tag:blogger.com,1999:blog-3426800777521979578.post5466656256838523157..comments2024-02-20T19:58:27.733-06:00Comments on Jake's Wisconsin Funhouse: Walker Medicaid plan- it's even more expensive than you thoughtUnknownnoreply@blogger.comBlogger3125tag:blogger.com,1999:blog-3426800777521979578.post-34146770482200307542013-02-17T22:31:54.765-06:002013-02-17T22:31:54.765-06:00Walker wouldn't make it very far in investment...Walker wouldn't make it very far in investments: his idea of a hedge being something subject to the exact same risk he'd be trying to hedge against.<br /><br />Whenever I've challenged Walker supporters on the MJS boards to say who his decision actually helps, all I get are crickets. So I've put together a handy guide to fill the vacuum:<br /><br /><br />It hinders<br />==========<br /><br />1. WI state taxpayers, who have to stump up more for the Walker plan.<br />2. WI federal taxpayers, who have their taxes changed not one whit by this decision but now get nothing for it instead of something.<br />3. The low-income uninsured, who are going to be paying more out of pocket and fewer are going to be covered.<br />4. Wisconsin's insured, who are going to face higher premiums to cover the ER-based care of a greater number of uninsured than otherwise.<br />5. Wisconsin's unemployed since it the Medicaid expansion would have created another 10,000 jobs for them (see http://citizenactionwi.org/myblog/citizen-action-of-wisconsin-releases-new-report-today-showing-medicaid-expansion-would-bring-big-economic-gains-to-wisconsin.html).<br />6. The Wisconsin economy, which would have been about 0.3% larger with the infusion of Federal monies.<br /><br /><br />It helps<br />========<br /><br />1. Walker's Tea Party credentials.GeoffThttps://www.blogger.com/profile/17317722272565026078noreply@blogger.comtag:blogger.com,1999:blog-3426800777521979578.post-50983172031451254232013-02-17T21:13:17.943-06:002013-02-17T21:13:17.943-06:00Geoff- Thanks for that clarification. And for expl... Geoff- Thanks for that clarification. And for explaining the DoubleSpeak in Walker's decision- allegedly worrying about the feds funding it, but relying on federal funding with the exchanges.<br /><br /> The reasoning is total jive, in addition to the fact that it's costing Wisconsinites a lot more and breaking the state's budget for the future.Jake formerly of the LPhttps://www.blogger.com/profile/15660401299391001751noreply@blogger.comtag:blogger.com,1999:blog-3426800777521979578.post-57959634445422117382013-02-17T21:04:01.520-06:002013-02-17T21:04:01.520-06:00"I'm not even mentioning the flip side of..."I'm not even mentioning the flip side of the "long-term federal funding" question- what if Congress decides one day to punish states that decide to try to screw with Obamacare in this way, and cuts the Medicaid reimbursement rates to states that DON'T want to expand Medicaid, to give an incentive to take up Obamacare regulations? Strangely, that more plausible scenario is ignored by GOPs in this issue."<br /><br />Actually it's the exact opposite: the one and only reason that the states could (in practice) decide to accept the Medicaid expansion or not is because Obamacare (as passed) made it an all-or-nothing proposition: that all existing Federal Medicaid funds would be withdrawn if the expansion was not accepted. This was the part of Obamacare that was struck down by the SCOTUS as being unconstitutionally coercive (see e.g. http://money.usnews.com/money/blogs/my-money/2012/06/29/obamacare-is-constitutional-now-what).<br /><br />The upshot is, the one and only reason Walker gets to make this decision is the *exact* same reason why the Feds cannot tie states' hands to pick up the Federal share of expanded Medicaid if the latter should flake out in future (i.e. on account of Republican desire to force Federal bankruptcy where no reason exists). The United States Congress cannot alter the law to force states to cough up a larger fraction of expanded Medicaid costs without giving them an out; nor can the Executive do so without violating the law as it stands.<br /><br />Walker's argument of potentially flakey Feds falls down on another front, too: while decrying that the Feds could flake out on subsidies for expanded Medicaid that would make low-income Wisconsinites' insurance affordable, his proposal is to insulate them from this risk by pushing them onto Exchange-brokered private insurance... that is only affordable to them because of, er, Federal subsidies.GeoffThttps://www.blogger.com/profile/17317722272565026078noreply@blogger.com