Sunday, May 28, 2017

Martha McSally's War on Medicaid

I’ll get back to that, but first here are some facts beginning with John Cassidy’s New Yorker report on The Republican’s War on Medicaid.

Many Republican-run states have refused to accept Obamacare’s expansion of Medicaid, but some—including Arizona, Iowa, Ohio, and Pennsylvania—have agreed to participate. Although the details differ from place to place, the common thread is that Republican governors and legislatures in these states have seized the opportunity get more of their citizens health-care coverage.

At the national level, however, the Republican Party remains implacably opposed to Medicaid expansion. As the House Republicans’ health-care-reform bill, called the American Health Care Act, makes clear, the Party doesn’t merely want to roll back the Obamacare reforms; it wants to shrink the entire program, transferring it to the states and imposing tight caps on the payments they receive from the federal government.

That is the blueprint for Medicaid laid out in the latest version of the A.H.C.A., which Paul Ryan, the House Speaker, and his colleagues voted through, earlier this month. According to the nonpartisan Congressional Budget Office’s scoring of the A.H.C.A., which it released on Wednesday, the bill would reduce over-all federal spending on health care by about $1.1 trillion over ten years. Of that, eight hundred and thirty-four billion dollars—fully three-quarters of the savings—would come from cuts to Medicaid.

What will repeal do to Arizonans?

Here are the numbers from a fact-checking report by The Republic ( back in December, How many Arizonans would lose health coverage with an ‘Obamacare’ repeal?

The most recent data available from the Centers for Medicare and Medicaid Services showed 185,497 people in Arizona were enrolled in the marketplace as of Jan. 14. …

Data from Arizona’s Medicaid provider, the Arizona Health Care Cost Containment System (AHCCCS), shows 397,802 adults had insurance through Medicaid because of the ACA expansion as of January.

AHCCCS Deputy Director Beth Kohler said the expansion through ACA also added 73,224 children over age 6 to Medicaid.

The total number of kids enrolled in KidsCare as of last month is 13,389, according to AHCCCS. KidsCare was not restored until Sept. 1, so not all eligible children have signed up for coverage. AHCCCS previously estimated 30,000 to 40,000 kids may sign up for KidsCare.

Those three categories total 669,912, which is about 40,000 fewer than the Urban Institute’s figure.

The Urban Institute’s researchers used their Health Insurance Policy Simulation Model to analyze the potential impacts of proposed health-care policy decisions based on the most recent data from the American Community Survey, which is administered by the U.S. Census Bureau.

The number of adults and children who gained coverage under the act’s Medicaid expansion, plus the number of people who enrolled through the marketplace and the number of children on KidsCare is about 40,000 fewer than Alliance for Healthcare Security’s 709,000 figure. It does not include thousands of KidsCare-eligible children who have not yet signed up for coverage, but it is more or less an accurate number.

So the number of Arizonans at risk Is somewhere between 669,912 and 709,000.

What effect will repeal have on what’s in your wallet?

The Tax Policy Center reports on the effects of repealing ACA on taxes paid by families in various income brackets.

On net, the ACA significantly increased average taxes on families in the top one percent of income, cut taxes on families in the bottom quintiles, and modestly increased taxes on the rest of families.[4] Repealing the ACA taxes in 2025 would provide an average tax cut of $46,000 to families in the top one percent, increasing their after-tax incomes by more than 2 percent (table 2). In contrast, average taxes for families in the bottom and second quintiles would increase by $90 and $170, respectively, reducing their after-tax incomes by at least .4 percent (table 3). Families in the middle quintile would receive an average tax cut of $240, increasing their after-tax incomes by .3 percent.

Check the original report for links to references. The bottom line here is that the repeal of ACA, Ryan’s AHCA, is a boondoggle, a transfer of wealth to the already wealthy.

What are the effects in Arizona’s CD2?

The US House voted, barely, to repeal ACA with the AHCA, aka Ryan-Trump-care. What did our Representative, Martha McSally do? She voted along with the other rabid Republicans for repeal. In fact, her voting record is 100% Trump and puts her among the top 12 members of the US House voting consistsently for the Trump/Republican agenda and against the well-being of her constituents.

According to numbers compiled by the Kaiser Family Foundation and reported by Indivisible in its summary of Affordable Care Act data by congressional district, thousands of McSally’s constituents will be negatively affected by ACA repeal. The Number of People Enrolled in a Marketplace Plan is 19,100 and the Number of People Gaining Coverage From Medicaid Expansion is 28,507, so the Total Number At Risk Due to ACA Repeal in CD2 is 47,607.

We then might well ask why McSally is voting against the well being of her constituents. And some Arizonan’s are asking exactly that question. Here’s a Letter to the Editor printed in this morning’s Daily Star titled “Where is McSally’s civility, compassion?”

I appreciate C.J. Karamargin’s column, “The time for civility, respect and understanding is now.” The Tucson community soars when it is a true community, and the threat phoned in to Congresswoman McSally reflected the worse of ourselves and must be denounced. So thank you C.J. But I believe that our political leaders should also reflect the best of our community. CJ’s boss, Congresswoman McSally, cheered on her fellow Republicans to pass their new health care bill yelling ”Let’s get this f—ing thing done!” Not exactly a model of civility. The bill she championed would deny healthcare to millions of Americans, not exactly a paradigm of compassion either.
Dr. David Sadker

With a 100% Trump voting record I despair of civil discourse shifting McSally’s behavior. The only other civil, compassionate course of action for us is to use the ballot box to give her the boot in 2018. She should lose by 47,607 votes - the number of her constituents who will be harmed by ACA repeal.

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