Republican Plan To Replace Obamacare Would Turn Medicaid Over To States

[sabra]

Source: NPR

Republicans plan to turn control of Medicaid over to the states as part of their replacement for the Affordable Care Act, according to an adviser to President Donald Trump.

Kellyanne Conway, a counselor to Trump, told NBC News's Sunday Today with Willie Geist, that the health care law that will replace Obamacare will turn Medicaid — a joint state-federal health insurance program for the poor — into a block grant program. The change would mean the federal government would give money to the states to implement Medicaid as they see fit.

"Those who are closest to the people in need will be administering it," Conway said in the interview, which was recorded the Thursday and Sunday. "You really cut out the fraud, waste and abuse, and you get the help directly to them."

...

But many health policy analysts say that block grants could lead to reductions in care. "A Medicaid block grant program would institute deep cuts to federal funding ... and threaten benefits for tens of millions of low-income families," said Edwin Park, vice president for Health Policy at the Center for Budget and Policy Priorities, in a report on the group's website.

Read more: http://www.npr.org/sections/health-shots/2017/01/22/510984148/republican-plan-to-replace-obamacare-would-turn-medicaid-over-to-states?utm_source=facebook.com&utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_content=20170122

[cstanleytech]

1. Yes the new Republican Death Panel plan will be so much better than Obamacare. nt

[heaven05]

2. and he has become death

I fear for americans......

[underpants]

3. Going out on a limb here - Willie Geist sat there and nodded

Aside from the decreased funding parsing it out to the states opens up the possibility of tremendous graft.

[cstanleytech]

4. Oh I disagree completely about the possibility of graft as there isnt any possibility

as its just about a certainty.

[bucolic_frolic]

5. Washing their hands of it

It will lead to benefits dispersed on the basis of first com first served, or
until the money runs out for the year, or which church you belong to,
or what the legislature will add to the pot

It's no kind of health plan at all

[Princess Turandot]

6. Actually, Medicaid is already administered at the state level...

Historically, the Feds have primarily doled out funding on a 1 to 1 match with the states, and have set a baseline of services that must be provided. (The states can offer additional benefits, which they fund themselves).

Thus her statement that Those who are closest to the people in need will be administering it," Conway said in the interview, which was recorded the Thursday and Sunday. "You really cut out the fraud, waste and abuse, and you get the help directly to them. is complete malarkey.

[standingtall]

24. The way I see it

"You really cut out the fraud,waste and abuse" Is republican code for we think that to many people are eligible for medicaid we are going to cut them off by allowing governors to tighten the eligibility requirements.

[DeminPennswoods]

7. Medicaid funds nursing home care

Wait until these middle class Trump voters figure out how much Mom and/or Dad's nursing home care will cost them once medicaid turns into a "block grant". Then wait until Medicaid comes after the assets they thought were protected in some kind of estate planning trust and would be their inheritance once Mom and Dad were gone. It is going to be a rude awakening.

[lark]

10. While this is totally horrible, at least it does have a silver lining.

My batshit crazy yellow dog repug boss would be hurt mightily by this change. Her dad has Alzheimers and pissed away all the family $ and is in a nursing home on Medicaid. Her husband is a Chief of Surgery so they have $$, but she doesn't want to spend her own money on mean ole' dad. She deserves the $4,000 month charge currently being paid by Medicaid. This is in FL and you know Voldemort and his paid minions in the legislature will make it so that Medicaid no longer covers all his care or covers much for anyone. The people that voted drumpf totally deserve this, they in their stupidity elected him. Unfortunately, the majority who didn't vote for him (like all my family) will also be fucked over badly too.

[DeminPennswoods]

11. It's 10k/month for private pay

It's 10k and counting for monthly care in a nursing home. I was told nursing homes do no worse than break even if they get only medicaid payments, but if medicaid goes away, they won't be accepting 4k/mo from families. 4k/mo barely covers assisted living.

[CBHagman]

13. But the progressive object is health care, not revenge.

Revenge doesn't improve the world. Innocent people will be harmed by this move.

[DeminPennswoods]

16. True, innocent bystanders will be hurt

but Trump voters will have to feel the pain personally before they'll understand what they voted for.

[lark]

18. I know and if I could I'd stop it.

I feel so sorry for so many that will be hurt by this through no fault of their own. Since there's probably no hope of this not happening, glad that some of the people that put him in office will also get hurt by what they themselves wrought.

[Princess Turandot]

21. Don't crow too soon. A state might decide to continue to fund nursing home care at/near its current

level while reducing/eliminating other services. That's what I would do, if I was a worthless-excuse-for-a-human-being right-wing governor.

Right now, the Feds set a baseline set of services that states must provide to Medicaid beneficiaries: I assume that will be completely eliminated in this Republican proposal. The states already decide how much to reimburse for specific services in their state: the Feds don't tell them how much to pay. So before those commercials start running warning that one's completely senile parent will be returning home, you announce that nursing home bills will, of course, be covered. Then you reduce payment rates for ED visits and obstetrics care directly, or establish large coinsurance amounts for them.

What would that accomplish? Nursing home care is the one area where Medicaid coverage impacts the middle-class, since many recipients only converted to Medicaid when their money ran out. (Or they managed to transfer their money to their children long enough ago to not fall afoul of the regulations concerning that, if those regs will even still exist.) Obstetrics and ED coverage largely impacts folks who were always low income, whom the republicans don't give a shit about. And there's also a bit of a safeguard for the politicians: when low-income Margaret is brought to a hospital ED about to give birth, they will deliver that baby regardless of her coverage.

So don't gloat yet.

[lark]

22. I live in FL, where the impact will be felt the most.

FL Repugs would love nothing more than to soak all that money from the middle class, but it would hurt them at the polls if Medicaid didn't cover the cost of nursing care anymore, just don't know how much with all the Tealiban here.

Don't get me wrong, I am totally NOT in favor of this.

[TomCADem]

8. Republicans Could Just Call The Block Grant, "Basic Income"...

...to make it sound more progressive, and you might confuse folks. Cut benefits to pay for tax cuts to the rich. Replace benefits with a block grant, which is then distributed to individuals as basic income allotment. Then, decrease amount of basic income grants over time.

[Vinca]

9. So in a blue state you would get care, but in a red state you'd suffer.

Nice going Trump voters.

[cbdo2007]

12. Inevitably people will move from red states to blue states for better care.

[moondust]

14. I think that's the plan.

Like voter suppression, some red states will try to make it increasingly difficult or impossible to qualify for Medicaid, making life as miserable as they can for "the poor" in the hope that many will move and become a "tax burden" on some other state. Then they can lower their taxes and attract wealthy sociopaths who don't need jobs to their tax-free havens. I've always assumed that was what refusing to expand Medicaid under the ACA was all about in states like Texas and Kansas--get rid of the poor rather than help them. (Such good Christians. ) Maybe they'll even figure out how to turn Medicaid into a slush fund for their own "priorities."

[karynnj]

19. One problem with that scenario

Think of all the low pay service jobs needed to do things for the rich who remain. Not to mention, these will not be pleasant places to live in.

[roamer65]

15. The blue states will implement more stringent residency requirements.

They will basically become like citizenship.

They will have no choice.

[harun]

20. Yeah, they just won't have the money for all the diaspora from the Red States.

We are moving closer to a Red Law/Blue Law society.

[briv1016]

17. Who decides the size of the "grant" each state gets?

I give you a hint. A two month old map might play a role.

[geek tragedy]

23. At that point there's no point to keeping Medicaid at all, as it's just a welfare payment from rich

blue states to poor red states that has only theoretical links to health care for poor people.

Which is exactly why they want to convert it into a block grant program--to kill it completely.

[adigal]

25. I really think we are going to see blue and red nation states

Especially if Susan Collins' ACA replacement succeeds in which states can choose to continue to receive Federal funds, keeping the ACA basically.
Blue states will prosper, red states will be third world countries.