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You are here: Home / Anderson On Health Insurance / Entrenching Medicaid Expansion

Entrenching Medicaid Expansion

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Just a pair of notes on the political entrenching of  Medicaid Expansion into the political and policy processes of the United States.

First in Arkansas:

 

Arkansas officials should consider transferring more high-cost enrollees from the private option to the traditional, fee-for-service Medicaid program, a sponsor of the law that created the program said Monday.

At a meeting of the Health Reform Legislative Task Force, Senate President Pro Tempore Jonathan Dismang, R-Searcy, said he’s concerned that health care costs of some enrollees are increasing the cost of coverage for others in the state’s individual insurance market.

The basic mechanics of this plan would be to shift more of the expensive, high utilizing and not too healthy members from the Arkansas Private Option subsidized on-Exchange risk pool that pays providers commercial rates to the legacy Medicaid program where providers are paid (in Arkansas) about half the commercial rate. The goal is to reduce Arkansas’ state contribution to Medicaid expansion by effectively making the Expansion eligible individuals in the Legacy Medicaid pool an effective and well funded low income high risk pool while dumping all of the good risk into the private option pool to minimize nominal premium increases on Exchange.

The simpler thing to do in general would have been a general expansion with new ID cards and little else, but that will not pass in Arkansas so we get this policy tweak that actually solves a problem and probably makes everyone but the providers no worse off if not a bit better off.
 

Next, in Indiana:


 

Governor Pence pushed for the Healthy Indiana Plan v2. (HIP 2.0) to expand Medicaid. It is a convoluted bastard of conservative pet rocks and hoop jumping but it actually does cover most of the people who need to be covered by Medicaid Expansion.

It is also not an immediately disqualifying event for Governor Pence to be elevated to a national ticket.

This is how policies get entrenched even as a party bitches about them.

Reader Interactions

46Comments

  2. 2.

    Yutsano

    It is also not an immediately disqualifying event for Governor Pence to be elevated to a national ticket.

    If this were a normal election cycle it absolutely would be. But nothing about this election cycle has been normal. I don’t think Trump put much thought into this beyond Pence ties to the Koch bank account.

  6. 6.

    Frankensteinbeck

    @Major Major Major Major:
    Kentucky is a cesspool of racism and generalized spite. The widely held belief, which they tell people who ask why they would vote to take away their own health care, is that if the unworthy are fucked over hard enough, a utopia will automatically appear for the worthy, who will no longer need government help. Even driving in Kentucky is a nightmare of people trying to cut you off as an instinctive reaction to seeing someone else want something.

    I am not sure that this is any different from other conservative states, especially the South, but I only know Kentucky from (deep) personal experience.

  7. 7.

    gorram

    It is also not an immediately disqualifying event for Governor Pence to be elevated to a national ticket.

    Unless of course, you are LGBT?

  10. 10.

    hovercraft

    I read somewhere maybe here in an earlier thread that there is a good chance that Hillary and the DNC know more about Pence than Trump does.
    Poor baby being forced by Indiana law to make this announcement with so little fanfare on the twitter machine. The presser tomorrow just won’t be the same, and after he spent all week building up to the dramatic moment.

  14. 14.

    Shell

    In 2012 didn’t Cole brave the Heart of Darkness to report on the GOP convention for us? (Course thats when he was still drinking.) Are there gonna be an BJers at Cleveland this year?

  15. 15.

    hovercraft

    @Frankensteinbeck:
    I think it’s the warped sense that feeds the belief in the Civil War being caused by ‘Northern aggression’, if black people had only not complained about their plight as slaves, then the North would never have ‘attacked the South, and they would never have been beaten and forced to bow down to those Yankees. So you see the problems of the south are all caused by those stupid ni**ers who had to go and mess everything up, so now we are going to f**k them every way we can to show them who’s still boss. Basically convoluted spite, like the spousal abuser who blames their victim for getting beat up.

  18. 18.

    dmsilev

    @Mike J: Where is it? I just sullied my computer by going to Trump’s campaign’s homepage, and there’s nothing there about Pence at all, never mind a new logo.

  23. 23.

    hovercraft

    @Mike J:
    What the phuck is that ? So far the roll out is just brilliant, your vp’s name was leaked yesterday, try to sneak vp into NY every one knows he’s on a plane, your press conference has to be pushed back by a tragedy, and to top it off your campaign logo looks like Sanskrit or some other foreign lettering, smooth, real smooth.

  24. 24.

    Frankensteinbeck

    @hovercraft:
    That’s the kind of logic they use, yes. It grows out of a culture of hate. Southern culture hates everyone, looking for an excuse to mark someone for abuse. That may be created by the backdrop of racism and Christianism. There’s a chicken-egg thing. Note non-Southerners in the same cultural atmosphere end up embracing the confederate flag and mythology.

  26. 26.

    aimai

    @hovercraft: Is it for real? Pence seems to be clinging to the Trump T like Jon Lennon wrapped around Yoko Ono. Also TrumpPence has a horrible ring to it, even sticking an ampersand in between would be better. (Although it would sound like the start of an excercise chant “Trump and Pence and Trump and Pence and Trump and Pence”–maybe a squat and fart.

  27. 27.

    bystander

    @Mike J: I wonder if the New Jersey Turnpike people will cry copyright infringement. At least they didn’t borrow anything from a white supremacist website.

  30. 30.

    FlyingToaster

    @Shell: No, he went to the Democratic convention with @AngryBlackLady. Nobody risked the hurrcane to go to the Romney do in Tampa. Not even Betty.

  34. 34.

    Amir Khalid

    If (when) the Republican ticket loses the presidential election, and let us all hope it does, Mike Pence will be a lame-duck governor facing unemployment in the new year. I presume there won’t always be room for one more media pundit or think-tank sinecure, particularly one not widely considered a genius. What will he do then?

  35. 35.

    Splitting Image

    Redstate has suggested that Trump hired a Democrat to design the logo.

    If you tilt your head to the left it kind of looks like a guy standing at a urinal.

  36. 36.

    JCT

    Someone reposted Pence’s 10 min interview with George Stephanopoulos after he signed his “Religious Freedom” law. It’s a laugh riot that nicely demonstrates the derp that is Mike Pence.

    Oh and +1 on that horrid logo. These guys give new meaning to “stepping on your dick”.

  37. 37.

    patroclus

    Well, until now, the Trump campaign was possibly the least anti-gay Republican Presidential campaign in recent memory – not because of anything specific about Trump, but merely because he hadn’t expressed antagonism the way most candidates had (and the way he has towards Hispanics, Muslims and women). That is, until now. In the past week, they just passed even more anti-gay stuff into their platform than previously and he just selected perhaps the most anti-gay VP candidate among his top tier. Pence actually believes that businesses not only should be allowed to openly discriminate in providing normal services, but they should be protected legally in doing so. So, according to the Republicans, we can’t marry, businesses should be protected if they discriminate against us, we should be subjected to reparative therapy and we can’t serve in the military. Yeah, let’s make America great again.

  40. 40.

    Technocrat

    @Mike J:

    Wow. Sometimes a cigar is just a cigar, but that “T” seems to be in a really penetrative relationship with that “P”. The dominance theme is overwhelming.

  42. 42.

    Uncle Cosmo

    @hovercraft:

    and to top it off your campaign logo looks like Sanskrit or some other foreign lettering

    That’s the Plan B cobbled up by the TP graphic team when at the last moment someone told them the Hakenkreuz had already been used…

  44. 44.

    Uncle Cosmo

    @Shell: Combover Caligula scattering stuff to the pigeons, foreground, one bird turns to another & says, This stuff tastes like horse puckey! Background, several birds puking their guts out…

  45. 45.

    Carl W

    @Mike J: Nice. I bet they also had ads prepared against Gingrich, Christie, ….

    I wonder how many ads they prepared in total?

  46. 46.

    J R in WV

    @Shell:

    No, no! Lets hope they DO get it tattooed on their face, so we can tell them from a reasonable distance, and avoid them.

    Sorta like the Aryan Nation guys getting released from prison as elderly tattooed men – everyone will know who they are, good people won’t have anything to do with them.

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