Why not let people buy into Medicaid?

[Yavin4]

For people whose incomes disqualifies them for Medicaid, why not just let them buy into Medicaid at a lower premium?

[KittyWampus]

1. I think you mean Medicare. Medicaid is intentionally designed for poor.

[Yavin4]

5. Yes. I'm saying expand it to people who don't qualify because of income, and

cannot afford private insurance. Let them buy into it. Wouldn't that make Medicaid stronger?

[Blue_true]

21. The ACA is designed to cover people that make too much

to qualify for Medicaid, but can't afford the premiums for a good health insurance policy. The issue is that our side has done a lousy job of educating people so that they see the benefits the ACA gives them.

[still_one]

2. They are on Medicaid in the first place because they don't have the means. Not to be sarcastic, but

that is like the supposed saying attributed to Marie Antoinette, "if they don't have bread to eat, then let them eat cake"

[Yavin4]

7. Okay. What I am saying is this....

if you're at a certain income level, you qualify for Medicaid, right. For those folks NOT at that level and cannot afford private insurance, why not allow them to get Medicaid but charge them a low premium?

[still_one]

8. Most of the Trump states were against expanded Medicaid, even though their respective states would

have benefited from Federal reimbursement.

The ACA currently contains many provisions to help the poor and lower-income Americans. Expanded Medicaid and for those who don't qualify for expanded Medicaid, but make less than a certain amount, subsidies to lower their premiums, deductibles, and out-of-pocket costs on the individual market.

They are not going to go for what you are proposing. Actually they are trying to destroy Medicaid along with the ACA, and finance tax breaks for the wealthy on the backs of the poor and less fortunate.

That is NOT hyperbole.

If they really wanted to help people they would do Medicare for all, and for those who couldn't afford Medicare, they would qualify for Medicaid

Unfortunately, none of that will happen

[napi21]

3. Because the Pubs would never vote against that GREAT CORP. PROFIT CENTER!

Hell, THEY want to privatize Medicare!

[Cary]

4. Great question.

I can only infer Republican thinking because that, "Republican thinking," is an oxymoron.

They have a mishmash of ideologies that are based on hatred of groups whom they rotate for maximum effect. Underlying that hatred is some kind of cockamamie notion that these groups somehow benefit disproportionately from social programs. I actually know people who are as dependent on these programs as one can be, and who have no problem scamming the system, yet they will oppose these very programs and talk about "those people" who abuse them.

It makes no sense at all.

[Orsino]

6. Yep. Medicare, too. n/t

[TexasBushwhacker]

17. Indeed. Let people 50 and over buy into Medicare

It would bring younger healthier adults into the program. It would also allow older people to work part time or retire before 65 if they wanted. There are plenty of over 50s who might want to wind down if health insurance was affordable. Considering that technology is going to be eliminating millions of jobs, we need people to retire earlier, not later.

[Blue_true]

23. Technology likely will eliminate 90% of jobs.

You are not going to stop that train by having people retire in their fifties. The only solution is a guaranteed minimum income that includes things like health, dental and vision coverage along with housing assurance, food assurance and access to transportation.

[TexasBushwhacker]

24. Oh, I'm for GBI too

I'm just talking about something that could be done now.

[WePurrsevere]

9. Although a 'dream' ATM, it's not a bad idea IMO. I'd actually prefer to see either...

Medicare expanded and include more or Medicaid expanded to all... perhaps a sliding scale fee 0$ to XXX$ for rich... Which sounds like what you're saying?

Medicare is pretty good but it doesn't cover most dental or glasses which IMO are very important to a person's health. Medicaid (at least here in NY) covers those things.

[Demsrule86]

10. There is not going to be any medicaid...and the Tyrantcare

actually is made to defund Medicare.

[stopbush]

11. For one thing, while Medicaid is free while you are on it, the State can ask

you to repay the expenses that you incurred if you leave an inheritance.

It would be easier to have a low-cost option for Medicare.

The problem is that at present, 100% of the working public pays Medicare taxes to support the 19% of the population that is on Medicare. And that's with the average Medicare patient paying around $120 a month in premiums. Taxes and/or premiums would have to go up to cover more than 19% of the population. Medicare-for-all would entail significant increases in taxes/premiums to cover 100% of the population. Would those increases be less than what people now pay in premiums? That's the idea. Most studies say yes, but if the savings aren't significant, the trade off is a hard sell.

[Yavin4]

12. Here's how I imagine it working.

First, everyone, automatically gets added to Medicaid. We fund it by raising the payroll tax and levying a national sales tax on non-essential goods/services (in particular cigarettes and alcohol).

For those folks that to retain their private insurance, they would get a slight refund on their taxes.

[stopbush]

13. The question is: how much is the increase in the payroll tax?

If 100% of the current tax covers only 19% of the population, it stands to reason that the payroll tax would need to increase 500-600% to cover 100% of the population. IIRC, that amounts to a payroll tax of 18%. Plus, you'd still have to pay a premium for Medicare on top of that.

You'd be looking at around 21% of your income paying for universal healthcare. Hey, that's what it costs. Let's not soft sell it.

[Yavin4]

14. It would not be soley a payroll tax. Like I said, it would be a combination of

a national sales tax on non-essential goods/services (with exclusions for food, housing, education, home energy, and healthcare), and payroll taxes. Revenue from the sales tax should offset skyrocketing payroll taxes, no?

Everyone pays in. Everyone gets covered.

[stopbush]

16. The problem with national taxes like a sales tax

is that they are by definition regressive.

Say you want to tax cigarettes. Most smokers are poor people these days. If you want to limit the tax to luxury items like expensive cigars, you will generate very little in tax revenue. And who gets to decide what items get taxed?

At least a payroll tax is calculated as a % of your earnings, which is much more fair than a user tax.

[Yavin4]

19. The national sales tax would be on non-essential items

It would not be on those items that the poor need to survive, food, clothing, shelter, healthcare, education, etc.

As for cigarettes and alcohol, consumption of these goods contribute a great deal to our healthcare problems. As such, we should tax them.

[stopbush]

20. So, sin taxes, depending on who decides what is a sin.

Last edited Tue Mar 14, 2017, 06:07 PM - Edit history (1)

Yeah, your idea just won't work. Start taxing beer and wine at higher levels and - again - you impact people at the bottom end of the spectrum disproportionately. Do you really think people are going to avoid beer and wine because it has a tax on it? Why should people who drink occasionally and who don't abuse it have to pay the same tax on the same item as a billionaire? So, a couple of scolds get to sit around and tell people it's their own fault for paying a tax on products they shouldn't be using in the first place?

With a sin tax, the only people who can enjoy the occasional beer are - again - the wealthy, who don't care about use taxes.

Obamacare had it right with a surcharge on the wealthy. That raised billions to pay for insurance for the less fortunate. Payroll, income and luxury taxes are progressive. Use taxes in general are regressive.

[Yavin4]

27. Not "sin"

First, everyone gets healthcare and everyone has to pay for it. Small sales taxes on non-essential goods brings in the revenue that you need for the program.

Second, a slightly higher sales tax on cigarettes and alcohol not only discourages consumption but improves the health of the public. We can throw foods high in sugars as well.

[stopbush]

29. Raising taxes on things like alcohol doesn't accomplish anything

outside of raising taxes. It does not curb consumption enough to be of a benefit. For that to happen, such taxes would have to curb consumption enough that taxing the item no longer made sense, because the curbing effect had so curbed usage that the item no longer generated significant tax receipts.

The fact that people claim such taxes curb consumption while at the same time believe usage won't be curbed enough to make a tax ineffective as a significant revenue generator just proves it's bullshit.

[beaglelover]

30. Agree 100%. Sin taxes do not work. We will need a VAT type tax to pay for universal

healthcare, like other nations have.

[Yavin4]

31. I advocated for a VAT tax with a slightly higher tax on cigarettes and alcohol. n/t

[Blue_true]

25. Taxes.

With fewer people chosing to smoke and a good share of the population that don't drink or drink little, relying on sin taxes to cover Medical insurance coverage is a dicey proposition. Also, payroll taxes would have to be raised by a very large amount to cover health insurance for everyone.

One of the issues with the USA is that we have never faced wars that leveled most of the country, the Revolutionary War, the War if 1812 and the Civil War were basically regional conflicts that inflicted large physical damage on a relatively small part of the nation. European nations had their country leveled repeatedly, as a consequence their citizens embraced social democracy as a way to get back on their feet.

[LeftInTX]

15. Pence had an expanded Medicaid with a fee scale

https://www.theatlantic.com/business/archive/2016/12/medicaid-and-mike-pence/511262/

Premiums were $27-55/month. For those between 100 percent and 138 percent of the federal poverty level.
I don't know enough about Medicaid to know if any co-pays are involved.

What Pence and some other Rs liked about it was it encouraged "fiscal responsibility". Whatever.......

I think this is a fairly small price to pay versus than nothing at all.

[RussBLib]

18. I'd like to start hearing this refrain from the Democrats

and pound it

[standingtall]

22. Well there is the medicaid works program

For working people who are disabled whose incomes would disqualify them that are allowed to buy into medicaid. However that program is kind of a joke. Very hard to obtain eligibility for it. You have to go before a state board for them to declare you disabled.

Technically your allowed to make some around 60 or 70 grand per year and stay on the program,but not really because if someone starts earning that much money it is almost certain state boards would claim they are no longer disabled ripping their benefits away.

[procon]

26. That's what Obamacare's Medicaid Expansion already does.

People with incomes of 100% and 400% of the federal poverty level are eligible, and it worked. States that expanded their Medicaid programs have seen sharp decreases in their uninsured rates.

[choie]

28. In New York State

we have a program called the Medicaid Spendown program in which, say, if you're $500 over the Medicaid income limit, you can either show that you have monthly medical expenses that equal $500/month (like a deductible) or you can pay Medicaid the $500/month (like a premium). The only problem is that the program is only for people who are 65 and older, disabled or blind.

[Exilednight]

32. The insurance companies would never allow the Republicans, and some Dems, vote yes.

Insurance companies are scared it would be so popular that they'd go out of business.

They've been trying for decades to end Medicare for seniors because of all the money they're losing to those over 65.