Healthcare Reform's Medicaid

[Joz]

I have two questions regarding it:

1.) It seems that since half of the 30 million extra insured will be via medicaid... isn't this like a huge back-door public option, even though it's only an option for the poor?

2.) Is medicaid coverage going to be free if you're eligible? Isn't it free right now for those currently eligible? It must not be free in this reform bill, otherwise... there would be no hardship exemption, and why would we not have universal coverage? Does anybody know how much it will cost to be on medicaid, or is that going to vary by state?

[TransitJohn]

1. In my state, Medicaid won't cover anybody for simply being poor

ie, unable to purhase insurance. You have to be disabled....so if you poke out an eye, yeah, a backdoor public option, I guess.

[sandnsea]

3. That's supposed to change

And every one of us needs to be watching our state governments to make sure it does change. No coming back here and whining if you sat on your hands while your state implemented the new Medicaid.

[EFerrari]

4. Here you have to be disabled or old enough or pregnant or have minor children

at home.

[Joz]

6. Yeah, but the reform bill changes that

You won't have to be poor AND something, just poor.

[EFerrari]

7. Is that clear yet? I don't think so.

A subsidy which is a tax credit won't help most poor people. And that's just the premium. Plus, this isn't the first time community health centers where going to fill the gaps. That's where our mental health system went. It never happened.

I know I'm being horribly negative but, there it is.

[Joz]

8. Yes, it's clear.

That's the way the bill works. Half of the newly insured are going to be new medicaid recipients. It's opened up to anybody within 133% of the poverty level, period. The bill also increases medicaid payments up to medicare payment levels, so that doctors will be willing to accept all these new patients. :-)

[EFerrari]

9. I don't want to rain on you Joz.

lol

:hi:

[Winterblues]

16. You can make very little money at all and still not qualify, if you own your home.

:shrug:

[AngryKansasknitter]

22. same here!

In Kansas if you are Poor you are shit out of luck...no way in hell are they going to just up and GIVE anyone medicaid...unless they are pregnant, disabled, or blind if you are under 65....They also help the elderly, but papers have to be signed that means the estate is given to the state to pay them back for the assistance once you reach 54-55 years of age... And, there IS no adult dental coverage on Medicaid in Kansas... Given that KS is a "Rethuglican" state, I fully anticipate that Topeka is going to opt Kansas out of the health care law in any way they can....

Nita

[sandnsea]

2. It's capped at 133% of poverty, including ALL adults

States will not be able to limit it the way they do now. It will be free, but you still have to be pretty poor to qualify for it. The waiver is for people between dirt poor and median poor.

[Joz]

5. Too bad it's not universal.

Yeah, I was aware of how it's to be changed, expanded, and brought up to medicare payment levels. I think it's a great idea, I just couldn't figure out if it's going to be free or not, thanks.

It seems too bad about the waiver thing. If the bill could have only expanded medicaid eligibility to 200%, or if not that just even a bit higher like the original House bill, and (even if it would be tough for some people) have no waiver, then we could have done universal healthcare. Granted, I don't agree with the for-profit system, but at least it would have been universal, and would be a huge political/social/historical win to have, but maybe it really wasn't politically feasible.

Anyway, pretty cool, I'm not a hater on this bill at all. I think it's a great step in the right direction.

[sandnsea]

10. Kennedy's HELP Bill was 150% of poverty too

Huge mistake in not getting behind that and the House bill to silence Baucus before he ever opened his mouth.

[demodonkey]

11. Are you going to have to "spend down" to get it?

Like for example if someone owns a home but is unemployed and makes income below the 133% of poverty line.... will you have to sell your house and use the money up for healthcare first before you can get Medicaid (that's the way it is now.)

[jbnow]

12. You don't have to sell your house even now for Medicaid

(with the exception of those who are in nursing homes a number of months and are not expected to ever be able to return home...)

There is an asset limit of 3,000 for Medicaid now but your home, furniture, one automobile, burial plans and various other things are exempt from that are exempt from that.
Don't know what might change with expansion...but no one will have to sell their house!

[Winterblues]

17. Medicaid is State run and State Regulated.

Every state is a little bit different.

[demodonkey]

21. It Ain't Necessarily So...

...It is correct as previous poster said that states are different.

Also there are situations. Some people need more than "one automobile" for work purposes (i.e. a farm truck needed by a low-income family farmer or a work van or truck needed by a low-income carpenter.) In most cases these work vehicles are large and it is actually much more economical to have a small second car for daily use than it is to drive the work vehicle all the time.

"Burial plans" are a scam; probably gotten into the Medicaid regs by some scammy lobbying on their behalf. Recently our local TV news reported the tale of a woman who bought a burial plan 20 years ago, and when she died this winter her son found out that despite regulations supposed to protect the purchaser the funeral home had gone under and there was no money. This left the son on the hook to pay for his mother's burial to the tune of thousands of dollars. (And some of us have no children or other family to pay when we are dead.) I would much rather have a small savings account for emergencies (including death) and/or have life insurance to cover my final expenses, however one generally has to declare such things as an asset and spend them down.

Some people have worked all their life for a second home, or a special asset (maybe like a boat or motorcycle or something) and wouldn't want to have to sell it because they are forced onto Medicaid during a (perhaps temporary) time of low income.

Finally, at least in my state, the Medicaid application is a horrible, demeaning process that a stray dog shouldn't have to go through. I was forced to do an application for my mother, with whom I share a home and property, and it was so incredibly intrusive I actually felt like I was being physically violated. Went home shaking with rage and shame after each session with the DPW, and felt I needed to take a shower.

Yes, it was that intrusive and it shouldn't be.

[AngryKansasknitter]

23. More than likely...

This is something Kansas definitely does...and certainly wouldn't put it past those blood sucking leeches!! Anything for a dollar...

Nita

[1776Forever]

13. Consumers Guide To Health Reform reports this - 133% of poverty level...

Consumers Guide To Health Reform
By Phil Galewitz
KHN Staff Writer
Mar 26, 2010

http://www.kaiserhealthnews.org/Stories/2010/March/22/consumers-guide-health-reform.aspx

.......Q: I want health insurance, but I can't afford it. What do I do?

A: Depending on your income, you might be eligible for Medicaid, the state-federal program for the poor and disabled, which will be expanded sharply beginning in 2014. Low-income adults, including those without children, will be eligible, as long as their incomes didn't exceed 133 percent of the federal poverty level, or $14,404 for individuals and $29,326 for a family of four, according to current poverty guidelines.

Q: What if I make too much for Medicaid but still can't afford coverage?

A: You might be eligible for government subsidies to help you pay for private insurance that would be sold in the new state-based insurance marketplaces, called exchanges, slated to begin operation in 2014.

Premium subsidies will be available for individuals and families with incomes between 133 percent and 400 percent of the poverty level, or $14,404 to $43,320 for individuals and $29,326 to $88,200 for a family of four.

The subsidies will be on a sliding scale. For example, a family of four earning 150 percent of the poverty level, or $33,075 a year, will have to pay 4 percent of its income, or $1,323, on premiums. A family with income of 400 percent of the poverty level will have to pay 9.5 percent, or $8,379.

In addition, if your income is below 400 percent of the poverty level, your out-of-pocket health expenses will be limited.

Q: How will the legislation affect the kind of insurance I can buy? Will it make it easier for me to get coverage, even if I have health problems?

A: If you have a medical condition, the law will make it easier for you to get coverage; insurers will be barred from rejecting applicants based on health status once the exchanges are operating in 2014.

[yurbud]

18. how do they keep insurance companies from jacking up rates for profits and exec pay?

[1776Forever]

19. Thought this info was relevant to your question:

The Insurance Industry Goes to War on Health Care Regulations
By: David Dayen Wednesday March 31, 2010 1:26 pm

http://news.firedoglake.com/2010/03/31/the-insurance-industry-goes-to-war-on-health-care-regulations/

...That’s the new battleground. The National Association of Insurance Commissioners have the task of writing many of the regulations that will govern insurance companies, and according to Wendell Potter, at a recent NAIC meeting he saw 1,700 representatives of the insurance industry, balanced by just 29 consumer representatives. Never mind the state-level regulations governing the exchanges that will have to be written; if anything those officials are even more captured by industry.

I don’t think you needed to be Nostradamus to figure this out. The regulations are the soft spot where industry lobbyists know how to navigate much better than anyone looking out for consumers. Basing the entire reform on a regulatory regime inevitably exposed it to this kind of danger.

..........

Goliath maybe tricked by David though - if they push too much we the people can have a good case to go back to the table! Progressive Candidates need our full support from now on! That is all we have it seems.

[zalinda]

14. There is something else to watch out for

When I was on Medicaid the first time, everything was fine for about 2 1/2 years. Then I made a small amount over what I should have had, to be on Medicaid (I had a very small online business). They not only threw me off Medicaid, but charged me $5,000 for what I used in Medicaid for the year.

What exactly will happen to you if you accidentally go over your allowed income?

zalinda

[SocialistLez]

15. Yikes

I guess people will just have to turn down extra hours at work or work under the table or something.

That's pretty f-ed how they made you pay for the services you used.

[zalinda]

20. And that's just one of the problems with

subsidies. It also will force people to decide on whether they can afford to take a better paying job or paying more for health insurance. This is a no win situation for the working poor.

I remember when people would turn down promotions because it would put them in a higher tax bracket. Now, they may have to turn down promotions because they would lose their health insurance subsidy.

zalinda