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Their new Android tablet will be more of a Kindle than an iPad.

And by the way, I do love my Kindle. Best Christmas present ever!

So what happens with Medicaid?

This will be the next big fight, but will take place on the state level. Republican governors may try to sabotage the health care act by insisting they won’t take the federal money for Medicaid expansion, but don’t underestimate the political pressure that will be exerted by voters who want what other states have. (Don’t forget that many of the reddest states are very poor and heavily dependent on programs like Medicaid.):

For many people without insurance, a key question raised bythe Supreme Court’s decision today to uphold the Affordable Care Act is whether states will decline to participate in the law’s big Medicaid expansion.

Although the court upheld the law’s mandate requiring individuals to buy insurance, the justices said the act could not force states to expand Medicaid to millions by threatening to withhold federal funding.Republican leaders of some states already are saying they are inclined to say thanks, but no thanks.Tom Suehs, the Texas Health and Human Services Executive commissioner whose state could cover an additional 1.8 million people by 2019, praised the court for giving “states more ability to push back against a forced expansion of Medicaid. The court clearly recognized that the Affordable Care Act put states in the no-win situation of losing all their Medicaid funding or expanding their programs knowing that they would face billions of dollars in extra costs down the road.”

The act, signed by President Obama in March 2010, required “states to extend Medicaid coverage to non-elderly individuals with incomes up to 133 percent of the poverty line, or about $30,700 for a family of four,” according to a March 2012 report by the Center on Budget and Policy Priorities, a liberal think tank. The extension was expected to cover nearly 16 million people by 2019, one of the law’s main ways of reducing the ranks of the uninsured.

The 26 states that challenged the health care law together account for an estimated 8.5 million of those who would benefit from Medicaid’s expansion by 2019, more than half the total, according to ProPublica’s analysis of an Urban Institute report prepared for the Kaiser Family Foundation.

Stanford University health economist Dr. Jay Bhattacharya wrote on Stanford’s medical school blog that some states may opt out. “Cash-strapped states will almost certainly consider this option since they will ultimately be on the hook for financing at least a portion of this expansion,” he wrote. “If enough states decide to deny the Medicaid expansion, this may substantially reduce the ability of ACA [the Affordable Care Act] to expand insurance coverage.”

Medicaid is a joint state-federal program that provides health coverage to the poor and disabled, with states putting up a portion of the money and the federal government funding the rest. Each state’s matching percentage is based on per capita income.

According to a separate Kaiser foundation report, “Medicaid currently provides health coverage for over 60 million individuals, including 1 in 4 children, but low parent eligibility levels and restrictions in eligibility for other adults mean that many low income individuals remain uninsured. The ACA expands coverage by setting a national Medicaid eligibility floor for nearly all groups.”Under the law, the federal government would cover nearly 93 percent of the costs of the Medicaid expansion from 2014-22, according to the Center on Budget and Policy Priorities.

Dipshit

Sen. Pat Toomey would rather pretend that we’re not in a time of disastrous climate change, and that previous standards don’t work anymore. I suppose he expects us to hold bake sales for neighbors who are flooded out?

Swat them down

Like the annoying insects they are! By all means, the feds should simply take over. You can’t let Republicans get away with simply ignoring the law — if you do, it just emboldens them:

The Supreme Court’s decision to uphold the Affordable Care Act shifts the focus from whether sweeping changes to the health insurance market should take place to a scramble to meet the law’s rapidly approaching deadlines.


A number of largely Republican-led states that gambled on delay now face the unsettling prospect that the federal government could take over their responsibilities, particularly in setting up the health insurance marketplaces known as exchanges, where people will be able to choose among policies for their coverage.


Under the law, which the court upheld in its entirety by a 5-to-4 vote, individuals must be able to buy insurance coverage through the new state exchanges by Jan. 1, 2014. But a more immediate deadline is less than six months away, on Jan. 1, 2013, when states must demonstrate to the Department of Health and Human Services that the exchanges will be operational the next year.


If they do not, the secretary, Kathleen Sebelius, “shall establish and operate” the exchanges for the states, according to the statute, a prospect that Republican governors like Rick Scott of Florida, Rick Perry of Texas and Scott Walker of Wisconsin would presumably find anathema.


Mr. Walker quickly raised the risk by announcing that, in spite of the ruling, he would continue to delay any imposition of the law while waiting to see whether Republicans took control of the White House or Congress in November. Republicans on Capitol Hill, and the party’s presumptive presidential nominee, Mitt Romney, have vowed to repeal the entire law if they gain power.


“Wisconsin will not take any action to implement Obamacare,” Mr. Walker said in a statement. “I am hopeful that political changes in Washington, D.C., later this year ultimately end the implementation of this law at the federal level.”

I wonder what all those nice Midwesterners who thought it was mean to recall Scott Walker will think of their governor simply making up his own rules.

Dark cloud on a sunny day

BTD says Roberts’ decision is an undermining of the commerce claus:

There is no satisfying response, but there is an obvious one—the Roberts five seek to dismantle the New Deal jurisprudence. With no need to even opine on the Commerce and Necessary and Proper question, Chief Justice Roberts has written an unfathomable opinion whose motive can only be the laying of groundwork—the groundwork to undo the New Deal.

Now, more than ever, we see the Roberts five agenda. We must reelect President Obama in order to stop it.

I don’t think there’s any question that’s been their intent all along, nor it is something that hasn’t occurred to most of us. To stop it is, quite literally, the only reason I’d vote for Barack Obama. But it’s an important one.

PBS interview with the shrill one

Your librul media! Watch as the interviewer does his best to make Krugman look like a kook:

Watch Paul Krugman on Germany’s ‘Whips and Scourges’ on PBS. See more from PBS NewsHour.

Watch Krugman’s Solution to Fiscal Stimulus? It Involves Aliens on PBS. See more from PBS NewsHour.

How they think

The American way!

WASHINGTON, D.C. — Businesses should be allowed to deny health insurance to cancer patients, according to a Republican senator, because “our nation was based on the foundation of freedom and limited government.”

Discussing health care outside the Supreme Court today, Sen. Ron Johnson (R-WI) told ThinkProgress that there “shouldn’t” be a law requiring businesses to cover employees who have cancer because that would “create an obligation” for others. “When you create a right for somebody,” Johnson said, “you create an obligation for somebody else, and then you’re taking away that person’s right.”

You mean, like when you pass a tax cut to make billionaires happy and then the rest of us have to pay for it?

Thunder in the morning

This morning’s storm was so bad, it woke me up because it was shaking the house.

Which of course made me think of this:

Why did Roberts do it?

From The Nation.

The law’s challengers—and the Court’s dissenters—rejected the characterization of the law as a tax. They noted that it was labeled a “penalty,” not a tax; that it was designed to encourage people to buy health insurance, not to raise revenue; and that Obama himself had rejected claims that the law was a tax when it was being considered by Congress. But Roberts said the question is a functional one, not a matter of labels. Because the law in fact would raise revenue, imposed no sanction other than a tax and was calculated and collected by the IRS as part of the income tax, the Court treated it as a tax and upheld the law.


Chief Justice Roberts did go on to say (for himself, but not for the Court’s majority) that he thought the law was not justified by the Commerce Clause or the Necessary and Proper Clause, because rather than regulating existing economic activity it compelled people to enter into commerce. When one adds the dissenting justices, there were five votes on the Court for this restrictive view of the Commerce Clause. But that is not binding, because the law was upheld on other grounds. And while some have termed this a major restriction on Commerce Clause power, it is not clear that it will have significant impact going forward, as the individual mandate was the first and only time in over 200 years that Congress had in fact sought to compel people to engage in commerce. It’s just not a common way of regulating, so the fact that five justices think it’s an unconstitutional way of regulating is not likely to have much real-world significance.

A few years ago, a team of researchers attempted to build an android replica of the late, great science fiction writer Philip K. Dick. They did a good job but somehow lost the android’s head — the most important part, of course — at an airport. The story is told in a nonfiction book called How To Build An Android, reviewed this week in the NYT. The review makes the Dick android sound amazingly like the first android to run for president, Mitt Romney:

The [android] was a dazzling blend of technology and art. He was also erratic, as you might expect any first-generation android to be. Unexpected questions and loud noises threw him off. Androids have a hard time responding to human speech cues, knowing when to answer and when to stop. Sometimes Phil would get into a self-­perpetuating conversational loop. His handlers — who monitored his responses on a computer screen — had to keep a close eye.

Let’s hope Romney’s handlers are more careful in transporting their android than handlers of the Dick android were.

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