 50 million dollars a year for ads trying to keep people from smoking.
In WW2 uniforms were made from wool and the army had problems securing enough to keep up with demand. So congress enacted wool and mohair subsidies in 1954. They are still going on to the tune of 20 million a year even though the military uses mostly synthetic fibers now.
So a responsible governor takes into account that a program will be hard to end and looks down the road for the consequences.
The average state pays 16% of its budget for Medicaid and opting into the expansion will raise costs an estimated 2.8% for the next eight years and more after that. Medicaid costs have rised over 7% a year over the last decade while state tax revenues have risen about 3.5%. Thus Medicaid is set to take up more and more of state budgets in the future. Given budget realities states need to look at ways to decrease amounts spent of Medicaid instead signing up for more spending.