As many of you know, there is federal Medicaid waiver that contributes about a billion dollars towards the state’s effort to cover the uninsured. It expires at the end of June; negotiations for another 3 year agreement are underway. With this much money at stake…there is a lot to talk about. Here’s a question for today…how will the outcome of Super Tuesday affect the feds level of continued support for Massachusetts’ (near) universal coverage law?
A few thoughts…
Senator Hillary Clinton is the only candidate still in the race whose health plan includes an individual mandate…and she draws on the MA plan more heavily than does Senator Obama. How might the feds take that into account if she becomes the frontrunner–will it help or hurt the waiver negotiations?
Senator Kennedy’s involvement was critical to the waiver negotiation last time. Does his endorsement of Senator Obama have any effect on the waiver this time?
Governor Romney’s administration negotiated the current waiver with strong support from the Bush administration. If he shows little chance of advancing beyond next Tuesday, would the Bush administration have less interest in making sure the MA plan succeeds?
How might the MA plan factor into a Republican Party health care platform, once one emerges, and how will that affect negotiations that are supposed to conclude in June?
How could any moderates and liberals backs war monger McCain. McCain wants to bomb Iran and stay in Iraq for 100 years and promised for more wars. McCain says he wants interest rates to be ZERO out of complete ignorance for how interest rates affect the economy. I’d like to see him say that to retirees on a fixed income. McCain want 10 million illegal immigrants to stay permanently and legal immigrants who can vote do not support it. How could this country be secure if he is in power??? Mitt Romney is an expert in economics and finance and is the man we need as president.
If anyone can rescue the economy at this point, it would have to be Mitt. The US is $53 trillion in debt, that is $400K per household. The dollar is becoming useless and the Euro is now becoming the credible currency. Along with the national debt, most citizens are also deeply in debt. Tommorow the market is likely going to take a dump. If we don’t have a good economy you can forget foreign policy, fighting wars, or healthcare, funding for top education. The economy needs to be front and center, not religion, steriotypes and other trivial things.
Mitt Romney’s successful business experience, successful Olympic experience, and successful state governing success
set him above all other candidates. His vision of using economic strength to combat terrorist and his Apollo plan for energy independence are also set him above all other candidates.
He is a real leader who can lead American to build a strong economic and therefore a strong nation!
Hope American people will elect Mitt Romney, the only competent candidate, to be our president.
Mitt Romney is a Social Darwinist opportunist who will say anything to get elected. He is certainly no friend to the common man. Senator Clinton’s support for an indivual mandate, and her connection to Jonathan Gruber, will have me voting for Obama, despite Deval Patrick’s endorsement.
Ron – Ditto for me.
While I’m here, let me tell you “thanks for the great reply you made to Mr McD at HCFA about the varying perspectives on the Mass. Mandate Plan/Chap 58 law”. You speak for more people than you’ll ever know, here in Mass. and across the nation, including Sen Obama.
I’ll copy your points below for those who might be intersted and add just a few more of my own here:
- While the law does some good things, in full measure it harms too many and wastes too much money to be supported and continued. We MUST change the law.
- It harms hundreds of thousands of people who are uninsured with its harsh punative mandate and financial penalties.
- It totally neglects the insured and underinsured in Mass. who are being crushed by high costs, and ignores the employers who need help with these costs, too
- It throws too much more of our hard-earned public money into the coffers of private insurance companies in the form of state subsidies for private coverage (a Romney-Bush triumph that our “Democratic” legislature overwhelmingly voted to enact).
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http://blog.hcfama.org/?p=1411#comments
Ron Norton Says:
January 31st, 2008 at 1:26 pm
John,
The problem with Chapter 58 is not that it isn’t perfect. The problem is that it is so glaringly imperfect. I know that you and many others see the law as an acceptable compromise. I, and many others, see it as a total capitulation to special interests. Chapter 58 does not truly reform the health care system; instead it expands and perpetuates the same costly and inefficient maze of private insurance that has led us into this sorry morass. The individual mandate is clearly government coercion! It makes us all either hostages of the insurance industry or criminal scofflaws. Where is the incentive to lower costs when products are compulsory? No incentive exists, since the burden can simply be shifted onto the hapless consumer. Please don’t talk to us about waivers and exemptions. The affordability guidelines that ignore the out of pocket costs associated with these plans are sheer fancy. Few have applied for exemptions from the mandate because the process is so intrusive and arbitrary. Many consider the game an exercise in futility. Besides, citizens in a democracy ought not to have to beg their government for mercy! The biggest problem with Chapter 58 is that it is an impediment to real progress. It has taken a large group of previously uninsured individuals and transformed them into a large group of underinsured individuals; folks who will delay care as long as they possibly can, and likely end up bankrupt in the event of serious illness. The state may be able to prop up this scheme in the near term, but within a few years we will be back where we started, or, more likely, worse off.
Currently in Massachusetts, those who opt to pay the penalty (which is likely to rise each year) actually subsidize the uninsured while remaining uninsured themselves.
The penalty money from residents failing to meet the mandate is siphoned through the DOR into the Commonwealth Care Trust Fund, as do any further penalty collections. It is then used to subsidize the cost of the low or non-payers and other Connector expenses.
This saves money that would have been needed from the state and federal governments, but is an indirect tax on those who can not afford the expense in the first place.
Citizens are unwitting cash-cows toward the goal of “budget neutrality” and reauthorization of the Section 1115 Demonstration waiver. They are also subject to all criminal penalties inherent in the jurisdiction of tax evasion if the are unable to pay.
This idea is fundamentally unfair and will not bring medical care to the many, but rather, it will progress to greater personal debt and lead to criminalization of those who cannot afford it.
So far, no presidential aspirant has shown the curiosity or guts to address this sorry truth. Does such a courageous soul exist?
There is something wrong with State lawmakers pass a health law and don’t know how many are uninsured.How do we let them get away with this?The entire law from start to finish is bad.Start with the MassHealth application that states you are signing over your property to the State;”if I am 55 or older the State may recover my asetts.”
If you do not qualify for subsidy you must buy into a high dedutable insurance plan and if you don’t you will be fined.Now that you are being fined that makes you a lawbreaker.So from start to finish you can’t win.Buy into bogus insurance or go to jail for nonpayment of taxes.Where does that leave us?The State has made being “uninsured”a crime!