Overhauling the United States health care system will be complicated and take time. It will rightfully involve feedback and questions from the states and assistance and flexibility from the federal government.
But having questions about the law should not deter states from cooperating with the implementation of the Affordable Care Act. Questions should be part of the process, not an excuse to wait until the next election with the hope of overturning the law then.
The Republican Governors Association sent a letter to the Obama administration last week seeking answers to many questions about the Medicaid expansion provision of the law and the required health insurance exchanges, which act as an online marketplace for people to shop for private insurance plans.
The letter was beneficial in the sense that it opened discussion about realistic concerns, instead of relying on common rhetoric about the law making Americans less free. Governors asked the federal government to explain how long-term funding of health care exchanges will be sustained and wanted to know the deadline by which states have to say whether they will participate in the Medicaid expansion.
The Republican governors asked what regulations will have to be reopened for public comment in regard to the health care exchanges. Also, when will the federal government provide guidance about health benefits required under the exchanges? How will the states be reimbursed through Medicaid for medical services provided to undocumented aliens?
Governors have an especially large number of questions concerning the expansion of their Medicaid programs — since the Supreme Court ruling allows the states to opt out of the Medicaid expansion without affecting current funding. Not all Democrats attending the National Governors Association meeting last weekend were committed to expanding Medicaid, while not all Republicans were ruling it out.
Gov. Paul LePage has said he will not make recommendations to the Maine Legislature until after he has answers to his questions and until after the November election — though he has expressed doubt several times about expanding Medicaid and building a health insurance exchange.
Though the law says the federal government will cover the entire cost of expanding Medicaid for the first three years and then 90 percent of the cost after that, some governors have said they want more assurance that federal officials will not pull the funding. Others have asked for more flexibility in running Medicaid.
But governors can’t have it both ways and claim they don’t have enough decision-making power while asking for more direction from the federal government. That’s what LePage did in his radio address on Saturday. He asked for more state flexibility and also expressed frustration about the federal government not providing enough guidance to states about running the health insurance exchanges.
States will need to have a little patience, while it’s up to the federal government to provide clear answers to the governors to help them prepare. Mainers may keep in mind that a similar process has happened before — with the enactment of Medicaid in 1965. It took years for each state to sign up, with Arizona the last one in 1982.
We hope it’s not too much to ask that Maine not delay for 17 years before getting on board with the Affordable Care Act. Let the questions be part of the process of implementing the law, not tearing it down.
When the federal government opens the floodgates for healthcare dollars there is no possible or other way to afford a 100% roll out.
We’ve seen this already with the federal stimulus funds. When fast track programs granted hundreds of millions of dollars for private investment, through public partnership funds and now, the results are all mediocre at best. To the absurd point of the fiscal-cliff, where taxes are raised just as government services are cut.
To suggest that every state should now expand the medicare program at the loss of other essential government services, is a challenge that needs a solution more than a recommendation.
Um, there is no expansion of Medicare planned. Did you mean Medicaid? Mediocre results are whose fault? It is not the federal funds but the recipients that will determine results. At least that is how it appears to me.
Better to let the federal government set up the program and have them pay the entire cost rather than have the states set it up never knowing when the Federal Government will dump the entire cost on the state. They say they will after three years pass 10% onto the state if the state sets it up…. how much in following years?
The time will come when it will get dumped on the states…unless there is a national health care system.
Like I said with HillaryCare: demonstrate it works in DC. Eventho the cards are stacked in the government’s favor in a federal district, show it works and the rest of the states will line up.
Good question for which there is no answer. Can be no answer. Will be up to Congress. You know. Our elected representatives.
another liberal heard from.
Hear, hear! Glad to hear it.
So….. who is it up to in your world? And, who has the crystal ball to see into the future?
The states are ill-able to handle the additional burden. If they want it let the feds pay for it. The moment the states accept responsibility. Your taxes will go up.
The feds (you and I) are paying for it for the first how many years and 90% after that. States will have no such burden unless someone pulls the plug as you suggested in an earlier post to which I replied no way to know. But we cannot be help hostage to those kinds of predictions. Our taxes have to go up at some point. There is no other way out of this mess created by spiraling health care costs that added to the deficit and two costly ‘wars’ and risky Wall Street behavior. Those that say no to tax increases are just digging the hole deeper. Locally my taxes went up in part to pay for increases in materials for local road repairs. I think spending tax money on infrastructure and health care is a good investment. About time.
The history of social programs particularly medicaid is of feds sitting up states to take the fall. Its easily predictable. If the Feds set it up they maintain responsibility. If Maine sets it up we are in a “you built it, you own it” situation.
Shortly after AHC is in full swing we will all come to our senses and realise how wrong the congress was not to commit to single payer health plan. That is the only way to control the increasing cost of health care. The free market system is flawed when Doctors, Hospitals,Drug companies and any one involved can make huge profits and deliver some of the worst results for the cost we have to bear.
You are confusing the state’s option of participating in Medicaid expansion (MaineCare here) with the state’s option of opening up subsidized health insurance exchanges. If a state turns down the former, no Medicaid expansion will occur in that state; if the state turns down the latter, the federal government will step in.
As the federal tax rates are at a lower level than at any time since WW II, you are clearly worried too much about increases in taxes. We had a far more prosperous economy under the higher rates Clinton enacted in 1993.
Funding for the Medicaid portion of the ACA should be more reliable as those states who refuse to take part will lose funding for it then creates more funding for those states who opt into the program. The last time I checked the State of Maine gets something like $1.47 returned from the federal government for every $1.00 it sends to them. If you start cutting federal money to the states you are cutting jobs. If you start cutting jobs the local tax returns will decline. This would lead to an increase in local fees and taxes including property taxes. It is dumb to refuse an increase in federal money.
The problem is what happens when the feds no longer send the increased amount of money? Then states are responsible for a huge sum of money at a time when very few states are operating in the black ink.
The first three years are covered 100% . The next years 90%. Who knows what the economic situation will be in five years from now? Who knows how much change in the health care situation will be five years from now? Sunshine is a rather optimistic name for a pessimist.
My sentiments exactly.
Gov. LePage is exactly correct in his approach. We must resist implementation of this behemoth boondoggle in every possible way, and pray that Obama is shown the curb in November so we can get to work to Repeal and Replace with sensible affordable effective reforms. Keep up the good work, Governor.
http://www.mittromney.com/news/press/2012/06/we-must-repeal-and-replace-obamacare-0
As for you, BDN: Is there a radical leftist cause you don’t support? Man, do I ever miss my once moderate hometown newspaper.
Better keep praying. Just remember prayers are not always answered, at least not in the way that you want.
It would be far better to do something constructive with Medicade than foot drag and depend on blind hope that you’ll get off the hook.
I think the radical here is you :S
Remember – politics before people.
I find it odd that most other first world countries (and many countries who are not first world countries) apparently can figure out how and manage to provide their citizens with health care…but in this country health care is like string theory…..and no Governor LePage I’m not talking about floss.