Block Granting Medicaid gives States power to Kill Care, Kill Constituents.

I recently posted this story...

Wisconsin Republicans should just seek death penalty for costly poor people, or is punishment more fun!

Republicans in the state have done it, they've now gone after everything a person, or family, needs to literally live; Work for food stamps, work for health care, and now work for housing. If you don't work, you don't live. We're now the death penalty state for the jobless!!!

GOP lawmakers have advanced a proposal that would require some able-bodied adults to work in order to get housing vouchers in Wisconsin.

All of this lunacy sprung out of the federal governments plan to give some leeway to the states trying a different approach to our safety net programs. You've seen what happens when voting rights are left up to the states to manage; hoops, regulations, confusion and suppression.

Block granting Medicaid the Prize: Now that Republicans control everything in Washington, Medicaid is about to become a block grant, meaning Republican states are developing plans to make it almost impossible to get health care...which is the reason they're doing this.

Kentucky is moving closer to an overhaul of the state's Medicaid program Bevin has said is aimed at controlling costs and encouraging more personal responsibility in consumers, changes that include elimination of basic dental and vision benefits for most "able-bodied" adults who instead would have to earn them through a "rewards" program.

Wanna get well? Beg me, roll over, jump, sit...the condescending cruelty of the Republican Party knows no bounds. I get a kick out the this old puzzler: "tailored to meet the unique needs of Kentuckians." Because people in Kentucky are genetically different from everyone else? 

It's hard to imagine a more bizarre set of hurdles: 

Proposed changes include monthly premiums, co-payments for services, mandatory work or volunteer activity to maintain Medicaid coverage and "lock-outs" of coverage for up to six months for some who fail to pay premiums. The state proposal also includes a "My Rewards" account where people can accumulate points for activities such as passing a GED exam, completing job training or completing wellness activities such as stop-smoking classes, points that go toward the purchase of services such as dental or vision care.

But Medicaid members also would have points deducted from their rewards account for infractions such as failing to pay premiums or "inappropriate" use of emergency rooms up to a negative balance of $150.

Richard Seckel, director of the Kentucky Equal Justice Center said other states that have attempted to impose modest premiums allowed by Medicaid have found that the cost of collecting monthly payments greatly exceeds any revenue the state takes in.

But the point has never been to help the sick or the unemployed. It's always been about vilify and punish needy.

Mark Carter, CEO of the Louisville-based Passport Health Plan, which manages care for about 300,000 Kentuckians, said the increased work will increase Passport's costs, which likely will mean more costs to the state Medicaid program. And he said it's inevitable some people won't understand the changes or be able to meet new demands and lose coverage. "…there will be some fallout from that," Carter said.

Republican Medicaid Block Grants on the way...dropping health care for millions of Americans!

Medicaid block grants are coming. It's one of Paul Ryan's top priorities and a scheme that Republican states want to change more than anything, so they can balance their depleted budgets. Since Medicaid (BadgerCare) consumes over 18% of the state budget, the GOP wants to take a meat clever to it and slash the number of people getting health care. Nasty place to cut.

Trump is almost certain to grant Ryan's request, which would cut the federal strings (rules and regs) that come with the program that protects the recipients and families.

You may be wondering why Republicans are doing this. Well, they think health care is a consumer product that we just go out and buy. But it's not. Insurance is. Their assumption? If enough people get treated for heart attacks, demand goes up, and the price will come down. Insane? Sure.

For example, here's New Hampshire's pie in the sky brutally cold proposal just rejected by the Obama administration. It's just a sample of things to come with "block grants:"

The Centers for Medicare and Medicaid Services is denying a New Hampshire waiver request that would impose a work requirement on the state's Medicaid beneficiaries, create new standards for verifying U.S. citizenship and penalize beneficiaries if they use the ER in non-emergency situations.

Verify U.S. citizenship and actually penalizing people for going to the ER for something that turned out to be not so serious? Who made average people doctors? The penalty amount may not be much now, but just wait.

Again, we're talking about a U.S. citizens basic health care needs, not some handout:

The CMS said it was unwilling to approve any of the requests as they “could undermine access, efficiency, and quality of care provided to Medicaid beneficiaries and do not support the objectives of the Medicaid program (PDF). The denial follows rejections of similar proposals submitted by Ohio and Arizona. 

Just like taking away food stamps, the "undeserving" aren't allowed to live a pain free healthy life or prevented from dying prematurely:

In August, the state requested that those considered eligible either work, train for a job, be actively searching for work or other work-related activities for at least 30 hours per week ... also sought to require newly-eligible adults to verify that they are U.S. citizens by providing two forms of identification, and verify that they are residents of New Hampshire by providing a state-issued driver's license or a non-driver's license picture identification card. 

They weren't done...

Finally, the state sought a policy that would require beneficiaries who visit the emergency room for non-emergency purposes to pay a copayment of $8 for the first visit and $25 for each subsequent visit. 

You can't tell me other states will come in at even higher penalties.

But this one basic true stood out for me:

“Linking Medicaid eligibility to employment has no connection to the purposes of the Medicaid program,” Community Catalyst, a consumer advocacy group, said in a comment.

Voters Reward & Elect Republicans for making Government Fail, Pt. 1

Did the war on poverty really fail? No, but it wasn't a rip roaring success either, thanks to the efforts of the Republican Party. And oh yea, what about "block grants" and "accountability?" 

The idea that Republicans want to restore "accountability" to taxpayer funded programs and policy is ludicrous. In one of the states biggest expenditures, education, Republicans made a point of reducing school accountability for taxpayer supported vouchers. Environmentally, they've almost completely eliminated any accountability for keeping our water supply plentiful and clean. 

Block Grant Scam that made the War on Poverty look bad: And now, research has revealed the same thing happened to the welfare reform "block grant" program, otherwise known as Temporary Assistance for Needy Families (TANF). The term "Block grant" is the first clue the Republican scam is on. Block grants allow Republican states to do pretty much anything they want with taxpayer money, federal or state, by reducing safety net programs and political accountability.

Besides all the liberal warnings about the "block grant" scam, let's check in with conservative Peter Germanis, who worked under Ronald Reagan and George H. W. Bush, and did research at the American Enterprise Institute and the Heritage Foundation. Wisconsin Budget Project:

In a January 2016 paper titled “The Need for Common-Sense Conservative Welfare Reform,” he wrote:

“TANF is not ‘welfare reform’ at all, but a fixed and flexible funding stream that has failed to provide an adequate safety net or an effective welfare-to-work program. In many states, it has become a slush fund used to supplant state spending and fill budget holes.”

Sounds like a scam to me. It basically allows Republicans like Scott Walker to pass budget busting tax and spending cuts, at the expense of those who really need it. It also adds to the GOP meme that government can't do anything right, a campaign winner that increases public resentment and anger, and produces lots of Republican votes. These are all GOP poison pill policy decisions that lets them off the hook, and avoid accountability:

There are many reasons why TANF has not been a successful anti-poverty program, but I think these are the primary factors:

1. The funding level has been frozen since TANF was created, and the fixed appropriation level has lost 35 percent of its value over that 20-year period.

2. Much of the funding is being spent for administration rather than direct assistance.

3. States are able to use TANF funds in ways that supplant money the state had had previously spent from its own coffers, as illustrated by Wisconsin’s use of TANF funds to reduce state support for the Earned Income Tax Credit.

Paul Ryan's Block Grant Scam: Anyone surprised?

Nevertheless, some conservatives consider TANF to be a success. Speaker Paul Ryan and a number of other Republican lawmakers want to use it as a model for changing Medicaid into a block grant to states, rather than an entitlement program. 

A new report by CBPP contains a number of good recommendations for addressing TANF’s failures. 

But the most important lesson is that TANF should not be used as a model for changes to critical safety net programs like Medicaid and Food Share.

As Germanis wrote this week about the Task Force Report offered by Speaker Ryan and a number of other Republican lawmakers, “it would not solve problems, it would add to them.”

And that just fosters more resentment while intentionally building on the scheme that government can't do anything right. Go GOP.