How Medicaid Funding will change

Your Virginia Tech Politics and Religion source
Forum rules
Be Civil. Go Hokies.
Post Reply
133743Hokie
Posts: 11220
Joined: Thu Aug 22, 2013 12:29 am

How Medicaid Funding will change

Post by 133743Hokie »

Been reading a little bit on this and it seems that the Senate plan is actually not unreasonable, despite the democrats calls that it is literally going to kill people.

Pre ACA Medicaid took care of "poor children, pregnant women, the disabled, and the ailing elderly". The ACA expanded that coverage to poor (less that 138% of the poverty line) able-bodied adults. Originally this was mandatory but the SCOTUS nixed that and made it voluntary. About 30 or so states signed up.

Pre ACA Medicaid paid states on a sliding scale based on how "wealthy" their population was . The poorest states got 75% (3 federal dollars for every 1 state dollar) and the richest 50%. VA for example received 50%, essentially a 1 for 1 matching. The ACA expanded reimbursement to 100% for new enrollees the first few years, dropping back to 90% in all subsequent years (9 federal dollars for 1 state dollar), for those states that participated. This perversion meant that "new enrollees", essentially those able bodied poor newly added to the rolls, would get more dollars per person than those historically covered (children, pregnant, disabled, elderly). How screwed up is that?

So the ACA expanded the pool of people covered by Medicaid, expanded the amount of federal dollars going to the states for Medicaid, and gave more dollars to the able bodied poor than the truly needy. This is why it is politically impossible for the Republicans to fully repeal the ACA -- there are too many (15M?) new people on the Medicaid rolls and the states (at least 30 of them) are getting more dollars from the USG to fund the program, meaning less have to come from their own coffers.

So the Senate proposes phasing out this enhanced payout to the able bodied poor over a period of several years such that everyone on Medicaid is covered the same on a dollar for dollar basis. The proposed bill gives refundable tax credits to those poor that lose some of their funding thru the scale back in an attempt to make them whole. The bill also adjusts the growth in funding to the inflation rate vs. the medical inflation rate. These two reductions are the primary factors in the $321M "cut" in Medicaid funding.

So it appears that the senate bill logically reins back in the expanded unequal (and unfair?) Medicaid funding of the ACA. I have no problem with it.
HokieJoe
Posts: 13122
Joined: Thu Aug 22, 2013 2:12 pm
Alma Mater: Virginia Tech
Party: Eclectic

Re: How Medicaid Funding will change

Post by HokieJoe »

133743Hokie wrote:Been reading a little bit on this and it seems that the Senate plan is actually not unreasonable, despite the democrats calls that it is literally going to kill people.

Pre ACA Medicaid took care of "poor children, pregnant women, the disabled, and the ailing elderly". The ACA expanded that coverage to poor (less that 138% of the poverty line) able-bodied adults. Originally this was mandatory but the SCOTUS nixed that and made it voluntary. About 30 or so states signed up.

Pre ACA Medicaid paid states on a sliding scale based on how "wealthy" their population was . The poorest states got 75% (3 federal dollars for every 1 state dollar) and the richest 50%. VA for example received 50%, essentially a 1 for 1 matching. The ACA expanded reimbursement to 100% for new enrollees the first few years, dropping back to 90% in all subsequent years (9 federal dollars for 1 state dollar), for those states that participated. This perversion meant that "new enrollees", essentially those able bodied poor newly added to the rolls, would get more dollars per person than those historically covered (children, pregnant, disabled, elderly). How screwed up is that?

So the ACA expanded the pool of people covered by Medicaid, expanded the amount of federal dollars going to the states for Medicaid, and gave more dollars to the able bodied poor than the truly needy. This is why it is politically impossible for the Republicans to fully repeal the ACA -- there are too many (15M?) new people on the Medicaid rolls and the states (at least 30 of them) are getting more dollars from the USG to fund the program, meaning less have to come from their own coffers.

So the Senate proposes phasing out this enhanced payout to the able bodied poor over a period of several years such that everyone on Medicaid is covered the same on a dollar for dollar basis. The proposed bill gives refundable tax credits to those poor that lose some of their funding thru the scale back in an attempt to make them whole. The bill also adjusts the growth in funding to the inflation rate vs. the medical inflation rate. These two reductions are the primary factors in the $321M "cut" in Medicaid funding.

So it appears that the senate bill logically reins back in the expanded unequal (and unfair?) Medicaid funding of the ACA. I have no problem with it.

Within the confines of this mess, people that actually paid into the system should always get more coverage. Always. As well, the idea that younger person in their productive years would receive the same benefit levels as an elderly person is ridiculous. The elderly should get more benefits because their need requirements are higher.
"I predict future happiness for Americans, if they can prevent the government from wasting the labors of the people under the pretense of taking care of them." - Thomas Jefferson
133743Hokie
Posts: 11220
Joined: Thu Aug 22, 2013 12:29 am

Re: How Medicaid Funding will change

Post by 133743Hokie »

HokieJoe wrote:
133743Hokie wrote:Been reading a little bit on this and it seems that the Senate plan is actually not unreasonable, despite the democrats calls that it is literally going to kill people.

Pre ACA Medicaid took care of "poor children, pregnant women, the disabled, and the ailing elderly". The ACA expanded that coverage to poor (less that 138% of the poverty line) able-bodied adults. Originally this was mandatory but the SCOTUS nixed that and made it voluntary. About 30 or so states signed up.

Pre ACA Medicaid paid states on a sliding scale based on how "wealthy" their population was . The poorest states got 75% (3 federal dollars for every 1 state dollar) and the richest 50%. VA for example received 50%, essentially a 1 for 1 matching. The ACA expanded reimbursement to 100% for new enrollees the first few years, dropping back to 90% in all subsequent years (9 federal dollars for 1 state dollar), for those states that participated. This perversion meant that "new enrollees", essentially those able bodied poor newly added to the rolls, would get more dollars per person than those historically covered (children, pregnant, disabled, elderly). How screwed up is that?

So the ACA expanded the pool of people covered by Medicaid, expanded the amount of federal dollars going to the states for Medicaid, and gave more dollars to the able bodied poor than the truly needy. This is why it is politically impossible for the Republicans to fully repeal the ACA -- there are too many (15M?) new people on the Medicaid rolls and the states (at least 30 of them) are getting more dollars from the USG to fund the program, meaning less have to come from their own coffers.

So the Senate proposes phasing out this enhanced payout to the able bodied poor over a period of several years such that everyone on Medicaid is covered the same on a dollar for dollar basis. The proposed bill gives refundable tax credits to those poor that lose some of their funding thru the scale back in an attempt to make them whole. The bill also adjusts the growth in funding to the inflation rate vs. the medical inflation rate. These two reductions are the primary factors in the $321M "cut" in Medicaid funding.

So it appears that the senate bill logically reins back in the expanded unequal (and unfair?) Medicaid funding of the ACA. I have no problem with it.

Within the confines of this mess, people that actually paid into the system should always get more coverage. Always. As well, the idea that younger person in their productive years would receive the same benefit levels as an elderly person is ridiculous. The elderly should get more benefits because their need requirements are higher.
Most people that fund Medicaid thru their taxes never see any return as they never use the service.
HokieJoe
Posts: 13122
Joined: Thu Aug 22, 2013 2:12 pm
Alma Mater: Virginia Tech
Party: Eclectic

Re: How Medicaid Funding will change

Post by HokieJoe »

133743Hokie wrote:
HokieJoe wrote:
133743Hokie wrote:Been reading a little bit on this and it seems that the Senate plan is actually not unreasonable, despite the democrats calls that it is literally going to kill people.

Pre ACA Medicaid took care of "poor children, pregnant women, the disabled, and the ailing elderly". The ACA expanded that coverage to poor (less that 138% of the poverty line) able-bodied adults. Originally this was mandatory but the SCOTUS nixed that and made it voluntary. About 30 or so states signed up.

Pre ACA Medicaid paid states on a sliding scale based on how "wealthy" their population was . The poorest states got 75% (3 federal dollars for every 1 state dollar) and the richest 50%. VA for example received 50%, essentially a 1 for 1 matching. The ACA expanded reimbursement to 100% for new enrollees the first few years, dropping back to 90% in all subsequent years (9 federal dollars for 1 state dollar), for those states that participated. This perversion meant that "new enrollees", essentially those able bodied poor newly added to the rolls, would get more dollars per person than those historically covered (children, pregnant, disabled, elderly). How screwed up is that?

So the ACA expanded the pool of people covered by Medicaid, expanded the amount of federal dollars going to the states for Medicaid, and gave more dollars to the able bodied poor than the truly needy. This is why it is politically impossible for the Republicans to fully repeal the ACA -- there are too many (15M?) new people on the Medicaid rolls and the states (at least 30 of them) are getting more dollars from the USG to fund the program, meaning less have to come from their own coffers.

So the Senate proposes phasing out this enhanced payout to the able bodied poor over a period of several years such that everyone on Medicaid is covered the same on a dollar for dollar basis. The proposed bill gives refundable tax credits to those poor that lose some of their funding thru the scale back in an attempt to make them whole. The bill also adjusts the growth in funding to the inflation rate vs. the medical inflation rate. These two reductions are the primary factors in the $321M "cut" in Medicaid funding.

So it appears that the senate bill logically reins back in the expanded unequal (and unfair?) Medicaid funding of the ACA. I have no problem with it.

Within the confines of this mess, people that actually paid into the system should always get more coverage. Always. As well, the idea that younger person in their productive years would receive the same benefit levels as an elderly person is ridiculous. The elderly should get more benefits because their need requirements are higher.
Most people that fund Medicaid thru their taxes never see any return as they never use the service.

Many people in nursing home facilities: or who receive in-home care utilize Medicaid assistance. Otherwise, they'd go broke. The problem is only to get worse because of boomers.
"I predict future happiness for Americans, if they can prevent the government from wasting the labors of the people under the pretense of taking care of them." - Thomas Jefferson
133743Hokie
Posts: 11220
Joined: Thu Aug 22, 2013 12:29 am

Re: How Medicaid Funding will change

Post by 133743Hokie »

HokieJoe wrote:
133743Hokie wrote:
HokieJoe wrote:
133743Hokie wrote:Been reading a little bit on this and it seems that the Senate plan is actually not unreasonable, despite the democrats calls that it is literally going to kill people.

Pre ACA Medicaid took care of "poor children, pregnant women, the disabled, and the ailing elderly". The ACA expanded that coverage to poor (less that 138% of the poverty line) able-bodied adults. Originally this was mandatory but the SCOTUS nixed that and made it voluntary. About 30 or so states signed up.

Pre ACA Medicaid paid states on a sliding scale based on how "wealthy" their population was . The poorest states got 75% (3 federal dollars for every 1 state dollar) and the richest 50%. VA for example received 50%, essentially a 1 for 1 matching. The ACA expanded reimbursement to 100% for new enrollees the first few years, dropping back to 90% in all subsequent years (9 federal dollars for 1 state dollar), for those states that participated. This perversion meant that "new enrollees", essentially those able bodied poor newly added to the rolls, would get more dollars per person than those historically covered (children, pregnant, disabled, elderly). How screwed up is that?

So the ACA expanded the pool of people covered by Medicaid, expanded the amount of federal dollars going to the states for Medicaid, and gave more dollars to the able bodied poor than the truly needy. This is why it is politically impossible for the Republicans to fully repeal the ACA -- there are too many (15M?) new people on the Medicaid rolls and the states (at least 30 of them) are getting more dollars from the USG to fund the program, meaning less have to come from their own coffers.

So the Senate proposes phasing out this enhanced payout to the able bodied poor over a period of several years such that everyone on Medicaid is covered the same on a dollar for dollar basis. The proposed bill gives refundable tax credits to those poor that lose some of their funding thru the scale back in an attempt to make them whole. The bill also adjusts the growth in funding to the inflation rate vs. the medical inflation rate. These two reductions are the primary factors in the $321M "cut" in Medicaid funding.

So it appears that the senate bill logically reins back in the expanded unequal (and unfair?) Medicaid funding of the ACA. I have no problem with it.

Within the confines of this mess, people that actually paid into the system should always get more coverage. Always. As well, the idea that younger person in their productive years would receive the same benefit levels as an elderly person is ridiculous. The elderly should get more benefits because their need requirements are higher.
Most people that fund Medicaid thru their taxes never see any return as they never use the service.

Many people in nursing home facilities: or who receive in-home care utilize Medicaid assistance. Otherwise, they'd go broke. The problem is only to get worse because of boomers.
Medicare will get worse because of boomers, not medicaid.
HokieJoe
Posts: 13122
Joined: Thu Aug 22, 2013 2:12 pm
Alma Mater: Virginia Tech
Party: Eclectic

Re: How Medicaid Funding will change

Post by HokieJoe »

133743Hokie wrote:
HokieJoe wrote:
133743Hokie wrote:
HokieJoe wrote:
133743Hokie wrote:Been reading a little bit on this and it seems that the Senate plan is actually not unreasonable, despite the democrats calls that it is literally going to kill people.

Pre ACA Medicaid took care of "poor children, pregnant women, the disabled, and the ailing elderly". The ACA expanded that coverage to poor (less that 138% of the poverty line) able-bodied adults. Originally this was mandatory but the SCOTUS nixed that and made it voluntary. About 30 or so states signed up.

Pre ACA Medicaid paid states on a sliding scale based on how "wealthy" their population was . The poorest states got 75% (3 federal dollars for every 1 state dollar) and the richest 50%. VA for example received 50%, essentially a 1 for 1 matching. The ACA expanded reimbursement to 100% for new enrollees the first few years, dropping back to 90% in all subsequent years (9 federal dollars for 1 state dollar), for those states that participated. This perversion meant that "new enrollees", essentially those able bodied poor newly added to the rolls, would get more dollars per person than those historically covered (children, pregnant, disabled, elderly). How screwed up is that?

So the ACA expanded the pool of people covered by Medicaid, expanded the amount of federal dollars going to the states for Medicaid, and gave more dollars to the able bodied poor than the truly needy. This is why it is politically impossible for the Republicans to fully repeal the ACA -- there are too many (15M?) new people on the Medicaid rolls and the states (at least 30 of them) are getting more dollars from the USG to fund the program, meaning less have to come from their own coffers.

So the Senate proposes phasing out this enhanced payout to the able bodied poor over a period of several years such that everyone on Medicaid is covered the same on a dollar for dollar basis. The proposed bill gives refundable tax credits to those poor that lose some of their funding thru the scale back in an attempt to make them whole. The bill also adjusts the growth in funding to the inflation rate vs. the medical inflation rate. These two reductions are the primary factors in the $321M "cut" in Medicaid funding.

So it appears that the senate bill logically reins back in the expanded unequal (and unfair?) Medicaid funding of the ACA. I have no problem with it.

Within the confines of this mess, people that actually paid into the system should always get more coverage. Always. As well, the idea that younger person in their productive years would receive the same benefit levels as an elderly person is ridiculous. The elderly should get more benefits because their need requirements are higher.
Most people that fund Medicaid thru their taxes never see any return as they never use the service.

Many people in nursing home facilities: or who receive in-home care utilize Medicaid assistance. Otherwise, they'd go broke. The problem is only to get worse because of boomers.
Medicare will get worse because of boomers, not medicaid.
They'll both get worse. The elderly represent 8% of Medicaid expenditures right now. Of that 8%, a large percentage is spent on elder care services such as nursing home care. Watch that number rise over time as boomers continue to leave the workforce; and even more so when all of those people dumped into Medicaid by Odipshiite start receiving nursing home care down the road.

All that said, nothing you've written has anything to do with the point I made in my first post. Some people who have paid into Medicaid do utilize Medicaid. They should receive more than someone who didn't pay into Medicaid. And they should be able to utilize the service without the states robbing them of house and home should they need to go into a nursing home.
"I predict future happiness for Americans, if they can prevent the government from wasting the labors of the people under the pretense of taking care of them." - Thomas Jefferson
133743Hokie
Posts: 11220
Joined: Thu Aug 22, 2013 12:29 am

Re: How Medicaid Funding will change

Post by 133743Hokie »

HokieJoe wrote:
133743Hokie wrote:
HokieJoe wrote:
133743Hokie wrote:
HokieJoe wrote:
133743Hokie wrote:Been reading a little bit on this and it seems that the Senate plan is actually not unreasonable, despite the democrats calls that it is literally going to kill people.

Pre ACA Medicaid took care of "poor children, pregnant women, the disabled, and the ailing elderly". The ACA expanded that coverage to poor (less that 138% of the poverty line) able-bodied adults. Originally this was mandatory but the SCOTUS nixed that and made it voluntary. About 30 or so states signed up.

Pre ACA Medicaid paid states on a sliding scale based on how "wealthy" their population was . The poorest states got 75% (3 federal dollars for every 1 state dollar) and the richest 50%. VA for example received 50%, essentially a 1 for 1 matching. The ACA expanded reimbursement to 100% for new enrollees the first few years, dropping back to 90% in all subsequent years (9 federal dollars for 1 state dollar), for those states that participated. This perversion meant that "new enrollees", essentially those able bodied poor newly added to the rolls, would get more dollars per person than those historically covered (children, pregnant, disabled, elderly). How screwed up is that?

So the ACA expanded the pool of people covered by Medicaid, expanded the amount of federal dollars going to the states for Medicaid, and gave more dollars to the able bodied poor than the truly needy. This is why it is politically impossible for the Republicans to fully repeal the ACA -- there are too many (15M?) new people on the Medicaid rolls and the states (at least 30 of them) are getting more dollars from the USG to fund the program, meaning less have to come from their own coffers.

So the Senate proposes phasing out this enhanced payout to the able bodied poor over a period of several years such that everyone on Medicaid is covered the same on a dollar for dollar basis. The proposed bill gives refundable tax credits to those poor that lose some of their funding thru the scale back in an attempt to make them whole. The bill also adjusts the growth in funding to the inflation rate vs. the medical inflation rate. These two reductions are the primary factors in the $321M "cut" in Medicaid funding.

So it appears that the senate bill logically reins back in the expanded unequal (and unfair?) Medicaid funding of the ACA. I have no problem with it.

Within the confines of this mess, people that actually paid into the system should always get more coverage. Always. As well, the idea that younger person in their productive years would receive the same benefit levels as an elderly person is ridiculous. The elderly should get more benefits because their need requirements are higher.
Most people that fund Medicaid thru their taxes never see any return as they never use the service.

Many people in nursing home facilities: or who receive in-home care utilize Medicaid assistance. Otherwise, they'd go broke. The problem is only to get worse because of boomers.
Medicare will get worse because of boomers, not medicaid.
They'll both get worse. The elderly represent 8% of Medicaid expenditures right now. Of that 8%, a large percentage is spent on elder care services such as nursing home care. Watch that number rise over time as boomers continue to leave the workforce; and even more so when all of those people dumped into Medicaid by Odipshiite start receiving nursing home care down the road.

All that said, nothing you've written has anything to do with the point I made in my first post. Some people who have paid into Medicaid do utilize Medicaid. They should receive more than someone who didn't pay into Medicaid. And they should be able to utilize the service without the states robbing them of house and home should they need to go into a nursing home.
As I said. Few if any people that "pay into Medicaid" will ultimately use it. You will have a hard time using Medicaid at a nursing home unless you are indigent.
HokieJoe
Posts: 13122
Joined: Thu Aug 22, 2013 2:12 pm
Alma Mater: Virginia Tech
Party: Eclectic

Re: How Medicaid Funding will change

Post by HokieJoe »

133743Hokie wrote: As I said. Few if any people that "pay into Medicaid" will ultimately use it. You will have a hard time using Medicaid at a nursing home unless you are indigent.

If you have a wife and/or children and are nearing retirement age, I suggest you speak with an eldercare attorney. Medicare only pays for 100 days of facility care (if necessary). After that, Medicaid expects you to 'spend down' personal assets to the $2000 threshold for nursing home care. After that, Medicaid will start picking up the tab. We're talking about a lot of people here, and many of them don't chose the nursing home option because Medicaid can potentially drain them of their personal assets. That means many people who actually paid into the Medicaid program their whole working life do not use the benefits. Why? Because we're too busy subsidizing people who don't pay a dime into the program at the expense of people who actually did pay into the program. That's f'd up.
"I predict future happiness for Americans, if they can prevent the government from wasting the labors of the people under the pretense of taking care of them." - Thomas Jefferson
133743Hokie
Posts: 11220
Joined: Thu Aug 22, 2013 12:29 am

Re: How Medicaid Funding will change

Post by 133743Hokie »

HokieJoe wrote:
133743Hokie wrote: As I said. Few if any people that "pay into Medicaid" will ultimately use it. You will have a hard time using Medicaid at a nursing home unless you are indigent.

If you have a wife and/or children and are nearing retirement age, I suggest you speak with an eldercare attorney. Medicare only pays for 100 days of facility care (if necessary). After that, Medicaid expects you to 'spend down' personal assets to the $2000 threshold for nursing home care. After that, Medicaid will start picking up the tab. We're talking about a lot of people here, and many of them don't chose the nursing home option because Medicaid can potentially drain them of their personal assets. That means many people who actually paid into the Medicaid program their whole working life do not use the benefits. Why? Because we're too busy subsidizing people who don't pay a dime into the program at the expense of people who actually did pay into the program. That's f'd up.
Again, such a small, small segment of the population. I don't think you fully understand Medicare and medicaid
HokieJoe
Posts: 13122
Joined: Thu Aug 22, 2013 2:12 pm
Alma Mater: Virginia Tech
Party: Eclectic

Re: How Medicaid Funding will change

Post by HokieJoe »

133743Hokie wrote:
HokieJoe wrote:
133743Hokie wrote: As I said. Few if any people that "pay into Medicaid" will ultimately use it. You will have a hard time using Medicaid at a nursing home unless you are indigent.

If you have a wife and/or children and are nearing retirement age, I suggest you speak with an eldercare attorney. Medicare only pays for 100 days of facility care (if necessary). After that, Medicaid expects you to 'spend down' personal assets to the $2000 threshold for nursing home care. After that, Medicaid will start picking up the tab. We're talking about a lot of people here, and many of them don't chose the nursing home option because Medicaid can potentially drain them of their personal assets. That means many people who actually paid into the Medicaid program their whole working life do not use the benefits. Why? Because we're too busy subsidizing people who don't pay a dime into the program at the expense of people who actually did pay into the program. That's f'd up.

Again, such a small, small segment of the population. I don't think you fully understand Medicare and medicaid

I understand Medicare and Medicaid as it pertains to nursing home/eldercare just fine. Relative population size has nothing to do with what is fair to those who paid into the system vs those who didn't. Moreover, chronic indigence is not a requirement for needing nursing home care. $3000-$5000/month is expensive for most people. Most people, should they need that sort of care, could not afford to pay that much money. It's a legitimate issue, and it's not one that should be brushed aside because some people are too lazy to use birth control (which is free to anyone who wants it).
"I predict future happiness for Americans, if they can prevent the government from wasting the labors of the people under the pretense of taking care of them." - Thomas Jefferson
Post Reply