It’s not like conservative-state residents will hear only one set of data and logic relative to the Medicaid expansion debate. Republicans have their own economic analysts willing to make their own cases. Douglas Holtz-Eakin, a former head of the Congressional Budget Office, and economist for the McCain campaign, has made an early case at National Review. He begins by asking, “If this is such a good deal, why did Obamacare have to mandate it in the first place and enforce it with a draconian penalty,” which is off, because the penalty isn’t all that draconian, but which will play well as a talking point.
Next, you have to understand that the right views the Medicaid system as broken.
Any individual who is above the poverty line is eligible for the federal subsidies in the state-based exchanges. Individual insurance is better than Medicaid, so a state has zero incentive to expand its program on the basis of this population. Individuals will simply get their insurance at the federal taxpayer’s expense (and this is expensive — as much as $3,000 more expensive per person than Medicaid). This is the budget cost that drove the drafters of Obamacare to change course and jam millions of Americans into the broken Medicaid system in the first place.
Even more striking, for those states that have already expanded coverage above the federal poverty line, Obamacare’s “maintenance of effort” requirements expire in 2014. Accordingly, a state could cut back any expansion of its Medicaid program and shift the cost to the federal taxpayer — a pure win for the state. This would include essentially every child age 19 or younger, every pregnant woman, and many adults in large states like California, New York, Illinois, Massachusetts, and more.
Individual insurance versus Medicaid shouldn’t really be the comparison here. It should be Medicaid versus no insurance. And on that score, Medicaid is light years better.
Further, the problem with foregrounding the experience of those between 100-133% of the poverty line, who are basically eligible for subsidies or Medicaid, is that this isn’t a large population. According to Urban Institute research, 80% of those newly eligible for coverage under the Medicaid expansion are below the poverty line. States could shift those between 100-133% FPL to the exchanges, but that’s just not a big universe of people.
Holtz-Eakin does get around to those below the poverty line. But he simply doubts that the federal government will pick up 90% of the costs of the Medicaid expansion over time. He highlights “the probability that a cash-strapped federal government will choose in the future to shift costs to the states.” Finally, he calls it a “federal bribe,” which is a tribal way of saying that the government wants to compel states to cover poor “other” people with your money.
I go through this to point out the counter-argument that will be made at the state level. It’s that a) Medicaid is a “broken system,” b) the poor have other options (even though most of them don’t), and c) this puts states “on the hook” for massive amounts of money. And then it’s a he said/she said argument, regardless of the veracity of these claims. There are surely plenty of studies to be mined showing that, factoring in the cost of uncompensated care, covering the uninsured at the low end would save money. But you’re talking about a public that, in substantial numbers, doesn’t even know the Supreme Court came to a decision. People are not up on the nuances of this debate, and if someone on their team says that people don’t die from prostate cancer and breast cancer anymore, they’ll tend to believe them.
As I said yesterday, logic will not rule this debate. This isn’t about facts and figures, but partisanship. The right has these talking points that sound like logic, and it’s enough to fool the media into thinking there’s a debate here. But the real debate will happen at an elemental level. Republicans will make a moral argument, one they’ve drummed into the heads of their supporters over time, about the unfairness of your tax dollars going to free health care for a population that should help themselves rather than relying on government. If Democrats respond with numbers, they lose.




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Douglas Holtz-Eakin is Dick Armey’s best bud and probably his snorting partner. Big Insurance owns them all and pulls the ring in their noses.
BTW, why doesn’t the DEA work the DC area? They would have a field day with all the politcos there.
July 4th, 2012
Dear Washington,
70+ million Americans have no access to health care.
That includes people without health insurance and people with it who pay outrageous premiums but can’t afford to see a doctor because of the high deductibles.
We are making a demand of our leaders starting today on our country’s birthday.
We don’t have health care.
You don’t have health care.
We don’t have protection from medical bankruptcy.
You don’t have protection from medical bankruptcy.
Why should you have what we don’t? You elites want everything for yourselves and make sure you have it while you tell the American people too bad for you you get nothing.
We demand that you, your staffs and the rest of the elites in Washington GET NO HEALTHCARE.
No doctors, no pills, no tests, no surgeries.
Nothing.
We demand you live like we do until you fix this broken system and every citizen in this country has access to health care.
The Right, the Left, the Center who have no healthcare are joining together to form a tsunami that will sweep over Washington.
Signed,
Americans who have no access to health care in the richest nation on earth
Fuck the right. Fuck the left. “Control corporations” and tax every “Wall Street transaction at .0003% to pay for healthcare services. Do not protect state based health insurers who have used contract law to screw Americans for decades. Especially when the tax exempt public charity status of these insurers is a taxpayer subsidy, and now we pay more not less for insurance.
Since Wall Street has been enabled in raping America as Sandusky was, we now know, enabled in raping children, the proximate cause of many health issues resulting from rape, rest with the rapist and the enablers. Make the fuckers pay. But the rule of law does not protect the victim. It protects the rapist!
Your right Ready!!! So much for the “GOVERNED,”
De facto Corporate Sodomy…………………….
The right wing believes that the government should play no role in helping people who suffer the misfortunes of life. They hide that belief–and do so very effectively–behind focus-group-tested catchphrases and talking points.
You might be asking yourself, “why can’t the Democrats do this as well? After all, most of the nation’s trial lawyers are Democrats.” The answer is that the party mandarins don’t want to.
Corporate appeasers, at our expense? :)
Democrats lost the moral argument when they went with a for-profit health care plan that has stiff deductibles and co-pays.
If we want to claim, as FDR did, that everyone has a moral right to basic health care, then that requires single payer, financed by general revenues, so that anyone can walk into any medical facility and be treated with worrying about who will pay the bill.
“Republicans will make a moral argument, one they’ve drummed into the heads of their supporters over time, about the unfairness of your tax dollars going to free health care for a population that should help themselves rather than relying on government. If Democrats respond with numbers, they lose.” Exactly!! We need to make our own MORAL argument and get it out. You can’t count on Obama or his people to do it though , because they’re just as hostile to public programs like Medicaid, SSI and the rest as the reactionaries are.
What moral argument?.Is there any moral argument left in all this politicians-corporations-money scheme?you tell me.
Opt out medicaid is even beneficial for democrats,because like republicans they don’t care about people,they are all for the money one way or another.
moral argument??ha,ha,haaaaaaa…where is the moral argument in mandate for profit of corporations?…
“Where is the moral argument in mandate for profit of corporations?’
Clack! 8 ball in the side pocket.
My comments don’t seem to be making it into this thread. I’ve submitted twice before this.
Well, David, it seems that you or a mod is censoring my comments on this thread. Why?
I’ll try one more time.
mtngun, I believe you meant “…without worrying….” I’ll agree.
Now I will try this part.
We send $3 billion/year to Isreal for their budget. They have universal health care. We, however, cannot find that same $3 billion to establish universal health care here. Of course, joe LIBerman and the other legislators who vote the money don’t compare the two health care systems.
You might be surprised to know that even though they act as for profit corporations, many insurers and providers are tax exempt corporations, determined by IRS, then considered public charities, under state law. No tax liability, as a corporation? Yet “they” get your money so you can have access to healthcare services?
Corporate sodomy, enabled by corporate money and politicians.
Your correct…. Its fucking absurd! Might just be time for another “Shot heard around the world?” These mother fuckers are no better than a fucking King and cadre of corporate cocksuckers……….
Servitude…….
I agree that logic, facts and figures are wasted.
I suggest portraying the governors refusing to expand Medicaid as murderers. Killers for profit.
Outlandish? Crazy? No one would ever swallow such a thing?
They believed death panels. They believe Obama is muslim.
The key is to get that message out first. Let the Right try to dispute it. Let them trot out “experts”. It will be too late once the seed is planted in fertile ground.
It would go something like this:
How many Floridians will die needlessly because of Rick Scott’s ambitions?
How many Springsteen fans will die because of Christie’s ambition?
How many of those that survived Katrina will die because Jindal wants to be president?
Demonize anyone that refuses the Medicaid expansion . they’re willing to kill for their own personal political ambitions.
And this talking point has to move quickly from the “far left” on in.
These Republican governors are ripe for the picking is only the left will learn to REALLY go after them the way the right went after the healthcare bill.
I disagree. I see this as a common type of view point that leads to Democrats making only weak arguments that go no where.
To say that we can’t portray the expansion of Medicaid as the “right” thing to do because we didn’t get all the way to single payer is self defeating.
And it allows the right to claim the moral high ground while the left gazes at their navels thinking, “If only…”.