Solving The Issues With The Veteran’s Administration Medical Care

Since the major combat missions in Iraq and Afghanistan started winding down, there have been repeated and unsolved issues with providing adequate and timely healthcare for our veterans. Despite repeated assurances and varied lip service out of Washington, things just don’t seem to be getting better. Even with new rules allowing vets who live beyond a 40 mile radius of a VA hospital being allowed to get local medical help…it still isn’t working.

But there is a solution available. It is staring all of us in the face. The Democrats in Washington are afraid to whisper it and the Republicans don’t even have it in their nervous system.

But here it is: Single Payer Universal Healthcare.

Every veteran would automatically be eligible and we can reduce the VA hospitals and dump the money directly into single pay. We can shut down Obamacare and dump all of that cash into single pay. Same with Medicare and Medicaid.

And now is the best time to introduce it…just when the GOP is writing their budget to defund the Affordable Care Act and cut funds for Medicare and Medicaid…yeah we want to replace Obamacare too! With Single Payer Universal Healthcare!

Single Payer Universal Healthcare!!

“Christian” Scott Walker wants to kick poor people off their healthcare

Well how very Christian of Gov. Scott Walker to want to kick poor people off their health insurance.

Defending his fellow Republican governors’ decision to block Medicaid expansion in their states, Wisconsin Gov. Scott Walker (R) on Friday suggested that denying health coverage to additional low-income Americans helps more people “live the American Dream” because they won’t be “dependent on the American government.”

Republican refusal to expand BadgerCare costs Wisconsin taxpayers $206 million

Remind me again how Republicans in Wisconsin are so “fiscally responsible.”

Wisconsin taxpayers would have saved $206 million over two years — 73% more than previously estimated — if officials had fully expanded its main health care program for the poor under the federal Affordable Care Act, a new nonpartisan report shows.

If officials decide to change course and expand the program in the next state budget, state taxpayers would save another $261 million to $315 million through June 2017, according to the Legislative Fiscal Bureau. The bureau serves the Legislature and is widely respected by lawmakers from both sides of the aisle.

As if Republicans in Wisconsin refusing to increase access to healthcare for all Wisconsinites wasn’t terrible enough from a moral standpoint, it’s also grossly irresponsible from a fiscal standpoint.

After all, $206 million is a lot of money, and that’s money that could have been spent to improve education, combat poverty, create jobs, or any number of other worthwhile programs.

Wisconsin’s Medicaid fund faces $93 million shortfall

But remember folks – Gov. Scott Walker is “fiscally responsible.” (emphasis added).

Wisconsin’s Medicaid fund faces a shortfall of $93 million in state tax dollars through the end of the biennium, according to a report sent to members of the Joint Finance Committee.

The shortfall is up from an estimated $20.3 million in March, when the Department of Health Services last sent an update to lawmakers.

,u>The report also noted when taking into account all funds — including federal money — the agency needs to find $232.5 million in savings through June 30, 2015 to balance the fund.

This is yet another example of how poor Republicans are at actually governing, and how patently false their claims of being fiscally responsible really are.

Outstanding Ignoramus of the Month.

This month’s award recognizing an outstanding achievement in rank ignorance is given to state Rep. Amy Loudenbeck (R-Clinton). 

Loudenbeck, in response to a bill put forth by state Rep Melissa Sargent which would allow individual counties access to federal Affordable Care Act money to expand Medicaid for their respective residents, said she needs to see what financial obligations Wisconsin counties would have to assume before she commented further on the bill.

Well then, Ms. Loudenbeck, have one of your staffers pick up the telephone and call the Wisconsin Counties Association. They passed a resolution four months ago, in the words of the Associated Press: “ reaffirming its longstanding position that the state ought to accept federal money to pay for Medicaid coverage under the Affordable Care Act. ”

I’m sure they’d be happy to fill you in, Rep Loudenbeck, and a side benefit is that you’ll be less likely to be in the running for next months award.

A Side Bar On Why Governor Walker Turned Down The Medicaid Money

This is going to be shooting from the hip without double checking the facts…so if I got my timeline wrong let me know:

Before the 2012 Presidential election, Governor Walker delayed making a decision on setting up a Wisconsin Health Exchange or deferring to the federal government. Certainly he expected Mitt Romney to carry the day and the creation of exchanges would be a moot point. But President Obama won and the indecisive governor decided the feds should run the Wisconsin exchange.

Now comes the decision on whether to accept the extra Medicaid dollars to fill the gaps between the current Medicaid recipients and those eligible for tax credits to pay for their health insurance on the exchanges.

Well the governor declined the extra Medicaid money…because he couldn’t be sure the federal government would be able to fulfill it’s financial commitment in the future. We all went pshaw and poppycock at the time and couldn’t believe our ears. But just maybe our governor is the eternal optimist and expects that a President Walker or similarly minded GOP candidate will retake the White House in 2016…and dismantle Medicaid as we know it…voila…self-fulfilling prophecy!

Scott Walker’s biennial budget includes “death tax” targeting Medicaid recipients (UPDATED)

Among the little-known provisions of the biennial state budget proposed by Republican Gov. Scott Walker and rubber-stamped by Republicans in the Legislature is a provision buried in the budget that would drastically expand the state’s ability to claim dead couples’ joint property – even if the assets are protected in trusts.

The language is designed to help the state recover Medicaid money spent on a number of long-term care programs, most notably Family Care, which helps keep disabled and elderly people out of costly nursing homes.

It’s unlikely the changes will take effect for months, but attorneys who specialize in elder law say they’re already creating concern among seniors who want to leave property to their children and other beneficiaries. The state has prioritized recovering every dollar spent on Medicaid over families’ well-being, said Carol Wessels, a Wauwatosa attorney and former chair of the state bar’s Elder Law Section Board of Directors.

[…]

The provisions would allow DHS to claim property even if it’s not subject to probate, a legal process creditors can use to settle debt after a death, or held in a trust, a financial arrangement in which a third party, such as a bank, holds assets until they’re passed on to beneficiaries. People often use trusts to protect property from probate.

Federal rules also prohibit people from divesting or giving away property to make themselves poor enough to qualify for a long-term Medicaid program. However, the regulations allow applicants to transfer some assets, such as interest in a business, at less than market value without penalty.

The Wisconsin budget eliminates that exemption, which means a Wisconsin resident seeking Medicaid coverage for long-term care would have to sell his or her assets, such as a share of a family business or farmland, for full market value even if it was going to a child.

So there you have it folks…Scott Walker and Republicans in the Legislature are sticking it to the elderly (and their families) even after they’re dead.

UPDATE: In an Op-Ed for the LaCrosse Tribune, Democratic State Rep. Steve Doyle explains just how bad Scott Walker’s Medicaid “death tax” could be for family farmers.

With the new “death tax,” when a family member on Medicaid dies and then their spouse dies, the state in certain cases can go after their farm, their business or their house to recover payment for their long-term health care expenses.

This expansion of the law will punish families who want to transfer the family farm or business if the head of the family is sick or disabled and needs certain Medicaid services.

Here in the Coulee Region, we have many family farms run by parents who hope one day to pass them on to their children. As part of their estate planning, parents often choose to transfer the business for less than market value because their children have earned significant sweat equity in the property and often don’t have enough money to buy the farm at full value.

But what if less than five years later a stroke forces Dad to go into long-term care paid for by Medicaid? Under this expansion, the entire family might be penalized. Dad might not be able to receive Medicaid, and if the farm is still in his name when he dies, the state will be able to take back the amount of money paid for his long-term care. To recover these fees, the state could even foreclose the farm.

What makes this truly a “death tax” is that when Mom dies, the state can move in and seize the farm and even the home.

This expansion of the asset-recovery program takes an onerous situation and makes it even worse. In the worst-possible cases, some desperate couples may choose to get a divorce so that the healthy spouse can safely pass on the family farm to the next generation without fear of foreclosure.

No family should be faced with that kind of decision.

A terrific moment of irony

So sayeth conservative blogger James Wigderson in his Waukesha Freeman column of last week hilariously titled, ” Free federal money not affordable, Walker health plan right choice.  Wigderson argues that Walker’s refusal to accept federal dollars to expand Badgercare is good policy because federal dollars aren’t really free. He then endorses Walker’s plan to shift almost 90,000 Wisconsinites from Badgercare to federally subsidized private health insurance plans available through the exchange to be created under the Affordable Care Act. His “terrific moment of irony” as he characterizes it, is that Democrats are suddenly afraid to use a provision of Obamacare, i.e. the exchanges.   A terrific moment of irony, indeed.

The Congressional Budget Office has estimated that it costs the federal government $3,000.00 more per recipient to subsidize a private plan than have someone on a public plan like Badgercare, $9,000.00 versus $6,000.00. Walker’s plan costs taxpayers 50% more federal tax dollars per person.

Wigderson supports the refusal of federal money so that more federal money can be spent. Gotcha, James! Free federal money not affordable. A terrific moment of irony.

You just can’t make this stuff up.

Republican State Sen. Jerry Petrowski: “We should pursue the full expansion of Medicaid” in Wisconsin

On June 1 I noted Republican State Sen. Terry Moulton went public with his support for a Medicaid/BadgerCare expansion here in Wisconsin, and it appears Sen. Moulton isn’t the only Republican State Senator who publicly disagrees with Gov. Scott Walker’s decision to refuse an expansion of Medicaid under Obamacare that would be financed almost completely with federal funds. Gov. Walker’s refusal to accept federal funds to expand Medicaid will cost state taxpayers $119 million from 2013 to 2015, according to estimates by the nonpartisan Legislative Fiscal Bureau.

In the June 13-20 edition of the City Pages, Republican State Sen. Jerry Petrowski of the 29th Senate district made it clear that he believes the state should pursue the full expansion of Medicaid as part of our state’s implementation of Obamacare. Sen. Petrowski cited several reasons for his belief that the state should pursue the full expansion of Medicaid:

First, fewer people would be insured if we force the portion of population who fall between 100% and 133% of the federal poverty level into Obamacare. Many of these people won’t enroll leaving them uninsured. Taxpayers will still pay for the care of the uninsured people, but it will be poorer care and at the same time more expensive care often provided in the emergency room.

Second, Obamacare policies cost taxpayers more than Medicaid coverage for these very low income people because the government pays for about 98% of their premiums for Obamacare. Simply put, having these people covered under Obamacare is expected to cost taxpayers around $550 to $830 more per person than keeping them in Medicaid.

Third, Wisconsinites pay the same federal taxes as any other U.S. citizen, and it doesn’t make fiscal sense to refuse dollars coming back here. We end up paying for people in other states without receiving any benefit here. I don’t see any of this as fiscally conservative.

Here’s a copy of Sen. Petrowski’s comments in the June 13-20 edition of City Pages:

Click for full size
Click for full size

In addition to Sens. Moulton and Petrowski, the folks over at Citizen Action Wisconsin have identified four other Republican State Senators who have expressed their concerns about Gov. Walker’s decision to refuse federal funds to expand Medicaid here in Wisconsin, a decision that as I noted above is estimated will cost Wisconsin taxpayers $119 million over the next biennium.

When I think of Gov. Walker’s decision to refuse billions of dollars in federal funding for Medicaid expansion for our state, costing Wisconsin’s taxpayers $119 million, I’m reminded of the saying, “Pennywise and pound foolish.”