(KMOV.com) — A state lawmaker has come under fire after comparing Missouri’s poor to animals in an interview with KMOX Radio.
“There’s a sign that says please don’t feed the animals,” said Rep. Paul Fitzwater, a Republican from Potosi. “There’s a reason. They keep coming back.”
Fitzwater used the analogy during a discussion on whether to expand Medicaid under the Affordable Care Act, which goes into effect in January of 2014. News 4 went to Potosi to talk with Fitzwater, but he declined to go on camera. Some residents said they were not offended by the quote, but thought Fitzwater could have used better wording.
“I don’t think the poor are animals, but i think he was saying the poor need to help themselves too,” said Potosi resident Vicki Brand.Fitzwater later agreed to speak to a reporter on the phone, and admitted to using a poor analogy.
“The example I was using is, if we continue to hand out funds and give people everything in society, they will continue to depend upon it,” said Fitzwater. “And I didn’t mean nothing by that, and I think you’re just taking it out of context.”
H/T: KMOV.com
Rep. Grayson: Fighting to Protect This.
Before we get down to business, just a brief reminder: if you would like a chance to join Congressman Grayson at Disney World, then click here and contribute $25 or more to his reelection campaign today (or here).
Evidence mounts each day that The Powers That Be in Washington are looking to cut Social Security and Medicare benefits. A couple of weeks ago, some key progressive leaders joined a conference call hosted by the Progressive Change Campaign Committee (PCCC), to discuss how to protect and defend Social Security and Medicare. Here is what Congressman Grayson had to say:
Adam Green: Hey folks, thank you so much for joining [us]. This is Adam Green, co-founder of the Progressive Change Campaign Committee. And I want to welcome you to our briefing today. In the midst of this sequester, we have great Progressives talking about their positions on the [Social Security and Medicare] cuts… . So without further ado, we are very proud to first turn things over to one of our bold, Progressive heroes, Congressman Grayson.
Congressman Alan Grayson: Yes. Thank you. Thanks very much. When we first put this [“No-Cuts.com”] letter together, I thought hard about the promise that it makes. And let me read it to you verbatim:
“We are writing to the President to let you know that we will vote against any and every cut to Medicare, Medicaid, or Social Security benefits — including raising the retirement age or cutting the cost of living adjustments that our constituents earned and need.”
I gave it a lot of thought before I signed off on this letter, as to whether I really meant it, whether that was my “red line.” I tried to think about all the different possibilities that might come up, the things that might go into a bill that would cut [benefits], what would be appealing to me. Honestly, I thought, ‘What if they had said they were going to end the war in Afghanistan? ‘[in a bill that would cut Social Security] — that’s something very important to me. But I realized in the end that I had nothing. I couldn’t think of a single thing that could be put into a bill that would make me willing to break our promise to our constituents, for something they earned and so badly need. They paid for it. They need it. They want it. They deserve it. It’s that simple.
And I understand the difficulty that many people may have in this Congress, in predicting what might come up and making a commitment, making up their minds. A lot of people always want to keep their options open. But I think this is a fair test. This is a fair test.This is a fair test of your commitment to basic principles, because a cut to Social Security benefits, Medicare benefits, Medicaid benefits is cheating old people, cheating poor people, cheating sick people. That’s what it comes down to. It’s taking something away from them that they need it to live – something they’ve earned themselves. And I can’t do it. So I’m happy to say to the President, to you all, and to anybody else that listens: I won’t do it. I just won’t. I’m not going to use my vote to hurt people who are that needy and that deserving. I won’t do it.
And I’m apparently not the only who feels this way, because even though we have had this [No-Cuts.com] letter just out now for a couple of weeks, before today we had 25 Members of Congress who had signed on to this letter. Today, there are two more. We have been joined by Stephen Lynch of Massachusetts and William Lacy Clay of Missouri. And there will be more to come, because first of all, it’s right, and secondly, it’s good politics. And that has become clear to me more and more, as I talk to people.
AUSTIN, Texas—Big in all things, Texas leads the nation in failing to provide health insurance. About one in four Texans are uninsured, the highest percentage in any state. That’s some 6 million people, the total population of Missouri.
Yet Gov. Rick Perry, back from his stumbles in the 2012 GOP presidential race, has insisted that Texas will not accept the federal money provided by President Obama’s health care law to expand Medicaid coverage. As Republican governors from Arizona to New Jersey have joined the program, Perry has amplified his opposition. In a bristling speech to conservatives last week, he said governors who accepted the money had “folded in the face of federal bribery.”
In no state does the decision to expand present such profound political and policy issues as in Texas. Whatever Perry decides, many Texans will benefit from the subsidies in the 2010 law that help the uninsured in lower-to-middle-income families purchase private insurance on health care exchanges. Perry has also refused to establish such an exchange, but the law allows Washington to step in, and Texans who qualify will receive those dollars. Rice University demographers Steve Murdock and Michael Cline recently projected those exchanges will cover up to 1.7 million of the state’s uninsured.
The law’s other mechanism for increasing coverage is to broaden Medicaid eligibility for adults near poverty, but Washington can’t mandate this expansion if states refuse it. Murdock and Cline project that another 1.5 million to 2 million Texans would receive coverage if the state participated.
The state medical establishment, reluctant to cross the governor too publicly, has been restrained in pressing for expansion. But Republican state Rep. John Zerwas, a health care leader who represents a district outside Houston, says legislators are getting an earful at home from providers and local officials worried about the state rejecting the money.
Key state Senate Republicans, though, are striking a harder line. Senate Finance Committee Chairman Tommy Williams says he will support enlarging Medicaid only if Obama allows Texas to transform the way it delivers Medicaid, not only to the expansion population but also to the current recipients. “The existing program is not sustainable,” Williams says.
That’s a hardball position, but not necessarily disqualifying: The administration has reached an agreement in principle with Florida, for instance, to move more Medicaid recipients into private managed care. Many here, though, wonder if Perry would take any deal. The widespread belief is that he intends to seek the GOP presidential nomination again in 2016, and accepting more Medicaid money would smudge his image of Alamo-like resistance to Obama.
Rejecting the federal money might not pose an immediate political threat to Texas Republicans, whose coalition revolves around white voters responsive to small-government arguments. But renouncing the money represents an enormous gamble for Republicans with the growing Hispanic community, which is expected to approach one-third of the state’s eligible voters in 2016. Hispanics would benefit most from expansion because they constitute 60 percent of the state’s uninsured. A jaw-dropping 3.6 million Texas Hispanics lack insurance.
Texas Democrats are too weak to much affect the Medicaid debate. But if state Republicans reject federal money that could insure 1 million or more Hispanics, they could provide Democrats with an unprecedented opportunity to energize those voters—the key to the party’s long-term revival. With rejection, says Democratic state Rep. Rafael Anchia of Dallas, Republicans “would dig themselves into an even deeper hole with the Hispanic community.”
In 1994, California Republican Gov. Pete Wilson mobilized his base by promoting Proposition 187, a ballot initiative to deny services to illegal immigrants. He won reelection that year—and then lost the war as Hispanics stampeded from the GOP and helped turn the state lastingly Democratic. Texas Republicans wouldn’t be threatened as quickly, but they may someday judge their impending decision on expanding Medicaid as a similar turning point.
H/T: National Journal
Now that Obamacare has survived at the Supreme Court and the ballot box, proponents and opponents of the law agree it’s here to stay. But Republicans remain committed to botching its implementation, which — along with inherent complexities in implementing parts of the law — leaves in place significant obstacles to achieving its key goals.
Although the GOP’s efforts to repeal, invalidate and defund the law have not succeeded, here are the four biggest obstacles the law faces in meeting its key goals:
1) Ongoing Disapproval Of The Law
Two leading health policy experts argue that the overarching threat to Obamacare is the fact that many Americans continue to disapprove of it.
“I would rank the number one obstacle to be ‘social acceptance,’” said Jonathan Gruber, a professor at MIT who helped craft the Affordable Care Act and the Massachusetts health care law that inspired it. “When we put in the mandate in Massachusetts we were worried that it would cause protests. None came. This was partly because we did a terrific job of advertising and promoting reform. The same is unlikely to be true in all other states. If folks are protesting, it undercuts the whole reform — if folks don’t sign up, then prices are higher, which leads to more protests, and so on.”
If the public doesn’t come around (supporters of the law are convinced it will), that could also encourage congressional Republicans to keep threatening to withhold funds for implementation, as they have been wont to do in recent years. In the future, with a Republican president or GOP-controlled Senate, they may seek to deny appropriating money for the ACA’s essential functions.
) States Declining To Expand Medicaid
Seventeen million Americans were projected to obtain coverage through the Medicaid expansion in the Affordable Care Act — until the Supreme Court made it optional for states. Even then, proponents believed the generous federal funding — 100 percent for the first few years and 90 percent after 2020 — would make the deal too good to pass up.
They miscalculated. Democratic governors are on board, but just six Republicans have said they’ll participate. Under pressure from the right, thirteen Republican governors have rejected the expansion, including blue staters like Scott Walker of Wisconsin and Tom Corbett of Pennsylvania. Ten GOP governors have yet to announce a decision.
The problem: Even though some Republican governors say they’ll look for other ways to expand coverage, it’s an open question how — or whether — Americans below 133 percent of the poverty line will obtain insurance in the states that do not participate.
3) States Refusing To Build Insurance Marketplaces
The law encourages states to set up and run their own one-stop marketplaces to connect sellers and buyers of health insurance — the central mechanism through which its subsidies and coverage guarantees are actualized. Although states had the ability to opt out, it seemed like a no-brainer because if they decline to set one up, the federal government is required to craft and operate one for them. Building and operating the exchanges in according with the complex regulations in the statute was never going to be easy, but this unanticipated political hurdle adds a new dimension of problems.
Conservatives are working to portray any governor who sets up an exchange as pro-Obamacare, despite the irony that refusing to do so would relinquish power over their health care to Washington. As a result, most Republican governors have refused to build a state-run exchange under the law. Others are looking for a way around some of the rules.
The problem: The ACA lacks a funding mechanism for Department of Health and Human Services to set up exchanges for states that decline to do so themselves — and congressional Republicans are unlikely to appropriate additional money for that. HHS, already stretched thin with the law’s implementation, must find the money within its budget.
4) Nullification Of The Medicare Cost-Cutting Board
The centerpiece of President Obama’s plan to save Medicare from bankruptcy in the long-haul is already law under the Affordable Care Act. Set to take effect in 2015, the Independent Payment Advisory Board will be tasked with cutting Medicare reimbursements to providers if per-beneficiary spending rises above per-capita GDP plus 1 percent. It cannot cut seniors’ benefits. IPAB will be composed of 15 Senate-confirmed experts.
H/T: Sahil Kapur at TPM
The Affordable Care Act’s biggest year is, without a doubt, 2014: That’s when the federal subsidies to purchase health insurance roll out. It’s also when penalties for not buying coverage kick in.
But many of the big changes will start gradually in 2013. They range from increasing payments to Medicaid doctors to upping Medicare taxes to the exchanges’ very first open-enrollment period. Here’s a quick guide to what will happen in health care in the next year1. Health-care cost growth will slow to a new low. The United States is expected to spend a $2.9 trillion on health care in 2013, according to actuaries at the Center for Medicare and Medicaid Services. That would be 3.8 percent more than then $2.8 trillion that CMS estimates we spent in 2012.
That 3.8 percent growth rate, if it actually happens, would be the slowest health-care growth in decades. That has little to do with the Affordable Care Act, the CMS actuaries explain, and a lot more to do with slow income growth.
2. Your Medicare taxes will increase. Some people mark the turning of the new year with champagne and kisses. The Affordable Care Act has something slightly different in mind: Two new taxes to finance Medicare. Both are meant to bring in additional revenue to continue funding the health-care program for seniors.
Employers already take out 7.65 percent of workers’ wages to support the elderly and disabled. Of that, 1.45 percent goes toward paying Medicare’s hospital bills. Obamacare increases the Medicare hospital tax by 0.9 percent, beginning in 2013, for anyone who earns more than $200,000 ($250,000 for joint filers). It also creates a new, 3.8 percent tax on investment income, setting income thresholds at the same $200,000 and $250,000 levels mentioned above. Taken together, those two provisions are expected to generate $210.2 billion over the next decade.
. Your insurance plan will be explained in plain English. Say goodbye to insurance forms with 8-point font that stretch on for dozens of pages. Starting in 2013, the Affordable Care Act requires insurance companies to send their subscribers a standardized, four-page summary of benefits and coverage that runs through the health plan in easy-to-understand terms. Think of this as a nutrition label for health insurance. Here’s what one page of thesample summary looks like.
This requirement actually kicked in a few months ago: Health insurance plans with open enrollment periods after Sept. 23, 2012, were required to offer this information. For anyone buying insurance from a plan with earlier open enrollment, these summaries will show up for the first time in 2013.
4. Primary care providers in Medicaid will get a 73 percent raise. The Congressional Budget Office estimates that Medicaid will gain 7 million new enrollees in 2014, as a result of the health law expanding the program up to 133 percent of the poverty line. The federal government wants to make sure that doctors keep serving that population, even though the Medicaid program tends to pay physicians less than private insurance. That’s why the health-care law includes a provision that boosts primary care reimbursements in Medicaid to match those of Medicare for 2013 and 2014. On average, that will mean a 73 percent raise for Medicaid doctors, according to researchers at the Urban Institute. As you can see in the map below, there’s lots of variation between states in terms of the size of this pay raise.
5. The Obamacare exchanges will open for business. We often talk about January 1, 2014 as the date that states need to be ready for the health reform law. But when you talk to the states actually working to roll out the law, they often talk about October 1, 2013 as a much more significant deadline. That’s the day when the health exchanges open for business, when any American can go online, compare plans and, if they want, purchase health insurance. This is true for state-operated health exchanges as well as those being run by the federal government.
h/t: WaPo
Rocker Ted Nugent apparently still has the keys to an op-ed column over at the Washington Times, which has given him a forum to opine on how to deal with the deficit as lawmakers work to reach an agreement to avert the fiscal cliff.
According to Nugent, the debt and spending problem is so dire that the only way to even begin to address it is to simply engage in the ritual “slaughter” of entitlement programs altogether.
“The three sacred entitlement cows in the room that no politician wants to poke are Social Security, Medicare and Medicaid,” Nugent wrote. “A blinding statement of the obvious is that we are never going to get our financial house in order until these sacred entitlement cows are not only poked, but slaughtered.”
Nugent argued that instead of raising tax rates on the wealthiest Americans, as many Democrats including President Barack Obama have supported, Congress should hike taxes on everybody — particularly the poorest 50 percent of Americans, whom Nugent accuses of mooching an “insane free ride.”
The next step, wrote Nugent, was to suspend “the right to vote of any American who is on welfare.”
“Once they get off welfare and are self-sustaining, they get their right to vote restored,” he added.
Nugent ended with an offhand plea to “eliminate voter fraud” by implementing a national voter ID law.
Click over to Nugent’s column for that and more extreme recommendations. If you already feel like your head is about to explode, click here for some better ideas on how Washington can responsibly address the deficit.
Fuck off, Ted Nugent!
Stripped to essentials, the fiscal cliff is a device constructed to force a rollback of Social Security, Medicare and Medicaid, as the price of avoiding tax increases and disruptive cuts in federal civilian programs and in the military. It was policy-making by hostage-taking, timed for the lame duck session, a contrived crisis, the plain idea now unfolding was to force a stampede.
Kevin Drum at Mother Jones: Romney-Ryan’s Real Poverty Plan: Soak the Poor
So what would Mitt Romney and Paul Ryan do for the poor and the working class if they were elected? Let’s recap:
(via More Evidence That Romney-Ryan Medicaid Plain Is Its Most Radical | TPMDC)
A new study underscores the far-reaching consequences of Mitt Romney’s plan to slash Medicaid spending and the stark contrast between the Republican candidate and President Obama’s vision for the program.
The analysis (PDF), released Tuesday by the Urban Institute for the Kaiser Family Foundation, finds that a Medicaid program modeled on vice presidential nominee Paul Ryan’s budget blueprint, would slash the program’s funding by $1.7 trillion over 10 years.
Romney has announced his support for Ryan’s budget, and has proposed, like Ryan, to turn the program over to the states and to cap its annual spending.
The reforms would save $932 billion by repealing the Affordable Care Act’s Medicaid expansion, and an additional $810 billion by converting Medicaid into a block grant for states that grows annually at the rate of inflation plus 1 percent, the Urban Institute study found. Romney has cited it as one way he would seek to bridge the budget deficit.
By contrast, Obama’s plan under the Affordable Care Act would grow funding for Medicaid and expand eligibility to provide coverage to as many as 17 million more low-income Americans.
Reelecting Obama would continue the implementation of the Affordable Care Act and its Medicaid expansion. Romney’s plan to repeal the law and further reduce Medicaid’s finances, while giving states unprecedented flexibility to reorganize it, would save money by endangering coverage for millions of Americans, according to the study.
1) “Syria is Iran’s only ally in the Arab world. It’s their route to the sea.” Romney has his geography wrong. Syria doesn’t share a border with Iran and Iran has 1,500 miles of coastline leading to the Arabian Sea. It is also able to reach the Mediterranean via the Suez Canal.
) “[W]hen — when the students took to the streets in Tehran and the people there protested, the Green Revolution occurred, for the president to be silent I thought was an enormous mistake.” Obama spoke out about the Revolution on June 15, 2009, just two days after post-election demonstrations began in Iran, condemning the Iranian government’s hard-handed crackdown on Iranian activists. He then reiterated his comments a day later in another press conference. Iranian activists have agreed with Obama’s approach.
5) “And when it comes to our economy here at home, I know what it takes to create 12 million new jobs and rising take-home pay.” The Washington Post’s in-house fact checker tore Romney’s claim that he will create 12 million jobs to shreds. The Post wrote that the “‘new math’” in Romney’s plan “doesn’t add up.” In awarding the claim four Pinocchios — the most untrue possible rating, the Post expressed incredulity at the fact Romney would personally stand behind such a flawed, baseless claim.
6) “[W]e are going to have North American energy independence. We’re going to do it by taking full advantage of oil, coal, gas, nuclear and our renewables.” Romney would actually eliminate the fuel efficiency standards that are moving the United States towards energy independence, even though his campaign plan relies on these rules to meet his goals.
9) “Well, Republicans and Democrats came together on a bipartisan basis to put in place education principles that focused on having great teachers in the classroom.” Education experts have faint praise for his proposals while he was governor. “His impact was inconsequential,” said Glen Koocher, executive director of the Massachusetts Association of School Committees. “People viewed his proposals as political talking points, and no one took Romney seriously.”
10) “So I’d get rid of [Obamacare] from day one. To the extent humanly possible, we get that out.” Romney cannot unilaterally eliminate a bill passed by Congress and his plan to grant states waivers may also be a non-starter.
11) “Number two, we take some programs that we are doing to keep, like Medicaid, which is a program for the poor.” Medicaid isn’t just a program for the poor. While it provides health coverage for “millions of low-income children and families who lack access to the private health insurance system,” it also offers “insurance to millions of people with chronic illnesses or disabilities” and is “the nation’s largest source of coverage for long-term care, covering more than two-thirds of all nursing home residents.” Medicaid is also a key source of coverage for pregnant women.12) “[W]e’ll take [Medicaid] for the poor and we give it to the states to run because states run these programs more efficiently.” A Congressional Budget Office analysis of Paul Ryan’s proposal to block grant Medicaid found that if federal spending for Medicaid decreased, “states would face significant challenges in achieving sufficient cost savings through efficiencies to mitigate the loss of federal funding.” As a result, enrollees could “face more limited access to care,” higher out-of-pocket costs, and “providers could face more uncompensated care as beneficiaries lost coverage for certain benefits or lost coverage altogether.”
14) “And then the president began what I have called an apology tour, of going to various nations in the Middle East and criticizing America. I think they looked at that and saw weakness.” Obama never embarked on an “apology tour.”
17) “I would tighten those sanctions. I would say that ships that carry Iranian oil, can’t come into our ports. I imagine the E.U. would agree with us as well.” Almost no Iranian oil has come into the United States since Ronald Reagan signed an executive order in 1987 banning all U.S. imports from Iran. The nation received a small amount of oil from Iran after the first Gulf War, in 1991.
18) “I see jihadists continuing to spread, whether they’re rising or just about the same level, hard to precisely measure, but it’s clear they’re there. They’re very strong.” Obama’s policies appear to have gravely weakened al Qaeda Central, the lead arm of the organization in Pakistan and Afghanistan principally responsible for 9/11.
20) “My plan to get the [auto] industry on its feet when it was in real trouble was not to start writing checks. It was President Bush that wrote the first checks. I disagree with that. I said they need — these [auto] companies need to go through a managed bankruptcy.” Romney’s plan for the auto bailout would have ensured the collapse of the auto industry. In his editorial titled “Let Detroit Go Bankrupt,” Romney advocated for letting the private sector finance the bankruptcy of General Motors and Chrysler. Auto insiders, however, have said that plan was “reckless” and “pure fantasy.”
Months after the GOP primary came to an end, Mitt Romney finally grew comfortable touting his Massachusetts health care law, even though he couldn’t really use it effectively as an asset on the campaign trail.
“[D]on’t forget — I got everybody in my state insured,” Romney said in an interview three weeks ago. “One hundred percent of the kids in our state had health insurance. I don’t think there’s anything that shows more empathy and care about the people of this country than that kind of record.”
But there’s a tragic plot twist in this father-son reunion tale. Though he clearly takes pride in the accomplishment — and as recently as 2008 had hoped to run for president as a candidate uniquely suited to take the program nationwide — the national health reforms he is now promising to enact in 2013 would deeply, perhaps fatally, undermine his greatest achievement in public life.
Like the Affordable Care Act, Romney’s Massachusetts law relies on adequate federal funding to provide subsidies, and an individual mandate — to pull younger, healthier people into the insurance risk pool and hold premiums down. Romney’s promised reforms as President — specifically his support for deep cuts to Medicaid and his call to allow individuals to purchase insurance across state lines — threaten that foundation.
“If Romney block grants Medicaid, the question with our Commonwealth Care system is just the money question. Would he give us the money we need to make that work?” says Jonathan Gruber, an MIT health care expert who helped design the Massachusetts law.”[For] the rest of our market, it essentially would unravel what the mandate would do. We’d be back to where we were before the mandate.”
Unlike the ACA, the Massachusetts law has two separate markets — one for people living under 300 percent of the poverty level and thus qualify for insurance subsidies; one for people above that threshold.
The subsidized pool is called Commonwealth Care. For that market to work, Massachusetts relies on the federal government, via Medicaid, to cover half the cost of the generous subsidies it provides to lower income individuals. If Romney were to block grant Medicaid and cut its spending as dramatically as he’s signaled he would, Massachusetts would slowly lose those dollars.
“[I[n the long run we would lose the federal money that makes this program possible,” Gruber said. “Remember that the feds pay for half of our program. It isn’t clear if the state would be willing to pay 100% of the costs if the feds pull this funding.”
“I’m not sure how viable that plan would be if they block granted Medicaid,” said Timothy Jost, a health care expert at Washington and Lee University law school.That’s one of two spears Romney is pointing at his own health care law. The other is aimed at the individual mandate.
So what’s the threat there? If Romney signs a bill allowing people to purchase insurance across state lines, he’ll compromise the integrity of the mandate, or pre-empt it altogether, causing his own law to unravel.
“It would depend on how such a law was written and how it would affect all state insurance mandates, not just those in Massachusetts,” he wrote in an email. “An individual who purchased a policy across state lines would still be legally subject to the requirements of the MA health reform law with it’s ‘minimum creditable coverage’ requirements … unless the ‘states’ rights’ supporting President Romney and Congress chose to override such state requirements and prerogatives.”
Absent an explicit pre-emption, he suspects that the Commonwealth Choice system would survive — because, he noted, allowing the sale of insurance across state lines “is the silliest and most uninformed health policy idea I’ve seen in about 30 years. Just dumb.”
H/T: Brian Beutler at TPM
Vice-President Joe Biden and vice-presidential candidate Paul Ryan covered a lot of ground in last night’s debate. But one program that didn’t come up is Medicaid, the joint state-federal program that provides health coverage to 31 million children, 1.9 million seniors, and millions of other disabled and low-income Americans. It’s worth correcting the omission because Ryan’s plans for Medicaid, laid out in the budget he engineered for the House Republicans, are arguably even more radical than his well-known plans for Medicare:
Ryan transforms Medicaid into a block grant. Right now, both the states and the federal government must provide the funding to meet the benefits outlined in the Medicaid program. Block grants would change the federal contribution into an annual lump sum, leaving state budgets to make up the shortfall in times of economic hardship. Other countries’ block grant programs appear to work well, but their history in American politics is not encouraging. In the case of welfare reform, which Ryan often touts as a model, funding was sometimes diluted and states often failed to meet families’ increased needs during the depression.
Ryan cuts Medicaid by a third in ten years. While he tends to focus on the block grants in defending his Medicaid plans, this is what hides behind them: A hard cut to how much the federal government will provide the program, by about$810 billion over ten years. The rates at which Medicaid reimburses health care providers are already extremely low, meaning the cuts will probably come out of the eligibility roles. The Center on Budget and Policy Priorities estimatedthis would kick 14 to 27 million people off Medicaid, depending on how the cuts are carried out. Another 17 million people who gained coverage under Obamacare would also lose it if Ryan repealed that law, as he says he would. And on top of all that, Ryan’s cuts to Medicaid go even deeper beyond the ten year window:
Ryan’s cuts harm current seniors. He’s often defended his alterations to Medicare by claiming the changes won’t harm current seniors. He has no such out for his Medicaid cuts. 1.9 million seniors rely on Medicaid to support their long-term care, and under Ryan’s plan they would immediately start seeing losses to their benefits in the realm of $2,500 a year.
Ryan offers Orwellian justifications for these cuts. His own budget scolds current Medicaid for its extremely stingy reimbursement rates, which drive away providers and risk the health of Medicaid’s enrollees. But to offer further cuts and the “efficiencies” of block grants as the solution is perverse. Medicaid’s provider payment rates are already a third lower than Medicare’s, and even further below those of private insurers. Ryan admits improper payments within Medicaid are only 10 percent of its budget, so even if all these inefficiencies were eliminated and the reclaimed funds plowed into reimbursement rates, Medicaid would still be well below Medicare’s rates — and that’s before accounting for the new cuts. Ryan also criticizes Medicaid for a spending trajectory that’s unsustainable over the long-term. That’s a fair point, but this is because Medicaid must keep up with rising health care costs in order to keep fulfilling its role in the social safety net. The bluntness and extraordinary size of Ryan’s cuts completely ignore these complexities.
It’s also worth mentioning that Mitt Romney’s budget plan, which Ryan must now defend as part of the ticket, is less detailed, but arguably even worse.
1. Romney and Ryan would eliminate health care for 31 million people who are poor or disabled. Medicaid, which helps poor Americans, some seniors, and children afford health care, is right in the crosshairs of Paul Ryan’s House budget. He proposed cutting $1.4 trillion from the program, a move that would kick about 11 million people off Medicaid over the course of ten years. The Romney-Ryan plan is even worse, and is estimated to force about 44 million people off the program.
2. Ryan considers Social Security a “Ponzi Scheme.” In the Fall of 2011, Texas Gov. Rick Perry (R) called Social Security a “Ponzi scheme,” and Paul Ryan agreed. Ryan wants to privatize the program.
3. 62% of Ryan’s budget cuts come from programs that benefit low-income Americans.Ryan’s budget proposes “$5.3 trillion in nondefense budget cuts.” 62 percent of the reductions would come from programs that specifically help low-income Americans:
4. Ryan voted for future defense cuts he now blames on Obama. Though Ryan claims Obama somehow orchestrated the sequester, a series of across-the-board spending cuts triggered if Congress can’t produce a better plan, the VP pick himself was a supporter of the mechanism. Not only did he vote for legislation to establish it, he peddled the plan to his Republican colleagues and proposed a similar initiative in 2004.
8. Ryan’s budget included the same $716 billion in Medicare savings included in Obamacare.The $716 billion that Obamacare takes out of Medicare will almost definitely come up in tomorrow’s debate. Ryan has claimed that Obama “raided” Medicare to pay for his health care reform. In fact, Ryan wants to make Medicare a voucher program and proposed taking the same cuts out of Medicare in his budget. But whereas Obamacare uses those funds to eliminate fraud and increase efficiency, Ryan proposed taking that money to pay down the deficit.
9.Ryan supported economic stimulus under Bush. If he’s going to follow the lead of his running mate, Ryan will invoke Obama’s stimulus plan, the Recovery Act, as failed legislation that wasted taxpayer money. But when George Bush was president, Ryan was supportive of a stimulus, and actually made a rousing case for infusing the economy with money, saying that it helped create jobs.
7. Ryan wants to kick 1 million students off of Pell Grants. As part of his budget, Ryan proposed cutting Pell Grants for nearly 1 million college students. Seventy four percent of Pell Grant recipients in 2011 came from families with incomes of $30,000 or less. There is no evidence that these cuts will curb rising college costs.
10. Ryan used to supports a key aspect of Obamacare. Ryan will likely say at the debate that the Affordable Care Act is government overreach. In fact, he might even invoke “death panels,” as he has done at recent town halls. But Ryan proposed something extremely similar to these so-called “death panels” in 2009 — twice. In December of 2010, Ryan also asked the Department of Health and Human Services for an Obamacare health care grant “for the Kenosha Community Health Center, Inc to develop a new facility in Racine, Wisconsin, an area within Ryan’s district.”
11. Ryan opposes abortion access for rape victims. When it comes to abortion rights, Ryan is among the most extreme anti-abortion members of Congress. He believes rape victimsshouldn’t have access to abortions and co-sponsored a “personhood” amendment that would have defined a fertilized egg as a human, thus outlawing not just abortion but also in-vitro fertilization and some forms of contraception.
12. Ryan supports a constitutional amendment banning same sex marriage. Ryan is vehemently opposed to marriage equality for same-sex couples. He has twice voted to amend the constitution to that effect, supported a same-sex marriage ban in his home state, and claimed that preventing same-sex couples from getting married was a “universal human value.”
[W]ho better than me, who’s already finished one of the entitlement programs, to come up with programs to do away with Medicaid and Medicare?Let’s block-grant what the state has, and allow the states to determine what’s going to go into Medicaid. And Medicare, let’s wait until everyone that right now is under 55 reaches 55 by age [sic] 2020, and give them a choice whether they want to purchase health insurance with a subsidy from the federal government, or stay on Medicare.
WASHINGTON (AP) — Just which 47 percent of Americans was Mitt Romney talking about? It’s hard to say. He lumped together three different ways of sorting people in what he’s called less-than-elegant remarks.
Each of those three groups — likely Obama voters, people who get federal benefits and people who don’t pay federal income taxes — contains just under half of all Americans, in the neighborhood of 47 percent at a given moment. There’s some overlap, but the three groups are quite distinct.
Confusingly, Romney spoke as if they’re made up of the same batch of Americans.
(LIKELY) OBAMA VOTERS
What Romney said: “There are 47 percent of the people who will vote for the president no matter what.”
He’s right on the nose, according to the latest Associated Press-GfK poll: Forty-seven percent of likely voters say they support Obama. And 46 percent say they support Romney, essentially a tie. This number fluctuates from poll to poll and week to week and could shift substantially before Election Day.
Who they are:
—Most are employed: Sixty-two percent of the Obama voters work, including the 10 percent working only part time. A fourth are retired. Five percent say they’re temporarily unemployed.
—Most earn higher-than-average wages. Fifty-six percent have household incomes above the U.S. median of $50,000. Just 16 percent have incomes below $30,000, and about the same share (20 percent) have incomes of $100,000 or more.
—They’re all ages but skew younger than Romney’s voters: Twenty percent are senior citizens and 12 percent are under age 30.
—They’re more educated than the overall population: Forty-three percent boast four-year college degrees or above; 21 percent topped out with a high school diploma.
EOPLE WHO GET FEDERAL BENEFITS
What Romney said: “There are 47 percent … who are dependent on government … who believe they are entitled to health care, to food, to housing, to you name it.”
Whether they are dependent and believe they are entitled to anything is arguable, but Romney’s statistic is about right — 49 percent of the U.S. population receive some kind of federal benefits, including Social Security and Medicare, according to the most recent Census Bureau data. Looking only at people who receive benefits that are based on financial need, such as food stamps, the portion is smaller — just over a third of the population. Many people get more than one type of benefit.
The biggest programs and their percentage of the U.S. population:
—Medicaid: 26 percent
—Social Security: 16 percent
—Food stamps: 16 percent
—Medicare: 15 percent
—Women, Infants and Children food program: 8 percent
THOSE WHO PAY NO FEDERAL INCOME TAX
What Romney said: “Forty-seven percent of Americans pay no income tax.”
Romney’s about on target — 46 percent of U.S. households paid no federal income tax last year, according to a study by the nonpartisan Tax Policy Center. Most do pay other federal taxes, including Medicare and Social Security withholding. And they’re not all poor. Some middle-income and wealthy families escape income tax because of deductions, credits and investment tax preferences.
Why these people don’t pay:
—About half don’t earn enough money for a household of their size to owe income tax. For example, a family of four earning less than $26,400 wouldn’t pay.
—About 22 percent get tax breaks for senior citizens that offset their income.
—About 15 percent get tax breaks for the working poor or low-income parents.
—Almost 3 percent get tax breaks for college tuition or other education expenses.
Who they are:
—The vast majority have below-average earnings: Among all who don’t owe, 9 out of 10 make $50,000 or less.
—But some of the wealthy escape taxes, including about 4,000 households earning more than $1 million a year.
H/T: Yahoo! News