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You are here: Home / Anderson On Health Insurance / Why we can’t have nice things

Why we can’t have nice things

by David Anderson|  April 17, 20158:56 am| 27 Comments

This post is in: Anderson On Health Insurance, Election 2016, All we want is life beyond the thunderdome

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I’ve been following the Florida Medicaid expansion fight fairly lightly as I did not think much would happen as the Tea Bagging lower chamber and the walking dildo/Voldemort doppleganger of a governor both opposed expansion.  However the Obama administration is using its leverage on not releasing other voluntary Medicaid related funds to pressure Florida to expand Medicaid or see its hospitals which perform a lot of charity care get kneecapped as compensating funds would be withdrawn.

That is hardball.  And Gov. Scott wants to assert a right of unrestricted reciept of federal funds, so he is suing that any linkage of federal funds towards achieving federal policy goals is illegal.  That is mildly interesting.

Far more important is the following sentence from the St. Petersburg Times blog:

The hospitals–which are most impacted by the pending elimination of Low Income Pool–laid low following the announcement. The Florida Hospital Association issued a statement saying that its “focus is on a responsible state budget hat includes coverage and a replacement for the low income pool. Both are essential to ensure low-income, working Floridians have access to preventative care and critical services. “

The FHA is ducking the issue, and is not indicating that it is willing to fight to get its hands on several billion dollars a year of new revenue.  As long as FHA won’t go to war with the Tea Baggers, Florida can’t get nice things.

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27Comments

  1. 1.

    sparrow

    April 17, 2015 at 9:00 am

    The FHA seems rather stupid. Why not fight?

    Regarding the lawsuit, the first thing that comes to mind, is the tying of federal highway funding to a drinking age of 21. No state managed to duck that one either, as I recall.

  2. 2.

    Belafon

    April 17, 2015 at 9:09 am

    SCOTUS has ruled time after time that you don’t have to take the money, but the government can put requirements on it if you do.

  3. 3.

    Frankensteinbeck

    April 17, 2015 at 9:10 am

    @sparrow:
    Maybe it’s ideological? ‘Fuck you, I do what I want,’ is the conservative ethos, hospital owners/boards are businesspeople, not practitioners, we have no shortage of examples of how the modern rich absolutely can’t stand being told what to do even if it’s good advice, and for too many whites the conflict between wanting to spit in the black president’s face and wanting the money and security his policies offer is paralyzing.

    That’s just speculation.

  4. 4.

    Napoleon

    April 17, 2015 at 9:14 am

    @Belafon:

    They reversed those rulings with the first Obamacare ruling they handed down, remember. The law as passed required them to take the Medicaid expansion if they wanted any Medicaid funds and the SCOTUS said that the feds could not do that, which is 100% horse shit, but that is the way they ruled.

  5. 5.

    OzarkHillbilly

    April 17, 2015 at 9:18 am

    @Belafon: Except for that one time they didn’t….

  6. 6.

    Belafon

    April 17, 2015 at 9:22 am

    @Napoleon: Forgot about that, though I think Roberts’ loophole was the requirement on new funds. How that would play out in the lawsuit, since the old program is going away – Florida wouldn’t need it if they would expand medicaid – will be interesting.

  7. 7.

    Betty Cracker

    April 17, 2015 at 9:22 am

    The FHA and other potential recipients of federal largess did successfully pressure Gov. Batboy to come out in favor of expansion a few years back. The tea party loons in the statehouse were not amused and let Gov. Batboy know that this might be detrimental to his reelection hopes, so he quickly walked it back.

    It’s the same tension between the GOP’s two factions: corporate toadies on the one hand vs. snake-handling nutbags who have completed the Jesus-to-Reagan and Satan-to-gubmint metaphysical transference. On a national scale, it led a corporate bagman like Boehner to preside over the government shutdown. In Florida, it leads to this shitshow.

  8. 8.

    OzarkHillbilly

    April 17, 2015 at 9:23 am

    @Napoleon: Beat me to it. Next time I won’t take the time to find an authoritative source and just spout out whatever pops into my head. ;-)

  9. 9.

    Napoleon

    April 17, 2015 at 9:38 am

    @OzarkHillbilly:

    It seems to work for me!

  10. 10.

    Ryan

    April 17, 2015 at 10:01 am

    There goes the governor, riding around in that state-owned Cadillac and buying all of the T-bones.

  11. 11.

    Mike in NC

    April 17, 2015 at 10:05 am

    SC just scuttled a proposal to provide healthcare to 200K citizens because Tea Party prom queen Nikki Haley threatened to hold her breath.

  12. 12.

    Snarki, child of Loki

    April 17, 2015 at 10:11 am

    Some enterprising person needs to set up a SuperPAC, keeping the identity of donors secret, to fight the Teabaggers on behalf of the hospitals.

    I’d bet the hospitals would be glad to drop a moneybomb that would blow the Teabaggers out of the water, as long as they can keep their fingerprints off of it.

  13. 13.

    Shantanu Saha

    April 17, 2015 at 10:12 am

    Scott reminds me of Count Orlok in “Nosferatu” more than Voldemort. I agree about the walking dildo analogy, though.

  14. 14.

    Waysel

    April 17, 2015 at 10:12 am

    @Betty Cracker: Well put.

  15. 15.

    gvg

    April 17, 2015 at 10:14 am

    Our Gov. is a former CEO of a Hospital corp and would actually like to take the money but…..the legislators are nuts. Rick Scott had no prior political experience when he was elected and evidently thought it was a lot like a CEO and he could do mostly what he wanted. He found out he couldn’t and the first 2 years or so he had horrible ratings and nothing got done. He was terrible at working with the legislature including his own supposed party. After that unfortunately he started to figure out how to do deals. He still strays from the script sometimes.
    I would say the problem is the legislature in this case not Scott. He mostly makes the required statements but his history says he would have taken the money without a second thought if he had the actual power to do so. He thinks money making is all that is important. The rest IMO is lip service. He has learned he has to say certain things, that his party of nuts won’t allow certain things which if he keeps trying to do and they stop him, makes him look weak….sort of like the old dictum don’t give an order you know won’t be obeyed.

  16. 16.

    japa21

    April 17, 2015 at 10:17 am

    There are very few business oriented groups, from state and national hospital associations, doctor’s groups, chambers of commerce, etc., that are against Medicaid expansion. Even Scott, probably due to his association, albeit criminal association, with the for-profit hospital industry, was for it originally.

    In so many ways, the current GOP is actually anti-business yet it still receives the bulk of business support.

  17. 17.

    Ned

    April 17, 2015 at 10:19 am

    I don’t know if it’s true, but I think the Low Income Pool is federal money paid directly to hospitals whereas medicaid would only pay for those covered when services are rendered. If you are a governor, wouldn’t it be nice to spread that money around to those who are worthy of your largess, rather than use it to directly help poor patients? My feeling is always to follow the money and influence.

  18. 18.

    dww44

    April 17, 2015 at 10:43 am

    @Waysel: @Betty Cracker: Not only well put, but worth preserving for future use.

  19. 19.

    RSR

    April 17, 2015 at 10:44 am

    >>any linkage of federal funds towards achieving federal policy goals is illegal

    This comes up repeatedly in education, especially with regards to the Elementary and Secondary Education Act/No Child Left Behind overhaul, Common Core, and the Opt Out movement.

    Parents, teachers, administrators and even entire districts have been threatened that if enough students do not take the prescribed standardized tests, that Title I money and other funding could be stripped by the feds.

    On the other hand, I’ve heard that once funding is allocated under one set of rules, the rules cannot then be changed with regards to that same funding.. In this case, the Title I funding cannot be used to coerce participation in the testing, since testing was not part of the Title I funding originally. (This is according to what I’ve been told, which was based on research into legal precedents of such maneuvers.)

    I guess the question is does this new legislation count as canceling the original funding and enabling new funding, which would then fall under new rules?

  20. 20.

    NorthLeft12

    April 17, 2015 at 10:58 am

    @Betty Cracker: Any possibility that the hospitals are working behind the scenes to apply pressure to the governor and state reps to flip flop again?

    As a Canadian I look at this and cringe. The so-called conservatives up here have talked around the possibility of “reforming” our universal health care system a couple of times, until it gets anywhere close to an election where they quickly back track those “ideas” because of the blow back.
    Messing with our health care system [especially the universality concept] is political suicide up here.

    That is precisely what the Republicans are terrified of. The longer the ACA is in place, the worse it will ultimately get for them when most people realize that it is not ushering in the apocalypse and is actually a good thing for the vast majority of people.

  21. 21.

    Shell

    April 17, 2015 at 11:08 am

    walking dildo/Voldemort doppleganger of a governor

    His opponents never have to search for an unflattering photo. i swear, every single photo of Scott is creepily scary.

  22. 22.

    Betty Cracker

    April 17, 2015 at 11:22 am

    @NorthLeft12: I’m sure they’re applying pressure to Scott, but he basically agrees with them (i.e., is all about the profits). I think they’d face the same seemingly insurmountable problem flipping the individual goobers in the statehouse that we libtards face: a deeply ignorant and belligerently partisan electorate that will vote for any appalling creature with an R after its name.

    One thing in our favor, even rural areas have medical service providers, so maybe they’ll wear down eventually. I wonder how many people will die in the interim, though. Like you said, it’s cringe-worthy.

  23. 23.

    Matt McIrvin

    April 17, 2015 at 11:36 am

    Meanwhile, Obama is set to sign a reform bill that establishes the Medicare doc fix, but will also cut Medicare through means-testing at the high-income end.

    http://thinkprogress.org/health/2015/04/15/3647206/congress-medicare-doc-fix/

    While I understand the reasoning here, and the cuts won’t gravely hurt the well-off people who are affected, I still don’t like it. The more these universal entitlement programs shrink into aid to the truly needy, the smaller their political base of support becomes. Also, while the cuts were probably made to appease Republicans, I fully expect those same Republicans to turn around and blame Obama for them.

  24. 24.

    Mnemosyne (tablet)

    April 17, 2015 at 12:57 pm

    @Matt McIrvin:

    Here’s the thing — if PPACA goes the way we all hope and eventually transitions into a single payer system, Medicare will go away, because it would be ridiculous to have two parallel separate government payer systems. But trying to get there is going to be damn ugly, because politicians have threatened Medicare so many times that it’s going to be difficult to convince people that they’ll still have healthcare, it’ll just be called something else.

  25. 25.

    CONGRATULATIONS!

    April 17, 2015 at 12:58 pm

    While I understand the reasoning here, and the cuts won’t gravely hurt the well-off people who are affected, I still don’t like it. The more these universal entitlement programs shrink into aid to the truly needy, the smaller their political base of support becomes.

    @Matt McIrvin: Bingo. This is why, although means-testing Social Security sounds like a good idea, it is, in fact, an awful idea.

    Also, while the cuts were probably made to appease Republicans, I fully expect those same Republicans to turn around and blame Obama for them.

    They’re already slamming him for not having a backup plan in case their lawsuit against ACA wins. Most days it seems like we have a government run by sadistic older teenage brothers – “stop hitting yourself!” Ah, one of my favorites from back in the day. Thanks, little brother, for not murdering me in my sleep, I’m sure I deserved it.

  26. 26.

    Wilson Heath

    April 17, 2015 at 2:56 pm

    Back in my day, challenging conditional spending was Rule 11 territory. Another reason for the rightReich sort of idiot litigants to thank the Roberts court.

  27. 27.

    Matt McIrvin

    April 18, 2015 at 6:11 pm

    @CONGRATULATIONS!: One of the tricks is the word “entitlements”: it sounds bad, like handouts to moochers, whereas “Social Security and Medicare” are things everyone likes. They’re the same thing, but they don’t sound like the same thing. So you can slam your opponents for not daring to cut entitlements, and then when they go and do it, you can complain that they cut Social Security or Medicare.

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