Skyrocketing Medicaid signups stir Obamacare fights

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Some GOP governors are saying: “I told you so.”

BY RACHANA PRADHAN

Medicaid enrollment under Obamacare is skyrocketing past expectations, giving some GOP governors who oppose the program’s expansion under the health law an “I told you so” moment.

More than 12 million people have signed up for Medicaid under the Affordable Care Act since January 2014, and in some states that embraced that piece of the law, enrollment is hundreds of thousands beyond initial projections. Seven states have seen particularly big surges, with their overruns totaling nearly 1.4 million low-income adults.

The federal government is picking up 100 percent of the expansion costs through 2016, and then will gradually cut back to 90 percent. But some conservatives say the costs that will fall on the states are just too big a burden, and they see vindication in the signup numbers, proof that costs will be more than projected as they have warned all along.

Obamacare originally expanded Medicaid — which traditionally served poor children, pregnant women and the disabled — to all childless low-income adults with incomes up to 138 percent of the federal poverty level (about $16,250 for an individual) across the country. But the Supreme Court made expansion optional in 2012. And 21 states, mostly with GOP governors, have resisted.

“The expansion of Obamacare will cost our state taxpayers $5 billion,” Florida Gov. Rick Scott said in an interview with POLITICO last week, referring to the 10-year cost. “Name the health care program — I think the only one is Medicare Part D — that cost less than what they initially anticipated…Historically, if you look at the numbers, with the growth in Medicare costs, Medicaid costs, it’s always multiples.” A bitter critic of Obamacare, Scott at one point surprisingly backed expansion, but withdrew his support earlier this year. His state legislature is deeply split on Medicaid policy.

In some states that did expand, the take-up has been startling — the result, officials say, of significant pent-up demand for coverage. In Illinois, nearly 541,000 people had signed up as of December, far beyond the 199,000 adults the state had estimated would enroll in 2014. The numbers increased to nearly 634,000 as of April.

In Washington, 535,000 people had signed up as of March — already beating the state’s January 2018 goal. Officials’ projection for March had been just 190,365 newly eligible enrollees.

In Michigan, where the first-year enrollment projection was 323,000 people, sign-ups hit 605,000 before falling back to 582,000 earlier this month. Kentucky signed up nearly 311,000 new adults by the end of its 2014 fiscal year, more than double its initial projection of 148,000. And in February 2014, Minnesota forecast that 147,000 newly eligible adults would enroll by December, but actual enrollment that month was at nearly 194,000.

Supporters of Obamacare say the enrollment surge might lead to some budget bumps down the road, but that the historic decline in the uninsured is a major achievement. In addition, they say the expansion is providing significant health and economic benefits to states that more than offset costs.

States — and hospitals and doctors — are getting billions of dollars from the federal government to cover low-income people, letting them save money on other programs that had been fully or partly funded through state dollars.

“Can we afford not to do this?” asked Audrey Haynes, secretary of Kentucky’s Cabinet for Health and Family Services under Democratic Gov. Steve Beshear. Kentucky under Beshear has fully implemented Obamacare, and it’s seen the second largest decline in its uninsured rate, after Arkansas.

But the money remains a concern not just for foes of expansion like Scott, but for GOP governors like Utah’s Gary Herbert who are trying to come up with some way for their states to expand. Herbert met with HHS Secretary Sylvia Mathews Burwell in late April and later voiced worries that any form of expansion could mean Medicaid consumes an even bigger chunk of the state budget starting in 2017.

“We’re trying to cover as many people as we can afford,” said Herbert, a Republican who supports expansion but has not yet managed to find the right mix of ACA expansion and conservative variants to bring his legislature on board. “Is it 90,000 or 110,000 people? I don’t know what that’s going to work out to be right now.”

The enrollment surge underscores those fiscal fears.

“If you’re spending twice as much on this program than expected, that’s twice as much money that’s being added to the national debt,” said Nicholas Horton with the Foundation for Government Accountability, a conservative think tank that has sought to highlight how much expansion enrollment has gone beyond expectations. Even if the states don’t pay nearly as much as the federal government for Medicaid expansion, he said, “You’re still going to spend more money overall. That’s still taxpayer money.”

Colorado has repeatedly revised its average enrollment estimates to account for increases. Early on, officials had projected that for the fiscal year ending June 30, about 144,000 new adults would be covered in any given month. In November, they bumped the number to nearly 205,000. It currently stands at about 234,000.

Beyond the low-income adults that became newly eligible for Medicaid because of the health care law, states have long feared the budget impacts of the “woodwork effect” — people previously eligible for Medicaid who are only enrolling now because of the broader outreach surrounding Obamacare. Generally, even the states that have shunned Obamacare Medicaid expansion are seeing enrollment growth. The federal government does not cover as much of traditional Medicaid costs; on average, the feds’ share is 57 percent and the states pay the rest.

That “woodwork” phenomenon could create budget concerns for states if enrollment is significantly higher than projections, acknowledged Matt Salo, executive director of the National Association of Medicaid Directors. But even that outcome, he stressed, “still solves a health care problem.” These people are now insured, and that could lead to less cost-shifting and crisis care that was also a fiscal strain on states.

And for states that expanded under the ACA, he said, “you don’t do an expansion and hope no one comes.”

“Everything’s got to make sense in a budgetary environment,” Salo said. “But you balance that with, isn’t this what you were trying to accomplish?”

In California, a spokesperson for the Department of Health Care Services said enrollment for new low-income adults has been on par with projections, but as of March enrollment of those previously eligible for Medicaid was about 200,000 people higher than expected. Kentucky similarly had expected about 17,000 of the previously-eligible population to sign up, but enrolled nearly 37,000.

But Haynes points to a Deloitte report that shows the substantial economic benefits Kentucky has gained from expanding Medicaid. In 2014, 12,000 jobs were created, the report said. And had the state not expanded, it would have incurred nearly $100 million in costs between 2014 and 2021.

Some state officials say that even though enrollment ballooned in the first year, the trend may be leveling off. Michigan says while enrollment to date has exceeded estimates, the numbers have started to decline as it begins annual redeterminations to make sure beneficiaries are still eligible for coverage.

In Ohio, where John Kasich was among the first GOP governors to embrace the ACA expansion, officials expected 366,000 people to enroll in the first year; more than 485,000 did. The numbers as of March stood at nearly 528,000.

Ohio Medicaid spokesman Sam Rossi says in spite of the higher expansion enrollment, overall Medicaid enrollment remains below projections by roughly 27,000 people because the state hasn’t seen as much “woodwork effect” as it anticipated. He adds that total Medicaid general revenue spending as of March was below estimates by $330 million.

Nathan Johnson, the chief policy officer for Washington state’s Health Care Authority, said that in some ways the booming Medicaid enrollment growth isn’t surprising. But the exact reasons as to why projections were so off have yet to be identified.

“We still assume that it’ll more than break even in terms of the financial component, even after higher than expected enrollment,” he said. A recent report funded by the Robert Wood Johnson Foundation seeks to quantify the state’s savings from expansion, but it assumes Washington will only have 480,000 newly eligible enrollees in the current fiscal year — a figure that has already been exceeded.

Haynes, of Kentucky, has strong words for the states that are shying away from enacting the Obamacare coverage expansion. Every state is tight on money, and people who say they can’t give health care to the poorest individuals either don’t understand the issue or it’s “political fodder.”

“It is usually a political decision, not a policy and economic decision,” she adds. “[Expansion foes] can make up whatever they want, to dispute those facts. But it’s made up. These are the facts.”

Read more: http://www.politico.com/story/2015/05/skyrocketing-medicaid-expansion-obamacare-republican-governors-118011.html#ixzz3aXB0gd7U

FEDS COLLECT RECORD $472 BILLION IN TAXES IN JUST ONE MONTH …

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By Stephen Dinan – The Washington Times – Thursday, May 7, 2015

The federal government set a record tax haul in April, taking in nearly a half-trillion dollars in one month alone, according to Congressional Budget Office statistics released Thursday.

April is always a busy month with the tax deadline on April 15, but this year’s haul was historic, totaling $472 billion, far outstripping the previous monthly record, set last April, of $414 billion.

Spending, meanwhile, was a more modest $317 billion, leaving the government with a surplus for that one month of $155 billion — also a record.

Despite that good month, the government is likely to run a deficit when the entire fiscal year is taken into account. But it will probably be smaller than last year’s deficit, and will be the lowest since President Obama took office.

The good news surprised the budget counters at the CBO.

“Receipts for the first seven months of fiscal year 2015 totaled $1,892 billion, CBO estimates — $155 billion more than receipts in the same period last year. That increase is roughly $40 billion larger than what CBO expected when it published its March 2015 report,” the nonpartisan agency said in its report.

Both taxes and spending are growing rapidly, at 9 percent and 7 percent, respectively.

The CBO said the biggest spending increases are in Medicare, Medicaid and Social Security — the big entitlement programs that are essentially on autopilot, with costs increasing as more poor, disabled and elderly people become eligible. Combined, they are up some $81 billion compared to the same time period from fiscal 2014.

Defense spending is down, dropping by nearly 4 percent.

Read more: http://www.washingtontimes.com/news/2015/may/7/feds-set-tax-haul-record-472-billion-one-month/#ixzz3ZU8nWvSR

Follow us: @washtimes on Twitter

The Odd Connection between Obamacare and Foodstamps

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BY MICHAEL MINKOFF

Ever since Obamacare has been implemented, food stamp usage has increased, seemingly disconnected from the “improving” economy:

In most affected states, the enrollment increases were not huge, ranging from 1 percent to 6 percent over two years, according to an Associated Press analysis. The sole exception was Nevada, where enrollment shot up 14 percent.

The enrollment is climbing as Republicans try to cut the costs of the food program and at a time when food-stamp usage would normally be expected to decline. Eligibility rules have not changed.

West Virginia’s food-stamp enrollment increased 4 percent after a Medicaid expansion that was part of the health care changes. Enrollment jumped because people were “more engaged with our systems and more aware what they’re eligible for,” said Jeremiah Samples of the West Virginia Department of Health and Human Resources.

So Obamacare forces people to engage with the welfare system in at least one way, and some of those people are dipping into other welfare services while they’re there. Because why not?

Everyone knew Obamacare was going to be more expensive than anyone had predicted. But not even the most diehard opponent of Obamacare foresaw this. People would have said we were grasping at straws if we had predicted an up-tick in welfare enrollment correlated to Obamacare. Yet that is just what is happening.

So what’s the solution? The solution is obvious. Get the civil government out of the welfare business. They are really terrible at it. By that, I mean that they are really terrible at actually helping people. They are very adept at finding new ways to give “support” to people who would probably be better off without it in the long-term.

There probably isn’t a chance of abolishing Obamacare at this point. Everyone points to how well it’s working. No one seems to care that we can’t afford it. Well at least we’ll be able to eat some freshly minted food stamps when the economy collapses.

Read more at http://eaglerising.com/17753/the-odd-connection-between-obamacare-and-foodstamps/#w3Qf34zmPiFHcMZ2.99

Double-dipping: Low wage-paying companies force taxpayers to fund benefits, says report

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More than half of the billions of dollars spent on state and federal government assistance programs each year goes to benefit working Americans because their salaries are too low to make ends meet.

A study published out of the Center for Labor Research and Education at the University of California’s Berkley campus this week says 56 percent of the $226.8 billion used annually on assistance programs between 2009 and 2011 went to working families.

“When companies pay too little for workers to provide for their families, workers rely on public assistance programs to meet their basic needs,” Ken Jacobs, the chair of the labor center and co-author of report released this week, said in a statement. “This creates significant cost to the states.”

The researchers say that around $153 billion in taxpayer money is spent each year, on average, aiding families that otherwise depend on earned wages.

The economists studied the use of state and federal funds on Medicaid, the Children’s Health Insurance Program, Temporary Assistance for Needy Families, the Earned Income Tax Credit and the Supplemental Nutrition Assistance Program, or food stamps, and then looked to see how much of that money goes to families where at least one person has worked a minimum of 10 hours per week for half a year or longer.

Read more

Poorest Americans left out of federal aid despite 74 percent spending surge

The report determined that working families make up roughly 61 percent of Medicaid enrollees and 74 percent of Earned Income Tax Credit recipients, and also reaped the benefits of food stamps and TANF around one third of the time.

Nearly three-quarters of those who receive earned income tax credit are in working families, and those funds are only available to people who hold down jobs but still make either near or below the standard of living.

In explaining his group’s findings, Jacobs says that consistently low wages have made it hard for families to meet the cost of living. The study determined that wages, adjusted for inflation, haven’t increased for anyone in the bottom 70 percent of earners between 2003 and 2013, and that those on the bottom 10 percent are actually making less now, after adjustments, than Americans were earning 35 years earlier.

“We’re subsidizing the profits of Wal-Mart,” SEIU 1199 New England President David Pickus, whose union represents healthcare workers, told the Hartford Currant. “They’ve lived this way as if this is the way things are. It’s an amazing sense of corporate welfare.”

ON OBAMACARE, IT’S THE PRESIDENT WHO REFUSES TO EMBRACE REALITY

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BY PETER SUDERMAN

Obamacare turns five years old this week, and to mark the occasion, President Obama took after critics of the health law, noting their ongoing opposition while briefly laying out the reasons he believes it to be a success. “It’s time to embrace reality,” he said, according to The Hill.

The president ticked off a string of points in support of the law: an additional 16 million insured, 50,000 fewer preventable deaths, slow growth in health premium costs, and lower deficit projections as a result.

The law, he said, is “working even better than expected.”

One could reasonably quibble with much of this, because not all of the points President Obama cited are clearly or fully attributable to Obamacare.

Health spending growth, for example, is indeed down, and this is driving much of the decline in the deficit, but at least a sizable portion of the decline—perhaps most of it—can be attributed to the recession. One study in Health Affairs last year concluded that about 70 percent of the health spending slowdown is a result of the economy, not any structural changes to health care delivery. Obamacare may be due some credit, but not too much.

Similarly, it’s true that a government report estimated that between 2010 and 2013, deaths from “hospital-acquired conditions” were reduced by about 50,000. But it’s hard to fully pin this on Obamacare when the report states up front that “the precise causes of the decline in patient harm are not fully understood.” 

Meanwhile, the 16 million insured figure comes from a March report by the Department of Health and Human Services, and it is a total of those who gained coverage through Obamacare’s exchanges, Medicaid, employment, and the individual market place, which means it’s not wholly attributable to the law. And it tallies those who signed up for coverage rather than those “effectuated enrollment”—those who have already paid their premiums. The actual number is probably not too far off from what President Obama stated, but, once again, Obamacare isn’t the entire story here.

So Obama is overstating the case, and, of course, leaving out points against the law.

For example: About half of the people who received subsidies through the law last year will have to pay them back through their taxes this year, according to a Kaiser Family Foundation study this week. On average, those who owe will have to pay a little more than a quarter of their subsidy back. A few will have to pay back the entire subsidy.

On the flip side, a little less than half will end up getting money back, but even that will be complicated by the fact that the federal government and California, which runs the biggest state exchange, sent out nearly a million tax forms related to the health law with incorrect information, leading the administration to ask many to delay filing their taxes as a result. California has already issued 120,000 correct tax forms, but there are still “tens of thousands” who haven’t gotten updated forms, according to the L.A. Times.

Whitehouse.gov

Beyond that, there are additional questions about whether the Internal Revenue Service is even equipped to handle all the new paperwork required by the law. According to the Chicago Tribune, roughly a quarter of tax filers will have extra filing requirements due to the health law.

And then there are the poll numbers for the law, which is still unpopular, just as it has been throughout the five years it has been law. Polls differ on the exact contours of public opinion about the law, but all the polls in the Real Clear Politics opinion survey show that oppositions outweighs support by at least seven points; on average, the opposition is 10.5 points higher than the support.

If the law is truly working so well for so many people, if it is, as Obama has now taken to saying, working better than expected or anticipated, then why does it remain so stubbornly unpopular?

When the law was being debated in Congress, many supporters of the law argued that it would grow popular once it passed. When that didn’t happen, Obamacare backers insisted that it polled poorly because the major benefits had yet to kick in.  When the major benefits kicked in, they argued that the botched launch of the exchanges was killing support.

These excuses no longer work. The coverage expansion has arrived, and while the precise numbers aren’t clear, there’s no denying that far more people are covered now than two years ago. The exchanges are still incomplete on the back end, but the consumer-facing part of the system works well enough. The health insurance subsidies have arrived, and are being doled out to millions, and so have the insurance rules restricting insurers from charging or denying coverage based on preexisting conditions.

Obamacare’s major benefits have gone into effect and had time to work their way through the system—and yet the law remains widely disliked. Obama’s message about the law, meanwhile, remains the same as always: It’s great, and people should stop resisting and recognize how great it is.

After five years, in other words, President Obama has not changed his message, even in the face of consistent broad public opposition, even as the various theories for why it remains unpopular have fallen away. Obamacare is simply not well liked. This is the political reality—and President Obama still refuses to embrace it. 

WHAT IF ILLEGALS LEFT?

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What if the illegals left?

Somebody really did their homework on this one. Best on the subject to present date.

What if 20 Million Illegal Aliens Vacated America?

Visit Obama Enemies for more on Illegal immigration

I, Tina Griego, journalist for the Denver Rocky Mountain News wrote a column titled, “Mexican Visitor’s Lament.”

I interviewed Mexican journalist Evangelina Hernandez while visiting Denver last week. Hernandez said, “Illegal aliens pay rent, buy groceries, buy clothes. What happens to your country’s economy if 20 million people go away?”

Hmmm, I thought, what would happen?

So I did my due diligence, buried my nose as a reporter into the FACTS I found below.

It’s a good question… it deserves an honest answer. Over 80% of Americans demand secured borders and illegal migration stopped. But what would happen if all 20 million or more vacated America? The answers I found may surprise you!

In California, if 3.5 million illegal aliens moved back to Mexico, it would leave an extra $10.2 billion to spend on overloaded school systems, bankrupt hospitals and overrun prisons. It would leave highways cleaner, safer and less congested. Everyone could understand one another as English became the dominant language again.

In Colorado, 500,000 illegal migrants, plus their 300,000 kids and grandchilds would move back “home,” mostly to Mexico. That would save Colorado an estimated $2 billion (other experts say $7 billion) annually in taxes that pay for schooling, medical, social-services and incarceration costs. It means 12,000 gang members would vanish out of Denver alone.

Colorado would save more than $20 million in prison costs, and the terror that those 7,300 alien criminals set upon local citizens. Denver Officer Don Young and hundreds of Colorado victims would not have suffered death, accidents, rapes and other crimes by illegals.

Denver Public Schools would not suffer a 67% dropout/flunk rate because of thousands of illegal alien students speaking 41 different languages. At least 200,000 vehicles would vanish from our gridlocked cities in Colorado. Denver’s 4% unem ployment rate would vanish as our working poor would gain jobs at a living wage.

In Florida, 1.5 million illegals would return the Sunshine State back to America, the rule of law, and English.

In Chicago, Illinois, 2.1 million illegals would free up hospitals, schools, prisons and highways for a safer, cleaner and more crime-free experience.

If 20 million illegal aliens returned ‘home,’ the U.S. Economy would return to the rule of law. Employers would hire legal American citizens at a living wage. Everyone would pay their fair share of taxes because they wouldn’t be working off the books. That would result in an additional $401 billion in IRS income taxes collected annually, and an equal amount for local, state and city coffers.

No more push ‘1’ for Spanish or ‘2’ for English. No more confusion in American schools that now must contend with over 100 languages that degrade the educational system for American kids. Our overcrowded schools would lose more than two million illegal alien kids at a cost of billions in ESL and free breakfasts and lunches.

We would lose 500,000 illegal criminal alien inmates at a cost of more than $1.6 billion annually. That includes 15,000 MS-13 gang members who distribute $130 billion in drugs annually would vacate our country.

In cities like L.A., 20,000 members of the ’18th Street Gang’ would vanish from our nation. No more Mexican forgery gangs for ID theft from Americans! No more foreign rapists and child molesters!

Losing more than 20 million people would clear up our crowded highways and gridlock. Cleaner air and less drinking and driving American deaths by illegal aliens!

America’s economy is drained. Taxpayers are harmed. Employers get rich. Over $80 billion annually wouldn’t return to the aliens’ home countries by cash transfers. Illegal migrants earned half that money untaxed, which further drains America ‘s economy which currently suffers an $8.7 trillion debt. $8.7 trillion debt!!!

At least 400,000 anchor babies would not be born in our country, costing us $109 billion per year per cycle. At least 86 hospitals in California, Georgia and Florida would still be operating instead of being bankrupt out of existence because illegals pay nothing via the EMTOLA Act. Americans wouldn’t suffer thousands of TB and hepatitis cases rampant in our country – brought in by illegals unscreened at our borders.

Our cities would see 20 million less people driving, polluting and grid locking our cities. It would also put the ‘progressives’ on the horns of a dilemma; illegal aliens and their families cause 11% of our greenhouse gases.

Over one million of Mexico’s poorest citizens now live inside and along our border from Brownsville, Texas, to San Diego, California, in what the New York Times called, ‘colonias’ or new neighborhoods. Trouble is, those living areas resemble Bombay and Calcutta where grinding poverty, filth, diseases, drugs, crimes, no sanitation and worse. They live without sewage, clean water, streets, roads, electricity, or any kind of sanitation.

The New York Times reported them to be America’s new ‘Third World’ inside our own country. Within 20 years, at their current growth rate, they expect 20 million residents of those colonials. (I’ve seen them personally in Texas and Arizona; it’s sickening beyond anything you can imagine.)

By enforcing our laws, we could repatriate them back to Mexico. We should invite 20 million aliens to go home, fix their own countries and/or make a better life in Mexico. We already invite a million people into our country legally annually, more than all other countries combined. We cannot and must not allow anarchy at our borders, more anarchy within our borders and growing lawlessness at every level in our nation.

It’s time to stand up for our country, our culture, our civilization and our way of life.

Interesting Statistics!

Here are 14 reasons illegal aliens should vacate America, and I hope they are forwarded over and over again until they are read so many times that the reader gets sick of reading them:

1. $14 billion to $22 billion dollars are spent each year on welfare to illegal aliens (that’s Billion with a ‘B’)

3. $7.5 billion dollars are spent each year on Medicaid for illegal aliens.

4. $12 billion dollars are spent each year on primary and secondary school education for children here illegally and they still cannot speak a word of English!

5. $27 billion dollars are spent each year for education for the American-born children of illegal aliens, known as anchor babies.

6. $3 Million Dollars ‘PER DAY’ is spent to incarcerate illegal aliens. That’s $1.2 Billion a year.

7. 28% percent of all federal prison inmates are illegal aliens.

8. $190 billion dollars are spent each year on illegal aliens for welfare & social services by the American taxpayers.

9. $200 billion dollars per year in suppressed American wages are caused by the illegal aliens.

10. The illegal aliens in the United States have a crime rate that’s two and a half times that of white non-illegal aliens. In particular, their children, are going to make a huge additional crime problem in t he US.

11. During the year 2005, there were 8 to 10 MILLION illegal aliens that crossed our southern border with as many as 19,500 illegal aliens from other terrorist countries. Over 10,000 of those were middle-eastern terrorists. Millions of pounds of drugs, cocaine, meth, heroin, crack, guns, and marijuana crossed into the U.S. from the southern border.

12. The National Policy Institute, estimates that the total cost of mass deportation would be between $206 and $230 billion, or an average cost of between $41 and $46 billion annually over a five year period.

13. In 2006, illegal aliens sent home $65 BILLION in remittances back to their countries of origin, to their families and friends.

14. The dark side of illegal immigration: Nearly one million sex crimes are committed by illegal immigrants in the United States!

Total cost a whopping $538.3 BILLION DOLLARS A YEAR !