States can opt out of Medicaid expansion, citizens must buy x, and that's a progressive victory?

[usregimechange]

Sorry, I'm short on glee right about now. I'd rather they kept the teeth on the Medicaid expansion and did away with the individual mandate.

[FarLeftFist]

1. You don't have to buy X, and it's a victory for those who want affordable coverage or have pre-exist

conditions, etc. I'm sure we all know the good parts.

[Luminous Animal]

10. Where is this affordable coverage of which you speak?

[FarLeftFist]

35. Health exchanges, subsidies, no cap, and the ability to pay only premiums vs. bankruptcy.

[Luminous Animal]

49. Health exchanges for some.... states can opt out.

And I have no idea what you mean by ability to pay only premiums. What? Where in the bill does it protect against bankruptcy? Massachusetts system, which is very similar to ACA, still has the same rate of medical bankruptcy as the rest of the nation.

Oh, and by the way, my family would not qualify for any exchange or subsidy. We currently pay $19,956 a year for a family of three for insurance coverage. We were actually turned down for a home loan because our insurance costs are so high. It's killing us.

So, where is this affordable insurance of which you speak?

[FarLeftFist]

54. With no lifetime cap you will only have to pay premiums.

Last edited Thu Jun 28, 2012, 10:16 PM - Edit history (1)

Also, with health exchanges & cost-sharing you may want to eventually switch providers. Not to mention that with more people buying insurance premiums should go down.

[SickOfTheOnePct]

60. The decision is an overall win but it isn't going to stop medical bankruptcies

Most people that file medical bankruptcy have insurance, and it isn't just the lifetime cap that gets them, it's the co-pays and payments for treatments not covered by insurance.

Nothing in this bill change any of that. There will most likely be fewer bankruptcies due to medical bills, but it's still going to happen.

This is the beginning, not the end.

[Schema Thing]

80. It's going to stop the vast majority of medical bankruptcies.

[SickOfTheOnePct]

106. Do you have any data to support that?

Or is it just an opinion?

[Schema Thing]

109. http://www.healthleadersmedia.com/content/FIN-265414/Despite-ACA-OutofPocket-Medical-Costs-Lurk.html

Most families will be able to "afford" the out-of-pocket. Won't be easy in a bad year, and not all will be able to make it, but most will manage.

[jeff47]

71. No, they can't.

A state can fail to set up an exchange. If they do so, the feds set up their exchange for them.

my family would not qualify for any exchange or subsidy.

That's only true if you're covered by employer-based insurance, and that premium sounds like you may not be covered by your employer. If you are not covered by a plan from your employer, you "qualify" for the exchanges.

So, where is this affordable insurance of which you speak?

Well, the exchanges won't exist until 2014, since Congress wanted to reduce the short-term cost of the bill. So it's a tad premature to expect the exchanges to lower cost.

[Schema Thing]

79. states cannot opt out of the exchanges

[Hoyt]

82. Wow, not disputing level of your premiums, but I bet at full phase-in you'll be better off.

Unless you are just in some high cost area, I think there's something in the ACA that will help you. Hope so.

[girl gone mad]

18. I think you're counting your chickens before they've hatched.

A lot of wishful thinking going on today.

[FarLeftFist]

37. I think you need to read the bill. A lot of denial going on today.

[girl gone mad]

44. At least I understand what is in the bill, including the fact that denials..

will still very much exist.

Many people here, yourself included, seem to believe that insurers can no longer deny claims or kick people off of their plans, both of which are completely false.

[FarLeftFist]

47. lolz. OH NO WE SHOULDN'T HELP MILLIONS BECAUSE WE CAN'T HELP THOUSANDS SO EVERYONE MUST SUFFER!

[girl gone mad]

90. Thousands will continue to die..

because we decided not to help millions so that corporations can continue to reap massive profits. We could have gotten a lot of the good things in this bill without the huge downside.

[dionysus]

104. would you rather have something flawed we can build on, or nothing at all?

nothing is ever going to magically wipe out the medical insurance companies in one fell swoop.

wishful thinking is believeingthat if the scotus overturned the ACA that somehow single payer will whoosh in and save the day...

[msongs]

2. so states can also opt-IN to medicaid expansion, making it possible for good states nt

[HopeHoops]

5. Even the ones that filed suit will eventually cave.

[Zalatix]

66. Keep dreaming.

[Trekologer]

111. Wait until GOP-controlled states' citizens find out what they are saying no to

Citizen: So you're saying that you could have expanded Medicaid coverage to me and my family and it wouldn't have cost the state anything for the first 3 years because the Federal government would have paid for all of it and even after that the Federal government still pays at least 90%?

[Zalatix]

117. I'll say this: I hope it happens that way.

Knowing those troglodytes, the Koch Brothers and their gang will re-indoctrinate them and they'll fight with renewed vigor for their right to be ripped off.

It's been that way in some of those GOP-controlled states forever.

[liberalmuse]

3. Yes.

It's a victory for all the people with pre-existing conditions, and it's a step forward to ensuring all Americans have access to affordable healthcare. As a long time progressive, I have learned to appreciate any step forward, especially since Reagan.

[HopeHoops]

6. That and those under 26.

[Luminous Animal]

24. Because of this, the insurance that I pay for my 22 daughter quintupled.

She was covered under Healthy San Francisco at $49 a month. Once ACA passed, Healthy San Francisco kicked her out of the program because they said that since she could now be covered under my insurance, she was not eligible any more. Now I pay $235 for her insurance. That brings the total for this family of three to $1663 a month. It's killing us.

[SickOfTheOnePct]

33. Yep

I also expect to see businesses begin to drop dependent coverage.

I'm not against expanding coverage, I just wish that people would be realistic about the costs.

[progress2k12nbynd]

81. So sorry to hear that...

But I wouldn't expect much response from DUers. Too busy cheerleading to actually check the real score of the game.

[Lasher]

101. That's premiums only.

Deductibles and copays are killing me as well. And I've got a better setup than most. My health insurance isn't too bad if I never need health care.

[Scootaloo]

102. Actually, that's because of Healthy San Francisco, from the sound of it

[treestar]

112. Yes. Who were they to drop someone on that ground?

It would be in their fine print, written in before the ACA.

[HopeHoops]

105. That seems awfully high and if you're already paying for a family plan it shouldn't have changed.

Something's screwy here. Other than catastrophic coverage (which would definitely be cheaper than $1663), the standard is a choice between individual (the one working) and individual plus family, regardless of how many kids you have. They shouldn't be charging you extra to add your daughter to a family plan you already have. What insurance company do you have?

[tblue]

4. I think the insurance industry is fine with ACA

You really don't hear a lot of griping out of them. And they're not exactly the shy, silent type.

I think they're delighted with this bill and they gave Roberts the directive to let it stand with the mandate.

The part about Medicaid is not good and kind of makes a mess of things.

Medicare for All would be so much better. Sigh.

[EFerrari]

7. Congress is going to have to fix the "incentive" for the states to expand Medicaid now.

So Roberts found a way for the insurance industry to hold off serving a high risk pool for a while until Congress can get it together.

[NYC Liberal]

21. What? Insurance cos. have spent a shit load of money fighting it.

[Honeycombe8]

8. If states opt out of Medicaid expansion,it costs them dearly in fed. funds. You don't have to buy X.

You have to buy some minimum coverage, and there are a lot of options.

If you qualify for Medicaid, the mandate doesn't apply to you. If you get ins. thru your employer, like most people, the mandate doesn't apply to you. If you are a senior, the mandate doesn't apply to you.

If you are one of the working poor, the mandate applies...and you will get govt assistance to buy some minimum of coverage.

If you are a decently paid middle class person/family, the mandate is for YOU. Since you can afford it but refuse to buy it, that can officially be called a deadbeat position, since you expect OTHER PEOPLE to pay for what you can afford possibly even more than the people who will have to pay your bills.

That is reasonable. And it's a step in the right direction, toward universal coverage.

[EFerrari]

11. No, today's decision was that the Feds can't dock states for opting out of expanding Medicaid. n/t

[jeff47]

72. That is not correct

The decision was that the Feds can only take away the new money for Medicaid expansion. The feds can't take away the old money they were already providing for current level of Medicaid.

[EFerrari]

75. A distinction without a difference. n/t

[jeff47]

94. So according to you, millions of dollars is exactly the same as 0 dollars.

So, could you give me 0 dollars then? I'll take it as 250,000 $20 bills.

[Honeycombe8]

110. I'm confused about it, now. I THINK I read that the states have to opt out of Medicaid ENTIRELY.

Can that be true?

[Autumn]

12. It doesn't cost them. If states opt out they still get the same amount they usually get.

If they did lose funding for opting out, that would be incentive but they do not lose any funding.

[Honeycombe8]

36. I read the opposite. nt

[Autumn]

41. You might want to re read that part.n/t

[jeff47]

73. Ditto

Feds can withhold the funds for the medicaid expansion. They can not withhold funds for the current level of medicaid.

[SickOfTheOnePct]

13. It doesn't cost states anything if they opt out of the Medicaid expansion

In fact, it saves them billions in the long run.

This isn't a win for people that make too much for Medicaid but not enough for premium subsidies.

[ProSense]

17. Not exactly

"It doesn't cost states anything if they opt out of the Medicaid expansion

In fact, it saves them billions in the long run. "

It doesn't cost them any existing Medicaid funding, but don't get the additional funding unless they abide by the law.

The votes for this outcome are divided among several opinions. Three Justices – the Chief, Justice Kagan, and Justice Breyer – took the position that depriving a state of all of its Medicaid funding for refusing to agree to the new expansion would exceed Congress’s power under the Spending Clause. Although Congress may attach conditions to federal funds, they concluded, it may not coerce states into accepting those conditions. And in this case, taking away all the states’ funds for the entirety of its Medicaid program just because it disagreed with a piece of the program would be coercive. But the remedy for that constitutional violation is not to declare the expansion unconstitutional – such that even states that want to participate would not have the option. Instead, the plurality held that the provision of the statute that authorized the Government to cut off all funds for non-compliance with the expansion was unconstitutional. The result is that states can choose to participate in the expansion, must comply with the conditions attached to the new expansion funds if they take that new money, but states can also choose to continue to participate only in the unexpanded version of the program if they want.

http://www.scotusblog.com/2012/06/court-holds-that-states-have-choice-whether-to-join-medicaid-expansion/

Also, the government is funding nearly the entire cost of the expansion so states aren't liable for "billions."

Federal Government Will Pick Up Nearly All Costs of Health Reform’s Medicaid Expansion
http://www.democraticunderground.com/1002496395

[SickOfTheOnePct]

22. Yes, I realize that if they don't opt in they don't get the additional funding

But getting $900,000 in funding to cover $1 million in costs is a losing proposition, fiscally speaking.

And, you're wrong, states that opt out will save billions in the future. That's just simple math.

[Luminous Animal]

27. Perhaps, you shouldn't use complicated phrases such as "in the long run."

[ProSense]

31. Math?

But getting $900,000 in funding to cover $1 million in costs is a losing proposition, fiscally speaking.

And, you're wrong, states that opt out will save billions in the future. That's just simple math.

For example: $1 million minus $900,000 would result in an exposure of $1 million over 10 years.

"Billions"?

What's the cost to a state for denying access to health care coverage for a segment of its population?

My guess is that these states are engaged in political posturing.

[SickOfTheOnePct]

34. I'm sorry I wasn't clearer

I didn't think that I actually had to state that the $1 million figure was used as an example due to the nice, round numbers involved.

Mississippi is one of the first states to come out and say they most likely won't opt in. Savings over 10 years estimated at $1.7 billion. And that's a pretty small state.

So yes, I stand by my claim that opt-out states will save billions in the long run.

[ProSense]

38. And

Mississippi is one of the first states to come out and say they most likely won't opt in. Savings over 10 years estimated at $1.7 billion. And that's a pretty small state.

...you believed that?

JACKSON, Miss. (AP) — Top Republicans in Mississippi say the state can't afford to expand its Medicaid program to cover more people under the federal health care overhaul. Some Democrats, however, say the state should jump at the chance to provide coverage for its more than half million uninsured residents.

<...>

House Speaker Philip Gunn, R-Clinton, said in a statement that the federal health care law could be "a budget-buster for our state." Republican Lt. Gov. Tate Reeves said adding 400,000 people to Medicaid would cost about $1.7 billion over 10 years.

http://www.sfgate.com/news/article/Miss-Medicaid-expansion-unlikely-GOP-leaders-say-3671131.php

Texas Medicaid Director: 91 Percent Of Texans Will Have Insurance If State Implements Obamacare (February)
http://www.democraticunderground.com/1002360864

[SickOfTheOnePct]

55. Was there a refutation of my claim in there somewhere?

Or did you forget to post a link?

[FarLeftFist]

42. But they won't be saving because their citizens will get sicker & sicker and need more expensive

procedures. There is also preventative care measures. Savings also come from having less people get sick costing billions over decades.

[SickOfTheOnePct]

62. States don't pay for people that show up at ERs with no coverage

The hospitals and doctors do, through higher prices for the insured.

[jeff47]

74. Because there's nobody insured by the state by some program called Medicaid....

Declining the expansion is a losing proposition because the same people will get broke enough to qualify for current Medicaid, and their care will cost more.

[Lionessa]

92. Some states only offer Medicaid to the disabled, so unless the disabled roles go up, nothing goes up

[jeff47]

93. And which states would those be?

'Cause they have to offer Medicaid to poor children, pregnant women and the elderly to get any federal funds.

[JimDandy]

84. My state gives funds to hospitals for ER care!

Last edited Fri Jun 29, 2012, 01:24 AM - Edit history (1)

Because the ER mandate is still in place, with today's ruling, those who don't/can't buy health insurance will, in effect, be paying annual insurance premiums for ER care - via the IRS. Perhaps the government could even earmark for ER care all refunds the IRS seizes from individuals who don't pay the 'no health insurance penalty'. In fact, to get away from both the "this is a new tax" meme and the negative connotation of "penalty payment" the administration could instead label these payments as "Emergency Room Insurance Premiums".

[dsc]

87. Not according to Rendel and Jerry Brown

Brown has said it would cost CA close to $3billion dollars over 6 years and Rendell says it would cost PA about $1.5billion over the same amount of time. While there would be some offsetting savings that aren't being counted the cost would still be billions.

[Trekologer]

113. $1.5B and $3B sound like big numbers

Governor Brown signed California's $142.6B budget on Wednesday. The estimated cost for California would be an additional 0.35% of that budget.

Pennsylvania's budget (signed today) is $27.7B. The estimated cost would be an additional 0.9% of the budget.

[dsc]

116. a fairer comparison would be deficit

in California that is about 16 billion and in pa it is about 300 million. Since both figures are for 6 years in California it is 500 b a year and in PA it is 250 million a year. In PA's case that is doubling their deficit.

[Iggy]

39. Fed Government Picks Up the Tab for First Three Years

that's my understanding.

it's called providing an incentive. and it's called state's rights.

I assume the crafters of the ACA did this to deal with the crybaby GOP governors out there who want to
play politics with the money-- just like they did with the grant money for "high speed" rail.

go ahead. any governor dumb enough to do this will pay the price come election time.

[SickOfTheOnePct]

63. Yes, feds pick up the tab for three years

Then 90% after that. And yes, it is states' rights, as in states have the right now to opt out.

And I wouldn't be so sure that voters will vote out conservative governors and legislators that decide to opt out. They elected conservatives for a reason.

[Iggy]

103. "They elected conservatives for a reason"

yes, and part of that is due to the fact not enough democratic voters bothered to show up to vote
in 2010.

in fact, in 2009-2010 the Repuglican Governors Assoc. put together a plan and funding to defeat
ten democratic governors in key swing states. they succeeded in NINE of the states- including the
nightmare walker in WI, Snyder in Michigan, and Kasich in Ohio.

WTF?! Helloooo? now these governors have a say over any redistricting going on.

did the Democratic Governors Assoc. do anything to try to stop this?

[Luminous Animal]

14. It won't cost them anything in Federal Funds. They will still receive the funds that they

currently receive for un-expanded Medicaid. In fact, states that opt out will save money by not offering expanded care because, even though the bulk of the funding for expanded Medicaid will be born by the Feds, the states are required to kick in a portion.

[SickOfTheOnePct]

16. Exactly - the decision created a new donut hole for the poor n/t

[loyalsister]

67. Notice how many red states are seally dipping into those funds here

West Virginia, Alabama, South Carolina..... Missouri was getting 70% + before the GOP took over the legislature. Now with the medicaid drawdown so much more money will be free to spend on other programs that are terribly underfunded


http://aspe.hhs.gov/health/fmapearly.htm

edited for afterthoughts.

[jeff47]

76. Because these uncovered people won't fall into traditional Medicaid as their health and income fails

Leading to much more expensive care.

Declining the expansion saves money the same way that not paying your electric bill this month saves money.

[loyalsister]

64. The Republicans are now going to be called out on votes that reject medicaid

Unless they go for those federal funds, the Dems can argue that they are driving up their state budgets.

[SickOfTheOnePct]

107. They aren't driving up their state budgets if they don't expand Medicaid

Paying 10% of something still costs more than paying 100% of nothing.

[loyalsister]

108. Medicaid rolls inevitably expand

Especially with veterans needing services not provided by the VA, aging baby boomers, reduced incomes, etc. Making sure there are matching funds for the already natural expansion will provide some relief in state spending.

Notice how much the poorer states draw down from the federal government.

http://aspe.hhs.gov/health/fmapearly.htm

[SickOfTheOnePct]

115. States will continue to get funds for the natural growth that occurs under the current formulations

It's funding for the expansion of the income limits that won't be funded, and since some states won't expand the income limits, they're still better off, in the long run.

I'm not saying it's right, it just is what it is.

[sabrina 1]

83. Who are these people, these 'deadbeats' you speak of who can 'afford it but refuse to pay for it'?

I know the far right has always maintained these people exist, but I've never been able to find them nor have they ever been able to introduce me to any of them. Why are we seeing this right wing meme here?

I KNOW people who have no insurance, and I can assure you that they would have it if they could afford it. I do not know a single person who can afford it who does not have it.

This is the third time today I asked for some statistics on this claim being thrown around. Not once have I received a response with back up for it.

44, 000 people die each year in the US because they have no insurance, I've asked this before, to no avail, so I"m trying again. Are you saying these people are 'dead beats' willing to die rather than pay for a policy? And if not, which age group are we talking about, men, women, working people, small businesses. Please clarify this statement you made because over the course of then years of hearing it from Rush Limbaugh et al, I have never seen one iota of evidence that these people exist.

[rustydog]

9. You can't be dropped for preexisting conditions...Insurance companies have to spend

majority of premium payments on healthcare instead of ceo benefits...your college kids can remain on your insurance...small businesses can deduct insurance premiums on workers...there is so much more that is good with the law.

Why are so many people ready to throw the baby out with the bath water?

[SickOfTheOnePct]

15. It's a big loss of for many poor people

If you make too much to qualify for Medicaid under current standards, but not enough to get premium subsidies, you're left out in the cold.

And don't be surprised to see employers drop dependent coverage.

[ProSense]

20. Your argument

It's a big loss of for many poor people

If you make too much to qualify for Medicaid under current standards, but not enough to get premium subsidies, you're left out in the cold.

...has nothing to do with the ruling. A "loss of for many poor people" implies that the law does something negative. That's not the case. It's a positive for many low-income Americans because it raises the income limits.

SCOTUS ruling on health care law a huge win for Medicaid
http://www.democraticunderground.com/1002868894

[SickOfTheOnePct]

25. You don't think the decision is a loss for the people that won't get Medicaid under this decision?

If they can't get Medicaid, and they can't get premium subsidies, how is that not a loss?

[FarLeftFist]

45. How are you saying a gain is a loss? I agree, not perfect, but it's a WIN for millions.

Like saying feeding a million homeless people is a loss because you can't feed 1.3 million people.

[SickOfTheOnePct]

51. I'm not saying it's a loss for everyone

But it's certainly a loss for poor people that, prior to this ruling, would have been covered under Medicaid and now won't be.

Of course it's an overall win, but it's certainly a loss for people that still won't have coverage due to the ruling today.

There is also the potential that a state could, if they choose, contract their current Medicaid coverage in order to save even more money.

For example, (and for ProSense, these numbers are just examples, not real numbers), if a state is currently required to offer Medicaid to anyone that is at 100% of the poverty level, with a 57/43 federal/state split, then that state could, in theory, decide to only cover people at 75% of the poverty level. Doing so would obviously reduce their Medicaid rolls, thus saving the state $43,000 for every $100, 000 they were paying out in fees/costs.

Until today, doing so would risk the federal government cutting off all Medicaid funding. But today's ruling is clear that the threat of taking away all funding is no longer an option. So, what is to stop cash-strapped states from reducing the number of Medicaid recipients in order to save money?

Yes, today is an overall win, but there are many people that won't have the coverage that they would have had prior to the ruling.

[SickOfTheOnePct]

28. Prior to the ruling, states had to expand Medicaid or lose all Medicaid funding

Now they don't. You don't consider that a loss for the people that yesterday could look forward to coverage and now can't?

Your definition of win v. loss is quite different than mine. In states that opt out (and why wouldn't they, there is no penalty or doing so, in fact, there is a financial incentive to opt out), there are many poor people that will now have no medical coverage. How is that not a loss?

[ProSense]

32. What?

You're comparing apples to oranges.

The increased poverty limits are effective under the health care law. Nothing about Medicaid in its existing form changes. The rules for existing Medicaid still apply to that program.

The expanded program (increased poverty limits) is what cannot be used to determine a penalty.

[SickOfTheOnePct]

46. I think you need to look again

States do not have to accept the expanded poverty limits for Medicaid. Prior to today, refusing to expand Medicaid would result in loss of all Medicaid funding. The decision today overturned that part of the law.

States will still cover the people that are covered under current standards, but they are no longer required to either accept the expansion or lose all funding. As such, all of the people that would have been covered under the expansion will not be covered in states that opt out. And those same people won't qualify for premium subsidies, so they won't be able to afford insurance in the exchanges either.

It's a new donut hole fo the poor in states that opt out of the expansion.

How will those people get coverage?

[ProSense]

50. No

"States do not have to accept the expanded poverty limits for Medicaid. Prior to today, refusing to expand Medicaid would result in loss of all Medicaid funding. The decision today overturned that part of the law. "

...you do. As I said, you are talking about the law as it relates to the expansion and the penalty. For those states that opt out, they cannot be penalized for not implementing the expanded program. Still, that has nothing to do with the current criteria for non-expanded Medicaid, the traditional program.

[SickOfTheOnePct]

53. I never claimed that it did

Why don't you tell me what effect you think this will have on people that looked forward to coverage prior to this ruling that will now not receive that coverage? You don't think it's a loss for them?

A win for most, yes, but we shouldn't deny the fact that it was a loss for many.

[Riftaxe]

89. Now find a Physician that accepts Medicaid

The ACA really should have done something useful, like giving the poor last year's left over lottery tickets.

[Luminous Animal]

19. Small businesses already can deduct insurance premiums, by the way...

[GarroHorus]

23. Fail thread is EPIC FAIL n/t

[MADem]

30. +1,000 nt

[Autumn]

26. Insurance finance reform.

[MADem]

29. Well, you're in the minority. Would you be happier if Roberts threw his vote the other way and

shit on We The People quite decisively?

It's a victory, even if it isn't a complete one.

One step at a time.

No pleasing some people. Don't be sorry, though--go on and stew if it makes you happy.

[usregimechange]

43. It is mixed but disappointed we couldn't do more

[MADem]

48. The journey of a thousand miles begins with a single step. nt

[AnotherMcIntosh]

57. If true, when is NAFTA going to be revised?

[MADem]

61. When enough people rise up and decide it is an issue that is sufficiently important to merit

revision--and not a moment sooner.

[AnotherMcIntosh]

68. Been there. Done that. 2008.

[MADem]

69. Ah, so, at first if you don't succeed....fuck it?

How very petulant.

You do realize we've been working to get this kind of health care coverage for well over HALF A CENTURY, don't you? Ted Kennedy died waiting on this day.

And you're whining that you didn't get your way at one crack?

Forgive me if I find your impatience and "One shot and I'm Out" attitude a bit tiresome.

If you put your shoulder to the wheel, be prepared to keep it there, year in, year out, for a long, long time. BTDT is for dilettantes.

[AnotherMcIntosh]

78. Maybe that is your way of handling it. Say "fuck it"? Be petulant?

Not only are you wrong with respect to the rest of your post, there is no factual basis for you to say or imply that "we've been working to get" mandatory purchase of health insurance "for well over HALF A CENTURY." It's simply not true. There is no factual basis for that whatsoever.

There is no whining at all, unless you are doing the whining.

There is also no "One shot and I'm Out" attituted displayed at all. The fact that you seem to be somewhat annoyed by my responses seems to indicate the exact opposite. If you're annoyed, too bad.

[MADem]

85. I am not the one who said "I tried ONCE ... in 2008."

Don't play the despair card and then get annoyed when I notice.

I'm not wrong with respect to any of my post, but think what you'd like. Gripe all you want. The only one you can bring down with your misery and carping is yourself.

Today is a good day for America.

[AnotherMcIntosh]

86. Such emotional language. I wonder why? But who really cares?

You say, "I am not the one who said "I tried ONCE ... in 2008." But so what? No one else did either.

You say, "Gripe all you want." I say, get a grip. I'm not griping.

You say, "The only one you can bring down with your misery and carping is yourself." I say, I'm not down. If you're engaging in carping and creating misery for yourself, too bad.

[MADem]

88. You're not the master at baiting that you apparently think you are.

Nothing will harsh my mood today....not even Debbie Downers like yourself!!

I'm glad I don't have your "emotional" shitty attitude!

You have a good one, there, Sport.

Strive to be happy, and all that....

[AnotherMcIntosh]

96. No one is baiting you at all.

You referred to an "'emotional' shitty attitude." That's your attitude, not mine.

[MADem]

98. That's exactly right--no one is baiting me! nt

[AnotherMcIntosh]

99. Right. You are causing your own anger in that you cannot compel someone to agree with you.

[MADem]

100. I am happy as a clam, couldn't be more thrilled today-- your concern is touching though.

But you are having a comprehension issue, I fear. See, I don't care what you think and I don't care if you "agree" about something that, like it or not, has already happened. I don't have much regard for your opinions, so they matter not to me. The one who seems terribly annoyed at not being able to compel agreement is you! You'll get over it. It's just the internet.

[Rosco T.]

40. It's an opening for Medicare for All...

.. the states won't provide, Medicare for all.

you watch.

[jeff47]

77. Thanks for letting me know Vermont doesn't exist. (nt)

[Hoyt]

52. States -- even the reddest -- aren't likely to do that. And, look at the legislation and you will

see that insurance companies are going to have to perform or they will wither and watch plans more popular among consumers flourish.

With the roadblocks faced, this legislation is pretty good. And it will get better.

But, if you still can't cheer anything -- think about the 30 million who don't have any coverage now who will finally have a chance. Think about those who lose their coverage being able to find new coverage because of removing the pre-existing BS. And, if they can't afford the new coverage, there will be subsidies.

[bhikkhu]

56. It is state-by-state, but it will be a sea-change for most

In mine, looking at the good beginnings they have, basically my family will get health insurance fully subsidized ( http://www.orhix.org/index.html ). As will most of my neighbors and most of the people I work with - this being a relatively poor area.

My family hasn't had any kind of health insurance since '03 and none of the guys I work with have either - and there is no underestimating the amount of underlying anxiety to that, knowing that a broken leg or a bad infection or anything internal would cost you your house and your job right away, and change the rest of your life (if it didn't simply end it).

Even if it work out that we have a monthly payment or a reasonable copays, its a huge difference.

[progressivebydesign]

58. DU Naysayers Health Insurance Plan: Bake Sales and Car Washes, and a penny jar on the counter. n/y

[EFerrari]

65. Which cost a penny more than what we have now and is just as effective. n/t

[MADem]

70. They're coming out of the woodwork, aren't they? All with a curious agenda.

One I don't think Bernie Sanders would endorse...

Now here's a guy who understands that it is flat out STUPID to make Perfect the enemy of Good.

[girl gone mad]

91. I think you are misunderstanding what single payer is.

But at least it's not another bigoted comment about "freeloaders".

[bowens43]

59. Yes, it is

but of course there is much more to it then your silly 'States can opt out of Medicaid expansion, citizens must buy x' nonsense.

[loyalsister]

95. Optional services under medicaid

as of 2004

_ Podiatrists' services
_ Optometrists' services and eyeglasses
_ Chiropractic services
_ Private duty nurses
_ Clinic services
_ Dental services
_ Physical therapy
_ Occupational therapy
_ Speech, hearing and language therapy
_ Prescribed drugs
_ Dentures
_ Prosthetic devices
_ Diagnostic services
_ Screening services
_ Preventive services
_ Rehabilitative services
_ Services for persons age 65 or older in mental institutions
_ Intermediate care facility services
_ Intermediate care facility services for persons with MR/DD and related conditions
_ Inpatient psychiatric services for persons under age 22
_ Christian Science schools
_ Nursing facility services for persons under age 21
_ Emergency hospital services
_ Personal care services
_ Hospice care
_ Case management services
_ Respiratory care services

Why in the world would the states reject funding to pick up what they are not covering when they are bailing out hospitals for indigent ER care, having their jails operating as mental institutions, putting financial pressure on counties and municipalities, etc?

Particularly those who advocate personal responsibility

[loyalsister]

97. I remember a conversation with a fellow advocate

A legislator told my friend she should (illegally) go ahead and drive despite her epilepsy. She said that she would love to see how much money he gets from insurance companies if he sponsors a bill to repeal the law that limits her ability to drive.

Similarly, watch how much insurance campaign contributions state legislators get if they opt out. Who do they want to pay what they won't? The same people we want to pay it "big government"

[RBInMaine]

114. This is a start, and a BIG one. Enough of this purist foolishness.