How do you feel about the possibility of expanding Medicaid coverage?

[Lone_Star_Dem]

Medicaid works in a pinch, but it's not good coverage. Don't get me wrong it's better than nothing. If you can manage the paperwork to qualify it beats the hell out of dying from cancer or heart failure or whatever. The constant re-qualification paperwork can be a real barrier if your sick. But again it beats dying so I'm not saying it's not a viable option when your faced with those two choices.

The reason I'm asking is I just read that they're knocking around the idea of expanding the eligibility to people within 150 percent of the federal poverty level on Medicaid in the health care bill.

Do you think this is good? Does this, in conjunction with expanding Medicare to begin at 55 years-of-age, make up for the loss of the public option?

Cantwell wants to increase Medicaid eligibility to 300 percent of the poverty line, but I don't expect to see that actually happen. However, if it were to pass like that, would that be a fair trade off for the public option?

What are your thoughts?

[rwheeler31]

1. It is ok but I want details.

[Rosa Luxemburg]

2. increasing medicaid makes sense

for all people who can't afford health insurance. Single young people for instance aren't covered by medicaid. It would be a start.

[proud2BlibKansan]

3. It doesn't quite make up for the loss of the public option

but I like the idea of expanding Medicare and Medicaid. I am 56 and my DH is 60. We are worried about him being laid off and me possibly forced into early retirement. At least now we know we'll have health care.

I also think that this will strengthen Medicare. Anytime you make your pool larger it's a good thing.

[Lone_Star_Dem]

6. The larger pool is one of the things I was thinking about, too.

That's always a good thing and it would increase the health care providers who accept Medicaid. Which would reduce one of the negatives against it.

The Medicare expansion is in my opinion a great thing. I'd love to see it and I hope that no matter what happens with this bill it at least includes a Medicare expansion. Medicare works, and it works pretty darn well. All we need to do is clean it up a bit and get rid of the "doughnut hole" in it.

[kelly1mm]

25. You do know that the buy-in is unsubsidised at least till 2013 and so

medicare coverage will be about $800 per month per person right? Is it still such a good deal?

[Lone_Star_Dem]

27. If they do this are they really projecting it will be that high?

If so why?

[kelly1mm]

29. It is me that is projecting it that high but with some justification.

1) the buy in is supposed to be unsubsidized at least till 2013
2) the "cost" per beneficiary right now for each medicare participant to the government is about $650 per person per month (not including the 100-300 in fees to the participant)
3) while 55-64's are younger and thus should have less medical problems, the restriction to those without coverage for several years coupled with (maybe) a pre existing condition requirement bump the numbers back up.

The key is that it is unsubsidized at least till 2013. A link to that is on taklking points memo. I will go look for it.

[catrose]

4. I need numbers

Like, how much would it cost without the subsidy? I dread the constant requalification, but having it as an option would free us from constant worry over keeping a job so that my diabetic unemployed husband can be covered.

[Lone_Star_Dem]

13. This is very preliminary.

I'm just wondering how this is resonating with those here. I know I'm not a huge fan of Medicaid, but I've had personal experience with it and I know a friend who had cancer who did as well. As you said, the constant requalification makes it difficult if you're already in a situation where your life is out of your control. That needs to be revised in my opinion. The process shouldn't be any more difficult nor dehumanizing than getting any other form of health coverage.

[Blasphemer]

5. My only problem is the fact that the coverage is not good

If they improve Medicaid while expanding it, then that would be a good thing.

[mucifer]

7. every state is different. Here in IL it's not bad. I've been a pediatric nurse for the last 20 years

and I have noticed some things are much easier to get covered by public aid than private insurance. However, over the past few years I have seen less coverage happen. But, it's usually a matter of making phone calls to Springfield to get certain meds covered. It's not as bad as insurance companies.

My patients have life limiting diseases and many of them were insured at one time. Most here in IL end up on public aid by final years or months because they lose their insurance and pretty much all kids in IL have the option of public aid if they are uninsured.

Another issue is that some doctors refuse to take patients with public aid.

[Lone_Star_Dem]

14. You bring up a great point

If this were to pass like this would we see a raising of the federal standard in Medicaid coverage? If not it won't work very well in states like Texas where the coverage is difficult to obtain and the qualification process is designed to be inhibiting.

Thank you for reminding me of that.

[HiFructosePronSyrup]

8. Honestly? I haven't the foggiest.

I'm not going to put any eggs in any basket.

I'll see what passes then think about it.

[Lone_Star_Dem]

17. No eggs here either. I'm just knocking things around

I don't know how I feel about this. I work with a lot of lower income/middle income people. I'm not sure how they'll embrace something like this if it were to come to fruition. For a lot of people the idea of being forced to take Medicaid is dehumanizing. I think that's something we'd have to work on.

[timeforpeace]

9. Whatev. You could call mandatory whippings at dawn "Healthcare Reform" and we would be for it.

[glinda]

10. I thought Medicare buy in would have to be at %150 of poverty level or am I wrong? I am pissed.

If a person is poor and does not have to pay much fine. But we are lower middle class, supposedly (hahahahahaha) , and are drowning in debt from trying to keep afloat. My insurance rates are drawn out of my husband's retirement which no longer covers the amount. I will be sooooo f@#^$%$%& pissed if we cannot get a break seriously. Things just keep getting worse for us financially. I want to worry about everyone getting something but I am afraid that I will be left in debtor's prison and trapped to attempt to pay the high amount that covers little as is. I really should drop paying BCBS at this point and if I get sick or die so be it. At least I could start to pay off the CCards that have enabled us to stay in our very not fancy home.
I think if you make 30 thou or less and they expect you to pay a 100 a month they are just sucking the bottle of the barrel dry.

[Lone_Star_Dem]

16. Nothing is in stone at this point

As to the Medicare buy in, it's looking a bit more positive, but nothing has actually passed so all that could change at the drop of a hat.

Would a reasonable Medicare expansion sweeten the deal for you? I'm not passing judgement, I know all our situations are different and as individual as we are.

[glinda]

28. Don't know what you mean by responsible. I think if they opened up Medicare

to everyone 55 to 65, no matter what their income level, I would be weeping with joy. Or at least for people making 100 thou a year or less. We are far less than that threshold. Middling but are tapped by every one for everything to the point that we cannot make it anymore.

[Mojambo]

11. It's not happening.

The rate is unchanged.

[Warpy]

12. Medicaid was originally supposed to be for the working poor

but eligibility was tied to fixed dollar amounts in the 1960s and those dollar amounts were never adjusted to reflect inflation.

That means the last resort insurance for poor workers became something only for the destitute, mostly old folks in nursing homes who had spent everything they'd worked for and very poor people on welfare.

They need to tie it to a percentage of median wage, not to any dollar amount.

[Lone_Star_Dem]

20. The fact that there's a social stigma attached to it now may be a slight hurdle

As you said it's become something only the destitute were eligible for. The coverage in my state reflects that stigma. Unless it's a rural physician or a physician working at a learning hospital, you're not very likely to get a decent provider. There are some, but they're not the majority. However, more people being on the program would actually be a positive influence, and may help correct this shortcoming in the program.

I agree with your observation regarding the percentage of the median wage. Any other way would simply not work.

[tabatha]

15. Is it not closer to single payer than the public option?

Or maybe I don't know what I am talking about.

[Lone_Star_Dem]

I was wondering the same thing

With some revisions to the programs this may work?

[mucifer]

18. I like public aid the way it is in Illinois. For our state it would be good. I think.

Other states, I'm not so sure. It also depends how many people they will allow to buy into it.

[timeforpeace]

19. Feel? Naive, mostly. More bait and switch and we fall for it every time.

[dflprincess]

21. For a single person, 150% of the poverty level is around $16,500

(assuming childless, single people will be eligible). I think the income level shoule be at least 3x the FPL, probably more.

As far as buying into Medicare - let me know what it costs and what it covers, then we'll know if it's a good idea.

Maybe the Democrats want to be the minority party again. Then they can go back to making empty promises about how things would change if they just had the majority - rather than having people expect them to deliver.

[Lone_Star_Dem]

23. I hear you

There's a lot we don't know and won't know until it's all finalized. I'm not saying this is even going to happen, I'm just wondering what it would mean if it did.

I'm not a huge fan of Medicaid as it sits now in my state. It's cumbersome to apply and qualifying is a nightmare. Then there's the issue of finding a provider. I've heard of situations where married couples filed legal separations just so they didn't have to make the choice of dying of lack of medical care or paying the mortgage and keeping the house.

The possibility of the Medicare expansion does have potential though.

I'm just wondering what others have to say regarding the concept. DU is a great place to help work through something like this when I'm not sure what my feelings are.

[Schema Thing]

22. I think it's a good thing

in some ways better than other weak public option schemes.


It seems like a good starting point to push for more. If it works, and lowers the cost of Medicare, then that should be strong incentive to open it up even further.


Anyone know about the program in Maria Cantwell's (WA ?)state that they are talking about including?

[w4rma]

24. It's crap. Medicaid used to be for 55 and up until Congress raised the age. BAD. (nt)

[juno jones]

26. Well, I'm 47 now. Only 8 more years til medicare sounds good to me.

In the meantime, I'll probably just stop trying to work so hard, try to find smaller, cheaper digs and go further into poverty level so I can get medicaid. At my income level, I would probably be worse off having to purchase insurance than I would simply becoming a couple of grand a year poorer and getting it provided.

I don't know whether to laugh or cry when these bastards start talking as if 10% of my 14,000 a year income is a reasonable amount to pay. And that's before co-pays, deductables and out of pocket. Shit, the 2.5% fine is probably easier than coming up with money to line the wallets of the insurance monsters.