PPACA’s Medicaid expansion is embedding itself into the American system. The latest round of evidence is from Kentucky.
Bevin also said he intends to “copy” Indiana’s alternative Medicaid expansion. Gov. Pence of Indiana is in audience, listening to speech.
— Abby Goodnough (@abbygoodnough) December 8, 2015
Bevin started his campaign with the intent to throw 400,000 people off of Medicaid expansion. He ended his campaign saying he would apply for an 1115 waiver from Health and Human Services to tweak the Medicaid expansion so that it is more punitive, more complex and expensive to administer and no more effective than straight up expansion. That is what he announced today.
So we’ll probably see a 5% to 10% reduction in Kentucky Expansion enrollment when the decision maker originally started calling for a 100% reduction. Is this absolute good news? Hell no. Is it relative good news both locally in Kentucky and nationally in its implications? Yes.
PPACA’s Medicaid expansion is a one way ratchet when reality and accountability meets rhetoric.
lets hope that the change of heart buys Bevin the best of both worlds, vitriolic spewing from his core constituency and a begrudging acceptance that being an asshole isn’t the best way to govern people.
I’d prefer to destroy the Republican party, root and branch. This is not good news and it hasn’t been since Bevin won the election. This is evidence that the GOP is the enemy of working families.
There is no other frame we should be presenting than that. We are in a cold civil war with troglodytes. We do not pat them on the back for being deciding to execute less of the prisoners of war than they previously planned to.
Fight or get the fuck out of the way.
@goblue72: okay, now that you have your piss and vinegar out, would you prefer 400,000 people with or without health insurance as those are the options in the reality as we live in today. We can change the reality that we live in tomorrow so that is not part of the choice space, but that is not what the choice space is today.
One suspects that hospital representatives came to have a little chat with Bevin during the campaign to explain what cutting off Medicare would do to the state’s hospitals. Possibly with baseball bats in hand.
@Richard Mayhew: “We” didn’t do anything. The existing framework of the system did. Such that any observation of the consequences of that existing framework isn’t at all related to what happened. And as such, its only value is in connection with moving the ball forward. And patting them on the back doesn’t accomplish that.
Richard — My age for Social Security eligibility is 66. (Dogdamn Reagan to hell.) I just hit 64 a week ago. When can I get Medicare? Thank you in advance for you answer.
ETA: I lost my job in 2008 and haven’t worked since. (It’s along story.) I have no insurance. At least I live in NYC and have access to care at a City-owned hospital which charges me reduced prices.
@PurpleGirli: You are eligible for Medicare at age 65. Part A is free. Part B has a fee that seems to go up every year.
Part B Medicare premium has not gone up in several years. It’s $104.90 per month, well worth the cost. If you can’t afford that, take Social Security a year early. You’ll lose some income but gain immense relief from the indignity of negotiating the American health-care system.
Richard, any thoughts on the Admin politely saying to Kentucky “your program isn’t broken, so we won’t actually accept your inferior new proposal”? Or at the very least push KY to not f’k up the current system as badly as you suggest? I mean, paying the same federal dollars to insure 5-10% fewer citizens is shit. I realize DHS may see that as better than kicking all 400,000 off, but are those really the two choices? Any power for DHS to negotiate?
@PurpleGirl: 65 is normal Medicare eligibility age
In other words, a typical Republican twofer. More expensive for the taxpayers and less effective.
@RaflW: that is a complex question let me think about the issue space
Is there any evidence that any of the alternative Medicaid expansion’s are working better than the old system?
Many thanks for any input. I’ve been asking this a lot and have yet to find so much as smidgen of evidence pointing one way or the other.
Purple Girl: So sorry for your health issues. Medicare eligibility age is still 65. It has not been indexed upward yet, but I suspect that is not far away, especially if the Repubs retain control of Congress. Wishing you the best health you can have.
Over the past 14 years, reality and accountability have gotten their asses kicked by rhetoric in the United Snakes of Amnesia.
So call me a skeptic.