Pumping up the base
Wednesday, Oct 1, 2014 - Posted by Rich Miller
* From that recent Rasmussen Results poll of Illinoisans that we discussed yesterday…
* Do you have a very favorable, somewhat favorable, somewhat unfavorable or very unfavorable impression of the new health care law?
Very favorable 17%
Somewhat favorable 27%
Somewhat unfavorable 14%
Very unfavorable 37%
Not sure 5%
So, 44 percent favorable, 51 percent unfavorable. Obamacare is upside down here, according to one poll at least.
* Keeping that in mind, from the Tribune…
Gov. Pat Quinn wasn’t especially visible when Illinois residents were signing up for Affordable Care Act coverage last year, but on Tuesday he called getting people health coverage the “mission of a lifetime.”
Three things have changed: The state has far exceeded expectations for how many people it has signed up for health coverage, public attitudes toward the program have improved, and President Barack Obama will raise money for a re-election-seeking Quinn in Chicago on Thursday.
The Democratic governor on Tuesday announced that Illinois has signed up 468,000 people through the state’s Medicaid program, far more than the roughly 200,000 Quinn administration expected to sign up this year and also surpassing the 342,000 the state thought would ever enroll under the health care expansion. Another 217,000 in Illinois signed up for private insurance coverage via the exchange set up under the health law.
* OK, back to the Rasmussen poll. Among Democrats, 71 percent had a favorable view of the new law, as did 72 percent of African-Americans. And, as we’ve seen in this and other polling, Quinn still has some “base” problems.
* Now, on to today’s Sun-Times story…
Newly surfaced video of Republican Bruce Rauner obtained by the Chicago Sun-Times shows him telling conservative activists in Lake County last year that, as governor, he would have blocked Gov. Pat Quinn’s 2013 expansion of Medicaid. […]
“If you were governor of Illinois, would you have accepted Medicaid expansion and what do you think about the other Republican governors around the country that rejected Medicaid expansion?” Rauner was asked.
“I would not have accepted the expansion,” Rauner responded then. “I’m deeply concerned: We have a massive problem in our Medicaid system in Illinois. It’s full of corruption and abuse, and we are facing a problem that will dwarf our pension problem in about four or five years with our Medicaid system. It’s out of control, it’s corrupt.” […]
Asked Tuesday whether Rauner’s words accurately portray his position now on rolling back Medicaid, a campaign spokesman sounded a similar refrain against “fraud” and “abuse” within Medicaid but didn’t explicitly say if the candidate favored undoing Quinn’s expansion or keeping it in place.
* The video…
Discuss.
- Jeepster - Wednesday, Oct 1, 14 @ 10:27 am:
This will help Quinn shore up his base.
- The Captain - Wednesday, Oct 1, 14 @ 10:27 am:
Should we really put the former head of GTCR in charge of rooting out fraud and abuse? Hahahahahahaha.
- Jose Abreu's next homer - Wednesday, Oct 1, 14 @ 10:29 am:
I thought Quinn was put on this Earth to solve the pension crisis rather than healthcare.
- VanillaMan - Wednesday, Oct 1, 14 @ 10:29 am:
He can cover himself with the “fraud and abuse line”. Like many other GOP governors, he will moderate that stand. It was last year when he wasn’t alone in saying these things.
Obamacare is not a third rail either.
- Demoralized - Wednesday, Oct 1, 14 @ 10:31 am:
Wouldn’t it be nice if there was actual proof provided for the “massive” fraud and abuse? I believe it’s already been determined that no such “massive” abuse is occurring.
What I see is another guy against providing healthcare for people.
- Quinntopia - Wednesday, Oct 1, 14 @ 10:34 am:
51% unfavorable? Good luck with that, Gov.
- JS Mill - Wednesday, Oct 1, 14 @ 10:35 am:
Rauner LOVES to through around accusations of corruption, when it comes to OTHER people. Funny, my mo used to say when you point a finger at someone there are four others pointing back at you, Rauner’s nanny probably didn’t tell him that.
- Grandson of Man - Wednesday, Oct 1, 14 @ 10:42 am:
One important aspect in many Obamacare polls is that many more would prefer to keep and fix the law rather than repeal it. Most of those respondents are Democrats. A recent Kaiser poll shows that independents favored the keep and fix option over repeal by a large margin.
Who wants to overwhelmingly repeal the law? Republicans. Pretty sad. I have family members who have been helped by this law.
Really, where else among advanced nations are people en masse trying to repeal universal health insurance?
Quinn needs to make this a big issue, assuming he doesn’t get torched by the NRI scandal.
- Judgment Day - Wednesday, Oct 1, 14 @ 10:45 am:
“Wouldn’t it be nice if there was actual proof provided for the “massive” fraud and abuse? I believe it’s already been determined that no such “massive” abuse is occurring.”
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Based upon what’s been talked about through the grapevine about the State’s digital information processing systems for Medicaid/social welfare programs, I’d be very doubtful that any real conclusions can be reached, one way or the other.
You’re talking about trying to generate performance metrics off data processing systems that are at least 20++ years old, and were never designed for these types of operations. To say there is ‘fraud’ or ‘no fraud’ is really meaningless, because right now, nobody can really tell and prove it. IMO, the computer systems just aren’t up to the task.
If you really want to know, it’s time to rebuild the systems (both hardware, operating software, and applications software) - and for the way this State does data processing projects (projects in general - see NRI as an example) - I’d be terrified.
Until then, this is just ‘noise’ on both sides.
- Yellow Dog Democrat - Wednesday, Oct 1, 14 @ 10:49 am:
Rauner said in a debate that he was against Obamacare because he thought the costs of Obamacare would dwarf the pension costs.
This ‘waste and fraud’ line is a fig leaf attempt to hide the deep-seated conservative belief highlighted in the debate between Obama and McCain in the 2008 debate.
Obama said he believes that affordable access to quality health care is a fundamental right.
McCain and ultra-conservatives disagree.
- walker - Wednesday, Oct 1, 14 @ 10:50 am:
I always laugh when “massive fraud and abuse” comes out of a Republican politician’s mouth. They love the phrase because they know it is heard as an indictment of those “takers” in society.
These politicians count on the public not realizing that the taxpayer money fraudulently claimed is actually going to entrepreneurs and large companies — often Republican supporters.
- steve schnorf - Wednesday, Oct 1, 14 @ 10:56 am:
The problem, though, is that when any significant financial fraud and abuse occurs in Medicaid, the abuse is by providers (say, like nursing homes) not participants. Participants don’t get money, fraudulent or otherwise, from Medicaid: providers do. Now, someone who has been in the provider business might have some experience with Medicaid fraud.
- Responsa - Wednesday, Oct 1, 14 @ 10:58 am:
I think Medicaid issues may have something to do with the poll showing Obamacare to be underwater here and elsewhere. Real people are beyond the theory stage and are into the practice stage.
==WASHINGTON — Enrollment in Medicaid is surging as a result of the Affordable Care Act, but the Obama administration and state officials have done little to ensure that new beneficiaries have access to doctors after they get their Medicaid cards, federal investigators say in a new report.
The report, to be issued this week by the inspector general at the Department of Health and Human Services, says state standards for access to care vary widely and are rarely enforced. As a result, it says, Medicaid patients often find that they must wait for months or travel long distances to see a doctor.==
http://www.nytimes.com/2014/09/28/us/for-many-new-medicaid-enrollees-care-is-hard-to-find-report-says.html
- Ducky LaMoore - Wednesday, Oct 1, 14 @ 11:04 am:
The guy that defrauds Georgia’s Medicaid system would know first hand about all the fraud within said system
- Joe Bidenopolous - Wednesday, Oct 1, 14 @ 11:04 am:
What Schnorf said. Sometimes there’s fraud and/or abuse and it rises to significant levels. A lot of the time it’s just waste though - system incompatibility, duplicate billings, plain ol’ incompetence.
Either way, it’s the docs, hospitals and nursing homes that cash the checks, not the recipients. And no one, especially most Republicans, really wants to take on providers.
- Amalia - Wednesday, Oct 1, 14 @ 11:05 am:
it’s incredible how the message and management of the health care plan were messed up at the Federal level. there are places where the program is loved…Kentucky….but even if individuals are getting better service, there is a larger opportunity missed to create faster attachment for the program. perhaps this will change with time. after all, Republicans were rabidly against Medicare back in the day and look at the program now.
- Matt Belcher - Wednesday, Oct 1, 14 @ 11:06 am:
While it pains to say this, a chunky segment of union iron workers, operating engineers, truck drivers, and ditch diggers viscerally detest the perceived handover of their ‘hard earned’ tax dollars to ‘those people’ through the expansion of Medicaid and the ACA.
The plurality of that segment/stratum of ‘very unfavorables’ will still vote for the Governor.
(However — are not ‘suburban, independent-leaning women’ more rational/receptive to decreasing the number of uninsured women and children? If so, perhaps their votes will decide the election.)
- Judgment Day - Wednesday, Oct 1, 14 @ 11:07 am:
“The problem, though, is that when any significant financial fraud and abuse occurs in Medicaid, the abuse is by providers (say, like nursing homes) not participants”
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Quite correct. And the problem is, the ‘fraudsters’ are much more ‘advanced’ (not sophisticated, just advanced) than the government is, because there’s normally very little way for the government to easily identify and as importantly, QUANTIFY the fraudulent behavior. And ‘Quickly’ isn’t even in the picture.
It takes the feds years (Social Security has many fantastic examples of fraud) to identify and crack down on fraudulent claims - see motorized wheelchairs as a most recent example. The federal data processing systems are just not up to it. And the State of Illinois makes the federal systems look positively state-of-the-art.
But Pat Quinn would rather hire political types who ‘create spreadsheets and plant trees’ than professional software developers.
- Del Clinkton - Wednesday, Oct 1, 14 @ 11:16 am:
I dont see many problems with National RommneyCare aka The Affordable Care Act.
- Jimmy - Wednesday, Oct 1, 14 @ 11:28 am:
Pat Quinn can’t “pump up” anything. He is not a ‘pumper upper’ (except for taxes). He’s just a Debbie Downer [of the state’s credit rating]!
- Ducky LaMoore - Wednesday, Oct 1, 14 @ 11:30 am:
@Jimmy
So cut taxes and our credit rating will go up!!! Yes of course!!! All tax cuts create more revenue!!! Man, one heck of an economist.
- wordslinger - Wednesday, Oct 1, 14 @ 11:52 am:
Far be it from me to question Rauner’s bona fides on the subject of Medicaid fraud and corruption.
Lason. THI. Medicaid fraud was the linchpin of the business plans.
I don’t get how corrupt providers relates to expanding coverage for individuals and families.
Apparently, some people think that Medicaid is like some welfare program, where if you’re enrolled you sit at home collect a check for phony ailments.
Enrollees never see a dime. The fraud and abuse that occurs is done by medical providers and snake-pit nursing homes like Lason. They’re the ones getting the money.
- Judgment Day - Wednesday, Oct 1, 14 @ 11:55 am:
“Republicans were rabidly against Medicare back in the day and look at the program now.”
——————–
Comparison of apples to oranges. Here’s why:
For Medicare (apart from the fact that it’s likely to go financially bust over the next few years), the eligibility is primarily age. 65 and you are good. When you only have very limited eligibility standards, makes administration much easier.
ACA/Obamacare is a whole lot tougher. And when you make eligibility standards require interfaces with up to 8 different databases located in different federal agencies/departments (original version passed into law) - currently only 5 different databases (’revised’ law as per Administration fiat) - well, that’s seriously DIFFICULT. Particularly when this cross-verification has to happen every single time. And don’t forget, the Systems aren’t all the same. In fact, most are substantially different.
And that’s just the front end issues.
You seem to want to “Keep, but change”. For a tech standpoint, it’s problematic where trying to ‘change’ the existing system could be a whole lot worse than just starting over. You really might want to consider that…..
Then you have a massive amount of back end (database) work - a fair portion which still isn’t fully complete. And here’s another problem - if you substantially mod the existing front end, you are going to likely need to modify, if not rebuild the back end (BD). So, you do the work, then re-do the work (because there’s always changes required to the original), and then you have to re-do it all over again.
Again, from a tech standpoint, this is fast becoming a case of “How much pain are you willing to endure?”
And after all the above is done, the back end (DB) has got to interface with the insurance companies, and then back to the consumer.
And then you have to have a reconciliation process - which we know isn’t done, because if the back end (DB) isn’t done, then the reconciliation process certainly isn’t done.
Had a mentor a while ago who always used to tell us that just when we though a project was going well - “TBD - There Be Dragons…..”.
Unfortunately, he had a tendency to be correct….
- Norseman - Wednesday, Oct 1, 14 @ 12:04 pm:
steve schnorf is on to something. With Rauner’s expertise in siphoning assets from nursing homes, he should know a lot of provider tricks.
- illinifan - Wednesday, Oct 1, 14 @ 12:09 pm:
“While it pains to say this, a chunky segment of union iron workers, operating engineers, truck drivers, and ditch diggers viscerally detest the perceived handover of their ‘hard earned’ tax dollars to ‘those people’ through the expansion of Medicaid and the ACA.”
They are already handing over hard earned dollars through taxes and higher insurance premiums to cover the cost of the uninsured. They are just arguing about which pocket they want the money to come from. It is time to stop seeing healthcare as a give away but a right of all to access.
- Formerly Known As... - Wednesday, Oct 1, 14 @ 12:10 pm:
What constitutes ==massive== fraud and abuse of Medicaid in Illinois? This seems like a start http://www.kmov.com/news/just-posted/Audit-reveals-half-of-people-enrolled-in-IL-Medicaid-program-not-eligible-230586321.html
- Judgment Day - Wednesday, Oct 1, 14 @ 12:15 pm:
“With Rauner’s expertise in siphoning assets from nursing homes, he should know a lot of provider tricks.”
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Just file the paperwork as per usual. The bureaucracy will probably never figure it out.
That’s what happens most of the time. And if by some chance they happen to stumble across, just lawyer up.
That’s what happens when the government spends all our money hiring people who “create spreadsheets and plant trees”.
- wordslinger - Wednesday, Oct 1, 14 @ 12:39 pm:
–ACA/Obamacare is a whole lot tougher. And when you make eligibility standards require interfaces with up to 8 different databases located in different federal agencies/departments (original version passed into law) - currently only 5 different databases (’revised’ law as per Administration fiat) - well, that’s seriously DIFFICULT. Particularly when this cross-verification has to happen every single time. And don’t forget, the Systems aren’t all the same. In fact, most are substantially different–
And the the ramistat is discombombulated to the flux capacitator.
Dude, expanding health care is a choice to provide better health care for those who don’t have it.
If it causes a problem for the IT whiz-kids, well, knock back a couple of Red Bulls and fix it.
- Carl Nyberg - Wednesday, Oct 1, 14 @ 3:21 pm:
On matters where the “Conservative” media has spent so much energy misinforming the public, I would like to see polls that separate people who are informed, people who are misinformed and people who know very little.
It seems like people who choose to be misinformed by consuming media outlets that lie should be dismissed by serious media as a fringe that exists but isn’t participating in the public discourse in a serious or honest way.
- Anon. - Wednesday, Oct 1, 14 @ 4:02 pm:
==Wouldn’t it be nice if there was actual proof provided for the “massive” fraud and abuse? I believe it’s already been determined that no such “massive” abuse is occurring.==
Wasn’t MCI supposed to be looking into that, back in the day? And I seem to remember there was some fraud and abuse found somewhere.
=It seems like people who choose to be misinformed by consuming media outlets that lie should be dismissed by serious media as a fringe that exists but isn’t participating in the public discourse in a serious or honest way.==
If you know of a media outlet (other than our beloved CapFax) that doesn’t lie (or at least is unbiased), please share it with the rest of us.
- steve schnorf - Wednesday, Oct 1, 14 @ 7:33 pm:
FKA, you know better than to assert because there are ineligibles on the roles there is massive fraud and abuse, now don’t you? Remember, we’ve all talked about this before; kids costing far less than adults, who cost far less than aged and disabled, people not getting/responding to verification notices, people moving out of the state, still on the roles but not consuming healthcare in this state, and so on.’Fess up. I’m as much in favor as anyone of removing the ineligibles from the roles on a regular basis, but you know and I know that there aren’t going to be huge savings from doing it.
- Papa2008 - Thursday, Oct 2, 14 @ 6:46 am:
I get very tired of being told there is a health care problem. There is not a health care problem. There is a “I don’t want to pay for my healthcare” problem. Solve that, the rest goes away.