published Monday, December 10th, 2012

A cruel class of lawmakers

  • photo
    Gov. Bill Haslam listens to a question after a speech to a Republican group in Nashville, Tenn., on Dec. 4.
    Photo by Associated Press /Chattanooga Times Free Press.

The lamentable spectacle of witless state legislators and myopic protesters urging Gov. Haslam not to establish a state insurance exchange in accord with the Affordable Care Act is sad enough. But if they shun that responsibility and leave it to the federal government to create the state's exchange with higher standards and more competitive comprehensive policies, so be it. That might well be better for the huge number of uninsured Tennesseans who need and deserve access to affordable, comprehensive health insurance.

The larger risk is that Gov. Haslam will refuse to extend Medicaid to people whose income falls between 100 percent and 133 percent of the federal poverty level, and with that action blow off $7.5 billion in federal grants that would come in the first five years alone to support expansion of Medicaid for the most needy Tennesseans. This would be a cruel and heartless travesty, all in the name of blind resentment toward the national health care reform championed, and achieved at long last, by President Obama.

The isolation of people with incomes between 100-and-133 percent of the federal poverty level is an anomaly of the ACA, which envisioned -- and tried to mandate -- expansion of Medicaid to the typically uninsured people in this income group. That seemed fair when the ACA was written. The federal government provides two-thirds of Medicaid funds; the state, the other third. People with incomes above the 133 percent of poverty level cut-off were made eligible under the ACA for wage-adjusted subsidies to help them buy the flat-rate, comprehensive care insurance that will be available to all comers under the competitive, non-profit policies offered through state exchanges beginning in January 2014.

The Supreme Court's June 28 decision approving the ACA, however, negated the federal mandate to states to expand Medicaid. That left it up to states to decide whether to voluntarily enlarge the Medicaid pool, and accept the increased portion of Medicaid funding that would come for that new group of members. The new federal grants for that would be sizable: 100 percent of the increased cost for the first three years, declining to 90 percent after that, and remaining at that point.

The logic for accepting Medicaid expansion is irrefutable. It would ensure preventive care for a significant group of people who otherwise opt for emergency-room care, which is a far more expensive and far less efficient way to obtain health care. It would actually save the state and insured citizens money by vastly reducing the cost-shifting of indigent-care costs for this segment of citizens to government and insurance premiums.

Legislators apparently haven't studied the economics of this equation. If they refuse to expand the Medicaid group, they will essentially make Tennesseans subsidize the funds that other states receive for this expansion, without any benefit for Tennessee.

Worse, they will leave a sizable segment of residents, about 200,000, without health insurance. That would essentially say that they so despise low-income people in this minimum-wage segment that they don't care a whit about their plight; or, that they are so privileged and distant from this class of people that they do not realize the enormity of their health care issues.

Their larger resistance to establishing state exchanges for Tennesseans above 133 percent of the poverty level further symbolizes their disdain for virtually a third of Tennessee's working age citizens below the Medicare-entry age of 65.

Legislators and the governor should learn precisely what groups and numbers of Tennessee have no health care insurance, or are grossly uninsured. The number of uninsured Tennesseans is over 900,000. Discount the number of Tennesseans above the Medicare age of 65; and those below the poverty level who get Medicaid; and the number of children covered by the state/federal CHIPs program for families with incomes up to 300 percent of the poverty level; and consider the fact that nearly half of all employers don't provide affordable-share health insurance; and that most self-employed people can't afford a private policy-- and you are left with the fact that virtually a third of working-age Tennesseans are uninsured, untreated, and vulnerable to medical-cost catastrophe and bankruptcy.

And the majority of Tennessee's legislators don't give a hoot. They rail against the ACA without reason or pertinent facts, and they don't want to help their uninsured citizens. They could not be more cruel or senseless, nor more shameless.

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joneses said...

It is simple. Tennesseans did not want obastardcare so let obastard manage what he is forcing on Tennesseans. Hopefully Governor Haslem will use his good business sense by not setting up obastardcare exchanges for Tennesseans as obastard cannot even tell what it will cost the state. My praise will go out to the Tennessee Legislature for making a good business decision for Tennesseans by not establishing the exchanges until a true cost to the state is known.

December 10, 2012 at 8:01 a.m.

When did the people of Tennessee actually get consulted on that, huh? Why would even a majority get to dictate to the minority on this anyway? Why aren't you concerned with the desire to take from the poor an opportunity to get health insurance? Why aren't you concerned with the failure to be responsible when you can just blame somebody else if things don't go perfectly?

Ah, the Republican attitude manifests itself. You even make false protests about the costs. Guess what? Making a state health insurance exchange? It's not like shopping at the store with a price on the label. It is a complex set of decisions by a number of people.

We can, however tell you that there are many hundreds of thousands of residents of this state without health insurance. What cost is your decision to do nothing but find a way to point fingers going to impose on them?

Once again, the right decides to duck solutions in order to create problems for others.

Why do you want to fail the people of this state just so you can attack Obama?

December 10, 2012 at 10:54 a.m.
tipper said...

I didn't realize that Tennessee was such a wealthy state that it could kick $7.5 billion dollars in grants for healthcare in the head. Actually, I agree with all of the state Republican legislators to let the federal government handle Tennessee's Medicare and Medicaid programs. It's handled Social Security since FDR and Medicare since LBJ pretty well. I don't know anybody who would turn those programs down today. Besides, I can immagine what a disaster and debacle healthcare would be when left up to the mindset of people like Richard Floyd and Gerald McCormick. This is a prime example of how a state Republican super-majority can return to the dark ages to appease extremists. Tennessee ranks at or near the bottom in almost every category; yet some state Republican legislators work so hard to keep it that way.

December 10, 2012 at 2:27 p.m.
joneses said...

Governor Haslam said today it was a business decision as there is no way of knowing how much it will cost the state. Of course you liberals do not understand business decisions that is why you are so shocked at this level headed decision. Obastard only needs to say how much it will cost the state but then again who in their right mind would believe this liar called obastard.

December 10, 2012 at 3 p.m.
Easy123 said...

joneses,

You're a moron.

December 10, 2012 at 3:03 p.m.
joneses said...

You liberals wanted more federal government intrusion in your lives so consider this a gift from Governor Haslam. What is wrong do you not trust obastard?

December 10, 2012 at 3:17 p.m.
Easy123 said...

joneses,

You're an idiot.

December 10, 2012 at 3:33 p.m.

Yawn, joneses expects us to believe his excuses, when the reality is that the price to the state is clear...from Haslam's decision.

Sorry joneses, but for all your crying about not having the final bill, you apparently want to ignore how business decisions include recognizing the costs of inaction.

Do you not want to understand that?

December 10, 2012 at 4:26 p.m.
tipper said...

joneses: I understand enough about business to know that losing $7.5 billion with the capability to tailor-make a healthcare system to benefit a state's citzens is just plain stupid. And the only reason you and others who don't want ACA is because it comes from someone you irrationally hate--a throwback concept from the old states rights mentality. Truth is, ACA will happen whether states accept it or not. The difference is some states will move forward while other like Tennessee will rest on narrow-minded principles at the cost of their own people. I don't think Tennesseeans thought they were electing such brainless fools.

December 10, 2012 at 7:03 p.m.
Easy123 said...

JonRoss,

You're ignorant and markedly so.

Does the asylum offer 24/7 internet access or do you get an allotted amount each day/week?

December 10, 2012 at 7:38 p.m.
Easy123 said...

JonRoss,

The United States Federal Government, honey.

December 10, 2012 at 8:15 p.m.

I'd say Connecticut and California, hotbeds of liberals.

Why don't you want to take their money? Think about it, they're just going to use it for their liberal agenda.

December 10, 2012 at 11:40 p.m.
Easy123 said...

JonRoss,

But seriously, you're a complete moron.

And I agree with Bulbs about the origin of the money. Heck, Obama probably prints the money himself in an underground bunker with Castro and Satan.

December 11, 2012 at 12:37 a.m.
librul said...

Get sick and die quickly you teabag nimrods.

December 11, 2012 at 1:41 a.m.
Easy123 said...

JonRoss,

Again, you're a moron.

December 11, 2012 at 5:12 p.m.
tipper said...

JonRoss: Blah, blah, blah! Anyone want to vote on who's the biggest, bigoted, racist, fool on this blog? You are so far in the dark ages, JR. Here's a challenge to you. Tell us what you really want. Tell us what you really believe in. I want to know what makes you tick inside. I don't care what you call me or others. I expect that from you. But what I don't know is what you are really made of. Tell us what you believe would be the best for this country and see if you can actually tell it without denegrating people. I don't think you have the guts to really come clean. Prove to me that I'm wrong!!!

December 11, 2012 at 6:30 p.m.
tipper said...

JR: No guts, no glory. Knew you couldn't do it. All show and no go. You answer my questions!

December 11, 2012 at 9:47 p.m.
Easy123 said...

JonRoss,

"So easy and tippy we will ask again, where is the $7.5 billion coming from for Tennessee ? From China ? From Federal printing presses ?"

Already answered this question.

"And what about the tax on the filthy rich 2% that obastard is demanding ? If that happens it will pay for only about 8 days of deficit spending"

Better than nothing. Are you suggesting we increase taxes on the middle class?

"Where does the other 357 days of deficit spending come from ?"

This is one of the stupidest questions ever asked by a sentient human being. Again, you are still an idiot.

You have absolutely no clue how our government works if you think that is a reasonable question to ask.

"These are really simple questions."

I've given you very succinct answers.

December 11, 2012 at 9:56 p.m.
Easy123 said...

That's a fair characterization.

December 11, 2012 at 11:32 p.m.
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