Is West Virginia Leading The Nation Towards Single Payer Health Care?

Earlier this week the Milwaukee Journal Sentinel reprinted an article in their Ideas Lab from Kaiser Health News reporter Julie Revnor. I have the hard copy but online I found it on the NPR site. The article wrangles with the notion of who is really protecting the Affordable Care Act’s clause to cover Americans with pre-existing conditions. It includes some discussion on the senatorial race in Wisconsin between incumbent US Senator Democrat Tammy Baldwin and her opponent State Senator Republican Leah Vukmir. It is worth the read.

But what caught my attention was the last paragraph where Ms. Revnor is debunking a statement made by the US Senator from West Virginia, Joe Manchin.

Meanwhile, Democrats who are chastising their Republican opponents over the issue are sometimes going a bit over the top, too.

An example is Manchin’s claim about the threat to coverage for 800,000 people in West Virginia. West Virginia’s population is only 1.8 million and more than 1 million of those people are on Medicare or Medicaid. That would mean every other person in the state has a pre-existing condition. A recent study found West Virginia has a relatively high level of pre-existing conditions among adults, but it is still less than 40 percent.

I am not going to fact check Senator Manchin’s claim…the fact that any American might lose coverage because of a pre-existing condition is enough of an issue on its own (full disclosure: I have a pre-existing condition, I had a heart attack in 1999 and am being treated for heart issues to this day). But what I found more interesting was Ms. Revnor’s assertion (and I didn’t fact check that either…she does this for a living so I am taking her at her word here) that over 1 million out of 1.8 million West Virginians are on Medicare or Medicaid. Fifty five percent plus of West Virginia is on federally sponsored single payer health care already. So apparently it works and works fine. So it wouldn’t be much of a push to get those other 44+% of West Virginians on Medicare for All (yes I hate that name because it isn’t factual but I am going to use it because it’s become the vernacular for comprehensive universal single payer health care that I support).

Maybe we should just make West Virginia a test bed and set up a universal single payer plan in just that state. I would think the population would be amenable seeing how the majority are already on similar plans. (just another aside: those on Medicare and Medicaid don’t have to worry about pre-existing conditions. Medicare can’t deny anyone who is old enough to be eligible and Medicaid can’t either and parts of it are essentially designed to cover pre-existing conditions). And it probably won’t be hard to convince the estimated 267,000 previously uninsured West Virginians using the Affordable Care Act to move either.

To me there should be a national move to a comprehensive universal single payer health care system in the United States…but since there is nothing but argument around it…let’s go with a test in West Virginia. It’s a small population…55% are already on a federally run single payer program…and they are close enough to Washington to be a decent social laboratory. Too bad their ‘good neighbor’ to the West (Senate Majority Leader Mitch McConnell) wants to cut back on Medicare and Medicaid. But that might make it easier for WV to volunteer to be the guinea pig here.

BTW: West Virginia’s electoral votes in 2016 went to President Donald Trump who pulled in 68.5% of the vote with only 57.45% turn out.

And this late breaking tidbit. While researching a few of the items above, it looks like Sen. Manchin might not be so far off. This Kaiser Family Foundation chart (from 2015) shows West Virginia having about 35% or so residents with pre-existing conditions that could have been denied coverage pre-ACA. Interesting.

Governor Walker continues to play politics with people’s lives

Just over a year ago we urged Governor Scott Walker to finally break down and accept the Medicaid expansion part of the Affordable Care Act. Of course he hasn’t done anything of the sort…well…because there’s no guarantee that the federal contributions will be there in the future (well if they aren’t it will be his Republican kith and kin who pull that plug)…and so far he’s cost Wisconsin taxpayers about $ 1 BILLION for his intransigence.

But in the meantime, in a surge of election year gifts, Governor Walker got permission to spend money to support a decrease in premiums for Wisconsinites on the ACA markets. Now, don’t get me wrong, Blogging Blue supports anything that will provide health insurance for the largest number of citizens at the lowest possible costs…but as many have pointed out this one is an election year stunt.

The total premium support is $200 million…$34 million in state funds and the rest from the federal government (I hope they have the money). The premiums for 2019 will go down 3.5% under the program after having risen 44% in this previous year. And of course the premium raises have had to do with the various GOP bills that removed the requirement for everyone to have insurance and the subsidies direct to insurance companies that held down premiums on the national level in the first place. Robbing Peter to pay Paul? And that 3.5% savings will probably be wiped out by inflation resulting from tariffs on any variety of goods…but that’s another story.

So for one year, Governor Walker is ready to spend another $34 million in state taxes, to buy down premiums by a slight amount, while ignoring billion dollar long term savings.

Do you think he’ll do this in 2020 if he gets re-elected? Pretty good odds he’ll be banging his anti-Obamacare drum again as soon as the election is over. Think not?

Walker has pursued the program to bring down premiums as he has separately sought to end Obamacare. This year, he gave Wisconsin Attorney General Brad Schimel permission to join with attorneys general from other states to file a lawsuit against the Affordable Care Act.

A Fearful Scott Walker Pivots Center On Healthcare

With the 2018 re-election campaign staring him in the face and the Democratic upset in Wisconsin’s 10th Senate District, Wisconsin’s Republican Governor Scott Walker is pivoting to the center on healthcare. After demonizing the Affordable Care Act since its inception and his refusal to accept the Medicaid expansion that it provides, suddenly the governor wants to use state and federal funds to stabilize the ACA marketplace in Wisconsin.

Wisconsin plans to seek federal permission to cover expensive medical claims for health insurers on the marketplace, which should lower premium increases and could bring back companies that dropped out, the governor said in an interview with reporters on Friday ahead of his election-year State of the State address Wednesday.

The state will also ask to permanently continue SeniorCare, a prescription drug program Walker has previously sought to pare down, he said.

This awkward turn in position is due to his listening to constituents as he’s toured the state:

“Health insurance — the biggest thing I hear from people across the state when I’m in listening sessions and sit-downs and discussions, is stability — that’s the biggest thing people are concerned about,” Walker said.

And of course this moves him dangerously close to the Democratic position and can it possibly steal some of their thunder?

Walker’s proposals aimed at stabilizing the state Obamacare marketplace is the latest plan he has put forward that reflects long-held priorities of Democrats, who begrudgingly said they would likely support the health care plan but called his recent proposals insincere and aimed at winning re-election in November.

And of course he is wrapping this all up neatly as a Wisconsin value…but governor…healthcare has been a Wisconsin value and concern since the state was established…why did it take you so long to get on board with it?

“I don’t think those are Democratic issues — those are Wisconsin issues,” he said.

There is one really strange thing going on in Madison though. Currently ACA prohibits insurers from disallowing enrollees who have preexisting conditions. Apparently the State Assembly has already passed a Democratic bill to insure that individuals in Wisconsin couldn’t be denied insurance because of preexisting conditions…and he is urging the State Senate to follow suit.

And while he’s at it the governor should take our suggestion to accept the Medicaid expansion too: Governor Walker Should Accept the Medicaid Expansion NOW!

Will miracles never cease?

If you want to read the governor’s press release you’ll find it HERE!

Debating the ACA Individual Mandate

Whether you support or have issue with the Affordable Care Act’s individual mandate…I would hope you at least support stripping it out of the tax reform cut legislation currently before Congress. Now the mandate says that every individual must have health insurance either through their employer, the ACA exchanges or through a private plan (plus Medicare or Medicaid). The thought behind it (and supported by the insurers) is the premiums paid by young people who are generally healthy will offset the costs to cover older people. If they don’t buy the insurance they pay a fine. I support the idea but unfortunately for many who fall beyond the income brackets that get premium support…the fines are cheaper than the cost of the insurance.

Now many in the GOP view the whole idea as vulgar…the government should never require anyone to buy a product (of course we could avoid that whole issue with single payer universal coverage…but that’s another story). So the mandate should be cancelled. And of course they couldn’t repeal/replace the Affordable Care Act in whole so now they stead a repeal of the individual mandate into the tax cut bill. And quite frankly it doesn’t belong there.

I don’t think it should be repealed but if you are going to repeal…put it up for a vote on its own. See where it goes…see if we get some lobbying action from the insurers.

But the convoluted thought process from the Republicans is that removing the individual mandate via the tax cut bill is the way to go…because it would lower taxes for those paying the fines rather than acquiring insurance. They are equating the fines as taxes…not quite.

Taxes are pretty much collected when you do something. You buy gasoline and pay the gasoline tax. Buy new shoes and pay the sales tax. You earn money and pay income tax, social security tax and medicare tax. You buy a house and pay property tax (although that is continual). You don’t buy health insurance you pay a fine. You don’t obey the law you pay a fine.

Congress might actually get a few more thing done…and get more bipartisan cooperation if bills contained just the items that belonged there. Then fewer people would have to hold their nose while voting for something…or vote against something that they generally agree with except for something odious and unrelated tagged onto the bill. If they try it they might actually like it.