JimofPennsylvan
Platinum Member
- Jun 6, 2007
- 909
- 622
- 910
The House Republicans Reconciliation bill is overall a bad bill and it will be an extremely bad development for America if it is enacted into law.! There is too many provisions in the bill that are just plain bad! On the Supplemental Nutritional Assistance Program - SNAP, the Food Stamps Program, the bill requires that beginning in FY 2028 the states begin to pay five percent of the cost of the benefits (Section 10006). The States are already struggling to pay their share of the Medicaid program, this will be an onerous financial burden on the states. The bill also reduces the Federal Government's share of the cost to administer the SNAP program from fifty to twenty-five percent of the total cost (Sec. 10007); this will result in poorer states not able to afford to establish a strong and reliable administration system for the program which will lead to ineligible people getting the benefit and likely under Republican administrations who tend to be strict in enforcing administration rules for social programs the Federal Government not accepting large numbers of enrollees in these weak administration states and eligible people in those states not getting this important benefit!
The bill goes after a very serious problem in the Medicaid program in the wrong way; today America has this problem where it has the same person enrolled in more than one state, often because the enrollee moved to a different state, and reports are that this double counting is costing the Federal Government about a billion dollars a year. The way this bill tries to fix this problem is that it will put a burden on the states beginning in 2029 where every month they will have to verify the eligibility of each person in the program in their state and provide information that the Secretary of HHS at the Secretary's discretion will require. (Sec. 44103) The thinking is that the State will then pick-up on instances where an enrollee moved out of the state and is no longer eligible. This seems to be an extremely burdensome unwise system, lets use our thinking caps America is the most advanced country in the world we have combat planes that can fly at twice the speed of sound, we have imaging technology that can identify cancer in the human body so for the Medicaid program which cost a huge sum of approximately $600 billion dollars a year America should have a national database for all the Medicaid enrollees across the fifty states. Which would allow a system to be established so that for a state to get a person in their state enrolled in the Medicaid program where the Federal Government would pay its portion of coverage for that person that person would have to be entered into the Federal Database and the Federal Database would reject a person being entered into the system if they were enrolled in the database from another state, that person seeking to be enrolled in the state where they moved to would have to contact their prior state and get disenrolled from that prior state; this seems to be an easy system to implement once the database was built which shouldn't be a problem for the strongest country in the world and it would fully solve the problem!
The bill for Medicaid and the CHIP (Children Health Insurance Program) does away with the option for enrollees to just make the representation that and their children are citizens to establish citizenship eligibility for these programs (Sec. 44110(b)(1)(A). That is a legitimate policy change for adults in the Medicaid program but it seems to be bad policy for children seeking health insurance coverage through CHIP it will be a hurdle many families fail to get over; good public policy seems to be that we want children to have good health care to facilitate healthy growth and educational development the government shouldn't be making obstacles to poor women with children getting their kids health care which this new policy will seem to perpetuate, remember many poor women in America struggle with finding basic shelter and food for themselves and their children this hurdle on healthcare eligibility will just turn into an obstruction for healthcare for these children. The old rules should be left in place for CHIP enrollees and the new rules should only apply to Medicaid enrollees. House Republicans are really out of line on this one point where in their bill for states that add illegal immigrants through their Medicaid Rolls even though the Federal Government is not paying one red cent for coverage of these illegal immigrants the bill cuts the Federal Governments share of the cost for a large section of that state's Medicaid enrollees specifically the additional Medicaid enrollees from the Affordable Care Act the cut is from ninety percent to "eighty" percent (Sec. 44111). Remember what the ACA did is that it expanded Medicaid coverage, it allowed people whose income was up to one hundred and thirty-three percent of the poverty level to be added to the respective state's Medicaid rolls for those states that wanted to participate. This punitive ten percent cut is bad policy it violates Federalism this is not the Federal governments business the states are picking up the entire tab here they should be allowed to do as they wish - it is a state issue. The Republican House members are unduly mixing partisan ideology (they want to deport all illegal immigrants) with healthcare policy where it doesn't belong. Further it underscores how the Republican Party's whole view on the illegal immigration is impractical, they don't offer solving the problem for America, because America is never going to deport all the twenty plus million illegal immigrants in the country because there is just not and never will be enough resources to accomplish that task! The only viable solution is to stop the incoming illegal immigration problem and then do comprehensive immigration reform that legalizes most people in this status so that the numbers are reduced to a level where the government can handle identifying and deporting people that have no legal right to be in America! So it makes no sense for the Federal Government to fight the states providing health care coverage for many illegal immigrants who one day will be legalized by Congress through a comprehensive immigration reform law and many of whom have been in America for decades!
The bill bans the Medicaid and CHIP programs from covering gender transition procedures (Section 44125). I totally think this amendment is good public policy for the CHIP program because children should not be having surgeries or procedures which are irreversible which destroy their birth sex anatomy one should be an adult to make such life altering decisions . For this ban in the Medicaid program I think the House Republican are bringing undue problems on themselves and I think this ban should be and will be found to be unconstitutional! I think the Supreme Court will find that people have a substantive due process right to change their sex if they wish to, it is a liberty right and stems from the right of privacy; I think that the Supreme Court will find that people being able to conform their physical body to their emotional and psychological make-up from a gender standpoint has a critical bearing on that person's psychological health so it is a serious matter and this law change is unlawful gender discrimination people have aright to conform their bodies from a gender standpoint to who they are internally, Medicaid doesn't deny coverage for basic breast reconstruction treatment for women that have had a complete mastectomy do they?
The bill in part "prudently" addresses the scheme where states tax health care providers then use the revenue to get matching funds from the federal government to increase claim rates to the health care providers by "capping" those claim rates to what Medicare pays (Section 44133). The bill unfairly puts a moratorium on new or increased provider taxes; that is unfair to those states that don't pull this scheme or to a small degree pull the scheme because they should be allowed if need be to tax the way other state's tax (44132). Fixing this scheme is probably politically too difficult today to accomplish because members of Congress from abusing states because of politics will protect their state. The real solution is to outright ban such taxes an idea Senator Lisa Murkowski has mentioned; and probably the whole policy approach of paying health care providers a higher rate should be based on a good public policy rationale like on how many Medicaid enrollees that provider is servicing! The bill stops the five percent increased percentage paid by the Federal government for two years for states whose purpose is to entice state's to expand their Medicaid program to their citizens earning up to 133 % of the poverty rate. This provision change isn't a major issue but the Republicans are wrong on this overall issue the Federal government's duty is to facilitate all responsible citizens getting healthcare and the Medicaid system is less expensive than the individual insurance exchanges with their Federal government subsidy for covering all Americans; for those ten states that haven't expanded Medicaid as the ACA law sought per KFF forty percent of their citizens that fall into the gap where they can get no health insurance through a government program are working they are good responsible citizens it is just the hours they can find to work provide an income below the Federal Poverty Level so there is no program for them. Some of these recalcitrant states like Florida and Texas are wealthy states and they boast about their low taxes they should boast about fixing their current deprivation of character and raise their taxes modestly so they can do what is right by these good citizens and provide health insurance for them! This is bad politics for Republicans and they are facing a judgment day here because I can see Democrats when they fully get into power in Washington getting tough with these recalcitrant states by going through the whole federal law and remove any financial help the system gives to these non-Medicaid expansion states you recalcitrant states want to save money by not expanding Medicaid fine you are free to do that and the Federal government is free to stop programs that pay your healthcare providers extra monies that Medicaid expansion states don't get!
The Republicans have a good idea in the 80 hour a month work requirement for Medicaid enrollees or what they call in the bill the community engagement requirement because the country has to stop the freeloading going on in social programs because the country cannot afford it and as a country we are heading down a path where we are losing our greatness partly because too many of our people are not responsible citizens and so we have to try to reverse it(Sec.44141). The big error that I believe the Republicans are making in the bill is to allow states to have multiple verification occasions on enrollees, the bill should require and limit this verification requirement to once every six months where if the person can establish they met the eighty hour per month requirement for two of the three prior months they pass on verification. The Republicans with the current plan are going to be causing themselves a very serious self-inflicted political wound if they allow more frequent verification requirements these verification occasions will rightly be perceived as very burdensome and so these enrollee voters who are subject to these multiple verifications will be very angry as well as the many voter who have a vested interests in these people staying on Medicaid and so Republicans will pay a price come election time.
The House Republicans with this bill are dishonest to the American people they claimed with their reconciliation bill they are not reducing benefits to people on Medicaid but their bill gives the states the power to institute up to a $35 co-pay per medical service received for those Medicaid enrollees made Medicaid eligible with the ACA law, this co-pay applies to enrollees whose income is above the poverty level up to 133% of the poverty level (SEC. 44142). This policy will block many of these poor Americans on Medicaid from getting needed medical services. The Republicans overall view on the Medicaid program is all wrong they should not be trying to deny that health care program to needy individuals, they should be trying to create more good middle class jobs in America so more Americans will have the income to get off of Medicaid and onto a private health insurer plan and to that end they should come out against the diabolically evil globalization economic model America has embraced for the past fifty years and permanently protect at least sixty percent of domestic manufacturing industries where the price point of the products in the industry will support middle class manufacturing jobs. What the Republicans are planning to do in their bill related to the Affordable Care Act is largely very bad (Part Two). The Republicans want to monkey around with the income verification system for advanced credits for individual insurance purchased on the state exchanges, they are using a chain saw on a problem that requires a scalpel. Republicans need to remember that there is a mechanism in the system to protect the Federal government from getting cheated it is the fact that when a person files their federal taxes they have to reconcile their income with the advanced tax credit they got for health insurance and if they got too much credits they have to pay back the amount. Republicans need to keep in mind if they get more demanding on the income verification front they are really creating a great hardship on those seniors that have retired and are living off their savings and 401k accounts because you cannot prove your income at the beginning of the year when the exchanges ask you to because you haven't withdrawn the money from you brokerage accounts yet you want to wait to let your investments grow and when you're a senior health insurance is super important to you because you have health issues. That being said Republicans are on solidly good ground with this policy initiative in their bill, this is a slight modification; Federal law should ban advanced tax credits for taxpayers who have not filed their taxes for the past year and have not filed an extension or have filed their taxes for the past year but did not on those tax forms reconcile their income with the tax credits they received or they did not file their taxes last year but filed an extension but have not filed their federal taxes from two years ago. Further, the Republicans in their bill seem to be trying to stop people who do not have an income over the poverty level from getting individual insurance on the exchange which is a great goal; I would just caution try to refrain from doing something that would hurt retired seniors living off their savings and their 401K so make the assumption that if the prior year's tax form for an applicant indicates their income was above the federal poverty level accept the applicants attestation that their income for the current year is above the poverty level for eligibility. The Republicans are making a mistake with their prohibition of transgender treatments as an essential benefit for individual insurance for the same reasons mentioned by this writer it was wrong to make this ban in Medicaid. The Republicans are wrong with their efforts to impair DACA people from getting individual on the exchanges that is cruel, unfair and not what the American people want. Lastly, the Republicans are way out of line in their bill to stop cost sharing payments for health plans that cover abortions you all with your policy are going to hurt a lot of innocent poor Americans that are not in any way involved in getting an abortion!
The bill goes after a very serious problem in the Medicaid program in the wrong way; today America has this problem where it has the same person enrolled in more than one state, often because the enrollee moved to a different state, and reports are that this double counting is costing the Federal Government about a billion dollars a year. The way this bill tries to fix this problem is that it will put a burden on the states beginning in 2029 where every month they will have to verify the eligibility of each person in the program in their state and provide information that the Secretary of HHS at the Secretary's discretion will require. (Sec. 44103) The thinking is that the State will then pick-up on instances where an enrollee moved out of the state and is no longer eligible. This seems to be an extremely burdensome unwise system, lets use our thinking caps America is the most advanced country in the world we have combat planes that can fly at twice the speed of sound, we have imaging technology that can identify cancer in the human body so for the Medicaid program which cost a huge sum of approximately $600 billion dollars a year America should have a national database for all the Medicaid enrollees across the fifty states. Which would allow a system to be established so that for a state to get a person in their state enrolled in the Medicaid program where the Federal Government would pay its portion of coverage for that person that person would have to be entered into the Federal Database and the Federal Database would reject a person being entered into the system if they were enrolled in the database from another state, that person seeking to be enrolled in the state where they moved to would have to contact their prior state and get disenrolled from that prior state; this seems to be an easy system to implement once the database was built which shouldn't be a problem for the strongest country in the world and it would fully solve the problem!
The bill for Medicaid and the CHIP (Children Health Insurance Program) does away with the option for enrollees to just make the representation that and their children are citizens to establish citizenship eligibility for these programs (Sec. 44110(b)(1)(A). That is a legitimate policy change for adults in the Medicaid program but it seems to be bad policy for children seeking health insurance coverage through CHIP it will be a hurdle many families fail to get over; good public policy seems to be that we want children to have good health care to facilitate healthy growth and educational development the government shouldn't be making obstacles to poor women with children getting their kids health care which this new policy will seem to perpetuate, remember many poor women in America struggle with finding basic shelter and food for themselves and their children this hurdle on healthcare eligibility will just turn into an obstruction for healthcare for these children. The old rules should be left in place for CHIP enrollees and the new rules should only apply to Medicaid enrollees. House Republicans are really out of line on this one point where in their bill for states that add illegal immigrants through their Medicaid Rolls even though the Federal Government is not paying one red cent for coverage of these illegal immigrants the bill cuts the Federal Governments share of the cost for a large section of that state's Medicaid enrollees specifically the additional Medicaid enrollees from the Affordable Care Act the cut is from ninety percent to "eighty" percent (Sec. 44111). Remember what the ACA did is that it expanded Medicaid coverage, it allowed people whose income was up to one hundred and thirty-three percent of the poverty level to be added to the respective state's Medicaid rolls for those states that wanted to participate. This punitive ten percent cut is bad policy it violates Federalism this is not the Federal governments business the states are picking up the entire tab here they should be allowed to do as they wish - it is a state issue. The Republican House members are unduly mixing partisan ideology (they want to deport all illegal immigrants) with healthcare policy where it doesn't belong. Further it underscores how the Republican Party's whole view on the illegal immigration is impractical, they don't offer solving the problem for America, because America is never going to deport all the twenty plus million illegal immigrants in the country because there is just not and never will be enough resources to accomplish that task! The only viable solution is to stop the incoming illegal immigration problem and then do comprehensive immigration reform that legalizes most people in this status so that the numbers are reduced to a level where the government can handle identifying and deporting people that have no legal right to be in America! So it makes no sense for the Federal Government to fight the states providing health care coverage for many illegal immigrants who one day will be legalized by Congress through a comprehensive immigration reform law and many of whom have been in America for decades!
The bill bans the Medicaid and CHIP programs from covering gender transition procedures (Section 44125). I totally think this amendment is good public policy for the CHIP program because children should not be having surgeries or procedures which are irreversible which destroy their birth sex anatomy one should be an adult to make such life altering decisions . For this ban in the Medicaid program I think the House Republican are bringing undue problems on themselves and I think this ban should be and will be found to be unconstitutional! I think the Supreme Court will find that people have a substantive due process right to change their sex if they wish to, it is a liberty right and stems from the right of privacy; I think that the Supreme Court will find that people being able to conform their physical body to their emotional and psychological make-up from a gender standpoint has a critical bearing on that person's psychological health so it is a serious matter and this law change is unlawful gender discrimination people have aright to conform their bodies from a gender standpoint to who they are internally, Medicaid doesn't deny coverage for basic breast reconstruction treatment for women that have had a complete mastectomy do they?
The bill in part "prudently" addresses the scheme where states tax health care providers then use the revenue to get matching funds from the federal government to increase claim rates to the health care providers by "capping" those claim rates to what Medicare pays (Section 44133). The bill unfairly puts a moratorium on new or increased provider taxes; that is unfair to those states that don't pull this scheme or to a small degree pull the scheme because they should be allowed if need be to tax the way other state's tax (44132). Fixing this scheme is probably politically too difficult today to accomplish because members of Congress from abusing states because of politics will protect their state. The real solution is to outright ban such taxes an idea Senator Lisa Murkowski has mentioned; and probably the whole policy approach of paying health care providers a higher rate should be based on a good public policy rationale like on how many Medicaid enrollees that provider is servicing! The bill stops the five percent increased percentage paid by the Federal government for two years for states whose purpose is to entice state's to expand their Medicaid program to their citizens earning up to 133 % of the poverty rate. This provision change isn't a major issue but the Republicans are wrong on this overall issue the Federal government's duty is to facilitate all responsible citizens getting healthcare and the Medicaid system is less expensive than the individual insurance exchanges with their Federal government subsidy for covering all Americans; for those ten states that haven't expanded Medicaid as the ACA law sought per KFF forty percent of their citizens that fall into the gap where they can get no health insurance through a government program are working they are good responsible citizens it is just the hours they can find to work provide an income below the Federal Poverty Level so there is no program for them. Some of these recalcitrant states like Florida and Texas are wealthy states and they boast about their low taxes they should boast about fixing their current deprivation of character and raise their taxes modestly so they can do what is right by these good citizens and provide health insurance for them! This is bad politics for Republicans and they are facing a judgment day here because I can see Democrats when they fully get into power in Washington getting tough with these recalcitrant states by going through the whole federal law and remove any financial help the system gives to these non-Medicaid expansion states you recalcitrant states want to save money by not expanding Medicaid fine you are free to do that and the Federal government is free to stop programs that pay your healthcare providers extra monies that Medicaid expansion states don't get!
The Republicans have a good idea in the 80 hour a month work requirement for Medicaid enrollees or what they call in the bill the community engagement requirement because the country has to stop the freeloading going on in social programs because the country cannot afford it and as a country we are heading down a path where we are losing our greatness partly because too many of our people are not responsible citizens and so we have to try to reverse it(Sec.44141). The big error that I believe the Republicans are making in the bill is to allow states to have multiple verification occasions on enrollees, the bill should require and limit this verification requirement to once every six months where if the person can establish they met the eighty hour per month requirement for two of the three prior months they pass on verification. The Republicans with the current plan are going to be causing themselves a very serious self-inflicted political wound if they allow more frequent verification requirements these verification occasions will rightly be perceived as very burdensome and so these enrollee voters who are subject to these multiple verifications will be very angry as well as the many voter who have a vested interests in these people staying on Medicaid and so Republicans will pay a price come election time.
The House Republicans with this bill are dishonest to the American people they claimed with their reconciliation bill they are not reducing benefits to people on Medicaid but their bill gives the states the power to institute up to a $35 co-pay per medical service received for those Medicaid enrollees made Medicaid eligible with the ACA law, this co-pay applies to enrollees whose income is above the poverty level up to 133% of the poverty level (SEC. 44142). This policy will block many of these poor Americans on Medicaid from getting needed medical services. The Republicans overall view on the Medicaid program is all wrong they should not be trying to deny that health care program to needy individuals, they should be trying to create more good middle class jobs in America so more Americans will have the income to get off of Medicaid and onto a private health insurer plan and to that end they should come out against the diabolically evil globalization economic model America has embraced for the past fifty years and permanently protect at least sixty percent of domestic manufacturing industries where the price point of the products in the industry will support middle class manufacturing jobs. What the Republicans are planning to do in their bill related to the Affordable Care Act is largely very bad (Part Two). The Republicans want to monkey around with the income verification system for advanced credits for individual insurance purchased on the state exchanges, they are using a chain saw on a problem that requires a scalpel. Republicans need to remember that there is a mechanism in the system to protect the Federal government from getting cheated it is the fact that when a person files their federal taxes they have to reconcile their income with the advanced tax credit they got for health insurance and if they got too much credits they have to pay back the amount. Republicans need to keep in mind if they get more demanding on the income verification front they are really creating a great hardship on those seniors that have retired and are living off their savings and 401k accounts because you cannot prove your income at the beginning of the year when the exchanges ask you to because you haven't withdrawn the money from you brokerage accounts yet you want to wait to let your investments grow and when you're a senior health insurance is super important to you because you have health issues. That being said Republicans are on solidly good ground with this policy initiative in their bill, this is a slight modification; Federal law should ban advanced tax credits for taxpayers who have not filed their taxes for the past year and have not filed an extension or have filed their taxes for the past year but did not on those tax forms reconcile their income with the tax credits they received or they did not file their taxes last year but filed an extension but have not filed their federal taxes from two years ago. Further, the Republicans in their bill seem to be trying to stop people who do not have an income over the poverty level from getting individual insurance on the exchange which is a great goal; I would just caution try to refrain from doing something that would hurt retired seniors living off their savings and their 401K so make the assumption that if the prior year's tax form for an applicant indicates their income was above the federal poverty level accept the applicants attestation that their income for the current year is above the poverty level for eligibility. The Republicans are making a mistake with their prohibition of transgender treatments as an essential benefit for individual insurance for the same reasons mentioned by this writer it was wrong to make this ban in Medicaid. The Republicans are wrong with their efforts to impair DACA people from getting individual on the exchanges that is cruel, unfair and not what the American people want. Lastly, the Republicans are way out of line in their bill to stop cost sharing payments for health plans that cover abortions you all with your policy are going to hurt a lot of innocent poor Americans that are not in any way involved in getting an abortion!
