Trump Wants to get rid of Medicaid

amother

Scarlet

Tue, Mar 14 2017, 10:40 pm

Medicaid abuse: just go to the emergency rooms they are full of people coming in for hives, bruises and sprained thumbs. Before I go to the emergency room I think a million times because it will cost me 3,000 dollars and that's after insurance covers 5,000. I'm not making these numbers up. It's like tuition we payers are covering all you non payers so you guys get to go to the doctor, hospital all you want without a care while I stay home agonizing over the decision to go:(

Medicaid should be fixed by A. Also going on a sliding scale not you make one dollar more and you're kicked off. B. Medicaid holders should also be penalized for going to the emergency room without real urgency just as other health insurances do. C recently things were added like dental coverage sorry but our country cannot afford to finance this. D. If someone is poor they should be able to see a doctor and recieve medicine. But not the extras. Fancy yearly vision and hearing tests, fluoride sealant procedures on babies are extras (many insurances won't cover) so Medicaid should not cover. D. The website and registration system is poorly managed. Improvement could be made there to create a more efficient and perhaps cheaper process. These are what I can think of off the top ofy head. Lots of dollars could be saved or atleast used more efficiently and even help more people.

MagentaYenta

Tue, Mar 14 2017, 10:44 pm

amother wrote:

I don't know if this is a regional problem or something else. I know several people locally who decided to use the ER for something other than an emergency and they got billed back for the charges. Admittedly, my local medical monopoly is pretty ruthless when it comes to billing.

Amarante

Tue, Mar 14 2017, 11:40 pm

Pointing out that premiums won't go down necessarily for an individual but premiums on the average might go down because

1) older people will not be able to afford premiums so there will be fewer of them bringing up the average

2) mandated coverage for certain things like maternity care will be eliminated. Now everyone pays for maternity care because that is what insurance is. You pay in and don't necessarily need it just as you have auto insurance but don't have an accident or homeowners insurance and don't have a fire. The cost for maternity coverage will be very high as it was before Obamacare

3) policies with extremely high deductibles will be sold. This is helpful to the wealthy because they benefit from HSA as a tax shelter. Most lower income or even middle income people don't have money to put. $5000 or $6000 in an HSA

Ryan and the rest of his merry band of reverse Robin Hoods are obfuscating that if premiums go down, it will be because there will be high deductibles and co pays. The people whose premiums will go down are the young because that's what insurance is. A pool of people so costs and risks are distributed.

4) premiums were actually going up less in the last year. I am not sure why people are blaming the high cost of insurance on Obamacare. For a good policy before it was implemented, I was paying in excess of $1000 per month. Many cheap plans had inadequate coverage and capped lifetime benefits which people only discovered when they were diagnosed wth an expensive disease like cancer and their insurance capped out.

5) Trumpcare is a way to redistribute income to the wealthiest. The cuts in Medicaid are being matched by tax breaks for the wealthiest including the end to the minimum tax. If one middle class person really thinks the Republican tax plan will lower taxes for them. I have a bridge for sale in Brooklyn that I will sell to you u for a great price. You ar as naive as the poor souls in Kentucky who got health care for the first time through expanded Medicaid and voted for Trump. They wer so stupid that they didn't realize what they were benefitting from was Obamacare.

Pointing out that half the births in the US are funded through Medicaid and most of the elderly in nursing homes are paid by Medicaid. If you cut Medicaid funding or "freeze" it do you want old people and babies out on the street because there is no money?

Elections have consequences.

nylon

Tue, Mar 14 2017, 11:47 pm

First, Medicaid is run on a state by state basis so some of rhese things depend on where you live.

Now. People clogging up ERs. There's a lot of reasons for that. I have one child on Medicaid (on top of regular group insurance) because he qualifies through a state special needs waiver. If I take him to the ER it is free. If I wanted to take him to urgent care, none of the urgent cares take Medicaid. I can afford to take him through blue cross so I do but if I didn't have it, what would I do? ER. Many Medicaid patients are seen through clinics and have difficulty getting access to urgent appointments, or can't fit it in around work hours. This is before any cultural issues where they're used to just going to the emergency room because it's what they're used to. There have been programs that sought to reduce emergency room usage. Some have been more successful than others. The thing is, it's really the hospital that's the loser, because Medicaid pays the hospital much much less than what your insurer does. The hospital is forced to eat the cost. Hospitals really do have the incentive to keep patients out of the ER.

Dental is covered for good reason and Medicaid coverage is already limited. Dental issues can be serious. Medicaid is not paying for cosmetic dentistry because your teeth are crooked. Sealants are actually a very good use of Medicaid money because they prevent cavities. You may think a little cavity is no big deal and maybe it isn't, till it turns into a root canal or an abscess. This is why sealants are recommended for all children. Medicaid also covers other things that private insurance doesn't, because it's the payer of last resort for people with disabilities. I get more coverage for therapies under Medicaid than I do under private insurance. A disabledfriend has supplemental Medicaid for her Medicare, because medicare has no cost sharing cap and her bills would be several times her income.

If one person has a whole slice of bread and the other person has half, you don't take the first person's bread away so you can feel like now you have the better deal. You give the second person more bread. The cliff between Medicaid and private insurance is a prpblem. The ACA did see that. They did provide extra subsidies to cover cost sharing for people who were middle income. But it wasn't enough. And the subsidies taper off at a point at which insurance is still a huge chunk of a family's income.

amother

Scarlet

Wed, Mar 15 2017, 12:10 am

Wow! Number one flouride sealant on babies is not necessary it is a luxury! As is dental care! Which is the reason I don't get those things! If you are poor you don't get things! Grow up! Work harder, go back to college, let every able bodied man and woman work to earn their keep! And if not pay the consequences. Yes don't die in the street but get the bare minimum of care not a luxury plan which is what your plan seems like to me. Beautiful that dental care is beneficial but if you can't afford it you brush your teeth three times a day and get checked out if something bothers you. Cost is so high because many are getting served for very cheap (by medicaid) so others foot the bill.

You do not have a peice of bread. You are being given a peice of bread because you are too poor to buy your own. But our country cannot afford to give out bread anymore. So people should grow up and start getting serious about finding a way to pay for their own bread.

I'm sorry if this sounds harsh but seriously you think everything should be handed to you on a silver platter? Did it ever occur to you the thousands of dollars the government has given you? Did it ever occur to you that money does not grow on trees and instead of just taking that money like it's owed to you to try your hardest hardest to pay your own way?

Amarante

Wed, Mar 15 2017, 12:26 am

tigerwife wrote:

Does the middle class ever benefit? Since the ACA, my co-pays had gone up from $10/$20 to $50+. My insurance changed policies regarding coverage and I was left with an astronomical bill after birth. My employer kept changing insurance providers since each one got more and more expensive every year. What is going to change now?

If you get insurance through your employer, it has nothing to do with Obamacare except for certain protections like being able to keep your kids in your policy until they are 26, requiring certain Mimi,um benefits like maternity care and birth control. Ironically those are the measures most people want to keep except of course for maternity benefits 🤔

Your employer buys insurance and decides how much they want to spend. Your co pays are going up because your employer only wants to pay for that level of coverage. The same is true for your deductible. Your employer could choose to pay for a better insurance plan.

Large corporations generally have better insurance. One reason is because they have a large pool of employees to spread the risk around so it is averaged.

If you work for a small employer, each employee is covered based on their age so if you have an older employee, the cost to insure that employee is much higher than for a young employee. That's because there is no pool to spread risks and costs.

But Obamacare is relevant for the most part only to people in the private market and those people who were able to get Medicaid with the expanded coverage.

tigerwife

Wed, Mar 15 2017, 12:37 am

Amarante wrote:

Thanks for taking the time to explain. My employer cannot afford the insurance anymore which is why the plans get worse every year- the cost keeps rising. Does that not have anything to do with Obamacare? Do people on Obamacare get insurance for less than $650 a month? I'll admit to being totally bewildered with the options. One of my doctors no longer accepts Medicaid/ jersey care. I've heard from other doctors that 'it is not worth it anymore'. What does this mean? Who has benefitted from ACA while the rest of us are struggling more than ever?

MagentaYenta

Wed, Mar 15 2017, 12:39 am

tigerwife wrote:

As it stands now people from 55-65 will be pretty much without anything. Well yea, if you have a sizable income and you can pay market rates. People tend to forget that gap. In most medicaid expansions states poor elders will not have coverage until 65, before Trumpcare medicaid expansion covered that. Medicaid expansion in some states also covered people 65 and over who had not paid sufficient $$ into medicare.

With cutbacks in federal public health programs fewer and fewer are able to or can afford to care for medicare and medicaid patients. It will get far worse since under Trumpcare mental health will not be covered, nor will addiction recovery services.

Amarante

Wed, Mar 15 2017, 12:56 am

tigerwife wrote:

It's hard to say what a premium would be since it's based in age, tyoe of coverage, location.

The benefit that employers get is that insurance is not taxable to their employee and is deductible by their employer. You are getting the equivalent of the insurance as a tax free benefit. If someone purchases insurance in the private market, their premiums are paid for with after tax dollars.

But in general employer provided insurance and insurance purchased on the private market aren't related. Costs are going up and employers are having their employees pay more of the cost through higher deductibles and copayments as that lowers the premiums the employer pays for you.

Economists have said the premiums might have gone up more without the affordable care act because there are provisions that were designed to lower medical costs like the cap on administrative costs.

And indirectly people used to pay for the cost of the uninsured anyway. They would be treated and incur expenses and that unpaid expenses would be passed through to everyone. Not to mention the cost of people being much sicker with vpchrinc diseases that weren't treated. Emergency rooms are the last resort and people don't go there to manage diabetes or high blood pressure for example.

ETA. Everyone admits that there are parts of Obamacare that need to be fixed so that it's more affordable. But Strumpcare will actually increase deductibles and decrease affordability because of the decrease in subsidies.

They should have worked in making subsidies more available to middle class

Also one huge problem is that your family is not eligible for subsidies on the exchanges if you get healthcare at work. Healthcare for families through employers can be extremely expensive and some workers would actually have been better off with no employer insurance so their family could purchase on the Exchanges. When Obamacare was implemented we decided to stop health insurance so our employees could get the their families insured on the exchange with subsidies. We give them bonuses so that they are not out of pocket. Their whole family is insured for less than what it cost to insure only the employee.

Look at the incredible group of organizations opposed to Trumpcare. The AMA, the hospital groups, AARP. These are not fringe radical groups but the medical groups realize that 24 millionpeople will be cut off from insurance insurance when Trumpcare is implemented.

Last edited by Amarante on Wed, Mar 15 2017, 1:29 am; edited 1 time in total

marina

Wed, Mar 15 2017, 1:27 am

amother wrote:

Are you upset about libraries? Libraries cost us taxpayers hundreds of millions of dollars. I'm wondering if you can post a rant like this about libraries. Because they are really luxuries. No one needs books. Thanks!

Last edited by marina on Wed, Mar 15 2017, 1:40 am; edited 1 time in total

marina

Wed, Mar 15 2017, 1:38 am

amother wrote:

Maybe the Lakewood rabbonim are rabbonim for a reason? I'm not even a Litvak, but kol hakavod to them for endorsing Trump (who is not an advocate for abominations in the Torah, cv's).

One example of an abomination in the Torah, cv's, is dishonesty in business.

Devarim 25 pesukim 13-16.

יגלֹא יִהְיֶה לְךָ בְּכִיסְךָ אֶבֶן וָאָבֶן גְּדוֹלָה וּקְטַנָּה:
ידלֹא יִהְיֶה לְךָ בְּבֵיתְךָ אֵיפָה וְאֵיפָה גְּדוֹלָה וּקְטַנָּה:
טואֶבֶן שְׁלֵמָה וָצֶדֶק יִהְיֶה לָּךְ אֵיפָה שְׁלֵמָה וָצֶדֶק יִהְיֶה לָּךְ לְמַעַן יַאֲרִיכוּ יָמֶיךָ עַל הָאֲדָמָה אֲשֶׁר יְהֹוָה אֱלֹהֶיךָ נֹתֵן לָךְ:
כִּי תוֹעֲבַת יְהֹוָה אֱלֹהֶיךָ כָּל עֹשֵׂה אֵלֶּה כֹּל עֹשֵׂה עָוֶל:

Just sayin.

Amarante

Wed, Mar 15 2017, 1:57 am

amother wrote:

You do not have a peice of bread. You are being given a peice of bread because you are too poor to buy your own. But our country cannot afford to give out bread anymore. So people should grow up and start getting serious about finding a way to pay for their own bread.

I'm sorry if this sounds harsh but seriously you think everything should be handed to you on a silver platter? Did it ever occur to you the thousands of dollars the government has given you? Did it ever occur to you that money does not grow on trees and instead of just taking that money like it's owed to you to try your hardest hardest to pay your own way?

We are one of the richest countries n the world and the only western democracy that doesn't guarantee health coverage for all.

Of course we can afford a safety net to guarantee health care for those what need it. The problem is the huge tax breaks given to the to one percent.

Trumpcare is just a ploy to reduce taxes on the wealthiest and take from the neediest. Cutoff funds for Medicaid and give that money to the richest among us in the form of lower taxes.

The middle class is not receiving any of those tax breaks.

And then the lies regarding Trumpcare. Instead of subsidies based in income, there will be tax credits based on age. So a 60 year old making $24,0000 a year is now currently paying about $1600 a year after subsidies. Under Trumpcare, health insurance will be unaffordable because premiums will be $16,000 per year and the maximum credit will be $4000.

And Ryan and the other Republican apologists are saying that is is then this person's choice to not have insurance and is a good example of free market economics.

Yes we will all have access to insurance as long as we have the money to pay for it just like we all have access to buy that Rolls Royce

Their other idiocy is that high deductibles will make people better consumers. The next time you have a heart attack, you should start shopping around for the lowest rates before gong to the hospital. 🤔😱

MagentaYenta

Wed, Mar 15 2017, 2:14 am

amother wrote:

Your argument is pitiable and your attitude towards dental care ignorant.

Miri7

Wed, Mar 15 2017, 2:41 am

Today I was asked to join the American Bar Association's Health Reform Task Force. The purpose of the group is to provide objective legal analysis of any proposed legislation, not to advocate any political position.

I was on the fence about joining but think that I'll do it. My neighbor, a primary care physician, was telling me over Shabbos that the county health program where he works (earning less than half what he could in private practice) had doubled its patient base in the past few years because of medicaid expansion. They literally had to build a new facility - we are talking going from 100k active patients to 200k under the ACÁ. Per patient costs had plummeted because more people were getting early care, so their emergency rooms were empty relative to before.

The facts are that people have bodies that get sick. Society pays a hefty price when people rely on free emergency care and don't get primary care to manage their conditions and reduce costs.

The federal government is already the biggest single payer in the system. It has the most leverage to negotiate down drug prices and other costs. So to me it makes sense to expand the pool of people covered by federal programs.

Anyhow, I'm keeping an open mind and will analyze the proposals as they're offered.

amother

Cerise

Wed, Mar 15 2017, 4:11 am

tigerwife wrote:

My mother has amazing insurance with Obamacare for just $325 per month. for many individuals, Obamacare was extremely helpful... it reduced premiums, copays, eliminated preexisting conditions, and allowed them access to better care. My mother's plan is a PPO so no referrals needed and everyone accepted it. I know that the quality varies state by state, but overall I think the ACA was great, especially considering the limitations congress placed upon Obama at the time.

amother

Cerise

Wed, Mar 15 2017, 4:14 am

amother wrote:

most people in the hospital with the sniffles are uninsured not individuals with Medicaid.

srbmom

Wed, Mar 15 2017, 7:45 am

Quote:

Under Trumpcare, health insurance will be unaffordable because premiums will be $16,000 per year and the maximum credit will be $4000.

I don't understand how this is any different right now? My parents who fall in this 55-65 yo age range have coverage for $1200 a month (my mom's entire salary for her part-time job goes towards healthcare, she does not get a paycheck). This is for a plan with a $10,000 deductible. Their out-of-pocket healthcare expenses for the 2016 year were $33,000 (that includes premiums, copays and co-insurance) and that is with no out-of-the-ordinary major medical issues.

At least in my state the biggest problem with the ACA was that premiums did not go up a crazy amount, but every single plan switched over to a huge deductible plan, so you are essentially paying for your insurance and then still paying out of pocket for every single healthcare expense over the year