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Old 10-08-2013, 06:56 PM  
Direckshun Direckshun is online now
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So what's the plan to provide health insurance to the working poor?

We're seeing it right now in Republican controlled states that are refusing to the Medicaid expansion to its working poor, which (for those of you who don't know) is provided almost entirely by Obamacare to people who are up to 133% of the poverty line -- but only if the state opts in for that expansion.

And we've heard over and over again that Obamacare -- including the Medicaid expansion, I guess -- is the demise of America, is part and parcel of the Communist Manifesto, is senseless and detestable.

Alright, then, conservatives. What's the plan then? We've got millions upon millions of the working poor in this country that, thanks to the ACA, now have a chance at Medicaid despite the fact that they work their rears off to stay above the poverty line.

What's the plan for these folks to have health insurance? What solution you would recommend for these people (a.) in the event that you were able to repeal Obamacare, or (b.) if you live in a state where the Medicaid expansion has been denied?

Here's another question if you get twitchy with those: did our pre-Obamacare health insurance system adequately provide for the working poor, in your estimation?

http://www.nytimes.com/2013/10/03/he...agewanted=all&

Millions of Poor Are Left Uncovered by Health Law
By SABRINA TAVERNISE and ROBERT GEBELOFF
Oct. 2, 2013

A sweeping national effort to extend health coverage to millions of Americans will leave out two-thirds of the poor blacks and single mothers and more than half of the low-wage workers who do not have insurance, the very kinds of people that the program was intended to help, according to an analysis of census data by The New York Times.

Because they live in states largely controlled by Republicans that have declined to participate in a vast expansion of Medicaid, the medical insurance program for the poor, they are among the eight million Americans who are impoverished, uninsured and ineligible for help. The federal government will pay for the expansion through 2016 and no less than 90 percent of costs in later years.

Those excluded will be stranded without insurance, stuck between people with slightly higher incomes who will qualify for federal subsidies on the new health exchanges that went live this week, and those who are poor enough to qualify for Medicaid in its current form, which has income ceilings as low as $11 a day in some states.

People shopping for insurance on the health exchanges are already discovering this bitter twist.

“How can somebody in poverty not be eligible for subsidies?” an unemployed health care worker in Virginia asked through tears. The woman, who identified herself only as Robin L. because she does not want potential employers to know she is down on her luck, thought she had run into a computer problem when she went online Tuesday and learned she would not qualify.

At 55, she has high blood pressure, and she had been waiting for the law to take effect so she could get coverage. Before she lost her job and her house and had to move in with her brother in Virginia, she lived in Maryland, a state that is expanding Medicaid. “Would I go back there?” she asked. “It might involve me living in my car. I don’t know. I might consider it.”

The 26 states that have rejected the Medicaid expansion are home to about half of the country’s population, but about 68 percent of poor, uninsured blacks and single mothers. About 60 percent of the country’s uninsured working poor are in those states. Among those excluded are about 435,000 cashiers, 341,000 cooks and 253,000 nurses’ aides.

“The irony is that these states that are rejecting Medicaid expansion — many of them Southern — are the very places where the concentration of poverty and lack of health insurance are the most acute,” said Dr. H. Jack Geiger, a founder of the community health center model. “It is their populations that have the highest burden of illness and costs to the entire health care system.”

The disproportionate impact on poor blacks introduces the prickly issue of race into the already politically charged atmosphere around the health care law. Race was rarely, if ever, mentioned in the state-level debates about the Medicaid expansion. But the issue courses just below the surface, civil rights leaders say, pointing to the pattern of exclusion.

Every state in the Deep South, with the exception of Arkansas, has rejected the expansion. Opponents of the expansion say they are against it on exclusively economic grounds, and that the demographics of the South — with its large share of poor blacks — make it easy to say race is an issue when it is not.

In Mississippi, Republican leaders note that a large share of people in the state are on Medicaid already, and that, with an expansion, about a third of the state would have been insured through the program. Even supporters of the health law say that eventually covering 10 percent of that cost would have been onerous for a predominantly rural state with a modest tax base.

“Any additional cost in Medicaid is going to be too much,” said State Senator Chris McDaniel, a Republican, who opposes expansion.

The law was written to require all Americans to have health coverage. For lower and middle-income earners, there are subsidies on the new health exchanges to help them afford insurance. An expanded Medicaid program was intended to cover the poorest. In all, about 30 million uninsured Americans were to have become eligible for financial help.

But the Supreme Court’s ruling on the health care law last year, while upholding it, allowed states to choose whether to expand Medicaid. Those that opted not to leave about eight million uninsured people who live in poverty ($19,530 for a family of three) without any assistance at all.

Poor people excluded from the Medicaid expansion will not be subject to fines for lacking coverage. In all, about 14 million eligible Americans are uninsured and living in poverty, the Times analysis found.

The federal government provided the tally of how many states were not expanding Medicaid for the first time on Tuesday. It included states like New Hampshire, Ohio, Pennsylvania and Tennessee that might still decide to expand Medicaid before coverage takes effect in January. If those states go forward, the number would change, but the trends that emerged in the analysis would be similar.

Mississippi has the largest percentage of poor and uninsured people in the country — 13 percent. Willie Charles Carter, an unemployed 53-year-old whose most recent job was as a maintenance worker at a public school, has had problems with his leg since surgery last year.

His income is below Mississippi’s ceiling for Medicaid — which is about $3,000 a year — but he has no dependent children, so he does not qualify. And his income is too low to make him eligible for subsidies on the federal health exchange.

“You got to be almost dead before you can get Medicaid in Mississippi,” he said.

He does not know what he will do when the clinic where he goes for medical care, the Good Samaritan Health Center in Greenville, closes next month because of lack of funding.

“I’m scared all the time,” he said. “I just walk around here with faith in God to take care of me.”

The states that did not expand Medicaid have less generous safety nets: For adults with children, the median income limit for Medicaid is just under half of the federal poverty level — or about $5,600 a year for an individual — while in states that are expanding, it is above the poverty line, or about $12,200, according to the Kaiser Family Foundation. There is little or no coverage of childless adults in the states not expanding, Kaiser said.

The New York Times analysis excluded immigrants in the country illegally and those foreign-born residents who would not be eligible for benefits under Medicaid expansion. It included people who are uninsured even though they qualify for Medicaid in its current form.

Blacks are disproportionately affected, largely because more of them are poor and living in Southern states. In all, 6 out of 10 blacks live in the states not expanding Medicaid. In Mississippi, 56 percent of all poor and uninsured adults are black, though they account for just 38 percent of the population.

Dr. Aaron Shirley, a physician who has worked for better health care for blacks in Mississippi, said that the history of segregation and violence against blacks still informs the way people see one another, particularly in the South, making some whites reluctant to support programs that they believe benefit blacks.

That is compounded by the country’s rapidly changing demographics, Dr. Geiger said, in which minorities will eventually become a majority, a pattern that has produced a profound cultural unease, particularly when it has collided with economic insecurity.

Dr. Shirley said: “If you look at the history of Mississippi, politicians have used race to oppose minimum wage, Head Start, all these social programs. It’s a tactic that appeals to people who would rather suffer themselves than see a black person benefit.”

Opponents of the expansion bristled at the suggestion that race had anything to do with their position. State Senator Giles Ward of Mississippi, a Republican, called the idea that race was a factor “preposterous,” and said that with the demographics of the South — large shares of poor people and, in particular, poor blacks — “you can argue pretty much any way you want.”

The decision not to expand Medicaid will also hit the working poor. Claretha Briscoe earns just under $11,000 a year making fried chicken and other fast food at a convenience store in Hollandale, Miss., too much to qualify for Medicaid but not enough to get subsidies on the new health exchange. She had a heart attack in 2002 that a local hospital treated as part of its charity care program.

“I skip months on my blood pressure pills,” said Ms. Briscoe, 48, who visited the Good Samaritan Health Center last week because she was having chest pains. “I buy them when I can afford them.”

About half of poor and uninsured Hispanics live in states that are expanding Medicaid. But Texas, which has a large Hispanic population, rejected the expansion. Gladys Arbila, a housekeeper in Houston who earns $17,000 a year and supports two children, is under the poverty line and therefore not eligible for new subsidies. But she makes too much to qualify for Medicaid under the state’s rules. She recently spent 36 hours waiting in the emergency room for a searing pain in her back.

“We came to this country, and we are legal and we work really hard,” said Ms. Arbila, 45, who immigrated to the United States 12 years ago, and whose son is a soldier in Afghanistan. “Why we don’t have the same opportunities as the others?”
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Old 10-08-2013, 09:08 PM   #31
Raiderhader Raiderhader is offline
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Originally Posted by Direckshun View Post
You, Raiderhader, get your wish of repealing Obamacare.

What do you do for the millions of working poor who do not have health insurance?
You want an honest to God conservative response? Not some supposed conservative that you see on tv talking about how the party needs to start changing its views to become more like the opposition if it wants to win but, down right dyed in the wool conservatism? You are not going to like it. But you asked......


First, let's diagnose the problem, then we will get to the solution.

Healthcare costs continue to rise beyond what the average person can afford with out going into debt, if not bankrupt. Why is this? Many cite the lawsuit problem and, while an issue that does need to be addressed, it is only a minor part of the problem. The biggest cause of rising healthcare costs in this country is the solution that everyone keeps looking to for the fix: government. When the government gets involved, and it does not matter what industry you want to discuss, costs go up. The logic behind it is simple: people/companies charge more when governments are involved. "Hey, the government has access to all the money it wants; we can raise our prices because they can afford it!"

To compound the issue the tax burden on the populace makes it increasingly difficult to afford such things as health insurance. Of course, the government is going to fix this situation as well BUT, not by allowing us to keep more of the money that WE, not they, bust our asses for. Instead we get Medicare and Medicaid and the prescription drug bill and Obamacare.

Now if you are still reading at this point after what is clearly an anti-big government stance, I would like you to do me a favor, go back and read that last paragraph again and then SINCERELY contemplate what I am about to say next. Go ahead and re-read it....

The government takes our money and then when we struggle to come up with the cash to purchase the necessities of life they come to the rescue with these programs that are funded by the money they took from us in the first place. WE ARE BEING BRIBED WITH OUR OWN MONEY!

"But Jamie, we have to pool our money to be able to provide for those who cannot afford it by themselves!" A nice sentiment but, where has that gotten us? The government has gotten more and more involved and prices just continue to sky rocket as a result. Now, we are beyond just the people below the poverty line who cannot afford these and we have moved on up into the middle class that is struggling. So naturally, your solution, and the solution of every other good intentioned liberal is more government, thus continuing the vicious cycle and ensnaring more people into grasp of the government's control as they look to it for assistance.

So, to the ultimate conservative solution.

Repeal Obamacare, Medicare, Medicaid AND the Sixteenth Amendment. With government out of the picture the artificial inflation of prices has to come down to the level of the consumer. Yes, that is correct, a free market at work! As medical costs drop so will insurance. Not to mention, with the income tax gone and relying solely on a sales tax, Americans will go home with a FULL paycheck and then be able to decide for themselves (this really seems to scare a lot of people for some reason) exactly how they are going to spend it. That may be health insurance, it may not. But if they want it, they now have the ability to be self reliant and get it for themselves.

As an added bonus, with all of that extra disposable income to spend, companies will then be forced to hire more workers to make and sell the products. More income earners means more people who are able to provide some sort of health insurance for themselves. Viola!

As to the remaining few, those who TRULY need assistance (and the truly part is key) it can easily be handled at state and local levels. There is absolutely no need for this massive central government. We can do most of the work ourselves. And that is the way it was intended to be in the first place.



There is a true conservative solution for you.
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Old 10-08-2013, 09:10 PM   #32
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I think a mandate makes sense. I don't like how Obamacare does it and I certainly don't like a mandate that requires everyone to carry politically bloated coverage.
Translation:
You like it but want it tweaked
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Originally Posted by patteeu View Post
I also don't like the shady approach to undermining employer coverage although I think it would be good to divorce coverage from employment.
Moving away from employes based health insurance was going to happen regardless if Obama or Obamacare never existed.
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But again, the primary focus needs to be on cost inflation. If that's not the top priority, I don't support anything else.
I agree. You control cost inflation, more people can afford health insurance. But, what do you tell the 40 million Americans without insurance? Get a job you lazy ****? Oh wait.........employer health insurance is going away.
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I believe Hitler hated Jews and had a lot of them killed. I dont believe it was anywhere close to 6 million though. I'm not an anti-semite; I just think that number has been severely inflated and there is a lot of evidence that supports this belief.
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Old 10-08-2013, 09:15 PM   #33
BigRedChief BigRedChief is online now
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So, to the ultimate conservative solution.

Repeal Obamacare, Medicare, Medicaid AND the Sixteenth Amendment.

There is a true conservative solution for you.
Why isn't getting rid of Social Security in there?

No taxes, No taking care of the old and sick. Damn good plan you got there Mr. Conservative. Good luck selling that insane idea.

My idea............ oldie bit goodie.......... A single payer Medicare for all type of insurance.
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I believe Hitler hated Jews and had a lot of them killed. I dont believe it was anywhere close to 6 million though. I'm not an anti-semite; I just think that number has been severely inflated and there is a lot of evidence that supports this belief.
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Old 10-08-2013, 09:16 PM   #34
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Translation:
You like it but want it tweaked
Incorrect. I want it burnt to the ground so we can start over and refocus reform on the real healthcare problem of cost.
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Old 10-08-2013, 09:22 PM   #35
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Originally Posted by patteeu View Post
Incorrect. I want it burnt to the ground so we can start over and refocus reform on the real healthcare problem of cost.
Go on...
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Old 10-08-2013, 09:24 PM   #36
Raiderhader Raiderhader is offline
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Why isn't getting rid of Social Security in there?

No taxes, No taking care of the old and sick. Damn good plan you got there Mr. Conservative. Good luck selling that insane idea.

My idea............ oldie bit goodie.......... A single payer Medicare for all type of insurance.
Social Security is a separate issue. And I did not say no taxes. I specifically said no income tax while using a sales tax.

I'll ignore the typical liberal rhetoric about the old and sick not being cared for. Because I am pretty sure I addressed that as well.....
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Old 10-08-2013, 09:24 PM   #37
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Incorrect. I want it burnt to the ground so we can start over and refocus reform on the real healthcare problem of cost.
So you have anarchist tendencies.
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I believe Hitler hated Jews and had a lot of them killed. I dont believe it was anywhere close to 6 million though. I'm not an anti-semite; I just think that number has been severely inflated and there is a lot of evidence that supports this belief.
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Old 10-08-2013, 09:29 PM   #38
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Go on...
I was done.
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Old 10-08-2013, 10:11 PM   #39
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Individual mandates for catastrophic care policies only.

But the primary focus needs to be on addressing out of control costs, not on universal coverage.
Yep.

Medicare/medicaid - both their existence and the woeful underfunding of those programs in decades past - are why costs are spiraling out of control. Massively expanding the number of underfunded government-paid patients is only going to make things worse.

But of course, this "plan" with Obamacare was never for it to work long-term, it was only meant to be a wedge to leverage a full government takeover of the entire system.
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Old 10-08-2013, 10:50 PM   #40
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Originally Posted by Direckshun View Post
We're seeing it right now in Republican controlled states that are refusing to the Medicaid expansion to its working poor, which (for those of you who don't know) is provided almost entirely by Obamacare to people who are up to 133% of the poverty line -- but only if the state opts in for that expansion.

And we've heard over and over again that Obamacare -- including the Medicaid expansion, I guess -- is the demise of America, is part and parcel of the Communist Manifesto, is senseless and detestable.

Alright, then, conservatives. What's the plan then? We've got millions upon millions of the working poor in this country that, thanks to the ACA, now have a chance at Medicaid despite the fact that they work their rears off to stay above the poverty line.

What's the plan for these folks to have health insurance? What solution you would recommend for these people (a.) in the event that you were able to repeal Obamacare, or (b.) if you live in a state where the Medicaid expansion has been denied?

Here's another question if you get twitchy with those: did our pre-Obamacare health insurance system adequately provide for the working poor, in your estimation?

http://www.nytimes.com/2013/10/03/he...agewanted=all&

Millions of Poor Are Left Uncovered by Health Law
By SABRINA TAVERNISE and ROBERT GEBELOFF
Oct. 2, 2013

A sweeping national effort to extend health coverage to millions of Americans will leave out two-thirds of the poor blacks and single mothers and more than half of the low-wage workers who do not have insurance, the very kinds of people that the program was intended to help, according to an analysis of census data by The New York Times.

Because they live in states largely controlled by Republicans that have declined to participate in a vast expansion of Medicaid, the medical insurance program for the poor, they are among the eight million Americans who are impoverished, uninsured and ineligible for help. The federal government will pay for the expansion through 2016 and no less than 90 percent of costs in later years.

Those excluded will be stranded without insurance, stuck between people with slightly higher incomes who will qualify for federal subsidies on the new health exchanges that went live this week, and those who are poor enough to qualify for Medicaid in its current form, which has income ceilings as low as $11 a day in some states.

People shopping for insurance on the health exchanges are already discovering this bitter twist.

“How can somebody in poverty not be eligible for subsidies?” an unemployed health care worker in Virginia asked through tears. The woman, who identified herself only as Robin L. because she does not want potential employers to know she is down on her luck, thought she had run into a computer problem when she went online Tuesday and learned she would not qualify.

At 55, she has high blood pressure, and she had been waiting for the law to take effect so she could get coverage. Before she lost her job and her house and had to move in with her brother in Virginia, she lived in Maryland, a state that is expanding Medicaid. “Would I go back there?” she asked. “It might involve me living in my car. I don’t know. I might consider it.”

The 26 states that have rejected the Medicaid expansion are home to about half of the country’s population, but about 68 percent of poor, uninsured blacks and single mothers. About 60 percent of the country’s uninsured working poor are in those states. Among those excluded are about 435,000 cashiers, 341,000 cooks and 253,000 nurses’ aides.

“The irony is that these states that are rejecting Medicaid expansion — many of them Southern — are the very places where the concentration of poverty and lack of health insurance are the most acute,” said Dr. H. Jack Geiger, a founder of the community health center model. “It is their populations that have the highest burden of illness and costs to the entire health care system.”

The disproportionate impact on poor blacks introduces the prickly issue of race into the already politically charged atmosphere around the health care law. Race was rarely, if ever, mentioned in the state-level debates about the Medicaid expansion. But the issue courses just below the surface, civil rights leaders say, pointing to the pattern of exclusion.

Every state in the Deep South, with the exception of Arkansas, has rejected the expansion. Opponents of the expansion say they are against it on exclusively economic grounds, and that the demographics of the South — with its large share of poor blacks — make it easy to say race is an issue when it is not.

In Mississippi, Republican leaders note that a large share of people in the state are on Medicaid already, and that, with an expansion, about a third of the state would have been insured through the program. Even supporters of the health law say that eventually covering 10 percent of that cost would have been onerous for a predominantly rural state with a modest tax base.

“Any additional cost in Medicaid is going to be too much,” said State Senator Chris McDaniel, a Republican, who opposes expansion.

The law was written to require all Americans to have health coverage. For lower and middle-income earners, there are subsidies on the new health exchanges to help them afford insurance. An expanded Medicaid program was intended to cover the poorest. In all, about 30 million uninsured Americans were to have become eligible for financial help.

But the Supreme Court’s ruling on the health care law last year, while upholding it, allowed states to choose whether to expand Medicaid. Those that opted not to leave about eight million uninsured people who live in poverty ($19,530 for a family of three) without any assistance at all.

Poor people excluded from the Medicaid expansion will not be subject to fines for lacking coverage. In all, about 14 million eligible Americans are uninsured and living in poverty, the Times analysis found.

The federal government provided the tally of how many states were not expanding Medicaid for the first time on Tuesday. It included states like New Hampshire, Ohio, Pennsylvania and Tennessee that might still decide to expand Medicaid before coverage takes effect in January. If those states go forward, the number would change, but the trends that emerged in the analysis would be similar.

Mississippi has the largest percentage of poor and uninsured people in the country — 13 percent. Willie Charles Carter, an unemployed 53-year-old whose most recent job was as a maintenance worker at a public school, has had problems with his leg since surgery last year.

His income is below Mississippi’s ceiling for Medicaid — which is about $3,000 a year — but he has no dependent children, so he does not qualify. And his income is too low to make him eligible for subsidies on the federal health exchange.

“You got to be almost dead before you can get Medicaid in Mississippi,” he said.

He does not know what he will do when the clinic where he goes for medical care, the Good Samaritan Health Center in Greenville, closes next month because of lack of funding.

“I’m scared all the time,” he said. “I just walk around here with faith in God to take care of me.”

The states that did not expand Medicaid have less generous safety nets: For adults with children, the median income limit for Medicaid is just under half of the federal poverty level — or about $5,600 a year for an individual — while in states that are expanding, it is above the poverty line, or about $12,200, according to the Kaiser Family Foundation. There is little or no coverage of childless adults in the states not expanding, Kaiser said.

The New York Times analysis excluded immigrants in the country illegally and those foreign-born residents who would not be eligible for benefits under Medicaid expansion. It included people who are uninsured even though they qualify for Medicaid in its current form.

Blacks are disproportionately affected, largely because more of them are poor and living in Southern states. In all, 6 out of 10 blacks live in the states not expanding Medicaid. In Mississippi, 56 percent of all poor and uninsured adults are black, though they account for just 38 percent of the population.

Dr. Aaron Shirley, a physician who has worked for better health care for blacks in Mississippi, said that the history of segregation and violence against blacks still informs the way people see one another, particularly in the South, making some whites reluctant to support programs that they believe benefit blacks.

That is compounded by the country’s rapidly changing demographics, Dr. Geiger said, in which minorities will eventually become a majority, a pattern that has produced a profound cultural unease, particularly when it has collided with economic insecurity.

Dr. Shirley said: “If you look at the history of Mississippi, politicians have used race to oppose minimum wage, Head Start, all these social programs. It’s a tactic that appeals to people who would rather suffer themselves than see a black person benefit.”

Opponents of the expansion bristled at the suggestion that race had anything to do with their position. State Senator Giles Ward of Mississippi, a Republican, called the idea that race was a factor “preposterous,” and said that with the demographics of the South — large shares of poor people and, in particular, poor blacks — “you can argue pretty much any way you want.”

The decision not to expand Medicaid will also hit the working poor. Claretha Briscoe earns just under $11,000 a year making fried chicken and other fast food at a convenience store in Hollandale, Miss., too much to qualify for Medicaid but not enough to get subsidies on the new health exchange. She had a heart attack in 2002 that a local hospital treated as part of its charity care program.

“I skip months on my blood pressure pills,” said Ms. Briscoe, 48, who visited the Good Samaritan Health Center last week because she was having chest pains. “I buy them when I can afford them.”

About half of poor and uninsured Hispanics live in states that are expanding Medicaid. But Texas, which has a large Hispanic population, rejected the expansion. Gladys Arbila, a housekeeper in Houston who earns $17,000 a year and supports two children, is under the poverty line and therefore not eligible for new subsidies. But she makes too much to qualify for Medicaid under the state’s rules. She recently spent 36 hours waiting in the emergency room for a searing pain in her back.

“We came to this country, and we are legal and we work really hard,” said Ms. Arbila, 45, who immigrated to the United States 12 years ago, and whose son is a soldier in Afghanistan. “Why we don’t have the same opportunities as
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Old 10-08-2013, 10:56 PM   #41
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I was done.
It seemed like maybe you had a plan to "refocus reform on the real healthcare problem of cost."
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Old 10-08-2013, 11:40 PM   #42
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What do you mean "Republicans at the table"?

I'm seriously asking, because I wasn't expecting you to advocate for the liberal endgame on healthcare.

I just want to make sure you're arguing for single payer.
Its actually the best fiscal way to do it and still have government involved in health care.
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Old 10-08-2013, 11:47 PM   #43
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Old 10-09-2013, 03:51 AM   #44
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Its actually the best fiscal way to do it and still have government involved in health care.
BUT GOVERNMENT CAN'T DO ANYTHING RIGHT!!!!!!@11!!1
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Old 10-09-2013, 05:35 AM   #45
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I'm not sure true conservative reforms can be implemented at this point. The public has been ingrained that health insurance=health care. A complete re-wiring of the public mindset must take place before free-market solutions can take place, unfortunately.
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