• Another one bites the dust!

    I’ve said it before, and I’ll say it again. It will be hard for states to turn down the Medicaid expansion:

    1. This is a pretty good deal for states. They’re getting most of the tab picked up by the feds.
    2. It’s one thing to turn down high speed rail. It’s another to tell your constituents that they can’t have insurance entirely paid for by the federal government in 2014.
    3. As more and more states take the money, those that don’t will be more easily marginalized.
    4. History. States threatened not to join Medicaid the first time as well. All did, eventually. Now the program is so American that threatening to remove it is “coercive”.
    5. There will be enormous pressure from doctors, hospitals,pharma, etc. who potentially will lose a lot of money in uncompensated care. They have pretty good lobbying groups.

    Florida just joined those states. Florida!

    Hours after the federal government agreed to grant Florida a conditional waiver to privatize Medicaid statewide, Gov. Rick Scott appears ready to endorse a plan to conditionally expand the health care program to at least 1 million more Floridians.

    Scott has hastily called a 5 p.m. news conference to make an announcement regarding Medicaid.

    It’s hard to ignore the irony here. Florida is, after all, the state that brought the case to the Supreme Court (and won!) to avoid the “mandatory” expansion. Now, Gov. Scott seems to be accepting it.

    The legislature still has to approve this deal, and that’s not assured. But with popular support in the state, and lobbying from various health care system groups, I think they’ll follow Scott’s lead.

    More states will follow.


    UPDATE: Here are Gov. Scott’s prepared remarks.

    • I love the headline on the flgov.com website:
      “Governor Rick Scott: We Must Protect the Uninsured and Florida Taxpayers with Limited Medicaid Expansion”

      Whata great guy…

    • We had Michael Cannon from Cato testifying in front of a Kansas Senate committee yesterday who used the death of Demonte Driver, the Maryland 12-year old who died as a result of an infection from an abcessed tooth, as evidence that Medicaid should not be expanded. Demonte was on Medicaid and couldn’t find a dentist to treat him, so therefore all Medicaid is bad.


    • So I stayed away of a while – got my blood pressure under control…

      Then I decided to see what was going on on IE…

      So much for low BP 😉

      Where does the “fed money” come from?

      We are broke – we don’t have the money to pay for this – or many other well intentioned programs.

      To be clear – the Feds can pay for the things you want by…
      1. Taking money from those that have it now.
      2. Taking money from our children and grandchildren.

      So I will see you in a couple of years since I am sure this will get me banned for being insensitive.


      • Or you have providers and hospitals raising their costs to cover non reimbursed care, which causes more people to lose their insurance coverage which causes more unreimbursed care…

      • Congrats LL. You’ve just proven that economic growth is a fallacy.

        Or maybe not . . .

      • LL:
        Since the US is clearly the most costly place on earth to get healthcare while producing mediocre outcomes, do you think that continuing the current system is a good idea?

    • Wow, so Tom Corbett here in Pennsylvania is among the last holding out?

      Corbett has made a series of proposals, decisions, and statements that are hugely unpopular on a number of issues, among various political leanings. I don’t know who likes him, other than shale gas drillers who pay no taxes courtesy of him.

      He has some study he says shows evidence that expanding Medicaid would be “bad for Pennsylvania”, horribly bad, but hasn’t released details of this for review apparently. Which is causing questions to be asked… and no answers are given other than to claim they’re not getting enough needed specific information from the federal government on the issue.

      Others say that it’s a no brainer that expanding Medicaid will help Pennsylvania, economically. This includes apparently hospital associations & such.
      There is supposed to be another study on this, due to be completed at the end of March. One can only hope that it will be too compelling for even Corbett to make up nonsense to argue about.
      But I’m not sure this guy has anything to lose at this point, his agendas have been so widely unpopular I find it hard to believe he’d have a snowball’s chance in hell of winning re-election in 2014.

    • “Where does the “fed money” come from?”

      Our Federal Gov’t is the creator and issuer of our currency. States have no ability to create money. New money is needed for economic expansion, and new money will be needed to help care for our seniors HC needs in the future. There is and will be no other way to cover the future enormous costs.

      • Wow – if you believe this – and others do then my country is lost.

        There is no magic…

        Every dime that our government spends must be repaid – maybe not today – but at some point. If you and I don’t balance our revenue and spending then our children and grandchildren will have to deal with the burden we choose to pass on to them.

        • ‘Every dime that our government spends must be repaid – maybe not today – but at some point.’

          Drastically paying down Federal Debt has led to recessions in our historical past. But generally all debt will never be paid down. To do so would mean that we and the world have no USD’s, as a USD is 1 dollar of Federal Debt. As we grow our economy, we have to grow the number of dollars (debt), and much of our debt will never need to be paid off.

          Yes I believe it, but most of our country and world does not. Because most don’t comprehend, or want to comprehend, or admit to comprehending, the differences between personal and Federal Debt.