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Tuesday, August 11, 2015

Medicaid Expansion - Ohio said yes but 20 other Republican states abandoned their poor

State's that chose not to accept the Medicaid expansion, offered under the Affordable Care Act (ACA), must face up to being wrong. In fact, I'd be willing to suggest a libaility risk for state's where people experienced healthcare suffering, as a result of unwillingness to accept the federal funds,


The refusal of some 20 Republican governors or state legislatures to accept the Affordable Care Act (ACA) Medicaid expansion has to rank as one of the biggest political and moral scandals of modern times. 

To allow millions of citizens to suffer or die needlessly without health insurance, merely to continue a political grudge, is beyond reprehensible, but to do so when such state costs are covered between 90% to 100% by the federal government descends to abject immorality. 

That funding fact, alone, makes today's sad episode one for the history books. Like the "Jim Crow" South or post-WWII "red-lining" of minority communities, this Republican policy of denying available health insurance to the poor is indefensible on a historic level.

Republicans are aware of their crime and, in particular, know that the biggest PR key to denying their culpability is to pretend that this withheld insurance is not fully or near fully funded by the federal government. 

After all, what moral person could gratuitously, miserly, refuse health insurance to their own citizens? No, it must be fiscally impossible. Out of the sinners' control. But how?

Daily Kos reports Fox's Megyn Kelly, at the last Republican debate on August 5th, asked an intentionally dishonest question:

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Governor John Kasich

KELLY asked: Governor John Kasich (of Ohio), "You chose to expand Medicaid in your state, unlike several other governors on this stage tonight. Now, (the program)  is already over budget by some estimates costing taxpayers an additional $1.4 billion in just the first 18 months."

"You defended your Medicaid expansion by invoking God, saying to skeptics that when they arrive in heaven, Saint Peter isn’t going to ask them how small they’ve kept government, but what they have done for the poor."

"Why should Republican voters (asked Kelly), who generally want to shrink government, believe that you won’t use your Saint Peter rationale to expand every government program?"

Wow!  So, Ohio's Medicaid expansion - passed over objections of the Republican legislature - is already $1.4 billion over budget?!? Holy cow!

But, no! This dishonest Megyn Kelly question (previously the rage on right wing web sites) is so galling, and dangerous, that it requires close attention:

In fact, Ohio's Medicaid expansion proved so necessary and appealing that more people signed up than predicted. Do you catch that trick?  Gov. Kasich illustrative numbers only originally hoped to reduce Ohio's uninsured rate by 5% in the first year, but wound up reducing it by 8%.

What about the $1.4 billion in extra costs? All of it, 100%, is covered by the federal ACA program, without any additional costs to Ohioans.

3. But Ms. Kelly mentions the "taxpayers"? Not Ohio taxpayers. She's slyly referring to federal taxpayers. But the ACA federal taxes are already being collected, and they don't go up or down whether Ohio expands Medicaid, rejects Medicaid or enrolls more (or less) than they expected in Medicaid. If Ohio Republicans succeeded in taking away their citizens' insurance, federal taxpayers would not save a penny.

In fact, the Medicaid expansion is paid 90%-100% by the federal government, while the traditional Medicaid is paid around 50%. So, with respect to the "overage," Ohio is getting double the Medicare reimbursement by accepting Obamacare, and eliminating the (substantial but inadequate) amounts that it used to spend on the uninsured.

Megyn Kelly certainly knew she was obfuscating information. Sorry, Megyn. The politics of your Republican bosses remain immoral . . . historically immoral. A true journalist would report the crime, not aid in covering it up.

BTW:  Kelly's question - "You defended your Medicaid expansion by invoking God," you talk about "arriv[ing] in heaven," and "Saint Peter" and what we should do "for the poor." Megyn Kelly is most worried about defending the morality, not the economics, of the Republican position. 

Indeed, with typical chutzpah, Kelly turned the question on its head and asked why Republican voters shouldn't "believe that you won’t use your Saint Peter rationale to expand every government program?" That's some nice old time religion, Megyn!, or so reports DailyKos.

Yes, the net effect of the Medicaid expansion has been hugely beneficial to Ohio (and other states).

But more important, those states where the Medicaid expansion has been rejected have huge numbers of people who are uninsured.  These uninsured people, in my opinion, have the right to launch a class action against their state providers, for not providing the care they need.  

Megyn Kelly is now a woman scorned by presidential candidate Donald Trump the Chump. Nevertheless, Kelly had an opportunity, at the August 5th GOP circus tent debate, to ask a meaningful question, but she failed to do so.

In fact, Governor John Kasich of Ohio (Who O Why O?) made a decision to take the money because his state's poor people needed the health care coverage.  Other states, like Maine, where the governor vetoed acceptance of the federal expansion, in spite of the legislative support, have put tens of thousands of people at risk for preventable illnesses and complicating morbidities.

The state where the Medicaid expansion was rejected by the state government have abandoned their poor. 

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