Those who liked yesterday’s 5-4 verdict in NFIB v. Sebelius, the formal name of the Affordable Care Act lawsuit, have made two arguments knocking down concerns that the ruling could have negative ramifications. One of them I completely disagree with, and one I think needs to be looked at a bit differently. I want to take both of them in turn in separate posts. Let’s start with the one where I disagree.
As I explained yesterday, the part of the ruling around the Medicaid expansion, where 7 justices agreed that this was basically a new program, and existing Medicaid funds could not be taken back by the federal government if states declined to comply, has the most near-term consequences for health care itself. Given that Medicaid expansion created half of the coverage increases in the bill, this offered half of the states the opportunity to really take an axe to the program by simply refusing to expand their Medicaid programs. And it leaves the poor between around 50% and 133% of the poverty line in a real no man’s land, because they would both be ineligible for Medicaid AND the coverage subsidies in the exchanges (and ineligible for the mandate, but that just puts them in the status quo, which is terrible).
This has been dismissed by the Democratic establishment as implausible. But it’s such a good deal for those states, they say. But everyone’s in Medicaid now, they say. Nancy Pelosi has a representative sample:
“I don’t think governors will turn that down. People have the need, the urgency is there,” the House Democratic Leader told reporters on a press call Thursday afternoon.
Pelosi argued that it will be extremely difficult for conservative states to opt out once their residents see how other states are benefitting from the Medicaid expansion. “Once this bill is rolling and people experience benefits of it, it’s very hard for a state to say [no],” she said. States will also receive full federal funding for the first three years of the expansion before they have to take up more the expense, which Pelosi described as a major incentive to get them to participate.
It’s true that it’s a very good deal for states. As Pelosi says, the first three years is basically free, and after that the state only has to pick up less than 10% of the costs. In the example of Texas, by 2019, the state will have spent a mere $2.6 billion on the expansion, while the federal government will have shelled out $52.5 billion. And Pelosi even hinted that the feds could pick up more of that cost (which sounds close to federalizing Medicaid, which is really the killer app here).
Furthermore, looking to history, Medicaid itself was created in 1965. It remains a voluntary program, and Arizona held out for 17 years, until 1982, becoming the last to create their own program for their state. So if all states, including the red states, have Medicaid now, doesn’t that suggest all states will take the expansion over time?
Perhaps. But Pelosi’s response strikes me as the typical Democratic dismissal of conservative ideological intransigence. This is a far more conservative era than 1965. These state governors are well to the right of the crop that held out in Arizona. And Obamacare is seen as the devil’s handiwork. I’d argue that these governors are ideologically far to the right of even 2009, when all of them took stimulus money eventually. The resisters just paid lip service and eventually took the funds. But there wasn’t a Tea Party to pressure them to the right on these grounds. Scott Walker and Rick Scott and John Kasich came right into office and denied the high speed rail funds for Wisconsin and Florida and Ohio, for example. That’s the crop we’re talking about.
And being on the hook for even a small amount of funds isn’t going to make any of these governors happy. Heck, here’s a Democrat, former West Virginia Governor and current Senator Joe Manchin, making the argument for them:
We should all recognize that the health care challenges that many West Virginians and Americans face are not going to go away unless Congress takes additional action to repair this bill. Now that the Court has ruled, we can move forward with fixing what is wrong with this bill and saving what is right. I have always been determined to reduce the burden on states from the Medicaid expansion, and this ruling affirms my position – and makes clear that states must have the flexibility to live within their means by determining Medicaid eligibility as each state sees fit. I have always said one size doesn’t fit all.
That’s going to be a compelling set of logic for a non-trivial number of governors. They’ll also distort how much the expansion would put their states “on the hook.” 26 states sued to eliminate the Affordable Care Act entirely, and they almost got there. Why wouldn’t they jump at the chance to eliminate the portion that creates half of the coverage benefits?
This isn’t going to be universal. New Mexico’s Republican Governor Susanna Martinez, for example, certainly sounds like she’ll take the money. But Southern states in particular, who paradoxically house the citizens most in need of the Medicaid expansion coverage, will be likely resisters at the outset. And it’s not like a lot of success in modern America comes from rallying at the grassroots level for poor and disenfranchised people.
The one hope, as Kevin Drum articulates, is if interest groups get involved:
There’s going to be a lot of pressure from various interest groups to accept the funding. That includes pressure from within government agencies as well as from outside groups. After all, state and local governments are already on the hook for indigent healthcare, and that includes caring for those who fall in between the current Medicaid cutoff and ACA’s new one (roughly speaking, those who are between 50% and 133% of the poverty line). Even the stingy states may discover that they’re already spending enough money on that group that they’d be better off simply enrolling them all in Medicaid and paying their small share of the new benefits instead.
This has logic on its side, but I want you to think about the last time that mattered in politics. Brute force usually wins, and unless the hospital industry delivers that, Southern red states will hold out.
The crazy thing is that if Democrats just changed the structure of the ruling to incorporate the old Medicaid program into the coverage expansion, everything would have passed Constitutional muster. Which makes the Court’s argument really shallow.
It sounds as though if the ACA had been structured in this way:
Title 15: Title XIX of the Social Security Act, as amended, is repealed.
Title 16: New Medicaid = ACA Expansions + the old Title XIX of the SSA are mereby enactedthat that would, formally, pass Roberts’s scrutiny.
But nevertheless, that’s the law, and ideological conservatives are poised to exploit it. They need to be fought. And I don’t think you do that by saying “oh, they’d never do that.”





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The last portion of your diary hits the nail on the head.
Medicaid will eventurally be absorbed into the Obamacare structure, and thus privatized.
Medicare to follow.
You’re right.
i would think the doc lobbies in these states will be supporting this along with the hospital lobbies.
that is a powerful lot of power, money and influence.
Heck, even Ezra Klein admitted that has been the plan all along.
Oh goody, now that Klein has proposed it I feel all better about it, j/k
People still pay attention to Ezra Klein?
The future is MEDICAID for ALL… Run by a handful of insurance/hospital conglomerates.
Each of which will have annual revenues LARGER than the defense budget.
Truly, the Democratic party died yesterday.
It’s become impossible for me to think that anything Pelosi does or says is done or said in good faith.
It’s good to keep an eye on your opponents. Although, I no longer really have the stomach for it.
(Not sure if I just mixed my metaphors or not).
Here in Arizona, and back in 1982, I and my political allies were at the “decision-making” Table when ACCESS was established, in lieu of the unfeasibility for calling it the “new” Medicaid. Regardless, the medical doctor who was hired and served three Governors, eventually, came around to our political view, and which was and still is, “open access” to Medicare, the VA, and Indian Health Services.
In these intervening years, not much has changed, when yardsticked against the inflicted damage done to the New Deal and the Great Society.
And given that I am a contrarian, long of tooth and grey of beard, having a “medical care delivered” Construct, bypasses the current arguments for Affordability and Applicability, while intentionally ignoring the “ethics” of this national dilemma.
It’s guache of me to criticize Progressives, but, if one can imagine a “medical care delivered” Construct that requires the VA to build/construct and contract out to, take, for example, Planned Parenthood, thousands of community clinics dedicated and open to all in need of medical care, and regardless of whether the patient is either Middle Class, Senior, or Poor, obviates, at a minimum and at a maximum, destroys all possible arguments presented by the Conservatives, Democratic and Republican alike, as well as the wrong-headed Progressives.
From here in the Sonoran Desert, the “Academic-Military Draft” will be established nationally and implemented, and on a large scale. Further Demographic Trends, being equivalent to a glacier, will chew up anything and everything political, especially when the astute Progressive fully understands that with 700,000 kids, on a monthly basis and turning 18 years of age, and cannot look forward to a decent paying job or a college education that is prohibitive due to cost and family finances, even from the standpoint of a single parent family.
Therefore, “fixing” the Affordable Care Act, if it’s to be accomplished, the Federal role should be sacroscant and not be delivered to states and where the state governors argue and complain that the State is unable to accept this “burden.” As such, any Progresiive that suggests that there should be a “state functionality” in Medical Care Delivered, has his or her head up the ass of the Status Quo. And if you’re not willing to Challenge the Status Quo by “empowering the Individual,” while
considering yourself to be my “compadre” among Progressives, is not going to happen, especially when the Native American and the Chicano, start speaking out and loudly at the national level. As such, white Progressives, had best put on their “thinking caps” otherwise the only cap readily available will be the Dunce Cap.
Jaango
She promised to cut funding for the Iraq War in 2006, then once elected passed more funding for the Iraq War – because George Bush made her.
But once Bush was out of office and Obama was president – more of the same. Not only that, Democrats who had campaigned as anti-war and signed pledges opposing funding the war suddenly switched their votes.
This is from an article by Jeremy Scahill, written back in 2009, explaining how anti-war Democrats became pro-war Democrats once their votes were needed to fund the war.
As long as we live in a Corp. plutocracy something like the ACA is about all we can expect as reform. It’s along the lines of those coupons and rebates you get in the mail from CVS. It’s all just clever marketing. In the end though none of this will work if the system just encourages the providers and the middlemen to gouge the customers at will. Eventually, their sacred free market will kick in and they will find themselves with a puzzling ( to them anyway) “lack of demand.” Sound familiar? These people don’t get it and they never will. They want to think they can turn us all into plantation slaves, but even slaves can only carry so much at a time on their backs before they simply sit down or die.
Well, it’s unfortunate for the poorer residents opf Southern states if those states opt out. At least the South cannot hold back the rest of the US, which has been its historic role in our country’s development.
You can’t fix stupid. Why worry about it?
Like they’d never give up women’s healthcare funds in order to kneecap PP.
If we had the power, we should federalize Medicaid. That,could be the first,step to Medicare for all.
Drum is overly optimistic. Not sure what interest groups would weigh in. Hospitals and doctors hate medicaid because its rates are generally so low.
The Medicaid expansion has always been the weak link in the ACA from the start.
It is difficult to find a doctor that will accept Medicaid as it stands 20 million new enrollees will make that worse. I really doubt that raising Medicaid rates to match Medicare rates will allieviate the problem.
My fully disabled daughter became eligible for Medicaid at age 18. We were forced into a privatized Medicaid HMO. It was harder to find a provider than with traditional Medicaid
Insurance that no provider will accept is no better than no insurance at all.
Hospitals were very active here in AZ opposing cuts to Medicaid. Low reimbursements are better than no reimbursements and loss of Medicaid funding would contribute to the loss of thousands of jobs and shutting down several hospitals and clinics.
I get the feeling this discussion is winding itself into a knot in a far corner of the room. Maybe Dday will unwind it to some extent when he posts his other comment about the aspect that “needs to be looked at a bit differently.”
The notion that right wing haters will opt out of an expansion of Medicaid seems to prove too much. If they are willing to opt out of the “expansion” program, regardless of economic incentives to opt in, then they would be willing to opt out of the “original” Medicaid as well, since that has always apparently been a “voluntary” program. Dday wrote
If the original was voluntary, and the expansion has now been made voluntary by Supreme Court fiat, and if wing-nuts will opt out of the expansion because of the Supreme Court suddenly making it voluntary, then the wing-nuts will opt out of the original, too. The wing-nuts are either gonna shit or get off the pot. The residents of wing-nut states living in poverty are either shit outta luck, or their state governments are going to opt in to the voluntary expansion the same way those govts opted in to the voluntary original program.
i think he believes they hate uncompensated care even more.
The key is how the Court portrayed this expansion as a new program. It’s possible one wingnut gov will get his back up and kill the existing fed/state partnership. But they kind of also need it to show how “they” are getting free health care with YOUR money. The expansion, as a new program, is most easily killed. It doesn’t generate headlines like “X dies after losing state-provided coverage.” With the expansion, they don’t provide the coverage to begin with.
Thanks. I am beginning to fathom the political dynamics you are trying to show us. I’m just confused how the political wrangling overcomes the awesome economic burden of the Medicaid patient population. Did you post your second comment yet, the one about an aspect that needs to be looked at a bit differently?
yes, but that was more about the long-term jurisprudence on the Commerce clause:
http://news.firedoglake.com/2012/06/29/roberts-health-care-ruling-and-the-impact-on-future-congressional-policy/
conservative free market elites fear the medicaid provision more than anything. The whole mandate thing was a smokescreen to them.
Look at it this way. The fed gov is going into a lot of poor states, which also happen to be the most conservative, and they’re picking up the costs for a much larger percent of the health costs of the poor populationS in these poor states. Currently the doctors, hospitals, and social agencies in these states are footing the cost. Of course they are going to jump on that opportunity to get paid from OUTSIDE their state, AND THE DOCTORS, HOSPITALS, CITY HEALTH AGENCIES, COUNTY HEALTH AGENCIES, probably even for-profit prison companies, etc. A lot of firepower from interests that are now going to get paid instead of getting next to nothing to help their budgets.
That basic economic relationship is what has the free market/insurance industry worried the most about ACA. The generous handout of Medicaid benefits to the states brings a LARGER percent of the population into government healthcare. THIS IS THE BACK DOOR APPROACH TO A SINGLE PAYER SYSTEM. And the real kicker is the conservative chief justice just framed it as a law that is able to TAX to raise revenue and make the system work better. That’s like saying, hey…..let’s have a payroll tax to fund Medicare for old folks !
So, it’s not a big step now to TAX other entities, corporations, pollution makers, cigarette makers, booze makers, industrial junk food makers – the folks who are making the population sicker all the time,, to fund the nation’s MEDICAID/ACA/SINGLE PAYER health system.