Archive for April 23rd, 2015

Montana Medikoolaid

by William Skink

It sounds like some MT Democrats are getting annoyed that James Conner keeps writing about the pesky details of Medicaid expansion in Montana. Yesterday Conner wrote about Rachel Maddow spreading MT Medicaid expansion misinformation. It may not technically be misinformation to state that SB-405 expands Medicaid eligibility for the 70,000 Montanans state legislators have been vigorously tweeting about, but it is misleading. As Conner keeps pointing out, the fiscal note puts the number of Montanans that could be covered at around 46,000. That means tens of thousands of Montanans could be eligible, but not covered, under SB-405.

The takeaway? Just because legislators tweet using popular hashtags, you still gotta read the fine print.

Thankfully, not every national publication is drinking the Medikoolaid. Mother Jones takes a look at how the Obama administration’s plan to expand Medicaid in red states is by weakening it. From the link:

Some red states have been coming around, lured by of the enormous infusion of federal funds they’ll receive by expanding Medicaid. And without participating, states soon stand to lose billions in other payments designed to compensate hospitals for care for the uninsured. (Florida could lose more than $2 billion on account of leaving 800,000 residents uninsured who could otherwise be covered under Medicaid.)

Despite that carrot and stick, Republican-controlled states have demanded additional concessions from the Obama administration before taking part in the expansion—and in many cases, as a new paper from the National Health Law Program suggests, the administration has agreed to changes that undermine its own goal of expanding coverage. These changes have made some states’ Medicaid programs more, well, Republican—not to mention punitive.

Montana is choosing the punitive premium approach to Republicanize Medicaid, ceding an opportunity to expose the notorious anti-tax right as pro-tax if it means punching poor people. Gee, I wonder how that’s going to work out. Here’s more from the Mother Jones piece:

Take Arkansas, which in 2013 was allowed to use its Medicaid funds to let poor residents buy private insurance on the state health exchange—policies that may not have the same protections or coverage as traditional Medicaid. Iowa and New Hampshire have followed suit. According to the NHLP, these initial waivers emboldened states to seek even greater concessions. An example is Indiana, where, in exchange for agreeing to expand Medicaid, officials not only won the right to charge poor people premiums and co-payments, but also to lock people out of the program for at least six months if they fail to pay those premiums.

The administration has granted such waivers through its authority to authorize so-called demonstration projects to encourage policy innovation in the states. But NHLP contends that waivers like Indiana’s violate the law, which “requires demonstrations to actually demonstrate something.” As NHLP points out, reams of research have long showed that such premiums dramatically reduce health coverage for low-income people. After the Obama administration granted Indiana’s request, Arkansas went back to ask for permission to charge premiums, too. And it prevailed.

To repeat, premiums DRAMATICALLY REDUCE HEALTH COVERAGE FOR LOW-INCOME PEOPLE. I’m yelling because too many MT Democrats appear to be deaf.

Conner ends one of his recent posts with this:

When Gov. Steve Bullock signs the bill, pay close attention to what he says. Will he speak the truth? Will he condemn the paucity and price of the coverage for 46,000? Or will he sing high praises of bipartisanship, compromise, and Sen. Buttrey’s wisdom and compassion? Will — can — Democrats be honest about legislation that they know, or should know, betrays the poorest of the poor?

Good question.

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