Tag Archives: Medicaid

Veterans Day Passes and Not a Peep From GOP Congress About Helping Low-Income Vets Raising the minimum wage would help one in five vets; instead, the GOP eyes Medicaid cuts affecting one in 10.

As Veterans Day recedes and Republicans in Congress take up tax reform purportedly to help everyday Americans, it is worth noting that one in five veterans would benefit by raising the federal minimum wage to $15 an hour, according to the Economic Policy Institute.

While that is not on the table in Congress, the GOP’s bill-writing legislators envision funding their tax cuts by cutting $1 trillion from state-run Medicaid over the next decade. Medicaid is the public health program used by about 10 percent of the nation’s vets, helping those who are poor or don’t live near Veterans Administration facilities. The Republican-led Congress is yet again showing its preference to do little to help poor Americans, including former soldiers who served in the military and are at the low end of the income spectrum for veterans.

“Of the 9 million veterans in payroll jobs across the country, approximately 1.8 million would get a raise if Congress raised the federal minimum wage to $15 by 2024, as was proposed earlier this year in the Raise the Wage Act of 2017,” wrote the Economic Policy Institute’s David Cooper and Dan Essrow. “This means that despite their service to the country, the intensive training that they have received, and the access to additional education provided to veterans through the GI Bill, 1 out of every 5 veterans is still being paid so little that they stand to benefit from raising the minimum wage.”

The veterans who would benefit from raising the minimum wage are in their 30s, approaching middle age, EPI’s experts noted.

“The stereotype that only middle-class teens working after school would benefit from raising the minimum wage is false. Yet this stereotype breaks down even more dramatically when considering the veterans who stand to benefit from a higher minimum wage,” they wrote. “Of the veterans who would get a raise, nearly two-thirds are age 40 or older, over 60 percent have some college experience, and nearly 70 percent work full time.”

Other studies of veterans’ post-service work have found women veterans tend to earn less than their male counterparts. The factors that account for these wage disparities include gender, educational attainment, work experience, length of military service, race, marital status, number of offspring, work history and region of the country where they live. Other studies, such as a VetVotes.org report on eroding prevailing wage standards in construction, have found changes in state law “disproportionately hurt veterans.”

These various studies suggest the federal government is not doing all it can to help ex-service members lead fiscally stable lives—even as one-third of veterans end up in government or public service jobs.

“The fact that so many former servicemen and women would benefit from raising the minimum wage is a reminder that labor standards like the minimum wage protect all workers—even those whose courage, training, and sacrifice should guarantee them a good job,” EPI’s experts said. “Unfortunately, Congress has let the federal minimum wage erode to the point where, adjusted for inflation, workers at the federal minimum wage are paid less today than during the Vietnam War. There is no reason why the federal minimum wage could not be significantly higher than it is today; Congress simply needs to act.”

By Steven Rosenfeld / AlterNet

Posted by The NON-Conformist

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The Republican Attack on the American Dream

The GOP speaker of the House says social mobility for the poor is a core American value. His plans to cut Medicaid would almost certainly achieve the opposite.

In an age of political polarization, one of the few values with near-universal bipartisan support is upward mobility—the idea that poor young Americans should have a chance to escape poverty and become middle-class or even rich adults. Most people simply call it the American Dream. But to understand how Donald Trump’s presidency might help or hurt people’s chances of achieving that dream, the best place to look might not be inside the White House, but rather inside that other large, white, marble building a few blocks away.

In Congress, House Speaker Paul Ryan has put upward mobility front and center in his new conservative reform plan. Ryan’s thesis sounds simple, moral, and intelligent: Work is the surest path out of poverty, and government programs should encourage low-income workers to find jobs, develop skills, and work their way off government support.

But unlike many liberal reformers, Ryan pushes a kind of minimalist-design-aesthetic approach to social policy—to add, one must first take away. With a deep belief that government support for the poor often hurts them in the long run, Ryan has repeatedly proposed to cut welfare programs by trillions of dollars in the next decade. More than two-thirds of the cuts in Ryan’s last budget came to programs for low-income people, like Medicaid or the Supplemental Nutrition Assistance Program (SNAP), commonly referred to as food stamps.

There are two problems with Ryan’s approach. First, to build support for his anti-welfare agenda, he exaggerates the failures of America’s fight against poverty. “Americans are no better off today than they were before the War on Poverty began in 1964” is the first line of Ryan’s latest reform plan. This claim is the keystone to his thesis that anti-poverty efforts are actually pro-poverty traps. But Ryan’s statement relies on a nonsense measure of poverty that doesn’t account for tax credits or adjust for the spending habits of a modern family. By more reasonable measures, which account for the growth of tax credits and the falling cost of food, the poverty rate has fallen significantly since the 1960s, particularly among the elderly, thanks to many of the very government programs that Ryan has insisted on reforming, like Social Security, Medicare, and Medicaid.

But there is a second, more consequential downside of Ryan’s approach: It will undermine his larger stated goal to help poor children achieve upward mobility.

Take, for example, his goal to cut Medicaid, which provides insurance to the poor and long-term care for the old and sick. The most recent Republican budget would cut $2.1 trillion from Medicaid in the next ten years, including the repeal of Obamacare’s Medicaid expansion. As a result, more than 20 million people would lose health insurance, and in ten years, the Children’s Health Insurance Program (CHIP) would be cut by about one-third.

What effect might these cuts have on the upward mobility of poor children? Academic researchers already have an answer. Since Medicaid expansions occur state by state, rather than among all states at once, this provides an ideal dataset for comparing outcomes of similar children with different Medicaid eligibility from several states. Their conclusions suggest that Medicaid cuts could have a devastating cost on the future health, education achievement, and future income of today’s poor children.

In a 2015 paper “The Long-Term Effects of Early Life Medicaid Coverage,” the economists Sarah Miller and Laura R. Wherry found that poor children whose mothers had access to prenatal coverage under Medicaid later had lower obesity rates, higher high-school graduation rates, and higher incomes in adulthood. The authors even found that children of new mothers on Medicaid showed “less reliance on public assistance” as adults. Another 2015 paper by the economists David W. Brown, Amanda E. Kowalski, and Ithai Z. Lurie found that children who benefitted from Medicaid expansions earned higher wages as adults and collected less welfare from the government.

In other words, Medicaid and CHIP don’t seem to trap families in poverty, as conservatives often suggest. To the contrary, they help poor children escape poverty, so that as adults they are less reliant on government support.

Conservatives’ “less-is-more” approach to upward mobility is alluring to some for its unsentimental logic: If poverty is extremely uncomfortable, the poor will have no choice but to work their way out of it. But the research on Medicaid’s benefits for poor children suggests that Ryan and his acolytes have things perfectly backward. In fact, more government support for poor working families might be the most cost-effective way to fight poverty, not only because it makes poverty slightly easier to escape, but also because early investments in poor young children pay dividends later in their lives.

Among other things, Trump’s victory was about the American Dream and its perceived evaporation for many middle-class families. Counties with less upward mobility were more likely to support Trump, according to a widely circulated Gallup study. But as Republicans are poised to enact an undiluted conservative agenda, they should consider another intuitive frame for fighting poverty at a discount: Early money is like yeast. Investments in poor young children’s lives improve their adulthood outcomes, thus reducing government anti-poverty spending in the future. Slashing these investments to make room for large tax cuts for the wealthiest Americans is a strategy to help rich families hoard opportunity for their own children, while poorer kids merely inherit their parents’ poverty.

Derek Thompson/TheAtlantic

Posted by The NON-Conformist

Yep, Medicaid expansion is working, where it’s allowed

SAN FRANCISCO, CA - SEPTEMBER 21: Protestors carry signs as they demonstrate against proposed cuts to Medical and Medicare outside San Francisco city hall on September 21, 2011 in San Francisco, California. Dozens of disabled people staged a protest aga
Image: Daily Kos

It’s not a big secret that Obamacare is working to reduce the uninsured in the states that fully embraced the law, particularly those that expanded Medicaid. That’s still true, according to two new studies which show that low-income patients have better access to care and hospitals are doing better financially in those states.

Fewer low-income residents of Kentucky and Arkansas, two poor states that expanded Medicaid in 2014, reported problems paying medical bills after the coverage expansions, especially compared with residents of Texas, which has rejected the health law.

More from The Daily Kos

Posted by Libergirl

238,000 US veterans died waiting for health care – leaked document

A leaked document shows nearly one-third of the 847,000 veterans in the Department of Veteran Affairs’ backlog died while waiting for treatment, amounting to more than 238,000 patients, according to documents obtained by the Huffington Post.

The VA maintains that the number is so large because it has no mechanism to purge the list of dead applicants, and that some of the veterans may have died years ago. VA spokeswoman Walinda West told the Huffington Post that some people on the list may never have completed an application, or could be using other insurance.

She said 81 percent of the veterans who come to the VA “have either Medicare, Medicaid, Tricare or some other private insurance,” West said. “Consequently, some in pending stays may have to use other options instead of completing their eligibility application.”

The documents came from a VA program specialist, Scott Davis, who has been a whistleblower on the department’s failings in the past. He disputed West’s answers, saying an incomplete application would not have made it onto the VA’s pending list. He added that the department only began electronic health care enrollment in 1998, and that this was when the backlog began. As for the point about veterans using other insurance, he said that was “immaterial and a farce.”

“VA wants you to believe, by virtue of people being able to get health care elsewhere, it’s not a big deal. But VA is turning away tens of thousands of veterans eligible for health care,” Davis told the Huffington Post. “VA is making it cumbersome, and then saying, ‘See? They didn’t want it anyway.’”

The documents also show poor record keeping at the agency. In one instance, 2.35 million veterans, whose records amounted to about 13.5 percent of the 17.4 million records total, died but did not have their date of death recorded in the enrollment system. Yet dates of death were recorded in a different information database.

Copies of the document have been sent to the House and Senate committees that oversee the VA, as well as the White House.

The VA provides $95 billion worth of entitlements to veterans each year. However, according to the agency’s own figures from 2008, only 36 percent of the 23.4 million military veterans from all wars were receiving benefits and services – about 8.5 million. The benefits and services include healthcare, education and training, disability payments, military pensions to veterans and their surviving spouses, and burial benefits.

The disclosure is the latest controversy to engulf the VA since last summer’s scandal at a Phoenix VA hospital that led to congressional hearings. Then-Secretary of Veterans Affairs Eric Shinseki resigned when it was revealed that about 40 veterans had died waiting for timely access to healthcare.

The VA’s Office of Accountability Review, which was established in 2014 to promote leadership accountability within the department, is currently handling 80 cases, of which 15 involve whistleblower retaliation.

From RT

Posted by The NON-Conformist

Feds to fine Florida over limit on Medicaid patients’ ER visits

Florida has been limiting Medicaid patients to six emergency room visits a year even though federal officials consider such a cap illegal.

As a result, the federal government intends to penalize the state by withholding a portion of Medicaid funding.

“We hope the state will realign their Medicaid program with federal standards to avoid this penalty,” said Emma Sandoe, a spokeswoman for the Centers for Medicare and Medicaid Services.

The Florida Agency for Health Care Administration is in the midst of an appeal of the federal government’s rejection of the six-visit limit. A September hearing is scheduled.

But while the fight has been pending, the state agency went ahead with its plan.

“We are concerned that CMS is prejudging this matter by seeking to impose administrative penalties” before the appeal has played out, said spokeswoman Shelisha Coleman.

“It’s unfortunate that despite a September hearing to resolve the matter CMS is withholding matching funding,” said Frank Collins, communications director for Gov. Rick Scott.

Federal officials did not estimate how many people have been denied Medicaid coverage for emergency room visits.

More from Brandenton Herald
Posted by Libergirl

The Myth of a Federal Government Out of Control

The Republican push to reduce the federal deficit solely through spending cuts is based on mythology rather than fact. That was clearly demonstrated by a series of reports issued recently by the non-partisan Center on Budget and Policy Priorities (CBPP). In a report issued Oct. 28, CBPP stated, “As a new budget conference committee seeks agreement on spending and tax priorities for the next decade, some policymakers and commentators who believe that future deficit reduction must come solely from spending cuts will likely repeat the claim that the federal government is exploding in size.  The data do not support such a claim. “To be sure, total federal spending as a share of gross domestic product (GDP) rose considerably in 2008 and 2009 and remained high in 2010 and 2011, in part because GDP was unusually low due to the Great Recession and its aftermath.  But spending dropped significantly in 2012 as a share of GDP and, as the latest Congressional Budget Office (CBO) data indicates, this downward trend is expected to continue over the next five years.” The report, titled “Size and Reach of Federal Government Are Not Exploding,” notes that those backing deep cuts in social programs neglect the real reasons for increased federal spending. “While total federal spending will rise modestly as a percent of GDP during the latter part of the decade under a continuation of current policies,  that is mostly because of a marked increase in interest payments,” the report stated. “In particular, as the economy recovers, interest rates will also rise, simultaneously increasing the interest we must pay on any given amount of debt.” The study also found, “Under a continuation of current policies, total federal spending –  including interest – will drop from 24.1 percent of GDP in 2011 and 22.8 percent in 2012 to 21.5 percent in 2013, before starting to rise in the middle of the coming decade, climbing back up to 22.7 percent by 2023.  At least three-fourths of the increase between mid-decade and 2023, however, will come from higher interest payments on the debt.  Interest payments are not a federal program, and increases in interest costs do not themselves represent an expansion of the government’s activities or reach.  It should also be noted that interest costs rise when taxes are cut, because the tax cuts add to deficits and debt just as spending increases do.” As I noted in this space last week, more than 90 percent of so-called entitlement benefits go to the elderly, disabled or working households. Furthermore, as the Center on Budget and Policy Priorities observed, increased spending on safety net programs because of the recession is both appropriate and temporary. “Congressional Budget Office (CBO) projections show that federal spending on low-income programs other than health care has started to decline and will fall substantially as a percent of gross domestic product (GDP) as the economy recovers.  By the end of the decade, it will fall below its average level as a percent of GDP over the prior 40 years, from 1973 to 2012. Since these programs are not rising as a percent of GDP, they do not contribute to our long-term fiscal problems,” CBPP said in a report titled, “Low-Income Programs Are Not Driving the Nation’s Long-Term Fiscal Problem.” I am not suggesting there are not some serious financial questions facing the nation. The rising cost of Medicaid is among those concerns. But it’s important to know why costs will rise rather than using it as an excuse to cut social programs. “To be sure, Medicaid is projected to rise significantly in cost, relative to GDP, for several reasons,” said the report on low-income programs. “To begin with, costs throughout the U.S. health care system – in both the public and private sectors – have been growing faster than GDP for several decades.  Medicaid isn’t the cause of this systemwide cost growth; over the past decade, in fact, per-beneficiary costs have risen more slowly in Medicaid than under private insurance, a trend expected to continue over the next ten years.” It also noted, “A second reason that Medicaid costs will rise faster than GDP is the aging of the population.  Older people have much higher average health care costs than younger people.  Elderly and disabled beneficiaries account for 24 percent of Medicaid beneficiaries but 64 percent of program costs.  As the population ages, the number and share of Medicaid beneficiaries who are elderly will increase, raising program costs. “Another reason that Medicaid costs will continue to rise significantly is the continued erosion of employer-based health coverage.  Over time, the share of low-income people able to get coverage through their (or their families’) employers has fallen, so more of them have turned to Medicaid for coverage.” Yes, the federal government needs to pay close attention to future spending and revenue. But not because spending is out of control or the safety net is bankrupting the country.

By George E. Curry/NNPA

Posted by The NON-Conformist

Why the Silence from the Sponsors of the Superior Full Medicare for All?

With the Tea Partiers relentless attacks on each of the troubles besetting Obamacare since its complicated, computer glitch-ridden startup on October 1, 2013, the compelling question is: Why aren’t the Congressional sponsors of H.R. 676 – full Medicare for all with free choice of physician and hospital – speaking out as strongly on behalf of this far superior universal health care coverage?

There are fifty-one members of the House who openly favor the single-payer solution for many good reasons. Legislators behind H.R. 676, such as Reps. Robert Brady (D-PA), Michael Capuano (D-MA), Donna Christensen (D-VI), Judy Chu (D-CA), Yvette Clarke (D-NY), Wm. Lacy Clay (D-MO), Steve Cohen (D-TN), Elijah Cummings (D-MD) and Danny Davis (D-IL) know that single-payer insurance with private delivery is by far more efficient, saving $400 billion a year just on administrative simplification.

Physician, scholar and advocate, Steffie Woolhandler, co-founder of Physicians for a National Health Program (PNHP) says that, “complexity is baked into Obamacare.” What does “complexity” mean beyond thousands of pages of legislation and many more pages of regulations? Over forty years ago, Canada’s single-payer system was enacted with a 13 page bill that covers everyone for less than half of the cost per capita than the U.S.’s waste-ridden, profiteering, corrupt medical-industrial complex that drives honest practitioners up the wall. And, the Canadian system produces better health outcomes at this reduced cost.

More from Nader.org

Posted by The NON-Conformist