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Scare tactics and real numbers

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* House GOP Leader Tom Cross had this to say yesterday after the US Supreme Court upheld Obamacare

Today’s Supreme Court decision affirms a federal law that has the potential to pile billions of dollars of additional expenses into our state budget that we cannot afford. We are encouraging Congress to repeal Obamacare at the federal level as soon as possible, and provide Illinois the ability to administer an efficient Medicaid program.

* But this is what’s actually going to happen

Aides [to Gov. Pat Quinn] say under the law, 500,000 more people will qualify for Medicaid coverage, which initially will be funded complete by the federal government. Illinois will be required to pick up 10 percent of the costs by 2020, but state budget officials say it should not cost the state any additional dollars because the federal government will still be reimbursing Illinois for health care at a higher rate than before.

Another news source

All of the cost of newly eligible Medicaid recipients would be covered by the federal government during the first three years. The federal subsidy is to drop to 90 percent in 2020 and beyond.

…Adding… Crain’s

Illinois Medicaid spending is likely to increase by $1.2 billion to $2.4 billion over the five-year period starting in 2014, according to a report by the Washington-based Kaiser Commission on Medicaid and the Uninsured, published in 2010. The range depends upon how many people actually join the program.

* And then there’s this

Officials estimate that another 1 million people will be able to purchase coverage through a state health insurance exchange, which has yet to be put in place.

The exchange is designed to create a competitive forum for people to buy insurance coverage, but state lawmakers have yet to pass legislation creating the online marketplace. Quinn said he will ask lawmakers to act when they return to Springfield this fall, but some health care advocates say Illinois is running out of time and Quinn should issue an executive order to set up portions of the exchange on his own.

Quinn dodged questions Thursday about using his executive powers to move forward with the exchange. But the governor did acknowledge that initially, at least, the state will partner with the federal government to run the exchange instead of operating the marketplace on its own.

* Cross blocked a bipartisan effort to create that exchange. And the going won’t be easy in the Senate, either

Quinn said he is not worried about missing the deadlines. Secretary of Health and Human Services Kathleen Sebelius, the named defendant in the Supreme Court case, told Quinn and other large-state governors in a conference call Thursday they had “great flexibility” in putting the plans together and complying with new Medicaid provisions.

The Republican whom Quinn narrowly defeated for governor, state Sen. Bill Brady, said he doubts any Republicans will be supportive of creating an Illinois exchange until seeing whether Congress votes to repeal the Affordable Care Act.

“I don’t know what the Democrats are thinking, but I can’t see the Republicans supporting any exchange language that incorporates a tax and creates an expense to our budget,” said Brady (R-Bloomington), who co-chaired the health exchange panel.

Brady also cautioned Quinn that there would be a political price to be paid if he tries to enact the exchange on his own through executive order.

“I don’t think the people of Illinois support a tax on Obamacare. I think there will be repercussions for members of his party who let him do that,” he said.

State Comptroller Judy Baar Topinka said the threat of fines could drive many of Illinois’ uninsured into Medicaid, costing the state $2.4 billion.

State Republican Party Chairman Pat Brady added, “Obamacare will lead to the implosion of our health care system, an explosion of our national debt and economic uncertainty for millions of job creators.”

“We can move forward with the insurance exchange. Basically, we can do it through legislation, which I think is a superior method. But other states have done it through executive orders through their governors,” said state Sen. Heather Steans (D-Chicago), who sponsored a Medicaid-reform package and was a member of the health exchange task force.

Discuss.

posted by Rich Miller
Friday, Jun 29, 12 @ 9:50 am

Comments

  1. So, Sen. Brady is saying that we should not follow a federal law until we see whether or not it’s repealed at some point? Since when have Illinois Republicans been given the right to impose injunctions?

    That’s utterly absurd.

    Comment by ThinkTangerine Friday, Jun 29, 12 @ 9:54 am

  2. The “we are opposed to everything” GOP is growing old. Richard Nixon would not even recognize this party.

    Comment by Endangered Moderate Species Friday, Jun 29, 12 @ 9:57 am

  3. “Funded completely by the Federal Government.” Umm, that means us doesn’t it?

    Comment by walter sobchak Friday, Jun 29, 12 @ 10:01 am

  4. I guess a scintilla of statesmanship is too much to expect from the hapless IL GOP. You’d think leaders who want the best for our state would applaud half of million more poor residents qualifying for medical coverage at no cost to the state.

    Comment by reformer Friday, Jun 29, 12 @ 10:04 am

  5. endangered: “would not recognize: no more than jfk woiuld recognize the current democrat party

    Comment by wizard Friday, Jun 29, 12 @ 10:05 am

  6. –State Republican Party Chairman Pat Brady added, “Obamacare will lead to the implosion of our health care system, an explosion of our national debt and economic uncertainty for millions of job creators.”–

    An “implosion,” followed by an “explosion.” I guess there’s bound to be “uncertainty” after all that action.

    We’re supposed to believe anyone really talks like that? Seriously, who writes this stuff? Day in, day out, it’s awful.

    Comment by wordslinger Friday, Jun 29, 12 @ 10:09 am

  7. Not sure what JBT means. Are there presumed to be large numbers of Medicaid-eligible people who aren’t signed up for Medicaid right now, in Illinois. And when ACA is implemented in 2014 will they be subsidized at 100 percent for a few years, or at the “old” Medicaid rate. Where did the $2.4 billion come from.

    As to the federal-state partnership, I think I’d feel more comfortable with that approach, than an exchange run by our ever-bumbling state bureaucracies on their own.

    Comment by cassandra Friday, Jun 29, 12 @ 10:11 am

  8. The insurance exchange is pure free-market capitalism, linking buyers to private insurance providers, for comparitive shopping. If they had the internet in Adam Smith’s day, he would have championed it, since “informed” buyers and sellers are what make his free market work best. As it is, insurance exchanges have been around for hundreds of years using paper, voice, and coffee shop technologies.

    If this were proposed during a GOP President’s administration, Cross and Brady would be telling us all what a brilliant idea it is, and how much money it will save us all. That’s why the insurance exchange gained bi-partisan support until they stepped in to stop it.

    Medicaid is a serious fiscal challenge for the state in any case, which must be addressed over time. The ACA with this ruling does not make it substantially worse or better for us.

    Sen. Brady, as usual, has trouble understanding numbers.

    Comment by mark walker Friday, Jun 29, 12 @ 10:15 am

  9. The gloom and doom predictions of the right wing on the ACA is just too much. Who really believes that bloviated rhetoric? I suppose it keeps the base foaming at the mouth, but really:

    “Obamacare will lead to the implosion of our health care system, an explosion of our national debt and economic uncertainty for millions of job creators.”

    It’s kinda comical.

    Comment by Deep South Friday, Jun 29, 12 @ 10:18 am

  10. Since the exchanges are not a tax, under any definition, it is hard to see how even a united Republican government in D.C. could remove them from the law, unless they can win 60 Senate seats and overcome a Democratic filibuster.

    You would be able to repeal some of Obamacare using the reconciliation process, but I don’t see how you remove the exchanges that way.

    Comment by ZC Friday, Jun 29, 12 @ 10:19 am

  11. Anyways, why do conservatives want to kill the exchanges so badly? They are a market for people to buy health insurance - from private companies - with much better information about prices and quality than they have now. In the very long run, they might help drive down the cost of insurance as people become “smarter shoppers.”

    They are very close in structure to what US Republican Paul Ryan wants to convert Medicare into - a regulated market of private health insurers offering their services to the elderly, who are provided with subsidies from the government to make their decision.

    But Obama supports it, so I guess it’s gotta be a commie plot.

    Comment by ZC Friday, Jun 29, 12 @ 10:22 am

  12. I don’t care too much about the exchanges issue. If state regulators/legislators had been forming competitive markets for insurance we wouldn’t be in this mess. Basic probs: too few providers, too few options of price and variety. Young and/or healthy people could be persuaded to buy inexpensive catastrophic-only; now the feds prohibit that too. Also there is the problem of little to no price competition for retail medical services, partly a consequence of nearly ubiquitous coverage of most svcs. We get some quality competition from word of mouth and experiences of friends, etc. But it’s limited really.

    The greater cost will be on taxpayers when the 22 new taxes kick in.

    Comment by Southern Peggy R Friday, Jun 29, 12 @ 10:22 am

  13. Thanks for the newsflash Rich, the party of No still says no. Also, the party of lies and propaganda are attempting, once again, to spread BS without any supporting evidence to support their claims.

    Comment by PublicServant Friday, Jun 29, 12 @ 10:23 am

  14. wizard: you’re right. The Democratic Party has been pulled substantially to the Right over the past thirty years.

    Comment by mark walker Friday, Jun 29, 12 @ 10:26 am

  15. mark walker: lol, obviously you snark. the “ask not” has been gone for decades replaced by “gimme someone else’s earnings”

    Comment by wizard Friday, Jun 29, 12 @ 10:32 am

  16. Officials estimate 1,000,000 people would buy health insurance through an exchange. With that kind of volume, is there no thought that maybe market forces would create some extremely competitive packages for small employers and self-insured people as part of an exchange pool? There are many insurance companies (not all Illinois based) who would want that volume. Plus the Feds will cover 90% of Medicaid? But the magic word ‘tax’ was mentioned and the GOP ‘NO’ wall slams down. Exactly like Pavlov’s dog and bell story. Excellent negotiation tactic when you have nothing else to offer. In the mean time, kick another, do nothing can down the road while medical costs keep rising. ‘Excellent, Smithers!’

    Comment by zatoichi Friday, Jun 29, 12 @ 10:39 am

  17. The fact that Republicans can demagogue and tell out and out lies about this law speaks volumes about how horribly the news media has covered this bill from the start. A strong majority of voters does not approve of the ACA as a whole. But broken out into its parts, each part receives strong support.

    Lies, spin and propaganda from the GOP. Abdication of responsible journalism from the news media. Democrats say X, Republicans say Y, despite the fact that X is largely true and Y is a bunch of BS. By quoting the GOP without challenging their assumptions, the news media give equal weight to their lies and distortions. No wonder the public is confused.

    Let’s all try to remember why this bill was needed, and why every president since Teddy Roosevelt has tried to find a way to extend health care coverage for Americans. We’ve made a huge step in the right direction. Is it perfect? Far from it, but now nearly 2 million Illinoisans will have access to affordable health care insurance and society’s long-term health care costs are finally going to trend lower.

    The tax issue is simply a tax on free riders. If you want to argue that people have the right to not purchase insurance, you must demand that they live with the consequences of that decision: they should die in the streets wihtout care, mercy or pity.

    That’s not the America most of us want to live in. The cost to care for these people are already borne by the rest of us. It’s only fair that those costs be paid by everyone.

    Comment by 47th Ward Friday, Jun 29, 12 @ 10:41 am

  18. Endangered, Ronald Reagan wouldn’t recognize today’s Republican Party.

    Comment by G'Kar Friday, Jun 29, 12 @ 10:50 am

  19. 47th Ward — they’re not going to die in the streets without care. They’ll pay their “tax” and then buy their insurance when they get sick — guaranteed issue and no preexisting conditions is going to bring this experiment down, not the GOP

    Comment by Lycurgus Friday, Jun 29, 12 @ 10:55 am

  20. I know Lycurgus, they aren’t dying in the streets now because the rest of us are paying for their care. That’s really all the ACA does: it forces the irresponsible to pay for their own care.

    And since when is paying an insurance company for health coverage a tax? Is Blue Cross/Blue Shield now a federal agency? And those who don’t purchase insurance will pay a fine, which isn’t a tax either in the same way that paying a parking ticket isn’t a tax.

    Words matter.

    Comment by 47th Ward Friday, Jun 29, 12 @ 11:10 am

  21. == initially will be funded complete by the federal government. ==

    That makes me feel better, since DC is awash in surplus cash.

    Comment by John A Logan Friday, Jun 29, 12 @ 11:20 am

  22. So long as JoAnn Osmond is there, offering killing amendment after killing amendment straight out of ALEC’s legislative play-book, the Insurance Exchange will have a tough go. Nothing like feeding your insurance business at the expense of the voters, JoAnn!

    Comment by Springfieldish Friday, Jun 29, 12 @ 11:22 am

  23. “The Republican whom Quinn narrowly defeated for governor, state Sen. Bill Brady, said he doubts any Republicans will be supportive of creating an Illinois exchange until seeing whether Congress votes to repeal the Affordable Care Act.”

    Brady added that he while he will likely vote for Romney, he still believes the GOP should have nominated Harold Stassen.

    Comment by OldSmoky2 Friday, Jun 29, 12 @ 11:37 am

  24. The Patient Protection and Affordable Care Act (a/k/a Obamacare) passed over two years ago.

    Those opposed to it have been yammering ever since for a “do-over” by the U.S. Supreme Court.

    Well, yesterday, they got it. Obamacare stands.

    So now, perhaps, we implement it — imperfect as it may be?

    Noooooooooooooo. Now the yammering is for ANOTHER do-over — this time to abide the November election.

    Heckuva way to conduct public policy, that: whimper and whine for do-overs from any quarter, on the off chance you finally turn things
    to your ideology.

    Lost amid all the wailing and whining and vitriol this week is a shocking report:

    Nearly 5,000 Illinois residents died between 2005 and 2010 because they didn’t have insurance. …Illinois ranked sixth among all states in the number of uninsured people between ages 25 and 64 who died prematurely, according to the report . http://www.chicagobusiness.com/article/20120626/NEWS03/120629878/illinois-uninsured-death-toll-at-5-000-report

    Look. I’m no fan of Obamacare. I would greatly prefer a national health care program — in effect, Medicare for All.

    But that’s not going to happen in my lifetime. Obamacare it shall be, for another generation at least.

    So suck it up. The deal has been done. The bargain has been struck.

    Perhaps it’s another screwed-up health care system. But for now, it’s what we’ve got.

    It’s Obamacare. Time now to harness it as best as we are able.

    Time now to pull together.

    Time now to put first things first.

    Time now to try — as best as we can — to save literally thousands of lives.

    Comment by Anonymous Friday, Jun 29, 12 @ 11:45 am

  25. I realize Judgement Day used Stalin instead of Hitler, but that’s close enough to Godwin this one, right?

    Comment by Colossus Friday, Jun 29, 12 @ 12:06 pm

  26. The GOP is just whistling past the grave yard, turn the page and think of something constructive.
    The BS is tiring we need jobs.They just can’t stand the thought of Obama winning anything.

    Comment by mokenavince Friday, Jun 29, 12 @ 12:08 pm

  27. SNARK

    Help Wanted:

    Fledgling Organization looking for Media-Savy self-starter, who can write and understand “message” for Chairman of this Organization.

    Must be willing to work with Chairman prone to Hyperbole, and strong enough in belief and willing ask tell Chairman, “Are you sure you want to say THAT?”

    Have foresight to be inclusive to extreme points of views from every angle, and that is from your “allies” and craft press and news messages that seem like logical responses to real-time events.

    Must be a visonary to look beyond the short term of media soundbites, and make the “message” something others in the Organization to rally around.

    If these qualities describe you, please call the ILGOP, at either office in Chicago or Springfield.

    ###

    This is Snark, but wouldn’t be a bad idea either.

    Comment by Oswego Willy Friday, Jun 29, 12 @ 12:08 pm

  28. “–State Republican Party Chairman Pat Brady added, “Obamacare will lead to the implosion of our health care system, an explosion of our national debt and economic uncertainty for millions of job creators.”–”

    Apparently Gags Brady has not noticed the health care system in America imploded long ago, except for the rich and some government workers.
    Most pay way too much for everything, RX, hospital, long term care, docs; because no one every tries force some reason to be used.
    People wait way too long for service. Docs get ripped off by their insurance companies even when they face no claims

    The list goes on

    There is a questions does Billboard plan another flyaround on a state plane to whip up the wing nuts?
    Will the ruling end the uncertainty that Wall Street was hiding behind as they manipulated stock bonds and derivitives?
    Answers please

    Comment by CircularFiringSquad Friday, Jun 29, 12 @ 12:13 pm

  29. ===I realize Judgement Day used Stalin instead of Hitler, but that’s close enough to Godwin this one, right?===

    Yep. Deleted. I was eating lunch and hadn’t yet seen that one.

    Comment by Rich Miller Friday, Jun 29, 12 @ 12:13 pm

  30. ===the federal government has apparently already set a ‘one size fits all’ service package,===

    No, that’s not accurate. What ACA does is to establish a minimum level of coverage.

    ===The administrative process for this thing looks to have been designed according to the highest standards of a combined effort from Joe Stalin, the Marquis de Sade, with financial oversight provided by Bernie Madoff.===

    Are those the same people Romney put in charge of implementing his plan in MA? Was that a nightmare that led to businesses fleeing the state?

    Comment by 47th Ward Friday, Jun 29, 12 @ 12:14 pm

  31. Note to Self;

    Any or all words ending in “-osion” doesn’t make it more effective with another word ending in “-osion” following the 1st “-
    osion” word.

    Makes you look a bit Dopey.

    Comment by Oswego Willy Friday, Jun 29, 12 @ 12:26 pm

  32. I’m constantly amazed hearing the Repubs rhetoric that sounds like the Confederacy defending slavery or the Segregationists defending Jim Crow. The absolute preposterous and irrational positions are so lacking in any contact with reality that it sounds like a Marx Bros. movie.

    Comment by D.P. Gumby Friday, Jun 29, 12 @ 12:37 pm

  33. Hey, he refrained from using er-osion in that statement, so he’s not hopeless.

    Comment by PublicServant Friday, Jun 29, 12 @ 12:38 pm

  34. The ACA isn’t the utopia the Democrats claim and it won’t be the total disaster the GOP claims. Love it or hate it, we’ll learn to live with it … and hopefully improve it.

    The biggest fault I see is the size of the fines. When the fine/tax for no insurance (for those who meet the guidelines to have to buy it with their own money) is just a few hundred and health insurance costs range from about six thousand to over ten thousand, there is no incentive to buy health insurance. It’s much, much cheaper to just pay the fine/tax. If I could change one thing in ACA, it would be to make the amount of the fine be double whatever an average policy costs … that would be an incentive to buy.

    Comment by RNUG Friday, Jun 29, 12 @ 12:53 pm

  35. Getting the exchanges up and running seems like a “no-brainer.” In fact, a Reuters-Ipsos poll indicated that 80 percent of Republican voters nationwide support the concept. I think it’s time for Cross and other state Republican leaders to work out the details for implementing this program. It would be ironic if their continued intransigence forced the federal government to step in to create, and possibly manage, the exchanges in our state.

    RNUG, most Democrats I know think the healthcare law is progress, but hardly utopian.

    Comment by Going nuclear Friday, Jun 29, 12 @ 1:11 pm

  36. going nuclear,

    I was being a bit snarky on the two extremes …

    Comment by RNUG Friday, Jun 29, 12 @ 1:18 pm

  37. The health care insurance exchanges will be set up, and they will provide an improved way for individuals to buy health insurance. The Republicans can participate in that process, and therefore get some of the credit for the outcome as well as some influence on the outcome, or they can boycott, in which case they will get neither credit nor influence. As a partisan Democrat, it is fine with me if they boycott because that will discredit them. As a citizen, I hope they participate because perhaps that will reduce the extreme polarization of our politics.

    Comment by jake Friday, Jun 29, 12 @ 1:20 pm

  38. The current system protects the companies from transparency and real competition. It is very difficult to compare policies among companies. Some may price a lower premium but when you apply you are likely for them to find some reason to exclude coverage for any preexisting condition.

    Ironically, the so called advocates of the free market, the GOP, seem to be most resistant to establishing a more free and fair market.

    Plus, it does not help that some of our Congressmen like Schock are running around the state and poisoning the well and throwing monkey wrenches into implementation of the plan. GRRRR!!!!

    My advice to Quinn: We have a state dept of insurance. My guess is that some of these folks have been studying up on how to make this happen. Just give them the freaking order: Get it done. And don’t worry about the GOP ankle biters.

    Comment by vole Friday, Jun 29, 12 @ 1:47 pm

  39. Over the past two years Illinois Dems have seemingly worked hard to make Republicans the party of the poor and working class, with the income-tax hike on the poorest Illinois workers to fund retirement packages three or more times the private-sector average, Medicaid cuts, regressive cigarette-tax hike, and push to shift all of the teacher pension funding from the state to the more regressive property tax.

    The Obamacare ruling seems to give Illinois Dems an opportunity to do some good for those below the median income. We’ll see if Quinn gets moving.

    Interesting that Republicans are worried about new Medicaid recipients and yet they also want to block the exchanges. Apparently obstruction is the order of the day.

    Comment by Anon Friday, Jun 29, 12 @ 3:11 pm

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