The Tangled Web Politicians Weave

When three separate people send you an article, you read it.

That’s what happened to me; three readers of this blog evidently live in or around Florida, and independently emailed a link to this column from the Palm Beach Post.

Here are the pertinent sections:

 The challenge to the Obamacare law was aimed at declaring it unconstitutional. While that didn’t work, foes of the new law were given a small consolation prize by the U.S. Supreme Court — a chance for the states to opt out of the expansion of Medicaid under the new law.

Florida, like 23 other Republican-run states, hung onto that thread and waved it around like a victory flag.

“For all of those who are about fiscal sanity and protecting the taxpayers of our states, the court’s decision on the Medicaid issue was a big win,” Florida Attorney General Pam Bondi said two summers ago at an event sponsored by the Koch-brothers group, Americans for Prosperity.

It certainly wasn’t a “big win” for the estimated 750,000 Floridians who have incomes that fall below 138 percent of the federal poverty wage, which is about $26,000 for a family of three and $15,000 for an individual.

Not only did Florida refuse to accept an expansion of Medicaid that would have used federal dollars to cover health-care costs for these people, but the state did its best to make it as difficult as possible for the rest of Florida’s 3.8 million uninsured residents to purchase plans under the new health-care law.

Umm…Hoosiers, does this sound familiar?

The state refused to set up an insurance exchange, spent no money to encourage citizens without medical insurance to sign up for the plan, and banned federal workers from helping Floridians sign up for insurance at county health departments. Even so, Florida led the nation with sign-ups for Obamacare plans, accounting for nearly 1 million insured state residents……

The state is losing $66.1 billion in federal Medicaid funding over the next 10 years, costing hospitals in the state $22.6 billion in lost reimbursements, the Robert Wood Johnson Foundation reported.

No other state has turned its back on so much money, the foundation found. If Florida invested $5.3 million in Medicaid expansion from now until 2022, it would get back $13.41 in federal funds for every dollar it invested in its citizens’ health care, the report said.

“Every comprehensive state-level budget analysis of which we know found that expansion helps state budgets, because it generates state savings and additional revenues that exceed increased Medicaid costs,” the report said.

Not to mention helping people like Charlene Dill, 32, a working mother of three from Central Florida. Dill died earlier this year from a lingering heart condition.

She worked a variety of part-time jobs and was selling vacuum cleaners when she collapsed and died. Dill couldn’t afford health insurance, but she would have been covered under Medicaid if Florida had expanded it under the law. But unlucky for her, she lived in a state that put her on the losing side of a “big win.”

How do you calculate that cost?

I have watched Republican governors tie themselves into pretzel-shaped knots trying to explain their hysterical opposition to a program originally developed by conservative think tanks and promoted by GOP leaders like Bob Dole and Mitt Romney (pre-presidential campaign). I’ve been amazed by the governors’ willingness to forgo billions of  dollars for their states–not to mention their willingness to let uninsured citizens continue to die–in order to deny President Obama a “win.”

(As Americans have begun to use the program, and warmed to it, some of those Republican governors have begun back-tracking. Indiana’s Governor is a case in point–his version of Medicaid expansion isn’t as inclusive as the real thing, but it’s a start.)

Here’s the thing. I’m one of many people who don’t think the ACA is particularly good public policy, although it is demonstrably better than nothing. If these naysayers proposed a better approach, I think a lot of us would consider it. Instead, we’ve been treated to a particularly ugly expression of high dudgeon–how dare the government use tax dollars to provide medical care to these worthless “takers”? 

I know that everything these days is politics, but shouldn’t there be some games even politicians won’t play?


  1. I have been talking to my daughter-in-law Anne about this situation in Indiana; she and my son with their three sons are one of the many victims of the state health care system here. Scott’s small masonry company employment does not have health care coverage; Anne’s job through the Indianapolis Catholic Archdiocese only provides Anthem-Blue Cross/Blue Shield whose family plan is $450 per month with $9,600 annual deductable. She applied – attempted to apply – in October when ACA opened it’s enrollment; she was naturally immediately caught up in the Pence state health care system requirement. You must be denied by ALL providers in this system to qualify to apply for ACA. She checked back several times only to be told they had no application for her so she again applied in January. Then began the calls and on-line searches seeking her status; a call to the state system in February informed her that they would not be releasing status information to applicants till April or May. She contacted ACA directly and was told to apply for any coverage offered through this state system to begin some action. The state informed her they would not be accepting any more applications till AFTER March 31st – the ACA deadline to apply. Late June they finally contacted her to let her know she qualified for state health system coverage for $1,200 per month with a $12,000 deductable. They are part of that 15% uninsured adults in this state which is higher than the national 13%.

  2. As respect Health Care in America I was lucky enough to work for large Multi-National Corporations most of my work life. They offered a good Package of Health Care Benefits. Here in the USA the Companies had a staff of people to deal with Health Care, then you had the Insurance Companies that had their own staffs, plus the Health Insurance had to make a profit.

    I never really had much faith in Obama’s “Hope and Change. ” Obama came into office with the Senate, and House in Democratic hands. Obama could have proposed the Public Option for Health Care, but it was torpedoed. No debate on the Public Option was allowed.

    Obama’s Health Care Program was ridiculous to begin with. The Program should have been a Federal Program, the States should not have had any say in it’s implementation.

    Cornell West is totally correct in his assessment of Obama – “The thing is he posed as a progressive and turned out to be counterfeit. We ended up with a Wall Street presidency, a drone presidency, a national security presidency.” “Obama comes in, he’s got all this populist rhetoric which is wonderful, progressive populist rhetoric which we needed badly. What does he do, goes straight to the Robert Rubin crowd and here comes Larry Summers, here comes Tim Geithner, we can go on and on and on, and he allows them to run things.”

    The GOP including Pence has no plan at all for Health Care, except to sabotage the even the totally inadequate ACA.

  3. The rest of developed world has the answer to effective universal health care. That answer is unacceptable to Republicans here due to that universality. In a plutocracy health care is a privilege of wealth.

    ACA was an attempt at what we used to call statesmanship. Compromise. It is a big improvement over nothing, the position offered by the GOP, but it has lots of room for improvement.

    When the GOP gets back to America first, party second, I’m sure that fruitful discussion will find many ways to improve it.

  4. Universal health insurance will eventually be a reality in this country. This progress may have been slowed down somewhat by the Kock brothers, but it WILL happen. Our healthcare system is an expensive failure. Health insurance never should have been turned into a for profit industry. The cadillac coverage that employees of large employers have enjoyed has been a significant contributor to the skyrocketing profits of health insurers and healthcare providers. I recognized 15 years ago that our country would reach a tipping point where we could no longer afford to pay the high costs. We actually reached that tipping point several years ago and the reality of this just started showing in the past 2-3 years. The ACA is only the beginning of a complete overhaul of our broken system. I hope the momentum speeds up soon.

  5. I am not certain what “Cadillac coverage” is, but I probably have it. Instead of suggesting that my coverage is too good, perhaps we should start to think that everyone in the country should have excellent coverage. There are societal and economic benefits to a country of healthy people. That’s why the actions of these Govenors is counter-productive (except perhaps politically). Charlene Dill could have been there for her famly and continued to contribute to the economy.

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