Republicans keep projecting their wishes on the future, forecasting that the things for which they long are “inevitable.” They say things like “With one single decision President Barack Obama pulled the rug out from under any moves by Mississippi Democrats to expand Medicaid in Mississippi.” And that undoing his “signature achievement as President” was “inevitable.” Now this bit of prognostication was a conservative Mississippian’s response to the Obama administration’s decision several months ago to delay “cuts to DSH payments” (“Disproportionate Share Hospital (DSH) payments are given to hospitals by the federal government to states through Medicaid for caring for the uninsured”).
Conservatives say this because they see a delay in implementing a shift in payment for indigent care (which they have been successful in labeling a penalty for the states) as a fatal flaw, even getting liberals to adopt the “Luntz” framing. And, although many of the people they, the Crpto-Fascists, count as supporters would die without expansion, they, in clear Atwater fashion, seem perfectly content with repealing:
- Ends Pre-Existing Condition Exclusions for Children: Health plans can no longer limit or deny benefits to children under 19 due to a pre-existing condition.
- Keeps Young Adults Covered: If you are under 26, you may be eligible to be covered under your parent’s health plan.
- Ends Arbitrary Withdrawals of Insurance Coverage: Insurers can no longer cancel your coverage just because you made an honest mistake.
- Guarantees Your Right to Appeal: You now have the right to ask that your plan reconsider its denial of payment.
And the pseudo-anti-judicial activists rejoiced in hearing an activist court legislate with under cover of a flimsy explanation like:
“What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding”
effectively revitalizing the old states-rights ideology almost a century and a half after the Civil War settled the issue and challenging Congress’ authority to determine how indigent care will be compensated. In one of the most striking examples of the effect of poor history education in America, the American public voted for people who are actually states-rights proponents as if they, “the people,” have no idea that this was the position of staunch white supremacists who sought to rend the Union asunder. How is Medicaid a new program? How does the Court tell Congress how to aid the indigent?
It is, indeed, amazing that somehow shifting the funding to compensate providers for indigent care from disproportionate care payments to Medicaid payments can be viewed as a penalty when:
“Congress had amended Medicaid more than 50 times since its enactment, with a trend of enlarging the population and services covered by the program”
And none of these expansions were considered penalties? As I said, the Supreme Court conservatives, who acted as neo-confederates, used a flimsy excuse to indulge in some conservative-orchestrated judicial activism.
Conservatives say that the
“Supreme Court of the United States ruled that states had the legal authority to reject expansion and the federal government could do nothing to penalize states for it.” Of course this was the courts response to “all or nothing.”
But there is nothing to stop congress from reducing the payments over time regardless of whether a state expands Medicaid or not Mr. State’s Rights, as in “ignoring states’ decisions to expand Medicaid when calculating the DSH reductions, meaning states won’t face a financial penalty for refusing the Medicaid expansion as the reductions could be made without any regard to whether a state expands Medicaid or not. Wishing that the law will go away and funneling your attacks to a hypocrite-judicial-activist, states-rights Chief Justice (whose states-rights ideology lines up with even Mississippi neo-confederates) doesn’t mean that the American people will get rid of a law which addresses
- Ends Lifetime Limits on Coverage: Lifetime limits on most benefits are banned for all new health insurance plans.
- Reviews Premium Increases: Insurance companies must now publicly justify any unreasonable rate hikes.
- Helps You Get the Most from Your Premium Dollars: Your premium dollars must be spent primarily on health care – not administrative costs.
- Covers Preventive Care at No Cost to You: You may be eligible for recommended preventive health services. No copayment.
- Protects Your Choice of Doctors: Choose the primary care doctor you want from your plan’s network.
- Removes Insurance Company Barriers to Emergency Services: You can seek emergency care at a hospital outside of your health plan’s network.
But back to that wishful thinking about the delay being the unraveling of the Affordable Care Act. The conservative’s argument goes:
“DSH payments were never going to be cut. One only need to look at the SGR and the annual “Doc Fix” under Medicare to see a perfect example of why,”
comparing Medicare advocacy to Medicaid advocacy. This is delusional, as the Medicare constituents are not the same as a substantial number of the Medicaid constituents. In their delusions about ObamaCare and their fixation with repealing it, conservative pundits have conflated the two. Medicaid constituents, by and large, are not appearing at Tea Party rallies, trying, asininely, to wreck the people’s government. Wish as the neo-confederates will, the people targeted in “their home districts for voting against providing health care to the most needy” won’t be the people who are vigorously advocating Medicaid expansion. It won’t be the people who know the 7 things Republicans don’t want their working class constituents to know who will be confused about who’s responsible for service reductions to the needy. The non-Republican Medicaid recipients already know who is trying to cut SNAP and WIC benefits, in short assistance to the most vulnerable. They know that wishing that Republicans would actually favor social programs won’t make it happen; they know that wishing won’t make it so.
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