Wyoming legislature to waste $20k to learn that work requirements aren’t allowed in Medicaid. https://t.co/fgtpMo42oM
— Emma Sandoe (@emma_sandoe) February 18, 2016
The governor of Wyoming wants to expand Medicaid. Governor Mead (R-WY) has wanted to do that for a couple of years. The basic reason is that it is a combination of the right thing to do and it solves a lot of budgetary problems without any hard trade-offs. The Republican Legislature is opposed to Medicaid Expansion. Instead they want to spend money on a study for Medicaid expansion alternatives. This study is supposed to be fairly comprehensive:
Senate File 86 …. bill would require the Legislature’s Management Council to direct the design of a program providing medical assistance to people who cannot afford adequate health care.
That program would seek to …“shall seek to provide greater health status improvements than those provided by the Medicaid program,” according to the bill’s text.
The program also would coordinate with other public assistance programs with the aim of providing “incentive (for participants) to improve their earnings and economic status,” and would include a work requirement for those able to work.
SF 86 also stipulates the program shall consider the use of health savings accounts or similar accounts, and seek to “avoid spending monies that Wyoming does not have and … avoid the creation of any uncontrolled entitlement.”
The bill also stipulates Wyoming shall not seek approval from the federal government of any Medicaid expansion until the medical assistance program has been designed and reviewed by the Legislature.
It is a bill that freezes everything in place while a study is conducted.
This study is supposed to be looking at a lot of things. It requires significant knowledge of the Wyoming legislative history, Wyoming social welfare policies, employment training policies, economic development policies and the Wyoming budgetary process. This is a big scope of work.
And $20,000 is being provided for the entire study.
$20,000 is not even enough money to pay one graduate student a research stipend for a year. $20,000 pays for a single policy analyst for a month or two of their time. $20,000 pays for a single consultant for a month. $20,000 is nothing.
The only way a “study” could be conducted for that amount of money is to give the money to a “research” group where their interns and junior fellows copy and paste articles into a Word document, a senior writer puts in the appropriate ideological language and hopefully has someone look at subject-verb agreement before sending it out the door.
This is pure disdain for the entire idea of society taking care of the working poor.
Butch
Speaking as a contractor whose company does that kind of work….that money would just about get you a Phase 1 ASTM environmental site assessment, which is a “check off the box” review of a few agency files to look for obvious contamination. If you find a Wal-Mart firm that uses a low-level analyst that budget might get you 150 hours.
Jado
“This is pure disdain for the entire idea of society taking care of the working poor.”
Whoa!! It’s like this was intentionally designed to fail, thereby creating a bottleneck preventing the expansion of Medicaid.
How unexpectedly diabolical. This is a real departure for Republicans.
Elizabelle
It would seem that healthier people are more likely to be in the workforce. Are there employers lining up to hire those who have been unemployed for a spell? Do tell.
The poor would seem to be the worst population to use and manage HSA spending.
I hope this study/delaying tactic blows back badly on the Republicans. If anything, it’s $20K wasted, is it not?
For shame.
Patricia Kayden
Well at least no one can claim that they don’t understand the Republican position on healthcare. We know exactly what we’re getting with a Republican administration. If the electorate in Wyoming wants Medicaid expansion, they should let their politicians know.
Bartholomew
Sure, ok. This is part of why we need single payer. Something most progressives probably knew before the election forever fever came.
What I want to know is where someone who is anti-war should go, since leftists have taken over the Democratic party? We don’t share issues.
I know where to go to support war, I know where to go to cheat my fellow man, I know where I can effectuate hatred against minorities, I know where I can be ritually insulted by those who claim liberal values but are just a reflection of the establishment. I know where to go to be sold out … WHERE can I go as a liberal American who rejects the corporate totalitarian state?
Hillary Clinton lying for 13 minutes straight
The Sheriff Endorses Baud 2016
@Bartholomew: Fuck the poor of Wyoming, you got yours, right?
Joe Falco
@Bartholomew: I hear you can get anything you want at this restaurant run by Alice.
Chyron HR
@Bartholomew:
You can tell Bernie Sanders is an unstoppable political juggernaut by the aura of calm confidence his supporters effortlessly exude.
The Thin Black Duke
I don’t know why, but I’m somewhat skeptical of the loudmouths who can’t even motivate themselves to get off their asses and vote are somehow going to start a revolution.
Cheap Jim, formerly Cheap Jim
@Bartholomew: I’ve never really trusted people who go in big for non sequitur.
NCSteve
Slowly but surely, Republican alternatives for a number of social, political and economic problems seem to be converging on a single simple, elegant win-win solution: privately owned and operated death camps built with local government tax incentives and paid on a cost-plus basis.
Marmot
So like, did the Wyoming legislature settle on $20k as part of that thing where conservatives can’t comprehend inflation?
Marmot
@Bartholomew: What does “effectuate” mean?
Kylroy
@Bartholomew: How’s the weather out in left field this time of year?
cmorenc
The upside is that at least the GOP governor and legislature are sensing enough pressure about either adopting Medicaid expansion or else seeking some sort of acceptable ACA-waiver variant, that they need to at least put on appearances of seriously considering their available options for implementation. At the same time, they are under considerable pressure to avoid appearing to tear through the confines of conservative ideological fencing – and so hence, the “study” they commissioned is not well-designed nor given the necessary resources to effectively reconcile these conflicting pressures – instead, what it will likely produce a proposal along the lines of what conservative lip-service to managing health-care for the poor would be if the GOP were to succeed in repealing the ACA and implementing some yet-undefined alternative.
But notice that at least it does represent perverse progress that the Wyoming legislature feels enough pressure to sense the need to go through the motions of appearing to attempt to come up with a tangible alternative ACA-“waiver” Medicaid program, albeit the result will likely be unacceptably distant from what’s needed to comply with that goal.
benw
Hey, I can do that study for twenty grand!
“Medicaid Expansion is the most effective way to expand health care coverage in Wyoming. The recommendation of this report is to expand Medicaid under the PPACA.”
Now, where’s the hookers and blow at?
Kay
I was shocked at how much resentment there was here at the expansion of Medicaid. We have a lot of people on Medicaid and we always have – I think the majority of the children in the county are on it- but it was “hidden” in a way- it was nursing homes (huge) and children and REALLY poor people are invisible. When it became a national debate, wow, the vitriol was amazing. It’s subsided some because it’s off the national radar but part of is how close some people are to a Medicaid-eligible income and they pay out of paycheck for employer-provided. It’s the tier right above the cut off who resent it most. They see it as “I am being punished for having a job”. If you could tell them “well, there’s all these other benefits to having your job” it would be okay, but there aren’t really that many benefits to them having the jobs they have.
MattF
@cmorenc: I guess that’s the maximally positive interpretation. The less positive interpretation is that 1) the Legislature is anticipating a Republican President next year, so they can make an absolutely minimal response and get away with it, 2) the Legislature is demonstrating who’s in charge and is suggesting that the Governor should go perform an unnatural act on a nearby orifice.
japa21
@Kay: It is always the folks just above the level of those getting the “special benefits” who resent it the most, which is somewhat understandable.
Recently, a major company raised its minimum wage to $16/hour. In general, this move was greeted as positive. However, there were a lot of people earning in the $16-$18 range who were quite upset as they did not see a raise and they had been there for years and why should these people who have a less important job get the increase, etc., etc. etc.
OzarkHillbilly
I think “taking care of the working poor” means something entirely different to them than it does to you, Richard.
dedc79
O/T – Speaking of doing a bad job hiding your disdain, take a look at Peggy Noonan’s latest column about the Supreme Court. It’s behind a paywall, so here’s a taste:
MattF
@dedc79: Well, Peggy makes up her own rules.
dedc79
@MattF: I’ve never heard ANYONE, EVER try to argue that 5-4 votes lend the Supreme Court an air of credibility. Until now.
WereBear
Same as it ever was.
Punchy
Please pay me $20 large to pen “After much less than exhaustive research, I know Wyoming’s desired conclusion–mirroring my own, of course, because ducats–is that dirty Negros will find a way to game the system, stay lazy, and shoot people while wearing saggy pants and picks in their afros. Therefore, no Medicaid extensions for anyone, unless you’re a white rancher, in which case, the hospital is yours pro bono. The End, suck it poars.”
TOP123
@dedc79: does reading the entirety of the column make clear whether her argument is actually that 5-4 is roughly balanced, but 4-5 tips too far one way?!?
FlipYrWhig
@dedc79: Not to mention that having 5 Democratic appointees would probably lead to a lot of 5-4 votes as well.
Xantar
@dedc79:
I guess by Peggy’s logic, a 5-4 Supreme Court ruling that the Earth is round would have more legitimacy than a unanimous decision.
dedc79
@TOP123: The only thing that reading the entirety of the column makes clear is that she’s a dishonest, partisan hack with a serious substance abuse problem.
If god forbid, Ginsburg were to drop dead the morning of President Cruz’s first day in office, I’m sure Ms. Noonan would have no problem with the monumental conservative swing that would follow the President appointing both Scalia and Ginsburg’s replacements.
ETA: For Noonan (and Republicans in general) the people have only “spoken” when they’ve elected Republicans.
MattF
@Xantar: Both sides!
Nylund
My only qualm: A typical yearly stipend for a grad student is usually in the $12-18k / year range. You could indeed get a grad student for a year, and then probably pay a real pro to spend a few days looking it over and making suggestions before kicking it back to the grad student. At least in academia. There’s no way the private sector does squat with that kind of money. But grad students are basically elephants in a circus. You can get them to do a lot of work for peanuts.
rikyrah
THIS IS NOT ABOUT SAVING MONEY
If it were about the most fiscally responsible thing to do…ALL THE STATES WOULD HAVE EXPANDED MEDICAID.
So, that they are wasting money should be no shock.
OzarkHillbilly
@Punchy:
This is Wyoming, they don’t have any “Negroes” to speak of, the have “Injuns”.
Russ
Any decision of SC with a vote of 7-2 in favor of the white people/corporation/men/real christians is fair and balanced………
WereBear
@dedc79: Well, if you are not going to believe someone would go there, Peggy is your mental-pretzel woman.
muddy
@cmorenc: But is it an ass-covering move, or just a way to kick the can down the road, past an election perhaps. Hey, why not both?
ETA: At the link there are only 3 comments, but all against the study.
Tinare
@dedc79:
I’m not drunk so I don’t quite follow Peggy’s logic. So, the court was 5-4, and that was a good thing. One passed away, so with a new addition it will inevitably stay the same split, but 4-5, I guess, but that’s bad? She couldn’t mean the issue is the side that the 5 are on, right? I mean that would be politicizing. I thought that roughly balanced meant everyone was heard? So, if it’s still roughly balanced, everyone still heard, what’s the issue? And we must have the American people decide via the upcoming election, because the last one wasn’t good enough? But, why does she think the next one will go her way?
I obviously need to take a shot.
Steve in the ATL
@NCSteve:
Well said, tastefully named fellow juicer. I expect to see this on my sister’s FB page within a fortnight, with a link to either breitbart or alex jones.
guachi
Wyoming doesn’t even have Native Americans. Montana (where I’m from) does.
Wyoming is 1.6% black, 2.7% Native American and 9.8% Hispanic
Montana is .6% black (least black state in the union!), 6.6% Native American, and 3.5% Hispanic.
Anya
@dedc79: But it will still be 5-4 but the other way around. Her argument is stupid. But what’s new.
dedc79
@Tinare: More than one shot.
Kay
@WereBear:
I do feel like politicians have to address it, though. It’s a real argument. It feels unfair to them and it isn’t like they’re doing great. They’re barely hanging on. Part of it is proximity. The lowest tier who are paying for health insurance live among the people who get Medicaid- there isn’t that middle class/lower class buffer where middle class people can say “the unfortunate” or whatever and point OVER THERE. They’re all “the unfortunate” to a greater or lesser degree, it’s just that some pay for health insurance and some do not.
I don’t have a real response to it, because “there but for the grace…” doesn’t really work in that situation.
dmsilev
@Nylund: Depends on the field. In the sciences, stipends are usually over $20K per year. And, the money paid directly to the student is not, by a long shot, the entire cost of keeping a grad student on payroll and busy. By the time the dust settles, a $25K a year student probably costs $40-45K a year.
scav
@guachi: Goes to show, they will always find someone to discriminate against and suspect of stealing everything that is “theirs”. Small enough environment, it’ll be close kin against same.
Roger Moore
@dedc79:
Shorter Noonan: A 5-4 Conservative majority is roughly balance, but a 5-4 liberal majority would be unthinkable.
dedc79
@Roger Moore: Yes, and the hoops she jumps through to get there…. All while drunk out of her mind.
mwing
Well, OUR grad student stipends are about $30,000 per year. But that’s in a high-cost city and for engineering students.
FlipYrWhig
@Kay: How about “I hear you. You make a good point. Maybe the state should expand health insurance a little bit more so you can be covered too.”
Rob in CT
@Kay:
Well, this is indeed an example of how “single payer” or another form of universal same-for-all health insurance would be better. Then there is no cutoff. One could, when discussing these matters with such folk, point this out.
The next best thing is probably to point out that the ACA includes subsidization up to 400% of the poverty line*. So it’s not that the group above the Medicaid cutoff “have to pay” and the group below gets free stuff. The group below gets more help, true. The group above gets some help too, though, which tapers off the better they’re doing.
* poverty line (from Healthcare.gov):
FlipYrWhig
@FlipYrWhig: In the last sentence, change “you” to “people like you.”
Roger Moore
@OzarkHillbilly:
And these days a fair number of “Mesikuns”.
Petorado
@muddy: In a state where Walmart wages are the norm, $20K sounds like a ton of cash to spend on a study – that’s more than a year’s wages at minimum wage, before taxes. These reps are engaged in a whole lot of CYA as they will have to justify the inevitable, but somehow have to claim it’s something other than Obamacare in order to maintain their government sinecure. With the crash in energy prices, their fossil fuel state paradise is anything but.
Amir Khalid
Off topic:
Harper Lee, author of To Kill A Mockingbird, has passed away at the age of 89 in her hometown of Monroeville, Alabama.
Karen
@guachi:
Then it’s the hatred of white poors vs. rich ones. They need someone to hate or there’s no GOP party.
Mike in NC
Let’s be clear: when Peggy Noonan talks about a 5-4 ratio, that’s her drinking 5 gin and tonics followed by 4 vodka martinis.
Roger Moore
@dedc79:
It seems to me that a sober mind would rebel at a lot of the “logic” needed to reach those conclusions. It’s not clear to me if the drink is a cause or an effect of the illogic, though.
Paul in KY
Surely a stalling tactic that they didn’t want to spend much on. Guess it gives them another year to twist his arm, or he could die…
Paul in KY
@Bartholomew: Bizarro USA? Would need a goatee.
Paul in KY
@cmorenc: I think it’s just a bit more sophisticated than their usual screaming tantrum tactic.
Paul in KY
@japa21: To me, if you do that, you have to give some kind of small raise to the other personnel (to mollify them).
scav
@Roger Moore: I don’t know. It seems increasingly evident that assuming sober minds have an affinity for logic, especially when it interferes with getting their own way, is untennable as a hypothesis. The justification that springs from the attached lips may garb itself in a veneer of logicality, but will be more akin to those legalisms toddlers adopt when trying to get their cookie and to assert that the absent parent would totally let them climb on the roof with power tools.
Paul in KY
@dedc79: It will still be balanced. It’s just that it will be 4 – 5, instead of 5 – 4.
Peggy Noonan is an idiot.
John M. Burt
@OzarkHillbilly: Yes, you need to make it clear what you mean by “take care of” the working poor: https://www.youtube.com/watch?v=OICRkzQz47Y
Paul in KY
@Punchy: And the pick will have a fist on the end of it!!! The nerve…
ThresherK
Not only will that $20k not buy a good study, isn’t this a real per-capita waste of money? WY only has 600k population.
satby
@Kay: and the reality is that because one set of folks may get Medicaid and someone just over the cutoff does not, the one who doesn’t qualify ends up worse off fiscally than the one who did qualify. Which doesn’t motivate a lot of people to feel happy for their neighbors.
Gex
@dedc79: Interesting how 5-4 is balanced, but 4-5 is COMPLETELY OUT OF WHACK!
boatboy_srq
@dedc79: Wow. She started her day early, didn’t she? And she’s even quoting the Washington Examiner: that’s a new low for her, yes?
Seanly
Can anyone explain what is with the fetish for health savings accounts? Considering that most Americans don’t save any money period. Most people can’t put aside 10% for retirement or another 5% for medical expenses. The system doesn’t work.
boatboy_srq
@Kay: The problem with addressing the divide is that the moment anything is done to make the situation better, the Reichwing will shriek about “free stuff” and “Those People” and the people on the wrong (i.e. high) side of the split will go right along with them. The US needs far more generous support, far higher wages and a gentler segue from assistance to independence; getting any of that, in these Teahadi days, makes turnips look like a cash crop for the Red Cross.
gene108
@Rob in CT:
If your employer offers qualified ACA compliant plans you do not qualify for subsidies.
And employers can still shovel a lot of the cost onto employees, making it a bad deal for people on the lower end of the earning ladder.
boatboy_srq
@Seanly: Mr. Mayhew may correct me here, but:
It’s one part Prosperity Gospel and one part Personal Responsibility. The fact that HSAs only work for the top 10% of earners doesn’t factor in: it’s putting aside your own money for your own needs (IOW being “personally responsible”), and at the same time it’s just one more way to shame the Poors for being unable to afford decent healthcare (which if they got it might just lift them out of Poorness*). Of course the PTB love the things: they’re basically 100% tax-free healthcare with good earnings potential on what they don’t use. That nobody but the PTB can make effective use of them is secondary. Added plus: with employer-provided insurance rates having climbed as high as they have they make the employers’ expense insuring their workers just that much lower, which makes the accountants happy.
* “Poorness” as social/cultural disdain, as opposed to poverty which is an economic condition.
dedc79
@boatboy_srq: Yes, Hugh Hewitt, noted arbiter of partisanship and impartiality
Matt McIrvin
@Seanly: I can see them actually working well in cases where you have predictable health expenses you’ve budgeted for, which is the case for some people.
But I think there is also a subset of wingnuts who have become suspicious of the entire concept of insurance, and the idea of health savings accounts as a substitute for real health coverage comes from there. It’s rugged individualism: I’m saving my own money, no mooching off my premiums just because YOU got in an accident or got cancer!
boatboy_srq
@dedc79: I love her subtext that 5-4 on SCOTUS is good and proper balance but 4-5 is unConstitooshunul Tyranny.
Matt McIrvin
@Seanly: …I remember one online argument in the run-up to Obamacare where somebody argued that insurance was a scam, he’d successfully avoided getting any kind of insurance policy, and the right way for people to get affordable healthcare was to do what he did and go down to Mexico for it.
Kay
@satby:
True. You really have to put a giant group of working and middle class people in front of poor people- join them to a larger group- or the programs are eternally vulnerable. Easy pick’ins.
I think one of the reasons the health care law subsidies aren’t that generous is because a lot of (low pay) employers plans aren’t generous, as far as real employee share. They had to aim for “equal footing” and equal footing is pretty low. You couldn’t have a situation where Employee was paying 240 a month out of paycheck and a person with comparable income was paying 100 on the exchange. I got specifically asked about that by lower wage people here who HAVE health insurance- “are they getting more than us”?
Shakezula
The Foundation for Government Accountability will get a check for $20K, in exchange for which they’ll produce a work of fiction.
Frankensteinbeck
@OzarkHillbilly:
As Cliven Bundy so eloquently pointed out, ‘The Negro’ doesn’t have to live next to you. He is somewhere, being lazy because the government gives him free stuff. That is enough.
@Tinare:
I do follow her logic. She is saying there are 4 conservative justices, 4 liberal justices, and a non-ideological justice on every issue. This, decisions are made not by partisanship, but by whether an objective judge can be swayed by either side. She mentions cases liberals won as her ‘proof’.
The real situation is that we had 4 liberal but mainstream justices, 3 deranged hyper conservative justices, and two hardcore conservative justices who sometimes had moments of sanity.
cmorenc
@MattF:
@muddy:
The important point I was making is that the GOP-dominated Wyoming legislature IS feeling enough pressure on the need to better extend medical services to the poor via Medicaid expansion in other states that they cannot simply blow it off with out-of-hand hostile rejection, but instead need to at least put on the appearance of taking the issue seriously, even though it runs strongly counter to their ideological grain to do so. They recognize they can’t get away with pure rejectionism against Obamacare/Medicaid expansion as a response, that they at least need to appear to be trying to come up with some conservative-compliant alternative proposal instead of stonewalling. Yes, their likely proposed alternatives will be deeply flawed, inadequate weak tea, but they recognize they can’t simply dismissively walk away from the need to address indigent medical services.
Peale
@Seanly: HSA’s give people who do save a tax break. Their existence also gives wealthier people a good way to blame poor people for their moral laxity and imprudent living. I mean, “I bet they once spent extra money to get premium puffy toilet paper and now look at you with your cancer. I bet you wish you had used newspapers now.”
Richard Mayhew
@Nylund: got to pay university overhead… My alma mater charge 52.5%
What Have the Romans Ever Done for Us?
@Kay: if only there were a way for working folks to demand better compensation from their employers (cough*Unions*cough). Instead of voting for the people who are trying to make it easier for employers go give them a worse deal than they already have, maybe they could vote for people who want to help them extract more pay and benefits from their employers. But no, we got to punch down rather than rise up.
glory b
@dedc79: In law school, the argument is that it is the exact opposite. A 9-0 or 8-1 decision lets everyone know that the matter is settled, get used to it.
5-4 means let’s try again next term, or let’s try again when a justice retires or dies.
boatboy_srq
@Kay:
There’s a long and ugly history of this. One employer from years back (well pre-ACA) advised me to shop the individual healthcare market because the company plan was so expensive and covered so little (and the company contributions were laughably low). Trouble is there are only two checks on bad benefits, and they are regulations and unions; with the Reichwing so staunchly opposed to either it’s small wonder employers can get away with offering so little.
boatboy_srq
@Frankensteinbeck: There’s also the legal assumption that 5-4 decisions are questionable, and should be expected as the exception rather than the rule; the more justices who agree on the decision the stronger the decision is.
JGabriel
Richard Mayhew:
I think that’s a bit unlikely – I can’t imagine they’d even bother with subject-verb agreement.
Matt
It’s a GOP legislature; they have nothing but disdain for the entire idea of government that does anything besides collect bribes from big companies and fuck over little people. The people of WY should be shocked if that $20k even buys them a canned report from ALEC with “Wyoming” consistently inserted in all the “[STATE NAME HERE]” placeholders.
Zinsky
Is it at all surprising that Republicans are more interested in obfuscation than enlightenment? The $20k will be just used to throw sand in the gears of progress. I read a great article on digby’s blog a while back (can’t find the link) about how many of the “cowboys” of the Old West were former Confederate soldiers who had found a horse and rode west after the Civil War because they hated Reconstruction and didn’t want to be under the Yankees thumb. It explains a lot of the anti-government sentiment in places like Wyoming and Idaho. They are simply late generation Confederates who hate government and are still stewing about getting their asses kicked during the Civil War.
Zinsky
A couple last comments about Peggy Noonan’s column mentioned up thread: She is a horrible writer who never makes any logical sense but her drivel always gets published by major East Coast newspapers because attends the right swanky dinner parties. She can take her creepy Antigonean obsession with Ronald Reagan and go bang herself!
moderateindy
Peggy the country already decided who they wanted to pick Justices when they elected OBama. Maybe I missed the caveat in the Constitution where appointing a Supreme Court Justice was part of a President’s duties except in yhe 4th year of any term.
Under Peggy’s logic the House wouldn’t convene in the last quarter of their 2 years, and god knows how the Senate would work. Why anybody brings her on a show with the Historian tag attached, that lacks the adjective conservative or Republican, shows how pathetic our corporate media is.
As far as Wyoming Republican’s stance on expanding medicare is concerned……….In other completely unsurprising news… Cat ignores owner, film at 11
Betsy
@Kay: Kay, you hit the nail on the head.
Conditions have deteriorated for working people to the point where it almost does not pay to be working, for a huge chunk of the working class.