Tuesday, February 12, 2013

A new twist to Medicaid expansion fight

Here is a new angle to the Medicaid fight. The Wall Street Journal reports states refusing to expand their Medicaid programs may hurt employers:

"Employers in several states are bracing for higher health-care costs as some governors, worried about the impact on state budgets from the federal overhaul, resist a planned Medicaid expansion.

Under the new law, lower-paid workers at companies such as the Nashville, Tenn.-based chain of Captain D's seafood restaurants could qualify for the national expansion of Medicaid set to begin in 2014. Having those employees on Medicaid, the health program for low-income people that is funded with federal and state dollars, would mean the workers get health insurance while the company pays nothing.

But the Supreme Court ruling on the health law last summer let states opt out of the law's Medicaid expansion. Captain D's operates mostly in Southern states that have signaled they will opt out, arguing that it is unfair to expose their already-strapped budgets to the federal government's overhaul of health care.

That means the company will have to spend thousands of dollars to insure each full-time worker who can't enroll in the program, or pay fines starting at $2,000 a person.

"If the state doesn't expand the Medicaid coverage then by default that population becomes the responsibility of their employer," said Michael Folks, Captain D's general counsel and a senior vice president.

That has paved the way for tough choices for states. If states don't expand the Medicaid programs, the cost of covering millions of uninsured full-time workers will fall to employers. But state lawmakers also worry their budgets can't absorb the costs of participating over the long term....

Some governors' choices could be upended by state legislators, but employers have begun trying to come up with a backup plan for insuring millions of additional workers next year.

"The more people we [insure], the more our costs would certainly go up," said Alexis Barnett Gillette, director of marketing for the Mooyah burger-and-fries chain. It owns three restaurants in Texas, where Republican Gov. Rick Perry opposes the Medicaid expansion.

Some states have taken employers' complaints into account. The New Mexico Human Services Department said states would be imposing a "de facto tax increase" on businesses if they didn't expand Medicaid. Human Services Secretary Sidonie Squier made that point to the Republican governor, Susana Martinez, who opted to go ahead with the expansion last month.

But in South Carolina, Republican Gov. Nikki Haley ruled out the expansion. Her health and human services director, Tony Keck, said he was worried employers who already provide health benefits to low-wage workers could use any Medicaid expansion to drop insurance coverage and dump responsibility for their workers on the government.

The health law included provisions for all states to extend their Medicaid programs to people whose income is as much as one-third greater than the federal poverty level, which would be up to $14,856 for a single person. That would have added 16 million Americans to the insurance program for the poor, including millions of full-time workers who make minimum wage or slightly higher, as part of the law's goal of covering most of the country's uninsured.

The federal government will pay the full costs of covering the new Medicaid enrollees from 2014 through 2016 and at least 90% in each subsequent year. Lawmakers opposed to the expansion say states can't afford the additional administrative expenses, let alone their long-term share of coverage costs. They also fear the federal government could scale back the amount it pays in the future.

Many business associations opposed the health law, chiefly because it requires large companies to offer a generous level of low-price coverage to all full-time workers, or pay penalties, starting in 2014. These groups say they are worried about the government-budget impact of expanding Medicaid.

"Business owners may be exposed [to higher costs] if the expansion does not go through," said Amanda Austin, director of federal public policy for the National Federation of Independent Business, which brought the Supreme Court suit against the law. "On the other hand, business owners are generally concerned from a macro-entitlement perspective that these costs are going to be passed onto businesses indirectly."

Katie Mahoney, executive director of health policy for the U.S. Chamber of Commerce, pointed to recent rules published by the administration that determined the poorest people living in states that don't expand Medicaid won't have to pay personal penalties for going uninsured. "There's a very compelling argument" for the federal government to give employers the same exemption, she said.
..." Rest of the article

5 comments:

Anonymous said...

Healthcare Americana is a complex game of cost-shifting. In the South the fried fish eaters will pay for the low wage workers' healthcare insurance. Elsewhere the low wage workers will have their healthcare paid by a combination of the eaters, the general polity, the under-paid workers, and the employers.

The healthcare industry, funeral directors, and top management in Mississippi will reap the benefits of not insuring the under-paid workers.

Anonymous said...

I didn't like Obamacare, but the gop's refusal to offer anything productive aside from "health savings accounts," ie shift costs form employers to workers, was beyond cynicism, which btw is why they're losing nationally. And the tea party is just the second coming of the know nothings.

Anonymous said...

"And the tea party is just the second coming of the know nothings."

Yea. Those Tea Party hicks can't seem to understand. Just because every prior government healthcare program has cost many times the amount projected and because each one has always failed to provide the quality of care promised and because each has always created a moral hazard (e.g., I'll just wait to go to the ER when I'm really sick because that's free), they think ObamaCare will be like all the other failed federal government healthcare initiatives. Why can't they realize that ObamaCare is different? President Obama said so.

Anonymous said...

The tea party harpy @2:27 makes its daily appearance.

Anonymous said...

Most of the savings from the President's program will be from unified billing, care plans, prevention, and reduced rates of disability and chronic diseases. The states will experience the same improvements from extended Medicaid coverage. Its true that the state match might change as states have healthier populations, but the state health outlays will not grow if we are becoming healthier.

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Trollfest '07 was such a success that Jackson Jambalaya will once again host Trollfest '09. Catch this great event which will leave NE Jackson & Fondren in flames. Othor Cain and his band, The Black Power Structure headline the night while Sonjay Poontang returns for an encore performance. Former Frank Melton bodyguard Marcus Wright makes his premier appearance at Trollfest singing "I'm a Sweet Transvestite" from "The Rocky Horror Picture Show." Kamikaze will sing his new hit, “How I sold out to da Man.” Robbie Bell again performs: “Mamas, don't let your babies grow up to be Bells” and “Any friend of Ed Peters is a friend of mine”. After the show, Ms. Bell will autograph copies of her mug shot photos. In a salute to “Dancing with the Stars”, Ms. Bell and Hinds County District Attorney Robert Smith will dance the Wango Tango.

Wrestling returns, except this time it will be a Battle Royal with Othor Cain, Ben Allen, Kim Wade, Haley Fisackerly, Alan Lange, and “Big Cat” Donna Ladd all in the ring at the same time. The Battle Royal will be in a steel cage, no time limit, no referee, and the losers must leave town. Marshand Crisler will be the honorary referee (as it gives him a title without actually having to do anything).


Meet KIM Waaaaaade at the Entergy Tent. For five pesos, Kim will sell you a chance to win a deed to a crack house on Ridgeway Street stuffed in the Howard Industries pinata. Don't worry if the pinata is beaten to shreds, as Mr. Wade has Jose, Emmanuel, and Carlos, all illegal immigrants, available as replacements for the it. Upon leaving the Entergy tent, fig leaves will be available in case Entergy literally takes everything you have as part of its Trollfest ticket price adjustment charge.

Donna Ladd of The Jackson Free Press will give several classes on learning how to write. Smearing, writing without factchecking, and reporting only one side of a story will be covered. A donation to pay their taxes will be accepted and she will be signing copies of their former federal tax liens. Ms. Ladd will give a dramatic reading of her two award-winning essays (They received The Jackson Free Press "Best Of" awards.) "Why everything is always about me" and "Why I cover murders better than anyone else in Jackson".

In the spirit of helping those who are less fortunate, Trollfest '09 adopts a cause for which a portion of the proceeds and donations will be donated: Keeping Frank Melton in his home. The “Keep Frank Melton From Being Homeless” booth will sell chances for five dollars to pin the tail on the jackass. John Reeves has graciously volunteered to be the jackass for this honorable excursion into saving Frank's ass. What's an ass between two friends after all? If Mr. Reeves is unable to um, perform, Speaker Billy McCoy has also volunteered as when the word “jackass” was mentioned he immediately ran as fast as he could to sign up.


In order to help clean up the legal profession, Adam Kilgore of the Mississippi Bar will be giving away free, round-trip plane tickets to the North Pole where they keep their bar complaint forms (which are NOT available online). If you don't want to go to the North Pole, you can enjoy Brant Brantley's (of the Mississippi Commission on Judicial Performance) free guided tours of the quicksand field over by High Street where all complaints against judges disappear. If for some reason you are unable to control yourself, never fear; Judge Houston Patton will operate his jail where no lawyers are needed or allowed as you just sit there for minutes... hours.... months...years until he decides he is tired of you sitting in his jail. Do not think Judge Patton is a bad judge however as he plans to serve free Mad Dog 20/20 to all inmates.

Trollfest '09 is a pet-friendly event as well. Feel free to bring your dog with you and do not worry if your pet gets hungry, as employees of the Jackson Zoo will be on hand to provide some of their animals as food when it gets to be feeding time for your little loved one.

Relax at the Fox News Tent. Since there are only three blonde reporters in Jackson (being blonde is a requirement for working at Fox News), Megan and Kathryn from WAPT and Wendy from WLBT will be on loan to Fox. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both and a torn-up Obama yard sign will entitle you to free drinks served by Megan, Wendy, and Kathryn. Get your tickets now. Since this is an event for trolls, no ID is required. Just bring the hate. Bring the family, Trollfest '09 is for EVERYONE!!!

This is definitely a Beaver production.


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Trollfest '07

Jackson Jambalaya is the home of Trollfest '07. Catch this great event which promises to leave NE Jackson & Fondren in flames. Sonjay Poontang and his band headline the night with a special steel cage, no time limit "loser must leave town" bout between Alan Lange and "Big Cat"Donna Ladd following afterwards. Kamikaze will perform his new song F*** Bush, he's still a _____. Did I mention there was no referee? Dr. Heddy Matthias and Lori Gregory will face off in the undercard dueling with dangling participles and other um, devices. Robbie Bell will perform Her two latest songs: My Best Friends are in the Media and Mama's, Don't Let Your Babies Grow up to be George Bell. Sid Salter of The Clarion-Ledger will host "Pin the Tail on the Trial Lawyer", sponsored by State Farm.

There will be a hugging booth where in exchange for your young son, Frank Melton will give you a loooong hug. Trollfest will have a dunking booth where Muhammed the terrorist will curse you to Allah as you try to hit a target that will drop him into a vat of pig grease. However, in the true spirit of Separate But Equal, Don Imus and someone from NE Jackson will also sit in the dunking booth for an equal amount of time. Tom Head will give a reading for two hours on why he can't figure out who the hell he is. Cliff Cargill will give lessons with his .80 caliber desert eagle, using Frank Melton photos as targets. Tackleberry will be on hand for an autograph session. KIM Waaaaaade will be passing out free titles and deeds to crackhouses formerly owned by The Wood Street Players.

If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!

This is definitely a Beaver production.

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