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Valued Social Butterfly
Posts: 22,308
Registered: ‎03-04-2009

Re: Medicaid Cuts

Message 1 of 90 (321 Views)

Gail..  we all seem to have lots of solutions. but which one is yours, what do you think would work well for all Americans?

do you have any ideas.?  a single payer systerm or National Health Care, just insurance agencies providing insurances. 
what is the solution? what are your ideas.?

Super Social Butterfly
Posts: 907
Registered: ‎12-31-2016

Re: Medicaid Cuts

Message 2 of 90 (337 Views)

GailL1 wrote:

A question to anybody -

If we are encouraging people to have health care insurance which covers the essential health benefits as legislated by the ACA, and subsiding premiums for those with incomes less than 400% of the FPL, and giving cost sharing subsidies to those who buy a silver plan with incomes less than 250% of the FPL -

 

Then WHY does MEDICAID in most states cover pregnant women up to 200% (or more) of the FPL - wouldn't their insurance take care of the pregnancy coverage?

 

Same thing with children - MEDICAID and / or CHIP also covers them up 200% (or more) of the FPL - in fact some states cover them up to 300% of the FPL.

 

I guess I am having a hard time determining why MEDICAID covers these populations up to that limit when the ACA has a plan for them too with subsidies?

 

 


It's my understanding that it was always assumed Medicaid-eligible people would enroll in Medicaid, and those who made a little too much would enroll in the individual marketplace and get subsidies.  

 

Pregnant women and children are covered under SCHIP.  States don't "have" to run SCHIP programs, so it will be interesting to see if any states cut them due to Obamacare coverage.  (Nobody will do anything now because the future of Obamacare is so up in the air).   

 

And I don't think most states will want to ditch their SCHIP programs.  From a state governance perspective, it's better to make health care as accessible as possible.    Particularly for lower income people.   Particularly for pregnant women and children.  If we can get better prenatal and postnatal health care, we have a better shot at better health outcomes.  And that helps set up babies to be healthier in general.   If things like folic acid supplementation, vaccines, etc., can be addressed in a timely manner, we have less risk of serious, lifelong disabilities that could potentially cost the state much more in health care.  

 

There are also the impacts that very common childhood health issues can have on a child's ability to learn, from repeated, untreated ear infections to things like undiagnosed ADHD.  And those types of things set up yet another generation of very low-income earners.   

Valued Social Butterfly
Posts: 21,009
Registered: ‎11-07-2009

Re: Medicaid Cuts

Message 3 of 90 (342 Views)

GailL1 wrote:

 
So when all of you are wringing your hands about some poor senior that might not get their nursing home bed under Medicaid - be thankful that that woman making 250%, 278%, 300%, 319% of the FPL is giving birth for free just because she might not have the money to pay her copays.   Grrrrrrrrrrrrrrrrrrrrr


Then you should support Medicare for all Gail, it would eliminate both of these and much more. People need to stop using their ability to afford very good health care as a symbol of being somehow better than others who cannot.  Grrrrrrrrrrrrrrrrrr

 

If we truly want to "Make America Great" we would start by providing health care for all Americans and try to lead the world in health care statistics.


"The only thing man learns from history is man learns nothing from history"
Valued Social Butterfly
Posts: 5,283
Registered: ‎02-16-2008

Re: Medicaid Cuts

Message 4 of 90 (347 Views)

Maybe it would be simplier to just go to "MEDICAID FOR ALL"

 

No .......... in 1945 Truman proposed national health insurance for all, it didn't pass, it was attacked as socialized medicine. In 1964 Congress with Johnson as President managed to pass a work around through Congress, Medicare and Medicaid.

 

Granted it's not national health insurance, it's a work around but it does work for those people who can actually qualify for it, and it did accomplish the goals it was intended to address, reducing poverty and providing health care for the elderly and the poor.

 

Now Republicans want to roll that back, starting with Medicaid, but they won't stop there, Medicare and Social Security are targets as well.

 

We should have national health insurance, the best way to describe that  so people can understand what  it is and how it works is Medicare for all.

 

How do we pay for it ? ...... With money

 

How do we raise the money ?  I suggest a broad basket of taxes designed is such a way they're hard or impossible to avoid.

 

How will it work ?  ........ Like Medicare 

 

What will it cover ? .......... Whatever we decide it should.

 

Will there be out of network issues ?  No there will not be, like Medicare it's a national plan.

 

 

 

 

 

 

 

 

Valued Social Butterfly
Posts: 8,624
Registered: ‎08-18-2008

Re: Medicaid Cuts

[ Edited ]
Message 5 of 90 (370 Views)

rker321 wrote:

 

I know the income eligibility for Medicaid/Medical. there is a maximum income to qualify. Why so many that they wouldn't qualify due to income are tied into Medicaid? that is what I understand by your posts.
I am ignorant as to what the ACA does and  if the people go to the exchanges and buy insurance with or without subsidies, that has nothing to to with Medicaid correct?

So why so many qualify for Medicaid now I imagine that it has to do with the Medicaid expansion. Doesn't that hurt the Medicaid program? So why would a woman wants to be covered by her pregnancy on Medicaid if she already has insurance?  or children covered by those programs that you mention? why then cover them also on Medicaid?


Has NOTHING to do with the Medicaid expansion under the ACA -

From Medicaid.gov.

States can apply to the Centers for Medicare & Medicaid Services for waivers to provide Medicaid to populations beyond what traditionally can be covered under the state plan. Some states have additional state only programs to provide medical assistance for certain low-income people who do not qualify for Medicaid. No federal funds are provided for state only programs.

(my comment:  that would be like California covering illegal immigrant children)

 

Also certain Medicaid eligibility groups do not require a determination of income by the Medicaid agency. This coverage may be based on enrollment in another program, such as SSI or the breast and cervical cancer treatment and prevention program. Children for whom an adoption assistance agreement is in effect under title IV-E of the Social Security Act are automatically eligible. Young adults, who meet the requirements for eligibility as a former foster care recipient, are also eligible at any income level..

 

This is from:  National Womens Law Center 05/2015 - Medicaid Coverage for Pregnant Women

States must cover pregnant women with incomes up to 138 percent of the federal poverty level (FPL),  and may choose to use higher eligibility thresholds.  Many states have gone beyond this threshold, with 29 states, including the District of Columbia, raising income eligibility to 200 FPL or higher.  Women who have health insurance may also rely on Medicaid for pregnancy-related coverage.  Women with coverage through an employer may face high out-of-pocket costs for maternity services, particularly through annual deductibles or inpatient co-insurance.

 

Women who meet (the states higher) income-eligibility standards may still enroll in Medicaid for pregnancy-related coverage, and Medicaid can then supplement their employer coverage to provide needed cost-sharing protections as well as improved benefits.
 
Women with coverage through the health insurance Marketplaces may also be eligible for pregnancy-related  Medicaid coverage. 
Some pregnant women in Marketplace plans may find it advantageous to switch to Medicaid coverage during their pregnancy. Medicaid has no cost-sharing for pregnancy-related services, so women do not have to worry about co-payments for prenatal services or high deductibles for a hospital stay. Many states also cover additional services that private insurers do not typically offer, such as nutrition classes, childbirth education, infant care education, genetic counseling, pre- and postnatal home visits, non-emergency transportation, and tobacco cessation.
 
Well - no wonder half of the births in the US are paid for by Medicaid. 
 
Take a look at the District of Columbus, Iowa, New Mexico, Minnesota -
 
The same thing holds true for Children - shown on same chart.
 
So under the ACA, we are giving a tax credit subsidy for folks with income levels up to 400% of the FPL.
If they have an income of less than 250% of the FPL and buy a silver plan in the marketplace, we further supplement them by picking up some of their cost sharing (co-pays, deductibles).
They have maternity coverage on their ACA plan but if they want it for FREE, they can enroll in Medicaid, with most likely full Medicaid benefits, not just maternity coverage.
 
I did not know this, did you? 
 
Cradle to Grave - seems we are already on our way.
Maybe it would be simplier to just go to "MEDICAID FOR ALL"
 
So when all of you are wringing your hands about some poor senior that might not get their nursing home bed under Medicaid - be thankful that that woman making 250%, 278%, 300%, 319% of the FPL is giving birth for free just because she might not have the money to pay her copays.   Grrrrrrrrrrrrrrrrrrrrr

 

 

 

 

Valued Social Butterfly
Posts: 4,343
Registered: ‎01-24-2014

Re: Medicaid Cuts

Message 6 of 90 (374 Views)

Rich-You are correct, and like I've tried countless times to explain to the righties,  they will be paying much more in the long run if people lose ACA coverage, Medicaid, or Medicare. They just don't seem to get it.

Gee, I miss having a real President!!
Valued Social Butterfly
Posts: 22,308
Registered: ‎03-04-2009

Re: Medicaid Cuts

Message 7 of 90 (385 Views)

Richva wrote:

Just to be clear, cuts to Medicaid or the ACA is simply cost shifting to hospitals who will have to provide services free and then attempt to increase the bills of "paying" patients to make up for it. If they cannot pass those costs on as overhead such as in poor neighborhoods or small communities, they will go under. 

 

Not a good plan. 


I am glad to see that more people think like me and see how bad is any plan that allows any of this to happen.   

Treasured Social Butterfly
Posts: 12,337
Registered: ‎02-28-2008

Re: Medicaid Cuts

Message 8 of 90 (390 Views)

Just to be clear, cuts to Medicaid or the ACA is simply cost shifting to hospitals who will have to provide services free and then attempt to increase the bills of "paying" patients to make up for it. If they cannot pass those costs on as overhead such as in poor neighborhoods or small communities, they will go under. 

 

Not a good plan. 

Valued Social Butterfly
Posts: 22,308
Registered: ‎03-04-2009

Re: Medicaid Cuts

[ Edited ]
Message 9 of 90 (398 Views)

Sorry, I will try to explain myself better.

I know the income eligibility for Medicaid/Medical. there is a maximum income to qualify. Why so many that they wouldn't qualify due to income are tied into Medicaid? that is what I understand by your posts.
I am ignorant as to what the ACA does and  if the people go to the exchanges and buy insurance with or without subsidies, that has nothing to to with Medicaid correct?

So why so many qualify for Medicaid now I imagine that it has to do with the Medicaid expansion. Doesn't that hurt the Medicaid program? So why would a woman wants to be covered by her pregnancy on Medicaid if she already has insurance?  or children covered by those programs that you mention? why then cover them also on Medicaid?

Valued Social Butterfly
Posts: 8,624
Registered: ‎08-18-2008

Re: Medicaid Cuts

Message 10 of 90 (406 Views)

rker321

You have lost me in your post - I do not understand it.  Sorry, you will have to try again for me to get your point.