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Thread: Southern governors secede from Medicaid

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    Re: Southern governors secede from Medicaid

    I've also read Christy in NJ, Walker in WI and ? in Iowa are resisting this likewise...

    Not exactly 'Southern states'...secession indeed...

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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by Kandahar View Post
    It's the feds that will be paying the 90%, not the states. The states are getting a 9-to-1 match on their money from the federal government...AND they get a lot of uninsured people covered...AND their health care providers will actually get paid for treating those people. States really can't afford NOT to take this deal. This is especially true of red states with stingy Medicaid programs, because they are eligible for more federal money to bring them into compliance with the Medicaid expansion.
    In three years time, it represents an increase in what states will have to pay for medicaid.
    This is when states are already cutting back on medicaid, as it is.

    The feds are only covering 100% of the cost for new people, not the people previously covered.
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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by Harry Guerrilla View Post
    Further reading on this subject has brought some more things to light.
    The feds are only going to cover, new eligible Medicaid at 100% costs, for the first 3 years and after that they'll pay 90%.

    Seeing that Medicaid, tends to be one of the largest budget items for states to begin with and even paying for these people at 90%, it still represents a greater burden on the states finances, to cover these people.
    If I were a state governor/legislature I'd reject it to, based on future financial obligation.
    You are absolutely right in that is an issue.

    But states could easily cover that by implementing an internet sales tax nationwide and having that revenue, or partial revenue, go to fund it.

    This would be a great way to deal with it since one reason why state budgets have been falling is because they are losing tax revenue because storefront vendors must pay state sales taxes but online vendors don't.

    It would also take away an unfair advantage from online vendors and allow storefront vendors to compete again.
    Also, we need to legalize recreational drugs and prostitution.

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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by wbcoleman View Post
    This isn't complicated. What the GOP governors are threatening to do is popular. The Democrats have to face the fact that the public has figured out the lies being used to promote the scheme.
    Yeah, it's especially popular to people who don't live in those states and won't have to deal with the consequences of what the governors are doing.
    Also, we need to legalize recreational drugs and prostitution.

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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by samsmart View Post
    You are absolutely right in that is an issue.

    But states could easily cover that by implementing an internet sales tax nationwide and having that revenue, or partial revenue, go to fund it.

    This would be a great way to deal with it since one reason why state budgets have been falling is because they are losing tax revenue because storefront vendors must pay state sales taxes but online vendors don't.

    It would also take away an unfair advantage from online vendors and allow storefront vendors to compete again.
    States are loosing money because of the unemployment situation and housing prices have stayed sunken.
    Lower house values, lower revenue.

    I don't believe an internet sales tax will fix this.
    I was discovering that life just simply isn't fair and bask in the unsung glory of knowing that each obstacle overcome along the way only adds to the satisfaction in the end. Nothing great, after all, was ever accomplished by anyone sulking in his or her misery.
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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by tessaesque View Post
    But that investment doesn't matter if they're limited to a 20% "profit" to cover overhead, salaries, and as a carry over for future expenses.

    They would essentially have to return that "investment" to the buyers until what they have left is that 20% of total revenue...and then apply that 20% to operations.
    I don't think that's how it works.

    Rather, I think how it works is that only a max of 20% of the premiums paid can be used to pay administrative fees.

    Let's say that a health insurance company takes in $100 million in premiums from their customers in a single year.

    They invest all that money in various ways that year and get a 5% return of their investments that year. So off of investments they will get $5 million in profits that year.

    Of the $100 million paid in from premiums, they must pay out at least $80 million to health coverage costs and at most $20 million for administrative costs.

    But they have that extra $5 million that they profited from through investments. Which they can then use however they want, such as to pay overhead, to pay salaries or compensation, to pay out more in coverage, pay in administrative costs, or invest it further to get a greater returns from it.

    One thing you have to keep in mind is that large institutions rarely keep cash reserves handy. Individuals tend to take their paycheck, deposit it in a bank, and just let it sit until they need it.

    Big businesses or individuals with large amounts of wealth don't do that. Every dollar that they sit on "just in case" is one dollar that they aren't investing. Which means it's another dollar that isn't getting a return for them. Which is a greater loss to them.

    That's why the credit crunch was so bad for businesses, even large ones. What businesses like to do is instead of have a cash reserve they do payroll via credit and then cash out their investments to pay it back, especially if the percentage of return they get from their investments is at a larger rate than the percentage they have to pay on borrowing the money on credit.

    That's also why large banks are resisting regulations requiring reserves on their capital. The more money they need to keep on hand for emergencies is less money they can lend to borrowers, which is less loans they are lending to get rates of return on.

    So health insurance companies, who basically profit via investments, will hold on to their money to ensure longer times it's used in investments to get greater returns until they absolutely have to pay out money for health coverage.

    Also keep in mind that this will help health insurance companies cut costs such as advertising. Because of the mandate, rather than advertising to convince people to get health insurance at all, companies will now have to advertise on the quality of the insurance they provide. And now that everybody is required to get health insurance, they are going to have a metric ****load of customers to them paying premiums to them. Which means a greater absolute amount of money the individual health insurance companies will take in.

    The reason for the cap is to ensure that executives don't keep increasing their salaries to ungodly levels now that every American is required to be a customer of theirs. Trust me - the health insurance companies won't be hurt by this legislation at all.

    Not even Halliburton got a deal this cushy.
    Also, we need to legalize recreational drugs and prostitution.

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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by Harry Guerrilla View Post
    In three years time, it represents an increase in what states will have to pay for medicaid.
    Yes, with a 9-to-1 match of free money from the federal government. I don't know about you, but if I could get someone to give me $9 for every $1 I spent on something that would benefit myself, I'd certainly take advantage of it even if it would cost me slightly more out of pocket. Let's not forget that this isn't simply money disappearing into the abyss; the states are buying something for their money...health coverage for many of their own residents. For every $1 they spend, they buy $10 worth of coverage.

    The feds are only covering 100% of the cost for new people, not the people previously covered.
    Right. This is exactly why the states with the stingiest Medicaid programs (i.e. the red states) especially can't afford to turn it down. They'll be eligible to bring on the most new people, since their program was so limited in the first place.
    Last edited by Kandahar; 07-13-12 at 10:54 AM.
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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by Kandahar View Post
    Yes, with a 9-to-1 match of free money from the federal government. I don't know about you, but if I could get someone to give me $9 for every $1 I spent on something that would benefit myself, I'd certainly take advantage of it even if it would cost me slightly more out of pocket.
    They pay now, but down the road, ALL that money goes away, and it is all on you, and you have no choice to to pay it. Look big picture, look long term.
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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by Arbo View Post
    They pay now, but down the road, ALL that money goes away, and it is all on you, and you have no choice to to pay it. Look big picture, look long term.
    The Affordable Care Act has no such end date. The federal government pays 100% of the cost of expansion for the first few years, then 90% of the cost of expansion thereafter, into the indefinite future.
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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by Kandahar View Post
    Yes, with a 9-to-1 match of free money from the federal government. I don't know about you, but if I could get someone to give me $9 for every $1 I spent on something that would benefit myself, I'd certainly take advantage of it even if it would cost me slightly more out of pocket. Let's not forget that this isn't simply money disappearing into the abyss; the states are buying something for their money...health coverage for many of their own residents. For every $1 they spend, they buy $10 worth of coverage.
    The benefit of this program is hardly going to help that much.
    It's already been demonstrated that people on government medical programs already us the ER at much higher rates, than the regularly insured.
    Medicaid co pays are nominal, Medicaid payments to medical facilities and doctors is low.
    It's not going to help them all that much, when many are limiting or dropping the program.

    All it will represent is an increased cost to states, with nothing else.

    Quote Originally Posted by Kandahar View Post
    Right. This is exactly why the states with the stingiest Medicaid programs (i.e. the red states) especially can't afford to turn it down. They'll be eligible to bring on the most new people, since their program was so limited in the first place.
    Most states, (both red and blue) are cutting back on Medicaid because the tax money isn't there.
    Most states (both red and blue) limit Medicaid to those are disabled, pregnant, under 18 or elderly.

    Sorry.
    I was discovering that life just simply isn't fair and bask in the unsung glory of knowing that each obstacle overcome along the way only adds to the satisfaction in the end. Nothing great, after all, was ever accomplished by anyone sulking in his or her misery.
    —Adam Shepard

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