Mike Johnson: "The WIC program, the nutrition program -- women, infants, and children -- that program won't be funded. FEMA won't be funded."

[Pound4abrown]

Since there is no criteria set for how to distribute the Rural Health Fund… having that fund is exactly like it having the fund.

The GOP is trying to convince rural voters that they care about them… that cutting $900 billion out of Medicaid which a lot of rural areas rely on can be offset by $50 billion in an amorphous pot of money with no clear way to shore up rural hospitals except for the name.

$50 billion is a bandaid on the wound that the GOP created and it isn’t nearly enough money to stop the contraction of rural hospitals

Doesn't it feel like the medicinal version of the subsidies to the farmers, a need created by Tariffs?
And still they wake up every morning and salute their Trump flag.

 

[Pound4abrown]

What about "WIC won't be funded" doesn't bother you?

I would start with what the "W" and the "I" and the "C" in WIC stands for.

 

[Pound4abrown]

It’s not a thing that is happening at any scale. It’s a myth. It’s like the drug testing for welfare nonsense. It’s a way to punish poor people that need help.



The BBB makes deep cuts into Medicaid. The bandaid for the gushing wound that they GOP created is the $50 billion to rural hospitals.

Their plan takes away much more Medicaid money for rural health care systems than it gives back.

This is going to accelerate the collapse of rural hospitals and make health care even more expensive in this country.

if they really wanted to ferret out fraud in Medicaid they would go after the providers with the same cudgel as they go after poor people.
That is where the REAL fraud is. Wonder why they aren't going that route?

 

[RetiredAtLast]

None of this has anything to do with the pandemic

The ACA premium special subsidy that is the subject of one of the arguments was put into place during the pandemic, The Democrats voted in 2023 to eliminate that special subsidy as of the end of 2025. Democrats have no decided that they don't want it to end this year.

Bailouts for Argentina and the billionaires while American families lose their health care is not tenable.

The only people that stand to lose their medical care are people who don't meet he new work requirement, and illegal aliens. The "bailout" for Argentina is a "swap line," a type of loan, and there is no "bailout" for billionaires.

 

[Greenbeard]

The ACA premium special subsidy that is the subject of one of the arguments was put into place during the pandemic,

It was passed in 2021 because that’s when the Dems took power. They had been running on fixing the ACA subsidy structure since early 2019, the fact that the pandemic happened is irrelevant.

The only people that stand to lose their medical care are people who don't meet he new work requirement, and illegal aliens.

17 million Americans are about to lose their health care. I know that’s not as important to MAGA as bailing out Argentina or committing our troops to the defense of Qatar, but for millions of American families it’ll be a pretty big deal.

 

[Jezcoe]

if they really wanted to ferret out fraud in Medicaid they would go after the providers with the same cudgel as they go after poor people.
That is where the REAL fraud is. Wonder why they aren't going that route?

They get elected to Congress.

Cough cough Rick Scott cough cough.

 

[RetiredAtLast]

They had been running on fixing the ACA subsidy structure since early 2019, the fact that the pandemic happened is irrelevant.

You're the only person I've seen to mention that "irrelevance." But even if it was, why did they vote to end it in 2025?

17 million Americans are about to lose their health care.

Who are they? I'm not asking their names, but why, as a group, are they going to lose their health care?

 

[Greenbeard]

You're the only person I've seen to mention that "irrelevance."

Perhaps because I can still remember talking about this issue six years ago, before COVID existed.

Musings on the ACA subsidies - House Dem, Biden, Buttigieg plans

So what's next? The House Dems have put forth their plan, based on more generous subsidies achieved by: (1) lowering the family premium contribution used to calculate the subsidy, and (2) making subsidies available to people over 400% FPL.

Meanwhile, Joe Biden has his plan and Pete Buttigieg just released his. A quick read suggests that as far as the subsidies go, they are the same thing (though Mayor Pete has a lot of extra stuff that's interesting, like a central clearinghouse for insurance claims, a national all-payer claims database, and greater antitrust oversight of providers).

Both B's would also make the subsidies more generous, but not quite the way the House Dems would. They would make the benchmark a gold plan, instead of the current silver, while as far as I can tell leaving the contribution percentage the same, other than lowering the upper limit of it to 8.5%. (I'm pretty sure Families USA was the first to suggest rescaling the subsidies to gold plans years ago.)

My read of where things stand in short:

Household income​	Max % of income put toward premiums (ACA)​	Max % of income put toward premiums (House Dems)​	Max % of income put toward premiums (Biden-Buttigeg)​
	Silver Benchmark	Silver Benchmark	Gold Benchmark
100%-133% FPL	2.08%	1.04%	2.08%
133%-150% FPL	4.15%	2.07%	4.15%
150%-200% FPL	6.54%	4.15%	6.54%
200%-250% FPL	8.36%	6.23%	8.36%
250%-300% FPL	9.86%	7.27%	8.5%
300%-400% FPL	9.86%	8.82%	8.5%
400% FPL and up	-	8.82%	8.5%

...
So a family buying the benchmark under B-B pays the same premium as it does today under the ACA (except at the upper end of the income distribution, due to the lower cap)--but it's for a more generous benchmark plan! If you're lower income and eligible for a CSR plan, that part matters less since you're probaby already getting something more generous than gold coverage. But if you're not, this helps substantially with getting a lower deductible/OOP spending plan.

Whereas under the House Dem plan a family would pay less in premiums toward the benchmark--but it's the same benchmark as today. The result is that the subsidies are more generous and thus it's easy to buy up to the gold tier. But not nearly as easy as under B-B. I'd estimate that, all things being equal, B-B would pump at least 3-4 times as much money into affordability as the House Dem plan, meaning it would make that much more of a difference for families. Of course B-B would likely be more effective at pulling more people into the marketplaces, which has a positive feedback on premiums so perhaps some of that expense would be offset.

But as far as I can tell, neither B mentions reinsurance, which would re-set premiums downwards and thus can be more than revenue neutral by drawing into the market people currenty sidelined by high premiums. The House Dems' bill does have reinsurance.

Perhaps we'll end up with an amalgamation: the House Dems' reinsurance and B-B's gold benchmarks.

But even if it was, why did they vote to end it in 2025?

They didn't, fiscal terms passed via reconciliation often require re-upping (see: Trump's tax cuts). It's time to re-up them.

Who are they? I'm not asking their names, but why, as a group, are they going to lose their health care?

Because the point of creating an expensive new bureaucracy and endless paperwork requirements is to create pretexts to separate them from their benefits. This has been amply demonstrated during the GOP's dry runs in Arkansas and Georgia.

 

[Buster Keaton]

Illegal aliens are more important to the greedy corrupt Democrat Party than American citizens

 

[RetiredAtLast]

Perhaps because I can still remember talking about this issue six years ago, before COVID existed.

Obviously, you don't remember talking about the Covid special premium before the pandemic.
"Although the premium tax credit (PTC) has been available since 2014, there is increased congressional interest in the federal subsidy due to the impending expiration of a provision that enhanced the PTC.

The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) established the PTC to help eligible households lower their payments toward premiums for qualified health plans offered through health insurance exchanges. The American Rescue Plan Act of 2021 (ARPA; P.L. 117-2) expanded eligibility for and the amount of the PTC for tax years 2021 and 2022. The Fiscal Year (FY) 2022 Budget Reconciliation Law (P.L. 117-169) extended the ARPA provision for three additional tax years, 2023 through 2025."
Greenbeard
They didn't, fiscal terms passed via reconciliation often require re-upping (see: Trump's tax cuts). It's time to re-up them.

Democrats wrote and passed the bill. They voted for the end of the tax credit to happen in 2025.

Greenbeard:
Because the point of creating an expensive new bureaucracy and endless paperwork requirements is to create pretexts to separate them from their benefits.

The point of adding the"work" requirement is to remove people for whom Medicaid was not intended, and to encourage people to get into school, work training, community service, etc.

 

[Greenbeard]

Obviously, you don't remember talking about the Covid special premium before the pandemic.

In the sense that there's no such thing as "the COVID special premium," that's right!

There's just the fix to the ACA subsidy structure the Dems rolled out in early 2019 and passed after winning the following election. See the linked thread above from fall 2019 where the various proposals on the subject were discussed. The end result ended up being something of a hybrid of the House Dem proposal and Biden-Buttigieg.

The point of adding the"work" requirement is to remove people for whom Medicaid was not intended, and to encourage people to get into school, work training, community service, etc.

Medicaid was "intended" for all Americans making less than 138% FPL in the 41 states that have taken up the ACA expansion, so this argument makes little sense. But if you sincerely believe the point of the GOP's new bureaucracy is intended to promote work (it isn't), bad news: empirically we know it fails to do that.

 

[RetiredAtLast]

Medicaid was "intended" for all Americans making less than 138% FPL in the 41 states that have taken up the ACA expansion, so this argument makes little sense. But if you sincerely believe the point of the GOP's new bureaucracy is intended to promote work (it isn't), bad news: empirically we know it fails to do that.

People who do nothing to get a job or training for a job have earnings of less than 138% FPL. If such a person is able to work, to go to school, to get job training or do some beneficial kind of community service, and doesn't do so, that person has made a conscious decision to take the work of others. While the freedom to make such a choice may be consistent with a liberal political position, it isn't consistent with the attitudes this country was founded with. And before someone says that's some kind of horrible conservative attitude, my own position is that I'm happy to, and do, help those who can't help themselves. I won't, however, have generosity demanded of me.

 

[Greenbeard]

While the freedom to make such a choice may be consistent with a liberal political position, it isn't consistent with the attitudes this country was founded with.

Voters in numerous red states have voted to make Medicaid available to all citizens below 138% FPL.

Utah, Idaho, Nebraska voters approve Medicaid expansion - Becker's Hospital Review | Healthcare News & Analysis

Voters in Utah, Idaho and Nebraska said "yes" to expanding Medicaid on Nov. 6, NPR reported.

www.beckershospitalreview.com

Missouri Voters Approve Medicaid Expansion

Missouri voters joined 38 other states (including DC) and adopted Medicaid expansion yesterday by a vote of 53% to 47%. The vote gave Missouri the distinction of being the sixth state to pass Medic…

ccf.georgetown.edu

Oklahoma Voters Approve Medicaid Expansion, Decide Legislative Races

Oklahoma becomes the 37th state to expand Medicaid, Stephanie Bice and Terry Neese advance to Congressional District 5 Republican runoff, and more than…

www.kosu.org

South Dakota voters approve Medicaid expansion

SIOUX FALLS, S.D., November 9, 2022 – South Dakota voters approved Constitutional Amendment D, which will expand Medicaid in the state. The American Heart Association, a global force for healthier lives for all, played a key role in the campaign to...

newsroom.heart.org

Or are these liberal states?

 

[RetiredAtLast]

Voters in numerous red states have voted to make Medicaid available to all citizens below 138% FP will be covered, in five states

If the voters make that decision, fair enough. I assume that the states will cover the cost without including it in the federal reimbursement, if the federal law includes the "work" requirement. I notice that, at this site, as many as 352,000 people in five low-population states, will be covered. Also, according to this site all of the states but two had budget surpluses in 2022. That can't be said of the Federal budget.