published Saturday, June 30th, 2012

The state’s future health

Now that the Supreme Court has affirmed the constitutionality of the Affordable Care Act, Tennessee Gov. Bill Haslam and state lawmakers have a clear duty to begin planning for the state’s nonprofit, flat-rate insurance exchanges that are required under the law. They also must decide whether to accept or reject the enormous benefit of federal funds to expand Medicaid to low-income Tennesseans, or possibly 200,000 to 300,000, who are now excluded from TennCare/Medicaid coverage because their incomes are just bit above the federal poverty level. The expansion would include those with incomes of 138 percent of the federal poverty level.

These crucial issues should be decided in the health interests of all Tennesseans, rather than on the basis of partisan political opposition to the ACA. Between the two programs, health care insurance for an estimated 930,000 Tennesseans, or roughly 15 percent of Tennesseans, hangs in the balance.

That number itself, to be sure, fails to suggest that a far higher percentage of working Tennesseans and their family members — about one out of four — now go without health care insurance. Why? Consider the larger picture.

Of the state’s 6.2 million citizens, those over the age of 65 — or roughly 806,000 — are eligible for federal Medicare. Another 1.2 million residents, with incomes below the federal poverty level, are covered by Medicaid/TennCare, two-thirds of the cost of which is provided by the federal government, and one-third by the state. And another notable segment of military veterans qualify for Tri-Care, a federal health care program.

There is also a significant number of children in families above the poverty level who are covered by the federal- and state-funded Children’s Health Insurance Program because their parents do not have employer-based health insurance for families. Another group of adult children who were uninsured are now covered under an ACA provision that allows those under 26 years of age to stay on their parents’ family insurance — if they have it.

Subtracting these large segments of the state’s insured population, and considering that less than 55 percent of employers still provide employee insurance programs, it turns out that around one out of four working Tennesseans between the ages of 18 and 65 goes without health insurance. Most are trapped in this circumstance because their relatively low wages — the sad norm in Tennessee — make meaningful private insurance plans unaffordable, or because insurers reject them over “pre-existing” conditions.

That one out of four working Tennesseans can’t get or can’t afford health insurance under this country’s broken, status-quo health care system should prompt state officials to implement all the ACA provisions. Despite all the Republican myopic ranting about “Obamacare,” it is clear that Tennessee’s unmet health care needs stoke last-resort emergency care. That leaves hospitals overburdened with indigent emergency care cost — the most expensive, least efficient way to deal with health care demands. And those staggering costs, in turn, are shifted to the insured patients, causing their insurance costs to soar.

If the ACA isn’t sabotaged by partisan lawmakers, it would help bring down the nation’s mounting health care costs by dramatically raising the number of insured, by opening the door for them to preventive care and by sharply restraining this nation’s horrendous indigent-care burden. The premium subsidies established by the ACA to help middle-class families purchase insurance on the regulated exchanges would further advance that goal.

Even with those subsidies, the non-partisan Congressional Budget Office has repeatedly shown that the ACA will dramatically slow the unaffordable cost curve of the current system, while greatly improving general health care for most Americans by eliminating the current insurance barriers (i.e, pre-existing conditions, limits on coverage, policy cancellations) to accessible, affordable and secure care.

Gov. Haslam and state lawmakers owe Tennesseans committed, nonpartisan help to make the ACA work for the state’s uninsured workers and their family members — and for all Tennesseans vulnerable to the frightening loss of their employer-based health insurance. It would be a moral failure to do less.

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AndrewLohr said...

Obamacare increases demand by insuring more people, and this reduces cost? Emergency care costs $50 billion a year, Obamacare costs a trillion--20x as much--and this reduces cost?

Forcing healthy people to pay sick people to be sick improves health?

Does "flat-rate" mean I have to pay smokers for smoking, fat people for overeating, drunkards for drinking too much, and fornicators for transmitting AIDS and other STDs?

June 30, 2012 at 3:39 a.m.
joneses said...

ObamaCare Will Inflict Vast Array of Tax Increases Despite the absurd ruling by the activist Supreme Court, the individual mandate is a power grab, not a tax — not that there is any shortage of taxes in ObamaCare, as Americans for Tax Reform documents:

  1. Excise tax on charitable hospitals ($50,000 per hospital hike).
  2. Codification of the “economic substance doctrine” ($4.5 billion tax hike).
  3. “Black liquor” tax hike ($23.6 billion hike).
  4. Tax on innovator drug companies ($2.3 billion).
  5. Blue Cross/Blue Shield tax hike ($400 million).
  6. Tax on indoor tanning services ($2.7 billion).
  7. Medicine cabinet tax ($5 billion).
  8. HSA withdrawal tax hike ($1.4 billion).
  9. Employer reporting of insurance on W2.
  10. Surtax on investment income ($123 billion).
  11. Hike in Medicare payroll tax ($86.8 billion).
  12. Tax on medical device manufacturers ($20 billion).
  13. Raise haircut for medical itemized deduction ($15.2 billion).
  14. Special needs kids tax ($13 billion).
  15. Elimination of tax deduction for employer-provided retirement Rx drug coverage.
  16. Annual executive compensation limit for health insurance executives ($600 million).
  17. Individual mandate excise “tax”.
  18. Employer mandate tax.
  19. Tax on health insurers ($60.1 billion).
  20. Excise tax on comprehensive health insurance plans ($32 billion).

In return for all the $billions upon $billions being looted from us, we get to watch vast armies of petty tyrant bureaucrats cut us off from our healthcare system.

Ramming ObamaCare down the country’s throat despite mass public resistance is the Manchurian Moonbat’s only achievement of any significance whatsoever. He ran on the incessantly repeated promise that he would not raise taxes “one dime” on 98% of Americans. That is, he ran on a brazen lie. Yet there are people who would vote for him again.

June 30, 2012 at 7:09 a.m.
joneses said...

Chief Justice Roberts Is a Genius Posted by I. M. Citizen on June 28, 2012 Healthcare.

June 28, 2012

Before you look to do harm to Chief Justice Roberts or his family, it’s important that you think carefully about the meaning – the true nature — of his ruling on Obama-care. The Left will shout that they won, that Obama-care was upheld and all the rest. Let them.

It will be a short-lived celebration.

Here’s what really occurred — payback. Yes, payback for Obama’s numerous, ill-advised and childish insults directed toward SCOTUS.

Chief Justice Roberts actually ruled the mandate, relative to the commerce clause, was unconstitutional. That’s how the Democrats got Obama-care going in the first place. This is critical. His ruling means Congress can’t compel American citizens to purchase anything. Ever. The notion is now officially and forever, unconstitutional. As it should be.

Next, he stated that, because Congress doesn’t have the ability to mandate, it must, to fund Obama-care, rely on its power to tax. Therefore, the mechanism that funds Obama-care is a tax. This is also critical. Recall back during the initial Obama-care battles, the Democrats called it a penalty, Republicans called it a tax. Democrats consistently soft sold it as a penalty. It went to vote as a penalty. Obama declared endlessly, that it was not a tax, it was a penalty. But when the Democrats argued in front of the Supreme Court, they said ‘hey, a penalty or a tax, either way’. So, Roberts gave them a tax. It is now the official law of the land — beyond word-play and silly shenanigans. Obama-care is funded by tax dollars. Democrats now must defend a tax increase to justify the Obama-care law.

June 30, 2012 at 7:52 a.m.
joneses said...


Finally, he struck down as unconstitutional, the Obama-care idea that the federal government can bully states into complying by yanking their existing medicaid funding. Liberals, through Obama-care, basically said to the states — ‘comply with Obama-care or we will stop existing funding.’ Roberts ruled that is a no-no. If a state takes the money, fine, the Feds can tell the state how to run a program, but if the state refuses money, the federal government can’t penalize the state by yanking other funding. Therefore, a state can decline to participate in Obama-care without penalty. This is obviously a serious problem. Are we going to have 10, 12, 25 states not participating in “national” health-care? Suddenly, it’s not national, is it?

Ultimately, Roberts supported states rights by limiting the federal government’s coercive abilities. He ruled that the government can not force the people to purchase products or services under the commerce clause and he forced liberals to have to come clean and admit that Obama-care is funded by tax increases.

Although he didn’t guarantee Romney a win, he certainly did more than his part and should be applauded.

And he did this without creating a civil war or having bricks thrown through his windshield. Oh, and he’ll be home in time for dinner.


June 30, 2012 at 7:52 a.m.
sjs823 said...

Well, the Times editorial staff has a short memory. Tennessee tried to expand the number of people insured with TennCare. I recall that a bunch of do-gooders kept suing Tennessee to force the State to provide MORE, MORE, MORE -- to the point that Democrat governor Bredesen, to his credit, made the difficult decision to cut people off the rolls to keep the State from going bankrupt.

So if Medicaid is expanded, how to do propose to keep the do-gooders from doing exactly the same thing again?

June 30, 2012 at 8:09 a.m.
EaTn said...

For those who would like to find a place to avoid individual mandates or similar as in Obamacare, read the following--

Baically it says that only in some third world country can you find healthcare not run or mandated by the government. Good luck.

June 30, 2012 at 10:25 a.m.
sjs823 said...

From the Knoxville News Sentinel today regarding the expansion of Medicaid: "Former Democratic Gov. Phil Bredesen called the mandated expansion "the mother of all unfunded mandates" and projected the cost to Tennessee at $1.1 billion over the first five years the state is fully on the hook for the new enrollees."

How I wish that more Democrats had the understanding of economics that Bredesen has and fewer were economic illiterates of the sort that write editorials for the Chattanooga Times. Unfortunately, the number of Democrats with Bredesen's understanding is limited.

June 30, 2012 at 9:04 p.m.

Sorry guys, but Reagan's EMTALA is the real mandate to worry about.

How many of you just want to let people die? Remember who cheered that idea.

June 30, 2012 at 10:29 p.m.

When I first started driving as a 17 yeard old male my car insurance was twice the rate my sisters was at the same age because statistically young men file more claims. That cost me $100 more a month the first 5 years compared to my sister. Of course no tickets or wrecks on my part just the statistical chance I would cause one. Totally legal to this day. Now It is a fact that women need more regular Dr visits(statistically speaking of coarse) than men but it is illegal to ask them to pay more for their health insurance. To me this is political pandering at its best/worse. Can you hear them now standing up claiming a victory in the ongoing war on women? Then with the next breath we are told that costs will be lower because obease people will eat less smoking will subside and drug abuse will be a thing of the past. This is wear the line gets blurred between heathcare(what you can do to help yourself) and medical care ( what you need done for you).Of course all I have to do is pay income taxes on my employer's healthcare contributions and in order to get my FIT age discounts I have to make lifestyle choices as I'm told. Such as having proper BMI, cholsetoral, be a nonsmoker, and have average BP. I love the new normal. Everyone gets something and It costs noone anything. It will be so successful by next election cycle(just before penilties are enforced in 2014) we should be heading toward free dental and vision and anything else that sells to focus groups. Just as long as it is not a tax and noone has to pay for it. 16 trillion and counting.

July 1, 2012 at 2 a.m.
joneses said...


Stop being such a liar. No one wants people to die stupid.

July 1, 2012 at 7:08 a.m.
joneses said...

How many people will die because of their medical needs being lost in the incompetency of Washington DC? It probably will not be a financial burden for the families because we all know dead people are still receiving SS benefits because of this same incompetency. So it stand to reason the parasitic liberals by wanting bigger government strives on incompetence.

Obama's death panels return: Rationing is at heart of President's health plan BY ANDREA TANTAROS DAILY NEWS STAFF WRITER Thursday, May 12, 2011 There is a dirty secret about health care that President Obama hopes will escape the headlines. In his newly released plan to "reform" Medicare as part of overall deficit reduction, Obama has punted actual cost-cutting and instead proposed a panel - the Independent Payment Advisory Board - to recommend savings for the financially doomed program. Translation: Welcome to the world of rationing.

The board, which was an original part of Obamacare (remember the death panel debate?), consists of 15 unelected bureaucrats who will have unchecked, binding power in the interest of supposedly greater efficiency and lower costs. That means that instead of you or your doctor making decisions about your care, a group of Washington micromanagers will do it for you.

July 1, 2012 at 8:07 a.m.
jazzman said...

joneses said... re: That means that instead of you or your doctor making decisions about your care, a group of Washington micromanagers will do it for you.

You must be referencing those republicans who initiated the forced, mandated transvaginal ultrasound probes.

July 2, 2012 at 2:35 a.m.
jazzman said...

joneses said... 'Here’s what really occurred — payback. '

more simple 'concepts' from a simple mind

July 2, 2012 at 2:39 a.m.
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