Gov. Robert Bentley has announced that he will oppose the Medicaid expansion for Alabama under the Affordable Health Care Act. From the tenor of his announcement, it appears his position is based as much upon making a protest as on the merits.
As someone who has been involved for 27 years in the issues of access to medical care for our neediest citizens, with apologies to the great English statesman Edmund Burke, I respond to the governor: “I beseech you in the bowels of Christ to consider that you may be mistaken.”
First a few points about the Medicaid expansion:
Gov. Bentley, it seems like overkill for Alabama to forego these billions of dollars for the benefit of our neediest citizens just to register unhappiness about Obamacare. To borrow an expression from my dear departed mom: Would we be cutting off our nose to spite our face?
Please also consider the human costs of rejecting the Medicaid expansion. It is a tragedy that 350,000 Alabamians will be denied insurance coverage and health care. Please look at this as an investment in “human capital.”
A healthier workforce will produce more. Healthier children will fare better in school. The poor stepchildren of Alabama can walk through the door for health care.
As our highest-elected official and “doctor in chief,” we hope you will be guided not by ideology but by the well-being of your people. Will you please hear from all the stakeholders and be ready to hit the “reset button”?
(Hank Caddell graduated from Decatur High School, the University of Alabama and Harvard Law School. He practices law in Mobile and for almost three decades has worked to promote access to health care for that city’s low-income citizens.)
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Gov, Bentley signed the Grover Norquist pledge.. Backs the Tea Party .What did anybody expect him to do ?
Gov Bentley needs to look out for the citizens of Alabama rather than the tea party. He is going to hurt thousands of people in Alabama. And he wants to call himself Christian?
The Governor is going to need a new tax just to pay the legal bills to defend the anti health care amendment we just voted in. It, like our anti-immigration bill will be declared unconstitutional, but not before we've spent millions of dollars of tax payers' money.But it's the principal of the matter. We're a wealthy state and can affort to continue to waste money on reassuring the world that ignorance is alive and well in the Heart of Dixie State.
The DD in favor of expanding government programs. I am shocked.
If the medicaid medicare rolls were purged of the free loading illegals and entitlement riders there would be no need to expand it. It however needs to encompass the elderly which it was designed for and care for them , not thousands of lazy drug peddlers and welfare babies being spewed out daily by welfare recipients. He should look at it from the point of helping those who have (worked ) and paid in to it all their lives as part of their retirement safety net as it was designed. Not to feed house and clothe Illegals and thugs and drug dealers in public housing with debit cards driving new cars and buying loud stereos and 65 inch tvs and fancy fine clothes , while the working class can hardly afford food and electricity and gas to get to work or clothes to wear, pretty pathetic what Obama has done in the last 4 years and to think the Idiots in this country reelected him , God help us -- but above all Buuba likes he can cash more welfare checks to buy beer and cigs and and live in his free housing and sell drugs out of his new car
States are already struggling to pay their Medicaid bills. Why put taxpayers on the hook to pay even more?
Medicaid is the single biggest item in state budgets today. It consumes, on average, 23 percent of state dollars spent, pinching funds for other high-priority functions - such as education, transportation and emergency services.
Yet expanding Medicaid was a central tenet of the Patient Protection and Affordable Care Act. It required states to open their program to all individuals earning less than 138 percent of the federal poverty level. The goal was to reduce the number of uninsured - by dumping 17 million Americans onto the Medicaid rolls.
Such a huge expansion wouldn't come cheap, and cash-strapped states grumbled that they couldn't possibly afford it. So the architects of Obamacare decided to take a carrot-and-stick approach to get the states to play ball.
The carrot: We, the feds, will pick up 100 percent of your expansion costs for three years, and lesser percentages thereafter. The stick: If you don't expand your program, we'll cut off all your federal Medicaid funds.
The fact that the authors of Obamacare felt the need to threaten states with total defunding tells you that they knew many states would resist expanding their programs - even with 100 percent federal funding.
Why? For starters, many state officials are leery of federal promises to pay program costs in perpetuity.
Such skepticism is warranted. Washington has rung up a $16 trillion debt and is running more than $1 trillion in the red annually, even without any of the costs associated with the health-care law.
Where will it get the money to make good on this promise? And will future administrations honor this promise, no matter what? State officials also worry about how such a massive expansion of their Medicaid programs will affect the quality of care available to their poorest citizens.
States are already having difficulty finding enough physicians willing to accept Medicaid patients, largely because of the program's low reimbursement rates. Expanding patient rolls by a third will only exacerbate this problem.
Here too, Obamacare tries to hoodwink the states. The states are required to increase pay to Medicare levels for primary-care physicians. The federal government picks up the tab, but only temporarily.
In 2015, states will either have to find the money to replace the federal dollars or let primary-care payments drop back down again. And if a state decides to keep the primary-care doctor rates up, guess what? Without doubt a flood of non-primary-care doctors and other health care providers will argue - wait, what about us?
To persuade doctors to start accepting Medicaid patients or increase their already swollen caseloads, states will have to sweeten the pot considerably. Cha-ching! And states unable to sweeten the pot sufficiently will see wait lists get longer and longer, and the quality of care decline.
"If a deal sounds too good to be true, it probably is." That adage certainly applies to Obamacare's promise of "free" expansion of Medicaid for the states. Thankfully, the Supreme Court struck down the law's "stick," ruling that threatening to yank all federal funding to states that refused to expand their programs was unconstitutionally coercive.
Now, states don't have to walk the plank on Medicaid expansion. And they shouldn't.
Medicaid is a troubled program than can't be sustained in its current form, much less on the grander scale envisioned by Obamacare advocates. What's needed is not expansion, but reform - a complete makeover of the program that gives the working poor access to private health insurance like the vast majority of Americans enjoy today and restores Medicaid to a true safety net to meet the needs of the most vulnerable in society.
from Nina Owcharenko director of the Center for Health Policy Studies at The Heritage Foundation.
Given that Bentley got a hold of the States rainy day fund, Is like giving a fox the keys to a hen house.
Bentley got off on the wrong foot in his first day in office. Saying that if your not a Christian your not my Brother ,or Sister.
When is this so called wealthy State,Going to improve our Interstate roads.Driving back from Nashville Thanksgiving.Day with family,It was like day light to darkness.The roads wasn't smooth,Grass three feet high.Faded reflector paint marking the Highway.If this state is wealthy ? Its all staying in Montgomery. Drive to Nashville and see how long it takes them to build a new Highway. The Bridge on South Belt Line is taking 10 times as long as Hartselle is taking to build a New High School .Is this not a State Project ?
Wealthy State ? I question that !
Lee from Decatur, Your comments are well written probably from some one that is not near retirement age.
Or has never lost a job, and been turned down looking for one.There are people struggling ,But that don't matter if you haven't been in that situation.Obama Care don't go into affect till 2014. You would throw people in the gutter, make that 47 Million people that don't have health care.It has already helped people with existing illnesses, keeping college interest loans down. Unlike what the Republicans wanted to do this past summer, Raising them from 3.4 % to 6.8 %...Obama Won Get Used To IT.. Don't be like the do nothing congress we have had for the last 4 years. People are getting away from the Grover Norquist pledge in droves.. Except for the law makers in Montgomery .. Maybe just maybe,This Country can move forward in the next 4 years. For all of the Bubba's out there,And the Druggies there are Mothers, Fathers and Grand Parents that played by the rules, That need our help.There is always going to be people that will beat the system. Always has been always will be. But its a drop in the bucket compared to the Banks,Insurance Company's Drug Company's,Oil Company's,And Wall Street People that we bailed out.
just tell me where all the money is coming from to pay for all this????????????
The Nanny State does NOT need to be expanded even further. Geez, DecDelay, move to Europe if you want Socialism so bad.
Tammy,A improved economy will help, With more people back to work. and more Jobs.Its going to take raising taxes to do that. It always has and always will ... The Top 2 % need to pay their fair share...When Republicans raised taxes,In the past READ MY LIPS No NEW TAXES. ((( George H Bush )))..Junior raised taxes three times. Sorry Grover Norquist, Take a Hike.. You have held the Country back long enough.
Why and how can a Non- Government Person control our Congress ? If you will notice its only in the Republican Congress.
I wonder what is the top 2% fair share? They pay a higher % of total tax revenue than they earn as a % of total income in the country. They pay almost double the effective rate on their income than what is normally considered the middle class. So tell me how do you define "fair share"