States’ Healthcare Insurance Exchanges (generation, legal, health care, Clinton)
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Romneycare mandated in effect has BEGUN APPROACHING UNIVERSAL HEALTH INSURANCE coverage in Massachusetts. It is less feasible for a state (rather than the federal government) to enact a single payer health insurance law. The lack of affordable health insurance politically denied the conservatives their preference for no government expenditure or taxes for support or inducement of health insurance.
If conservatives could not prevent government’s intervention within the issue of health insurance, they definitely agreed with many others that persons who had no other source of minimal legally qualified health insurance (affordable to themselves), be legally mandated to purchase their own insurance. This is compatible to concepts of mutual insurance and personal responsibility.
The concept of mutual insurance, the sharing of aggregate risk to decrease individuals’ exposure to great financial harm is a well established. Both the proposed single payer or the passed federal personal health insurance mandate generation of revenues that will (similar to Massachusetts health insurance plans), pay health providers who are not required (and are unlikely to be) government employees or administered health providers.
I’m less comfortable with the legally created federal mandating that those otherwise lacking qualified health insurance (and can afford to purchase their own qualifying insurance), do so. I’d be more would have preferred we had rather passed additional federal taxes to fund federal single payer for all minimal qualifying heath plans. I do not understand but am pleasantly surprised that the federal mandate was judged to be constitutional.
As the law’s now strand, I foresee the question of what is affordable to each individual person as a consistently contending issue. Of lesser importance but also in contention would what should be deemed as minimally qualifying health care insurance.
Conservatives enabled the passage of the passage of the federal healthcare insurance laws by their failure to offer any reasonably feasible remedy for unaffordable healthcare insurance.
The law offers states an opportunity and financial inducements to operate their states’ own “health insurance exchanges”. Many conservative state governments have threatened to waive their right to do so. These states will forego an opportunity to reduce their own costs and by enabling the federal government to exercise the law’s only alternative. Federal administration of many states’ healthcare insurance exchanges will greatly please more politically liberal factions because it is more likely to induce eventual single (federal government) payer and fully administrated of minimal qualified healthcare insurance.
One has to realise that what states are bulkigon is paying additional funds to support federalmandated pools and increases state medicaid payments which the supreme court ruled they do not have to.thta was a big part of the markup for ther bill's fund.Single payer failed i the clinton adminsitration which was why democrats did not go that path this time.The new bill sealed single payer issue and certainly funding which was w thew problem i Clinton markup hasn't gotten better witht eh deficit.Not goig to happen ;at least in our lifetime.
Some states have decided that it wasn't worth the cost of implementing their own pool. Since the federal govt already is determining the minimal requirements for the plans, might as well just let them supply the option for the plan.
its the same problem that if the federal governamnt does it they do not have the people basically. its like doubling your jobs production without any extra help. That is the basic reaso to have state pools setup by states.CBO now says that they estimate 15 millio will still be without insurance by 2020.
the federal government is offering to pay for the increased medicaid expense for a period of time, but that time isnt forever. its unaffordable. it also doesnt do anything to solve the problem most americans had with healthcare, the cost.
the federal government is offering to pay for the increased medicaid expense for a period of time, but that time isnt forever. its unaffordable. it also doesnt do anything to solve the problem most americans had with healthcare, the cost.
Captain NJ, conservative state governors and legislative chambers have been posturing and threatening not to set up state healthcare insurance exchanges and/or not to expand their Medicaid programs.
They pretend to be doing whatever they can to undermine the Affordable Healthcare Act and the Democratic Party. Their motives’ are to placate their conservative base and avoid a primary battle against a strong Tea Party opponent.
Before 2014 they will decide not to surrender the political jobs, patronage, and whatever policy discretion that’s exercised by administers of their state’s insurance exchange. A federal administration is required by law and will be pleased to operate healthcare insurance exchanges for any states that do not do so,
There are no savings, only less revenue for states that choose not to expand their Medicaid during the years when other states are receiving their additional inducements for expanding their programs. Even after the financial inducement years cease, the reduced medical services are not unlikely to be net detrimental to the state. I presume during elections comparisons between states differing medical services would be occasionally discussed. We tend to take personal interest when someone close to us dies sooner or suffers needlessly because of insufficient or untimely medical care.
It’s likely that hospital boards of directors and administrators will be displeased due to the unexpanded state Medicaid programs. They’ll be asked to service more uninsured patients with no additional funds. They’re receiving less (than other states) federally provided funds for disproportionate share of hospitals) payments because those payments are based upon the numbers of Medicaid patients they treat. If their states do not expand their Medicaid, their populations must be provided with lesser (than other states) per capita medical services or they must make up the financial shortfall themselves or similar to any other mechanism, peoples’ lack of proper (medical) maintenance will be costly in future repairs or performances. These are the alternative consequences that could occur if a state does not expand their state’s Medicaid program.
Federal disproportionate share of hospitals payments
Quote:
Originally Posted by CaptainNJ
the federal government is offering to pay for the increased medicaid expense for a period of time, but that time isnt forever. its unaffordable. it also doesnt do anything to solve the problem most americans had with healthcare, the cost.
Captain NJ, Federal DSH, (i.e. disproportionate share of hospitals) payments are directly distributed to hospitals.
Medicaid is more similar to a charity rather than an insurance operation. The states pay a very significant proportion of their states’ Medicaid expenditures of hospitals within less affluent states have historically received lesser compensating payments from their state governments to defray the expenditures on behalf of Medicaid patients.
These federal DSH payments have been proportionately per capita of greater assistance to the budgets of hospitals within less affluent states.
States choosing not expand Medicare do not reduce the numbers of uninsured patients they treat, but they do receive less federal DSH funds for their efforts.
I think a lot of the states that declined the expanded Medicaid will end up changing their minds and taking it due to pressure from their hospitals that want to get paid.
However for the state run vs. federally run health care exchange, that ship has already sailed. There were hundreds of millions in federal funds to pay for the development of the exchanges, and for the states that opted not to take it that money is no longer available. A federal exchange removes the state from selecting and administering the health care plans. Instead of the state setting the minimum standards for a plan, they will have to accept the federal standards.
I do believe that the movement toward the federal exchange brings us closer to single payer than the state exchanges would. I wonder how much the feds encouraged this movement by not providing the guidance that the states needed to design their exchanges.
I think a lot of the states that declined the expanded Medicaid will end up changing their minds and taking it due to pressure from their hospitals that want to get paid.
However for the state run vs. federally run health care exchange, that ship has already sailed. There were hundreds of millions in federal funds to pay for the development of the exchanges, and for the states that opted not to take it that money is no longer available. A federal exchange removes the state from selecting and administering the health care plans. Instead of the state setting the minimum standards for a plan, they will have to accept the federal standards.
I do believe that the movement toward the federal exchange brings us closer to single payer than the state exchanges would. I wonder how much the feds encouraged this movement by not providing the guidance that the states needed to design their exchanges.
Celestyn, I wasn’t aware of federal seed money for states to set up their own exchanges was and now is not available to them.
Nothing has to be forever. I’d not be shocked if in the future they devise a scheme to obtain federal funds or they bite the bullet and spend their own funds to gain greater influence over healthcare within their own state.
You underestimate conservative state governments’ capabilities; they do not require guidance other than federal resolving any ambiguity regarding federal methods and policies for overseeing and enforcing the federal responsibilities with regard to this act.
Some conservative state governments are not enthusiastic supporters of this federal act. Some among them would (if they could), choose to harm their own state if their efforts would additionally undermine the federal Affordable Healthcare Act.
I agree that states’ decisions not to accept the task of setting up and operating their states’ healthcare insurance exchange makes it more likely that future USA’s basic federally qualified healthcare insurance may become federal universal basic insurance funded through the federal government as the single payer to healthcare providers. That would be something similar to our current Medicare for the elderly.
I fully expected almost our entire 50 state would expand their Medicaid programs prior 2014. I did not expect the deepest red states to begin accepting it so soon.
Governor’s Plan will Boost Economy, Preserve Safety-Net and Rural Hospitals
PHOENIX – Governor Jan Brewer today was joined at Maricopa Medical Center by a coalition of Arizona’s premier business leaders and health care advocates as they voiced support for the expansion of the State’s Medicaid program.
“My concerns about the Affordable Care Act are well-known, but it is the law of the land. With this expansion, Arizona can leverage nearly $8 billion in federal funds over four years, save or protect thousands of quality jobs and protect our critical rural and safety-net hospitals,” said Governor Brewer. “The business and health care communities are uniting with me in this effort because they know how important this issue is to Arizona. I’m grateful for their support and am confident it will grow as we continue to make our case across this state.”
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Expanding Medicaid
