Affordable Coverage Act


I have spent the last few months writing things against Mitt Romney.  By now I hope everyone who has read my  blogs know what Romney is really like.  Of course, those of you who are racist are not going to care – anything to get the “black” man out of the White House.  You are not worth my time any longer.  If you have not managed to change your racist ways by now, you are probably never going to.  I hope your children and grandchildren are more mature than you are.

No, I have decided that since President Obama is too modest, or unassuming, to tout his own good things, like the lowest taxes in these last 20 or so years, and will not talk about his taking down of Osama ben Laden, or his breakthrough jobs bill (even if it is not the big one he wanted), or his health care, I am going to.  And I’m going to start with “Obamacare”.

I am mostly going to quote Joseph Fishkin, an assistant professor at the University of Texas School of Law, simply because he spells things out in a better way than I can.  His article mostly applies to Texas, but you can substitute your state name for every case that the word “Texas, Texans” shows up.  Or substitute your Governor’s name (who is probably a Republican).

He writes:  “””Beginning in January 2014, insurance companies must offer everyone health insurance and charge everyone the same.  Those without insurance will pay a tax penalty; income-based subsidies will help middle-income people afford insurance.

Congress’ solution to the problem of the lower-income people is simple:  a new, greatly expanded Medicaid program, also beginning in January 2014, will cover those earning up to 133 percent of the poverty line, which this year is $14,856 for a single person (like me, with my income of just over $11,000), $30,657 for a family of four.  In Texas, according to figures from the Kaiser Family Foundation, the Medicaid expansion will cover about 1.8 million people in 2014.  The federal government will pay for nearly all the cost.

That’s unless Rick Perry, Governor, turns down the money.

This incredibly bad idea got a boost from the Supreme Court’s ruling that if states choose to turn down the money, they can keep the federal funding for their existing, much smaller Medicaid programs.

According to the Kaiser figures, in 2014, the State of Texas will pay $2.6 billion for the expanded Medicaid program.  The federal government will pay $52.5 billion.  By statute the federal government will always pay 90 percent or more of the cost of this program.

In other words, Texas will always get at least $9 in federal funds (and at the start, $20) for every $1 it spends.

For Texas taxpayers, that is a ridiculously good return on investment.  All Texas has to do is say yes, and pay its comparatively small portion, and the spigot will be opened for all those federal dollars to flow to hospitals, clinics, doctors, and other health care providers throughout Texas.

This massive infusion of federal money will create jobs for Texans.  Texans will become healthier.  Most important, thousands of Texans who would die without this health coverage will live.

Meanwhile everyone from individuals and businesses to the state itself will save money on future health insurance premiums as a result of the Medicaid expansion.  When uninsured people people show up at hospitals without the means to pay, hospitals shift the costs to everyone else.  Far fewer uninsured means far less cost-shifting.

And if Texas refuses the money, federal payments for the Medicaid expansion will flow to other states.  Every one of us will be paying for this through our federal taxes.  Our tax dollars will flow out – the only question is whether we will get our share back.  For perspective, our share – $52.5 billion in 2014 – amounts to more than half the size of the entire Texas budget, or 4 percent of Texas’ gross domestic product.  As a matter of basic arithmetic, any state would be crazy to turn down this money.

Let’s be clear.  The reasons to turn down the money are purely political.  The logic is simple:

1) Republicans oppose Obamacare.

2) this Medicaid expansion is part of Obamacare.

3) Therefore, some Republicans oppose the Medicaid expansion.

Perry’s letter reads like a news release from his now defunct presidential campaign.  “I stand proudly against this power grab, thanking God and our nation’s founders that Texas can refuse to cover millions of its citizens, that accepting the money would only enlarge a broken system that is already financially unsustainable.”  The growth of health spending is indeed a problem for all businesses and governments.  But Medicaid is more efficient than private insurance.  Not less.  Medicaid has lower administrative costs, and overall Medicaid costs have been rising far more slowly than private plan costs over the past 15 years.

There is still plenty of time for the Legislature and the governor to change course and take the money.  This is one of those high-stakes moments where it’s important that pragmatism – and simply arithmetic – win out over ideology and striking a political pose.”””

I have edited out a few lines, a couple of paragraphs, and changed some of the above to make it better fit all states, and not just the State of Texas.  But I have not changed the meaning of anything Professor Fishkin wrote.  You may read the entire article in the Austin American-Statesman of Saturday, July 14, 2012, page A13, for proof of this.

Now, don’t be thinking that this will all go away next year.  Mitt Romney is not going to get the presidency.  The polls call his run close to Obama’s, but I am certain there are people who are getting asked if they would vote for Obama over Romney who are saying “no” are probably racist, even if they have voted Democratic over the past.  Polls cannot show what is in one’s heart, and I know I and most of the people I know have never been asked who they are going to vote for.  I see and hear way more people saying they are going to vote for Obama than some of these polls are actually talking to.  I don’t worry about polls.

And from what I am also hearing and seeing, John Boehner and others are raising money to give to state campaigns in an effort to try to turn the Senate to Republican majority, and keep the House.  But when I am also made to understand that Eric Cantor’s seat is in jeopardy, I am aware that things are not going as well as the Repubs are trying to make you think they are.

Carol Stepp, Austin, TX

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About carolstepp

Music is about the most important thing in my life, and I follow a large number of musicians, particularly Irish, Scots, Classical, Crossovers of any of these. I was writing a blog about Celtic Thunder regularly on MySpace, and now I have left them after a year, and will start writing my blogs here. I am 70, retired, living on Social Security, and have a lot of social network fans.
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