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Old 10-08-2013, 06:56 PM  
Direckshun Direckshun is offline
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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 10-09-2013, 05:06 PM   #76
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AMA Insight.

The American Medical Association has weighed in on Obama's new health care package. The Allergists were in favor of scratching it, but the Dermatologists advised not to make any rash moves. The Gastroenterologists had sort of a gut feeling about it, but the Neurologists thought the Administration had a lot of nerve. Meanwhile, Obstetricians felt certain everyone was laboring under a misconception, while the Ophthalmologists considered the idea shortsighted.

Pathologists yelled, "Over my dead body!" while the Pediatricians said, "Oh, grow up!" The Psychiatrists thought the whole idea was madness, while the Radiologists could see right through it. Surgeons decided to wash their hands of the whole thing and the Internists claimed it would indeed be a bitter pill to swallow. The Plastic Surgeons opined that this proposal would "put a whole new face on the matter". The Podiatrists thought it was a step forward, but the Urologists were pissed off at the whole idea. Anesthesiologists thought the whole idea was a gas, and those lofty Cardiologists didn't have the heart to say no.

In the end, the Proctologists won out, leaving the entire decision up to the assholes in Washington
Missed that one earlier...
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Old 10-09-2013, 05:09 PM   #77
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What is the annual salary range in your definition of the "working poor"?
Still waiting for an answer to this.
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Old 10-09-2013, 05:16 PM   #78
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Still waiting for an answer to this.
Minimum wage 26 year old children
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Old 10-09-2013, 05:24 PM   #79
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Repeal Obamacare and start over.
ding ding....we have a winner
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Old 10-09-2013, 05:28 PM   #80
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How about free physicals with the government paid for abortions? Keeps it clean and not part of ObamaCare and Planned Parenthood can skim some off the top
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Old 10-09-2013, 05:40 PM   #81
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Minimum wage 26 year old children
You can't afford insurance by the time you are 26? I had two kids and a wife on my policy by that time.
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Old 10-09-2013, 05:45 PM   #82
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You can't afford insurance by the time you are 26? I had two kids and a wife on my policy by that time.
The Dems have shape shifted into the new rainbow & rimjob party
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Old 10-09-2013, 09:16 PM   #83
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Not so sure... I do know another kid.. well early ( 20’s ) that broke her ankle playing kickball. Bill was about 50 K they just wrote it off because she didn’t have insurance and they knew it would never be paid
I don't think you understand how this whole thing works.
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Old 10-09-2013, 09:56 PM   #84
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Not so sure... I do know another kid.. well early ( 20’s ) that broke her ankle playing kickball. Bill was about 50 K they just wrote it off because she didn’t have insurance and they knew it would never be paid

Kramer: It's a write-off for them.
Jerry: How is it a write-off?
Kramer: They just write it off!
Jerry: Write it off what?
Kramer: Jerry, all these big companies, they write off everything.
Jerry: You don't even know what a write-off is.
Kramer: Do you?
Jerry: No, I don't.
Kramer: But they do - and they are the ones writing it off.
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Old 10-09-2013, 10:40 PM   #85
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I think the poor are covered and the Rich are fine it is the rest of us getting it up the turd-cutter,

I got off the phone with the hospital less than 2 hours ago making a large payment and a payment plan. Short story is.. My company switched to a High Deductable plan with a HSA last spring. This is now the only plan available. A couple months ago the daughter had a Kidney infection. I took her to the Dr. 2 times do to high fever and vomiting. Prescribed anti-biotic and some anti nausea medication. This was after an X ray, 2 blood tests and two urine tests. She seemed to be doing better and so I sent her to visit her mother before school started the next week ( see hypochondriac X wife) . Kid got sick again, X called Dr. Dr says take her to the Emergency room. After multiple tests including a full body MRI, higher doses of Anti-biotic were prescribed. Kid all better and can go back to College. 1 Kid, 1 kidney infection. Out of Pocket expense 5 K. If I were rich it wouldn’t be an issue. If I were poor they would pick up the tab. Regular guy me screwed.
Is all of that cost below the deductible?

Hospitals know that their itemized prices are inflated. Some give their staff authority to negotiate the bill down. You could look into that if you have not already paid in full.
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Old 10-09-2013, 10:57 PM   #86
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Individual mandates for catastrophic care policies only.
This is actually very, very close to what I would want. (I'd also throw in free routine preventative check-ups, because that would save money)

The problem is not the first $5,000, it is the last million or two. Everybody needs catastrophic coverage. After that, its up to you, if you can afford better coverage good, if you can't, then go BK on the few thousand you can't afford.

Unfortunately, I believe that this view which patteeu expressed and which I share, is far, far, far left of the current stupid, insane tea party. The current incarnation of the GOP is basically a "screw you, I got mine" party, which believes in a "you are completely on your own" society that I refuse to endorse. If I have no other choice but the status quo or the Heritage Foundation's Conservative Alternative to Clintoncare (otherwise known as "Obamacare" today), I guess I'll choose the latter.
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Old 10-10-2013, 06:18 PM   #87
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This is actually very, very close to what I would want. (I'd also throw in free routine preventative check-ups, because that would save money)

The problem is not the first $5,000, it is the last million or two. Everybody needs catastrophic coverage. After that, its up to you, if you can afford better coverage good, if you can't, then go BK on the few thousand you can't afford.

Unfortunately, I believe that this view which patteeu expressed and which I share, is far, far, far left of the current stupid, insane tea party. The current incarnation of the GOP is basically a "screw you, I got mine" party, which believes in a "you are completely on your own" society that I refuse to endorse. If I have no other choice but the status quo or the Heritage Foundation's Conservative Alternative to Clintoncare (otherwise known as "Obamacare" today), I guess I'll choose the latter.

I am really, really, really, really growing sick and tired of the slanderous lies and out right character assassination of the Conservative movement. What you said here cannot be further from the truth.

Conservatism is rooted in the belief of the individual, the faith in our fellow man to be able to over come incredible odds and difficulties in the pursuit of success and happiness.

When I was but knee high to a grasshopper I sat in the living room with my folks one Sunday evening watching one of the network magazine shows, 60 Minutes, 20/20, I do not recall exactly. Which ever it was, they did a piece on this guy who had no arms. Not even stubs, just a clean cut at both shoulders. I do not remember if he was born that way or if some kind of accident had occurred. Regardless, the man had no arms. Now this man had taught himself to get by using his feet. He fed himself with his feet (gross yes but, not much in the way of alternatives obviously), he taught himself how to write using his feet, and even taught himself how to drive using only his feet. He succeeded in gainful employment (possibly even worked for himself, as I say I was young enough that we are talking twenty plus years ago) and providing for himself. He reached down deep inside himself and found the will and the ability to surmount a disability that would side line most, if from depression and feeling sorry for themselves if for no other reason. But this guy proved that the emotional, mental and physical downsides to what would easily be considered an extremely limiting condition could be over come.

As many here are aware I am a big K-State fan. Now I have absolutely zero idea what Bill Snyder's politics are and would not presume to speak as if I do. However, his approach to football, and what he has accomplished in Manhattan, Kansas provides another example of what I am talking about. He takes kids who clearly are on lower rungs of the talent ladder than the big programs and he helps them learn how to reach with in themselves and work to over come their limitations to accomplish a level of football that they themselves likely did not know they were capable of.


When you have children and they reach the point where they are trying to learn to walk, do you allow them to do so even though they may fall down and possibly even experience a little pain in the process? Or do you just carry them around all the time so that they do not have to experience defeat and pain? Do mothers carry their adult children around nursing them from the tit, protecting them from harm and hard work? We Conservatives are referred to as cold hearted and calloused on a routine basis. We are demonized as self centered "screw you guys I got mine" assholes. In reality, we want to see people succeed. We want them to fulfill their goals and dreams. We just realize that falling down, that adversity and yes, even defeat is not only a part of life but, a necessary one. It is from falling down and picking ourselves up that we grow tougher, stronger, smarter, more capable. We understand that something EARNED is more rewarding and more respected than something given. Kansas State football teams, and the armless man have discovered how to overcome the obstacles life put in front of the. Discovered being key here. They have stumbled, they have fallen, they have been beaten. But they stayed the course and learned how to walk tall and win a few battles of their own.

Helping people become addicts of government bubble wrap around their lives is what is cruel and cold hearted. Assisting in dependency versus encouraging self reliance is why this nation is failing today. It is falsely called compassion but, in fact, it robs people of their pride and their dignity. It steals their sense of self worth. It retards their growth as human beings. It stunts their creativity. We could very well have an individual out there at this moment who were it not for generations of family reliance on government assistance that has been passed down to him or her could be on the verge of a cure for cancer. But we will never know because instead of fostering personal responsibility, self reliance, hard work and perseverance, we have fostered society into thinking we are victims; we are owed something; we can't hack it on our own; we are dumb; we are impotent. Were that the mentality of our Founding Fathers, we wouldn't have any founding fathers. We never would have broken away from England. The greatest nation on the face of the earth would not exist.



Conservatism is not selfish. It is not cold hearted. It is not unsympathetic. Conservatism is the belief in one's own self, and the belief in every other individual to accomplish great things in this life.

Truly, those who say "Screw you I got mine" are the government dependent bums who do not care (and in all reality who believe it is the owed to them) that someone else got up, went to work and earned the money that is providing for their existence. There is your group of selfish, cold hearted and calloused individuals.
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Old 10-10-2013, 06:24 PM   #88
Gravedigger Gravedigger is offline
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Repeal Obamacare and start over.
Don't you mean hold the country hostage and be the catalyst for America defaulting on its debts and then blaming Obamacare and the Democrats for the whole thing?
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Old 10-10-2013, 06:31 PM   #89
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Don't you mean hold the country hostage and be the catalyst for America defaulting on its debts and then blaming Obamacare and the Democrats for the whole thing?
No one is holding a gun to the democrats' heads and forcing them not to reopen the government or increase the debt ceiling.
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Old 10-10-2013, 07:03 PM   #90
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I'd start smaller than the giant abortion Obama signed into law.

Kids under 21 given preventive and catastrophic care paid for by a bump in all current insurance policies no matter what your income.

Keep the law if you're 26 or younger that you can stay on your parent's insurance unless your employer offers coverage. Again, that is paid for by all people currently insured unless you are working.

After that, if you are uninsured you pay a tax in which goes towards a catastrophic policy, which is not passed on to anyone that has insurance. No exclusions in the tax, poverty level or whatever.
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