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Tag Archives: Medicaid expansion

Campaign Finance: expansion

28 Thursday Nov 2019

Posted by Michael Bersin in campaign finance, Healthcare

≈ Leave a comment

Tags

campaign finance, Medicaid expansion, missouri, Missouri Ethics Commission

Yesterday at the Missouri Ethics Commission:

C190918 11/27/2019 Missourians for Healthcare Community Treatment Inc 227 Main Street Festus MO 63028 11/25/2019 $12,500.00

C190918 11/27/2019 Missourians for Healthcare Missouri Primary Care Association 3325 Emerald Ln Jefferson City MO 65109 11/27/2019 $50,000.00

C190918 11/27/2019 Missourians for Healthcare Missouri Primary Care Association 3325 Emerald Ln Jefferson City MO 65109 11/27/2019 $25,000.00

[emphasis added]

They’re for Medicaid expansion in Missouri:

Missourians for Healthcare – Active
MECID: C190918
PO Box 144
Jefferson City MO, 65102
Committee Type: Campaign
Established Date: 7/26/2019
[….]
Supported/Opposed Ballot Measurer [sic]
Measure Election Date Subject Political Subdivision Support/Oppose
Medicaid Expansion 11/3/2020 Medicaid expansion Statewide Support

[emphasis added]

Alrighty then.

Previously:

Campaign Finance: The Healthcare (November 16, 2019)

Campaign Finance: they’re serious

10 Tuesday Sep 2019

Posted by Michael Bersin in campaign finance

≈ Leave a comment

Tags

campaign finance, initiative, Medicaid expansion, missouri, Missouri Ethics Commission

Today at the Missouri Ethics Commission for the initiative campaign to expand Medicaid:

C190918 09/10/2019 Missourians for Healthcare North Fund 1101 Connecticut Ave NW Suite 450 Washington DC 20036 9/10/2019 $500,000.00

C190918 09/10/2019 Missourians for Healthcare The Fairness Project 1342 Florida Ave NW Washington DC 20009 9/9/2019 $9,249.94

[emphasis added]

This is serious money – usually these kind of amounts are right wingnut republican territory.

Previously:

Campaign Finance: it’s healthy (September 5, 2019)

Campaign Finance: but wait, there’s even more (September 6, 2019)

Campaign Finance: but wait, there’s even more

06 Friday Sep 2019

Posted by Michael Bersin in campaign finance

≈ 1 Comment

Tags

campaign finance, initiative, Medicaid expansion, missouri, Missouri Ethics Commission

Today at the Missouri Ethics Commission in support of the initiative to expand Medicaid in Missouri:

C190918 09/06/2019 Missourians for Healthcare Missouri Hospital Association PO Box 60 Jefferson City MO 65102 9/5/2019 $250,000.00

[emphasis added]

You think there’ll be more? Yeah, we do, too.

Previously:

Campaign Finance: it’s healthy (September 5, 2019)

Campaign Finance: it’s healthy

05 Thursday Sep 2019

Posted by Michael Bersin in campaign finance

≈ 2 Comments

Tags

campaign finance, health care, initiative, Medicaid expansion, missouri, Missouri Ethics Commission

Today at the Missouri Ethics Commission, a total of $1,396,465.00 in support of an initiative campaign for Medicaid expansion in Missouri:

C190918 09/05/2019 Missourians for Healthcare Prospects for Missouri 460 Nichols Rd Kansas City MO 64112 9/3/2019 $396,465.64

C190918 09/05/2019 Missourians for Healthcare BJC Healthcare 4249 Clayton Avenue Suite 310 St Louis MO 63110 9/4/2019 $250,000.00

C190918 09/05/2019 Missourians for Healthcare Health Forward Foundation 2300 Main Street Suite 304 Kansas City MO 64108 9/4/2019 $750,000.00

[emphasis added]

The committee:

C190918: Missourians For Healthcare
Committee Type: Campaign
Po Box 144
Jefferson City Mo 65102
Established Date: 07/26/2019
[….]
Ballot Measure History
Ballot Measures Election Date Subject Support/Oppose
Medicaid Expansion 11/03/2020 Medicaid Expansion Support

They definitely appear to be serious about this.

So, why hasn’t Medicaid Expansion happened in Missouri?

31 Sunday Mar 2019

Posted by Michael Bersin in Healthcare, Missouri General Assembly, social media

≈ Leave a comment

Tags

ACA, Chris Kelly, General Assembly, healthcare, Kip Kendrick, Medicaid, Medicaid expansion, missouri, social media, Twitter

Good question.

From Representative Kip Kendrick (D):

Kip Kendrick @Kip_Kendrick
Missourians represent at least a quarter million of these individuals.

Kaiser Family Foundation @KaiserFamFound
Nationally, 2.5 million poor uninsured adults fall into the “coverage gap” that results from state decisions not to expand Medicaid.
They earn too much to qualify for Medicaid, but not enough to…

3:09 PM – 30 Mar 2019

Rep. Kip Kendrick (D) [2019 file photo].

The human toll, from the Kaiser Family Foundation:

Table 1: Uninsured Adults in Non-Expansion States Who Would Be Eligible for Medicaid if Their States Expanded by Current Eligibility for Coverage, 2017

State Total Currently Eligible for Medicaid Currently in the Coverage Gap (<100% FPL) Currently May Be Eligible for Marketplace Coverage (100%-138% FPL**)

Missouri 232,000 13,000 124,000 95,000

[emphasis added]

And:

[….]

The ACA Medicaid expansion was designed to address the high uninsured rates among low-income adults, providing a coverage option for people with limited access to employer coverage and limited income to purchase coverage on their own. In states that expanded Medicaid, millions of people gained coverage, and the uninsured rate dropped significantly as a result of the expansion. However, with many states opting not to implement the Medicaid expansion, millions of uninsured adults remain outside the reach of the ACA and continue to have limited options for affordable health coverage. From 2016 to 2017, non-expansion states saw a significant increase in their uninsured rate, while expansion states saw a decrease.

By definition, people in the coverage gap have limited family income and live below the poverty level. They are likely in families employed in very low wage jobs, employed part-time, or with a fragile or unpredictable connection to the workforce. Given limited offer rates of employer-based coverage for employees with these work characteristics, it is likely that they will continue to fall between the cracks in the employer-based system.

It is unlikely that people who fall into the coverage gap will be able to afford ACA coverage, as they are not eligible for premium subsidies: in 2019, the national average unsubsidized premium for a 40-year-old non-smoking individual purchasing coverage through the Marketplace was $478 per month for the lowest-cost silver plan and $340 per month for a bronze plan, which equates to nearly eighty percent of income for those at the lower income range of people in the gap and more than a third of income for those at the higher income range of people in the gap.

If they remain uninsured, adults in the coverage gap are likely to face barriers to needed health services or, if they do require medical care, potentially serious financial consequences. Many are in fair or poor health or are in the age range when health problems start to arise but lack of coverage may lead them to postpone needed care due to the cost. While the safety net of clinics and hospitals that has traditionally served the uninsured population will continue to be an important source of care for the remaining uninsured under the ACA, this system has been stretched in recent years due to increasing demand and limited resources.

Most people in the coverage gap live in the South, leading state decisions about Medicaid expansion to exacerbate geographic disparities in health coverage. In addition, because several states that have not expanded Medicaid have large populations of people of color, state decisions not to expand their programs disproportionately affect people of color, particularly Black Americans. As a result, state decisions about whether to expand Medicaid have implications for efforts to address disparities in health coverage, access, and outcomes among people of color.

[….]

From former State Representative Chris Kelly (D):

Chris Kelly @repckelly
And virtually all of them are working.
Props to @Kip_Kendrick for articulating this serious problem.
7:31 AM – 31 Mar 2019

But, the right wingnut republican majority in the Missouri General Assembly can’t believe this problem has adverse affects on rural Missourians? Right.

They won’t because they’re vindictive and petty

24 Friday Mar 2017

Posted by Michael Bersin in Missouri General Assembly, social media

≈ Leave a comment

Tags

ACA, General Assembly, Medicaid expansion, missouri, Obamacare, social media, Tony Messenger, Twitter

This afternoon from Tony Messenger, via Twitter:

Tony Messenger‏ @tonymess
Dear #moleg: The only reason you didn’t expand Medicaid was in ridiculous gambit to make #Obamacare fail. You lost. Now do the right thing.
3:34 PM – 24 Mar 2017

Not a chance. Lucy, Charlie Brown, football. I rest my case.

Reports of your Missouri General Assembly in action

13 Thursday Aug 2015

Posted by Michael Bersin in Uncategorized

≈ Leave a comment

Tags

abortion, General Assembly, Medicaid expansion, missouri, social media, Twitter

Today, via Twitter:

barb shelly ‏@bshelly

#MOLeg “sanctity of life” committee grasping for an irregularity in Columbia clinic opening. No bombshell yet. [….] 1:40 PM – 13 Aug 2015

Yael T. Abouhalkah ‏@YaelTAbouhalkah

Glad colleague @bshelly is watching Planned Parenthood witch-hunt. Don’t need to see more #moleg shenanigans today  [….] 1:52 PM – 13 Aug 2015

Sean Nicholson ‏@ssnich

This ‘hearing’ is actually dumber than I expected #moleg 1:53 PM – 13 Aug 2015

Peak Wingnut can never be realized, nor will the Wingnut Event Horizon ever be broached.

Grace Haun ‏@gracehaun

The bombshell is a “Cmte on the Sanctity of Life” isn’t discussing #Medicaid expansion #MoLeg [….]2:06 PM – 13 Aug 2015

Bingo!

Are we talking about the same Missouri General Assembly?

25 Thursday Jun 2015

Posted by Michael Bersin in Uncategorized

≈ Leave a comment

Tags

ACA, Jay Nixon, Medicaid expansion, missouri, Obamacare, SCOTUScare!, Supreme Court

“…I look forward to working with the General Assembly next session to finally bring our tax dollars home and provide affordable health coverage to hundreds of thousands of hard-working Missourians through Medicaid expansion.”

A statement released by the office of Governor Jay Nixon:

Gov. Nixon statement on ruling by the U.S. Supreme Court in King v. Burwell

June 25, 2015

Jefferson City, MO

Gov. Jay Nixon today issued the following statement regarding the U.S. Supreme Court’s ruling in King v. Burwell.

“Today’s ruling is good news for hundreds of thousands of working Missourians who will continue to have access to affordable health coverage through the federal exchange,” said Gov. Nixon.  “However, it is important to note that there are hundreds of thousands more Missourians who continue to be denied access to affordable health care due to the Missouri legislature’s inaction on Medicaid.

“Today’s ruling by the Roberts Court to uphold the Affordable Care Act a second time removes all doubt that the ACA is and will remain the law of the land.  There are no more excuses for continuing to send our tax dollars to other states and denying 300,000 working Missourians the opportunity to access affordable health care coverage through Medicaid expansion.  I look forward to working with the General Assembly next session to finally bring our tax dollars home and provide affordable health coverage to hundreds of thousands of hard-working Missourians through Medicaid expansion.”

A guy can dream.

Previously:

* SCOTUScare! (June 25, 2015)

Rep. Vicky Hartzler (r): has a SCOTUScare! sad (June 25, 2015)

How we know Obamacare is a success …

18 Saturday Apr 2015

Posted by Michael Bersin in Uncategorized

≈ Leave a comment

Tags

ACA, Affordable Care Act, healthcare, Hospital mergers, Kit Bond, Medicaid expansion, missouri, Obamacare, Ryan Silvey

So how do we know that Obamacare is a success? There’s all the standard measures: enrollment numbers, decreases in uninsured, stable or dropping medical costs, deficit savings, etc. – which are all looking great, by the way. And then there’s Kit Bond’s recent Op-Ed in the St. Louis Post-Dispatch.

An editorial note at the end of the post, notes that Bond’s lobbying firm has taken on the thankless task of promoting the Obamacare Medicare expansion – an expansion that the obdurate, anti-Obama, ideologically-blindered State Legislature just won’t countenance (if you listen carefully you just might hear the sound of tiny stamping feet and spluttering screams of “no, no, we won’t, you can’t make us” echoing off in the distance). The Op-Ed reveals Bond’s strategy for dealing with the ferocious anti-Obama-on-funny-but-misguided-principle crowd in and out of the legislature: pretend that Medicaid expansion has nothing to do with the loathsome program.

The first thing you will note about the Op-Ed is it’s evasiveness. It only mentions the Medicaid expansion once, near the end of the piece, and only equates it with the Obamacare legislation obliquely. Instead, Bond, cleverly cries a few tears over the problem of hospital closings in Missouri, problems he attributes mostly to “Obamacare-mandated cuts in funds hospitals receive for uncompensated care – the care hospitals are required by law to provide regardless of folks’ ability to pay.”

Since Bond knows his audience very well, he fails to point out that these hospital closings could far more honestly be attributed to the failure of the legislature to accept the Medicaid expansion funds offered through Obamacare, funds for care which was intended to take the place of the emergency room as the main mechanism for care of the uninsured and so offset the loss of federal emergency care dollars – and emergency room care is, incidentally, a far more costly and inefficient way of dealing with the uninsured than granting insurance through Medicaid. Aren’t Republicans supposed to be the financially responsible ones?

Instead Bond argues that the answer to the loss of these funds is to enable hospital mergers as a way to keep the hospitals pinched by the loss of emergency room funds functioning in underserved communities. And then he decries the fact that the Federal Trade Commisison (FTC) review process, which has the power to okay or deep-six a proposed merger, is, guess what, thorough. Or, the short version, the FTC does what it’s supposed to do and Bond knows that that gets his intended audience hot under the collar because, you know, big government:

Despite helping to create the problem for hospitals with expensive new mandates and cuts to reimbursements, the federal government is now making it difficult for these hospitals to deploy this private-sector solution. Currently, the Federal Trade Commission is moving painfully slow to evaluate any proposed merger or system expansion. Reviewing applications through the narrow lens of a century-old anti-trust law, the FTC is taking months or even years of bureaucratic analysis to approve these hospital partnerships – often too late for a community on the brink of losing its only hospital and largest employer.

Despite Bond’s anti-Obamacare, anti-FTC song-and-dance, Obamacare has actually been fueling hospital consolidation. But, Bond’s encomium to the merged entity that became  BJC HealthCare in the St. Louis area offers only one view of the possible outcomes of such mergers. Ill-considered consolidations have the potential to raise consumer prices, create physical access problems, as well as barriers to access to reproductive health services. As an article in Becker’s Hospital Review points out, there are a number of factors that determine whether a merger will be benign or harmful. Hence the FTC review process. It’s there to protects us, the consumers of health services – something Republicans don’t seem to understand or care about.

But of course, this whole, lengthy argument is not the real point of Bond’s Op-Ed, and is stealthily followed by this little tidbit:

Inaction by legislators in Jefferson City is also putting our health care safety net in Missouri at risk. State Sen. Ryan Silvey, R-Kansas City, has proposed a solution to reform our state’s Medicaid program that would increase access to care for hardworking Missourians, protect our health care safety net in rural and urban communities, and safeguard the state’s budget.

Unfortunately, anger over Obamacare has confused the issue, and right now, legislators are refusing to consider this common-sense solution … .

Senator Silvey’s proposal? Simply a way to try to make Obamacare Medicaid expansion somewhat palatable to the GOP heads-up-their-backsides contingent of the state lege. Such expansion, all by itself, could take care of the squeeze that the loss of federal emergency room dollars creates for hospitals. But – and here’s the magic of Bond’s rhetoric – in this article, it’s been aligned with “common-sense,” GOP-acceptable solutions to healthcare problems that Bond alleges to have been caused by that big winger bogey, big government, including – wait for it – Obamacare itself. One could read this article and leave persuaded that Silvey’s proposals have nothing to do with Obamacare and are only exciting opposition because the tentacles of evil Obamacare have confused the thinking of the poor souls in the Missouri capital.

Wow! Talk about tangled logic. Kit Bond, I salute you.

What this tells us is that conservatives who are capable of distinguishing their front from their backsides, know that Obamacare is a success and that now is the time to get Missouri in on it and let Missourians share that success. The deviousness of this piece of casuistry also reaffirms that reasonable conservatives also understand the real reason that Missourians don’t have this benefit – unbalanced, hysterical hatred of Barack Obama on the part of GOPers who can’t accept the failure of the dream of the conservative Reich that took root during the Bush years, and on the part of constituents who either fear and hate the black man in the white house, mostly because of that black-white dichotomy, or who credulously swallow all the nonsense their Foxified leaders have been spewing in their war against the godless, socialist Kenyan and his Nazi hordes.

And the funny thing? Politicians like Bond were more than willing to fan this hysterical fervor; they thought it was their ticket back into power. Now they have to serve it – or, as Bond is trying to do in his Op-Ed, trick the true believers and give GOPers in the lege a way to save face. Because Obamacare is a success and now we know they know it too – they just can’t say it out loud.

Medicaid Expansion – Missouri Rural Crisis Center sponsored panel in Warrensburg – April 2, 2015

03 Friday Apr 2015

Posted by Michael Bersin in Uncategorized

≈ Leave a comment

Tags

ACA, General Assembly, Medicaid expansion, missouri, Obamacare

Yesterday evening the Missouri Rural Crisis Center sponsored a panel discussion on the Affordable Care Act (Obamacare) and Medicaid expansion in Missouri. The center has been organizing these discussion across the state. Last night the panel included Aaron Swaney, a certified application counselor with the Family Health Center; Amanda Avent, Corporate Events Director, American Heart Association; Ruth McKinney, Family Development Specialist, Missouri Valley Community Action Agency; Mike Sutherland, Public Policy Director, Missouri Budget Project; Brendan Cossette, Director of Government Affairs, Missouri Primary Care Association; Brian Smith a rural organizer with the Missouri Rural Crisis Center; and Reverend Heather Jepsen, Pastor at First Presbyterian Church in Warrensburg.

The panel for the Missouri Rural Crisis Center’s discussion on the Affordable Care Act and Medicaid expansion held in Warrensburg on April 2, 2015.

The panel outlined the economic and budgetary reasons for implementing Medicaid expansion (specifically, the coverage gap) in Missouri. They also explained the practical impact on rural communities – with the current absence of expansion hurting rural hospitals and local economies.

The was some hand wringing on the part of some panel members about being polite when contacting recalcitrant representatives in the General Assembly. Individuals in the audience expressed frustration about their representatives’ lack of understanding and knee jerk ideological opposition to Obama and Medicaid expansion.

Members of the General Assembly who represent the area did not attend the event.  

The panel took questions from the audience. Interestingly, one individual couldn’t quite grasp the negative economic and moral implications of denying access to health care to the working poor. Everyone else in attendance appeared to get it.

Reverend Heather Jepsen, First Presbyterian Church, Warrensburg.

Reverend Heather Jepsen, Pastor, First Presbyterian Church, Warrensburg: ….You’ve heard the numbers and you’ve heard the logic. I’m here to give a faith perspective on expanding Medicaid. As you may or may not know, all faith traditions encourage their followers to care for the vulnerable and the most needy in their communities. Obviously I’m from the Christian faith. When Jesus Christ is asked to sum up the whole of the tradition he says, Love your God and love your neighbor. To ignore our neighbors in need is to ignore our God and to ignore our faith. We call ourselves a Christian nation and then we turn around and create a system where health care becomes a privilege for the wealthy rather than a right for every individual in our midst. There is absolutely no excuse for this coverage gap. As people of faith [applause] we should consider it an act of faith to demand that our legislators put, make policy changes that care for all people in our state. We should demand it. It is a faith act. Go out and do it for your neighbor and for your God. [applause]

Now, to get the right wingnut republican controlled Missouri General Assembly to understand that.

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