It’s time for GOP to accept reality of ObamaCare
Last spring, conservatives were certain that the U.S. Supreme Court would rule ObamaCare unconstitutional. It did not. Earlier this month, U.S. voters likewise refused to toss out the law’s prime architect, re-electing President Obama to another four-year term. Neither ObamaCare nor its namesake is going anywhere.
So now what?
While some Republicans acknowledge the fact that ObamaCare is now permanent, other GOP politicians seem intent on trying to sabotage the law through inaction even if they lack the support to repeal it. Last week, for example, Gov. Nathan Deal signed onto the strategy of passive resistance against the law when he announced that Georgia would refuse to exercise its authority under ObamaCare to create and operate its own insurance exchange.
The decision means that come 2014, Georgians who try to purchase private health insurance using federal subsidies will be required to compare and buy policies on a federally designed exchange, instead of an exchange that was specially tailored to and operated by Georgia. In short, Deal has chosen to view any cooperation in implementing ObamaCare as a form of collaboration with the enemy.
(UPDATE: The AJC’s Misty Williams has a piece in today’s paper explaining how a decision to reject the expansion of Medicaid also could devastate Georgia hospitals, such as Grady Memorial, that serve a poorer clientele.)
On the narrow question of creating a state version of the health insurance exchange, Deal might have made the right decision for the wrong reasons. While Georgia politicians were playing a delaying game, hoping that ObamaCare would be killed by the courts or the voters, other states that intend to launch their own exchanges have been working on the programs for months if not years. Trying to play catch-up at this point might very well not be worth Georgia’s investment of time, energy and political capital, particularly with a federal exchange as an backup option.
However, the larger and by far more consequential question involves Georgia’s participation in an expanded Medicaid program offered through ObamaCare beginning in 2014. If Georgia ultimately decides to take part, Medicaid coverage would be extended to an additional 600,000 lower-income Georgians. (For a family of four, households with an income of roughly $32,000 and below would be eligible for coverage.) Those Georgians would get covered at very little cost to state taxpayers.
Under ObamaCare, from 2014 to 2016 the federal government will pay 100 percent of the costs for insuring those additional Georgians. In later years, the share covered by the federal government will drop slightly — Uncle Sam will cover 95 percent of the cost in 2017, 94 percent in 2018, 93 percent in 2019 and then 90 percent from 2020 on out. (For comparison’s sake, Georgia pays a little over a third of the cost for current Medicaid recipients.)
Nonetheless, Deal announced at the Republican National Convention in August that Georgia would refuse to take advantage of the expanded Medicaid program. Even with the federal government paying all or most of the cost, Deal said, the state simply couldn’t afford the additional expense.
That’s a foolish decision, especially given that Georgia has the fifth highest rate of uninsured in the country. In effect, Deal would be denying health insurance coverage to some 600,000 Georgia citizens just to make a partisan political point. It also means turning away billions of federal dollars — an estimated $14.5 billion over the first six years — that would flow into the state’s health-care delivery system. That’s a benefit of particular importance to rural Georgia, where the health-care infrastructure is skeletal at best because so many residents are uninsured and have few resources from which to pay medical bills.
(UPDATE: The AJC’s Misty Williams has a piece in today’s paper explaining how a decision to reject the expansion of Medicaid also could devastate Georgia hospitals, such as Grady Memorial, that serve a poorer clientele.)
Deal’s explanation notwithstanding, it’s not a question of whether Georgia can afford it. It’s a question of political priorities. As Tim Sweeney of the Georgia Budget and Policy Institute points out, Georgia’s spending per Medicaid recipient in 2009 was already the second lowest in the country, which says a lot. It says that ObamaCare aside, the health of Georgia citizens simply isn’t important to those elected to lead this state, and if they have to deny health insurance to hundreds of thousands to prove it, harming the state economy in the process, they’re willing to do so.
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658 comments Add your comment
indigo
November 21st, 2012
12:43 pm
Ben, Irwin
I’ll stop calling our Military socialist when you stop calling Obamacare socialist.
Don't Forget - Obama is a two term president.
November 21st, 2012
12:43 pm
For those of you without a clue, here’s your first:
Hostess Brands Inc., the bankrupt baker of Twinkies and Wonder bread, will seek permission to pay bonuses to key managers while closing operations that will leave most of its 18,500 workers unemployed as it begins a liquidation that may attract bids from private-equity firms and rivals.
Ben Shockley
November 21st, 2012
12:43 pm
““There is also price-fixing inherent within Obamacare”
“as there is within private insurance”
Doctors are not required to participate in private insurance plans if they wish to practice.
EPIC FAIL
Nice try though
Brosephus™
November 21st, 2012
12:43 pm
Everyone pays taxes
Well, in Ben’s case, he does have telltale signs of suffering from adverse reactions to widely known truths.
Regnad Kcin
November 21st, 2012
12:43 pm
““That’s what our founding fathers thought, too, and that worked out okay…”
If you set “okay” as you goal, and don’t mind the 200 or so years of regression, then you’re right on track to get just what you asked for”
=========
GT/MIT – time to reset your ironometer… I guess the irony slipped by you.
Doggone/GA
November 21st, 2012
12:44 pm
“First, conservatives don’t depend on government to fulfill all our hopes and dreams”
No one does. Next argument.
Erwin's cat
November 21st, 2012
12:44 pm
indigo…i never did
p
RF
November 21st, 2012
12:44 pm
Well, Ben, if you’re going to decry the “illegals” and the ER, you might want to get the facts straight about how we got there.
Ben Shockley
November 21st, 2012
12:45 pm
“I’ll stop calling our Military socialist when you stop calling Obamacare socialist”
You’re free to post stupid crap as much as you want.
St Simons - he-ne-ha
November 21st, 2012
12:45 pm
okay, one last time, from a Ga hosp Administrator –
The absolute damn legal definition of ER – Triage, Stabilization
That is NOT healthcare by any stretch. Jeez, man
Ben Shockley
November 21st, 2012
12:46 pm
“Well, Ben, if you’re going to decry the “illegals” and the ER, you might want to get the facts straight about how we got there.”
Why don’t you tell us which fact(s) I got wrong?
Good luck.
Erwin's cat
November 21st, 2012
12:46 pm
Got to run…enjoy your lucnh of false equivalences…
Seriously folks have a safe and happy turkey day
Doggone/GA
November 21st, 2012
12:47 pm
“You’re free to post stupid crap as much as you want”
Just following your stellar example
RF
November 21st, 2012
12:47 pm
“You’re free to post stupid crap as much as you want.”
Pot and kettle there…
If it bothers you too much, just push the button over there on the wall in the dayroom and the nice lady in the scrubs with the moustache will come and give you some happy pills and you’ll feel allll better for a while…
Ben Shockley
November 21st, 2012
12:48 pm
Doggone,
You’re pretty good at snark.
Logic and and analysis, though…..well, not so much……………..
Ben Shockley
November 21st, 2012
12:49 pm
RF,
If you can’t post anything substantive, just post crap like your 12:47
Regnad Kcin
November 21st, 2012
12:50 pm
” This crap bill miust be resisted by all means by the states because it was forced down the throats of Americans by underhanded means and by one party rule”
Another “throat-forcer” – this seems to be some kind of conservative obsession…
Regnad Kcin
November 21st, 2012
12:52 pm
““But, if the Govt. runs our healthcare, that IS socialism. Right?”
Yes, because it is a transfer of weatlh from those who pay taxes to those who do not.”
Ben – the military does that, too. So, you agree thant the military IS socialist, right?
DannyX
November 21st, 2012
12:53 pm
“Ben – the military does that, too. So, you agree thant the military IS socialist, right?”
BENGHAZI
Whoops I meant BAZINGA
RF
November 21st, 2012
12:54 pm
“There is also price-fixing inherent within Obamacare”
numbers please to prove that?
“it is a transfer of weatlh from those who pay taxes to those who do not.”
proof?
Well, anything except limiting illegal immigration and/or limiting illegals’ access to free emergency room care
again, proof of that?
OOOOkay, so you made points without evidence. Who doesn’t? Now on to better things, ummmkay?
nobodyyouknow
November 21st, 2012
12:55 pm
REDCOAT, You’re right on.
Regnad Kcin
November 21st, 2012
12:57 pm
DannyX – for some, BENGHAZI! is always the right response.
Moderate Line
November 21st, 2012
12:57 pm
Mary Elizabeth
November 21st, 2012
8:18 am
TO JAY BOOKMAN:
I am asking you to stop the gratuitous insults to me, especially by ALEX as his remarks are not only erroneous but they are abusive. Stopping Josef’s inane put-downs toward me, in almost every post he writes of me, which I have endured for months, would also be appreciated.
Calling names and insulting others, as I did to both Alex and Josef yesterday, was not like me, generally, and it was not in keeping with the way I was raised nor with the principles of nonviolence that I hold most dear. I will respond to any poster, in the future, who will address me with both courtesy and respect, whether that person agrees with my point-of-view or not. Name-calling is unfortunate and destructive, whoever engages in it. I believe that stopping it needs to come from you, Jay, and not from me nor from others. I regret having lost patience and having indulged in name-calling, myself, yesterday, even to defend myself against it.
I will not be responding simply because I do not want to incur elevated blood pressure, as I sustained here yesterday. Thank you for considering this request.
++++
I find that very few people insult me. It does happen on occasion. However, I do not believe that the people who disagree with are either uninformed, immoral, lack intelligence or have bad intentions. I know people who are conservative and liberal and most are good people. I know bad people on both sides and I find we are all hypocritical to some degree.
Most of the post I have read from you have a tone even when not stated directly of questioning people on one of the four things I mention. Emotional arguments are usually met with another emotional argument sometimes escalating. If your true goal is convincing people who do not agree with you of your point removing emotion is the only way your going to do it.
Doggone/GA
November 21st, 2012
12:58 pm
“Logic and and analysis, though…..well, not so much……………..”
Just following your stellar example
Moderate Line
November 21st, 2012
12:59 pm
Out of here.
St Simons - he-ne-ha
November 21st, 2012
1:00 pm
bengazi teleprompters crammed down our wealth-transferring throats.
socialism! – its so obvious, why can’t you see his genius, sheeple?
alex
November 21st, 2012
1:01 pm
@ ben something about doctors not required to accept certain insurances;right in theory, wrong in practice,If you don’t accept BCBS, you’ll go hungry and BOY do they know it….
@ St Simmons, If triage is not healthcare,well you or that administrator is pretty clueless, good luck with that concept. I know turkey day is tommarrow, but “that pig don’t fly”…
RF
November 21st, 2012
1:01 pm
Ben: here’s some interesting stats for you:
Among the under-65 population, the uninsured were no more likely than the insured to have had at least one ED visit in a 12-month period.
Persons with Medicaid coverage were more likely to have had multiple visits to the ED in a 12-month period than those with private insurance and the uninsured.
ED visits by the uninsured were no more likely to be triaged as nonurgent than visits by those with private insurance or Medicaid coverage.
Persons with and without a usual source of medical care were equally likely to have had one or more ED visits in a 12-month period.
http://healthexecnews.com/trends-whos-most-likely-to-wind-up-in-the-er
In the over 65 crowd, there are more ED/ER visits and that number will likely rise as the population ages. Normal considering the decline of overall health condition as we age.
southpaw
November 21st, 2012
1:01 pm
RF @12:25
Promoting the general welfare is mentioned in the Constitution’s preamble, but the Constitution itself is supposed to set limits on that promotion. One of the Anti-Federalists had the same idea you seem to imply, as seen from this excerpt from the Anti-Federalist Paper #5.
In the 1st article, 8th section, it is declared, “that Congress shall have power to lay and collect taxes, duties, imposts and excises, to pay the debts, and provide for the common defence, and general welfare of the United States.” In the preamble, the intent of the constitution, among other things, is declared to be to provide for the common defence, and promote the general welfare, and in this clause the power is in express words given to Congress “to provide for the common defence, and general welfare.” — And in the last paragraph of the same section there is an express authority to make all laws which shall be necessary and proper for carrying into execution this power. It is therefore evident, that the legislature under this constitution may pass any law which they may think proper.
For the full text, see http://www.constitution.org/afp/brutus05.htm.
James Madison rebuts that notion in the Federalist #41. In fact, he ridicules it just a bit. I won’t copy the ridicule, but the most important part of the rebuttal is this, after he refers to the enumeration of the federal government’s powers: “For what purpose could the enumeration of particular powers be inserted, if these and all others were meant to be included in the preceding general power?” I encourage everyone to get the context, and Madison’s thoughts about the Necessary and Proper Clause, by reading the rest of the Federalist #41 at http://www.constitution.org/fed/federa41.htm.
St Simons - he-ne-ha
November 21st, 2012
1:10 pm
somejerk – “If triage is not healthcare,well you or that administrator is
pretty clueless, good luck”
no, she’s qualified, and you’re not, don’t be a hater.
’cause now you’re a jerk AND a hater, and that’s no way to go thru life
but by all means keep posting.
RF
November 21st, 2012
1:10 pm
“It is therefore evident, that the legislature under this constitution may pass any law which they may think proper.”
And our responsibility as citizens is to vote for representatives we believe will pass laws consistent with our needs/desires. If they do not, then we vote in new ones who can offer up such legislations as we feel needed.
The balance of “necessary and proper” has been debated for a long time. And that is central to the healthcare debate. As I’ve posted several times today, the one time you use it and your life is saved and/or improved as a result, your view of its necessity or propriety will be supportive. The one life you know it saves will impact you, IMO.
alex
November 21st, 2012
1:25 pm
St. Simmon :good, brilliant response to someone who has actually WORKED in an E.R., this adminstrator is not qualified to take care of patients. You really are a turkey-get it-ha, ha. No, fat dumb and stupid (to paraphrase Dean Wormer) is no way to go thru life…..
middle of the road
November 21st, 2012
1:30 pm
“I just can’t understand why one cannot look at the past history of ANY government program that is not over spent and BROKE
Social Security. ”
Are you STUPID or something? Social Security is in the black – has money in the bank. Now it willnot be forever unless we change its business model, but for today, it is more than solvent.
0311/8541/5811/1811/1801
November 21st, 2012
1:35 pm
If Hamas hadn’t fired the first rocket there wouldn’t need to be a “ceasefire”.
nobodyyouknow
November 21st, 2012
1:46 pm
I did not support or vote for O,bama but he is president now and we all better hope he does not fail on the economy and world affairs. If he does fail, we all suffer. The O,bama healthcare bill has so many paragraphs and pages its hard for most to deciper. We’ll see in the next couple of years what happens.
Katherine Helms Cummings
November 21st, 2012
1:49 pm
Mary Elizabeth- the sniping and name calling I get from people on the Right generally results from asking for data and respectful discussion of differing opinions. Hang in there. The discussion will not advance unless you do.
Doggone/GA
November 21st, 2012
1:58 pm
“we all better hope he does not fail on the economy ”
And what do you think HE can do about the economy without the cooperation of the Congress?
josef
November 21st, 2012
2:13 pm
Testing, one, two, three….
josef
November 21st, 2012
2:19 pm
Well, I see I’ve not been banished, as requested, to the lower 40 of the Liberal Plantation!
Hope everybody, including the Du-k-sha-nee, the Wa-do and Sue Ellen, are having as happy a day before Turkey Day as we are ’round cheer…Life is good…all the kids and their kids, folks in from Oklahoma, got my crepes ready and going to dinner out with most of the tribe tonight. No mess to clean up either place…
Oh, and the thread? The Insurance Companies. Medical Industry and Pharmaceutical Industries ain’t kvetching. Vive le socialism!
alex
November 21st, 2012
2:23 pm
@ josef:, old cheech and chong routine: class, class, CLASS..SHUTUP….thank you…..
Modern Day
November 21st, 2012
2:25 pm
@Alex the state of Cali is broke but not the people of Cali. In Alabama the state has money but the people don’t. Oh yea…Southern states accept millions of dollars from the feds. but tell their voters it’s wrong to accept money from the feds. But i hope all republicans continue with their ways. It will only continue to offend and push more Democrats to the polls. Thanks for the rhetoric and FOX news…it was the best motivation to get Democrats to the polls in record number.
josef
November 21st, 2012
2:26 pm
Alex
So, you’re still on the verandah, too? How’s the blood pressure? Need a valium?
alex
November 21st, 2012
2:28 pm
“to the barricades, off with his head…..”ain’t josef one of those communist names..shoooot, boy, we ought to fry that sumobch…….Kum by ya,Kum by ya….are you a good witch or a bad witch?
josef
November 21st, 2012
2:31 pm
Alex
You better be careful…I’m liable to give you my curriculum vitae and the titles in my library…!
JKL2
November 21st, 2012
2:32 pm
jamvet- Keep Hopelessness Alive!
Is that obama’s new slogan?
alex
November 21st, 2012
2:35 pm
@ Modern we can very much agree that this election is a motivator and that is good. For me it means we are a big step closer to equality for all races, and creeds and genders. Time to end quotas. If repubs continue with their social conservatism they will flounder at the national poles more than local….I’ve been to Cali, the people are broke, yes they are nice and smart , but they do not want to work, at least norhtern cali, go to a resturaunt, go to a giants game-get a soda, ride BART (if you can tolerate it). Beautiful area, smart laxy people-of course not all, but enough that it’s very frustrating..
don’t be condescending I do not watch msnbc or fox, mostly CNN, John King is great. If the Dems overplay heir current advantage and they will, the party in ascention always does, then things will change, for now…MORE COWBELL
josef
November 21st, 2012
2:38 pm
Alex
Just don’t try to take that cowbell to the Egg Bowl…
JKL2
November 21st, 2012
2:40 pm
scout- If Hamas hadn’t fired the first rocket there wouldn’t need to be a “ceasefire”.
Funny how they want a ceasefire now that Israel is tired of playing with them..
Hillary to the rescue!
0311/8541/5811/1811/1801
November 21st, 2012
2:44 pm
JKL2:
They want a ceasefire because they are getting ready to get their “arse” kicked by the IDF !!
josef
November 21st, 2012
2:47 pm
Hamas got what it set out to get, death and destruction for the evening news to show just how evil those Israelis are, the Mid East in a roil, and, mission accomplished…time to back down and assess the outcome…
JamVet
November 21st, 2012
2:59 pm
jamvet- Keep Hopelessness Alive!
Is that obama’s new slogan?,/i>
2, you must be a big hit with the fifth graders on the play ground…
alex
November 21st, 2012
3:00 pm
“when will they ever learn, when will they ever learn….’
or”send in the clowns”
Charles Plumpick
November 21st, 2012
3:19 pm
Bring out the teacups. The times in which we live could be better, could be worse. They’re not as bad as 90 years ago, not as good as 40 years ago. We can wring our hands or we can embrace today and tomorrow, be thankful that we are living today – that hopefully somebody cares about us and most importantly that we can and do care about others.
Elections Have Consequences
November 21st, 2012
3:48 pm
It’s the ultimate shell game. Put aside state’s rights, or that the law remains unpopular as a whole. The states are supposed to now roll over and agree to a monumental increase in entitlement spending.
The carrot, of course, is that the Feds pick up 100% for the first two years; after that the number drops as a percentage, but in real dollars, given the projected astronomical cost curve, it poses a financially devastating situation for states with higher Medicaid spending. It’s humorous that the argument somehow gets twisted into an obstructionist political one without examining the true long term net impact on cost.
Billybob
November 21st, 2012
5:45 pm
thanks doggone/for showing the liberal democratic way is for their ilk when they are in power to use gov’t to take more and more control of our lives….thanks again for enlightening everyone here……here’s a quiz….what is the definition of industry being privately owned and gov’t controlling every aspect of it based on the whims of bureaucrats?…..the anser is of course the new leftist democratic party way….or some might call that……?
Obamacare ........oh no!!!!!'
November 22nd, 2012
10:16 am
To the folks on this blog making comments about the details of the pending changes to healthcare, put a big cushion on your seat! It will help to eliminate some of the impending orifice exam! Being involved with healthcare for 25 years, please read the details of the “Affortibility Care Act” it will open your eyes to say the least!
Vast Right Wing Conspiracy (aka "Knuckle-Dragger")
November 23rd, 2012
9:23 pm
Put it to a vote to repeal here in Georgia, and you will get something greater than or equal to the charter school vote. The common sense vote can still carry the day in this state, although if y’all put 100,000 more on food stamps, that may be in jeopardy.
barackaclauscare will put the same caliber folks that have destroyed the Post Office, etc., etc., etc. in charge of a large portion of our economy. The incompetence, graft, etc., etc., etc. will be painful to watch. Our best and brightest will begin to avoid healthcare like the plague (pardon the pun), and a “MD” will begin to mean little more than a glorified automobile mechanic. The good doctors that elect to remain in business will become “concierge” doctors, catering to private pay only. As the system becomes less and less solvent, the cry will continuously go out for more money, a la the public school system.
Perhaps between the concierge doctors and the countries gearing up to provide health care to Americans one can stay healthy, but who knows? As in Britain, it will quickly get to the point where a trip to the hospital is a game of Russian roulette.
Lewis Swanson
November 25th, 2012
5:19 pm
The ACA health program is a great thing We need an exchange in Ga. If Shady Deal can figure out a way,he and his close friends and cronies can benefit from it, in a monetary way,he will be for it.