HOME



Digby's Hullabaloo
2801 Ocean Park Blvd.
Box 157
Santa Monica, Ca 90405



Twitter:
@digby56
@DavidOAtkins

emails:
Digby:
digbysez at gmail
David:
isnospoon at gmail
Dennis:
satniteflix at gmail








Infomania

Salon
Buzzflash
Mother Jones
Raw Story
Huffington Post
Slate
Crooks and Liars
American Prospect
New Republic
Common Dreams
AmericanPoliticsJournal
Smirking Chimp
CJR Daily
consortium news

Blog-o-rama

Eschaton
BagNewsNotes
Daily Kos
Political Animal
Driftglass
Firedoglake
Taylor Marsh
Spocko's Brain
Talk Left
Suburban Guerrilla
Scoobie Davis
Echidne
Electrolite
Americablog
Tom Tomorrow
Left Coaster
Angry Bear
oilprice.com
Seeing the Forest
Cathie From Canada
Frontier River Guides
Brad DeLong
The Sideshow
Liberal Oasis
BartCop
Juan Cole
Rising Hegemon
alicublog
Unqualified Offerings
Alas, A Blog
RogerAiles
Lean Left
Oliver Willis
skippy the bush kangaroo
uggabugga
Crooked Timber
discourse.net
Amygdala
the talking dog
David E's Fablog
The Agonist


Saturday Night at the Movies by Dennis Hartley review archive

01/01/2003 - 02/01/2003 02/01/2003 - 03/01/2003 03/01/2003 - 04/01/2003 04/01/2003 - 05/01/2003 05/01/2003 - 06/01/2003 06/01/2003 - 07/01/2003 07/01/2003 - 08/01/2003 08/01/2003 - 09/01/2003 09/01/2003 - 10/01/2003 10/01/2003 - 11/01/2003 11/01/2003 - 12/01/2003 12/01/2003 - 01/01/2004 01/01/2004 - 02/01/2004 02/01/2004 - 03/01/2004 03/01/2004 - 04/01/2004 04/01/2004 - 05/01/2004 05/01/2004 - 06/01/2004 06/01/2004 - 07/01/2004 07/01/2004 - 08/01/2004 08/01/2004 - 09/01/2004 09/01/2004 - 10/01/2004 10/01/2004 - 11/01/2004 11/01/2004 - 12/01/2004 12/01/2004 - 01/01/2005 01/01/2005 - 02/01/2005 02/01/2005 - 03/01/2005 03/01/2005 - 04/01/2005 04/01/2005 - 05/01/2005 05/01/2005 - 06/01/2005 06/01/2005 - 07/01/2005 07/01/2005 - 08/01/2005 08/01/2005 - 09/01/2005 09/01/2005 - 10/01/2005 10/01/2005 - 11/01/2005 11/01/2005 - 12/01/2005 12/01/2005 - 01/01/2006 01/01/2006 - 02/01/2006 02/01/2006 - 03/01/2006 03/01/2006 - 04/01/2006 04/01/2006 - 05/01/2006 05/01/2006 - 06/01/2006 06/01/2006 - 07/01/2006 07/01/2006 - 08/01/2006 08/01/2006 - 09/01/2006 09/01/2006 - 10/01/2006 10/01/2006 - 11/01/2006 11/01/2006 - 12/01/2006 12/01/2006 - 01/01/2007 01/01/2007 - 02/01/2007 02/01/2007 - 03/01/2007 03/01/2007 - 04/01/2007 04/01/2007 - 05/01/2007 05/01/2007 - 06/01/2007 06/01/2007 - 07/01/2007 07/01/2007 - 08/01/2007 08/01/2007 - 09/01/2007 09/01/2007 - 10/01/2007 10/01/2007 - 11/01/2007 11/01/2007 - 12/01/2007 12/01/2007 - 01/01/2008 01/01/2008 - 02/01/2008 02/01/2008 - 03/01/2008 03/01/2008 - 04/01/2008 04/01/2008 - 05/01/2008 05/01/2008 - 06/01/2008 06/01/2008 - 07/01/2008 07/01/2008 - 08/01/2008 08/01/2008 - 09/01/2008 09/01/2008 - 10/01/2008 10/01/2008 - 11/01/2008 11/01/2008 - 12/01/2008 12/01/2008 - 01/01/2009 01/01/2009 - 02/01/2009 02/01/2009 - 03/01/2009 03/01/2009 - 04/01/2009 04/01/2009 - 05/01/2009 05/01/2009 - 06/01/2009 06/01/2009 - 07/01/2009 07/01/2009 - 08/01/2009 08/01/2009 - 09/01/2009 09/01/2009 - 10/01/2009 10/01/2009 - 11/01/2009 11/01/2009 - 12/01/2009 12/01/2009 - 01/01/2010 01/01/2010 - 02/01/2010 02/01/2010 - 03/01/2010 03/01/2010 - 04/01/2010 04/01/2010 - 05/01/2010 05/01/2010 - 06/01/2010 06/01/2010 - 07/01/2010 07/01/2010 - 08/01/2010 08/01/2010 - 09/01/2010 09/01/2010 - 10/01/2010 10/01/2010 - 11/01/2010 11/01/2010 - 12/01/2010 12/01/2010 - 01/01/2011 01/01/2011 - 02/01/2011 02/01/2011 - 03/01/2011 03/01/2011 - 04/01/2011 04/01/2011 - 05/01/2011 05/01/2011 - 06/01/2011 06/01/2011 - 07/01/2011 07/01/2011 - 08/01/2011 08/01/2011 - 09/01/2011 09/01/2011 - 10/01/2011 10/01/2011 - 11/01/2011 11/01/2011 - 12/01/2011 12/01/2011 - 01/01/2012 01/01/2012 - 02/01/2012 02/01/2012 - 03/01/2012 03/01/2012 - 04/01/2012 04/01/2012 - 05/01/2012 05/01/2012 - 06/01/2012 06/01/2012 - 07/01/2012 07/01/2012 - 08/01/2012 08/01/2012 - 09/01/2012 09/01/2012 - 10/01/2012 10/01/2012 - 11/01/2012 11/01/2012 - 12/01/2012 12/01/2012 - 01/01/2013 01/01/2013 - 02/01/2013 02/01/2013 - 03/01/2013 03/01/2013 - 04/01/2013 04/01/2013 - 05/01/2013 05/01/2013 - 06/01/2013 06/01/2013 - 07/01/2013 07/01/2013 - 08/01/2013 08/01/2013 - 09/01/2013 09/01/2013 - 10/01/2013 10/01/2013 - 11/01/2013 11/01/2013 - 12/01/2013 12/01/2013 - 01/01/2014 01/01/2014 - 02/01/2014 02/01/2014 - 03/01/2014 03/01/2014 - 04/01/2014 04/01/2014 - 05/01/2014 05/01/2014 - 06/01/2014 06/01/2014 - 07/01/2014 07/01/2014 - 08/01/2014


 

This page is powered by Blogger. Isn't yours?

Hullabaloo


Monday, June 27, 2011

 
Legacy shrinkage

by digby


So, I was thinking back to the health care debates the other day and reminded about what a terrible squeeze the whole thing put on the progressive faction of the Democratic Party over the Medicaid expansion. You remember that, right? That was the big liberal kahuna, the one outright progressive policy that was going to bring necessary health care to millions of working poor Americans and their families who could not afford even the allegedly affordable health care policies that would become available in the exchanges.

That provision was always vulnerable in the long term but I think everyone assumed that the president himself would protect all aspects of his health care reforms above all --- it's his "signature issue" etc, etc. as I've written here many times. That seems to be seriously in question. Joan McCarter writes:

The Center on Budget and Policy Priorities has a review of one of the Medicaid proposals the White House has forwarded in budget negotiations, warning that the cost shift it includes would mean a cut in services...

Under current law, the federal government pays a fixed percentage of each state's Medicaid costs, from 50 to 75% of costs depending on the state with an average of 57% nationally. It pays 70%, nationally, of the children's health program, SCHIP. The Affordable Care Act would increase that commitment to 100% for the population that is made newly eligible for Medicaid under the law, and for the first three years (2014-16) with a reduced commitment until 2019, when it's down to 90%. States that expanded Medicaid to cover patients who aren't traditionally covered (childless adults) could qualify for a higher matching rate from the federal government.

That's all if the ACA is implemented as written, in addition to current law. This new, blended-rate proposal, however, "would replace this mix of matching rates with a single matching rate for each state, which would apparently apply to all of a state’s Medicaid and CHIP expenditures, outside of administrative costs." And that would mean more burden on the states and, likely, curtailed ability on the part of the states to pay providers (meaning fewer doctors taking Medicaid patients) and to cover people who would otherwise qualify...

The fact that it would undercut the expansion of Medicaid under the ACA—the most significant part of the law for actually expanding health care—should send White House negotiators back to the drawing board on what to do with Medicaid in these budget negotiations


Indeed, they should. But since they are the one's proposing it, I doubt that's what going to happen.

A lot of us have been trying to read the tea leaves about how the Democrats were going to end up handling "entitlements" during this time of irrational deficit fever and there's been a ton of speculation about Medicaid in recent days. For all the talk about them, Medicare and SS are third rails for a reason --- they have a large and distinct constituency that will vote on those issues regardless of their political ideology. It's a heavy lift to fight back the endless assaults, but if enough people put their weight behind it, they have shown that it can be done.

But Medicaid is vulnerable and always has been. It's why the progressives with conscience were torn apart at the idea of walking away from the one chance they saw to expand this program in this era of extreme selfish indifference (if not outright hostility) to the plight of those at the lowest income strata. When would this again be possible --- and under the protection of the president and party which implemented it for at least a few years to come?

I don't think anyone expected the Democratic leadership and the president to walk away from their own hard fought health care reforms before they even had a chance to be implemented. And I didn't think this because I believed the Democrats and the president were good hearted folk who just want to help the poor. I have no idea what's in their hearts. But I did think they would have wanted to give their legacy issue a chance to be implemented in full at the beginning, so they could continue to brag about bringing health care to 30 million uninsured Americans if nothing else. I suppose they'll continue to say it, but if they approve these changes it won't be true.

But as the president says, in these tough times the government has to tighten its belt just like all American families. I guess he must realize that one of the things American families have had to cut out is their health insurance. So much for that legacy.

Oh, and by the way --- the only way this gambit saves any money is if they cut people off. Medicaid is the least expensive health care in the country.


.

Search Digby!