Good news from the Affordable Care Act. Despite continued Republican moaning about the "failure" of "Obamacare," new numbers suggest that as a result of the law's first year of expanded health care (about 10 million Americans gained private insurance or Medicaid coverage), hospitals nationwide will save $5.7 billion in providing care to impoverished, previously uninsured Americans who otherwise would show up without coverage at emergency rooms, or go without care whatsoever.
You might ask: How much of that huge savings will benefit hard-pressed hospitals in Wisconsin, where Gov. Scott Walker refused to accept expanded Medicaid support from the federal government? The exact figure is not yet parsed, but the likely answer is: little, or nothing, or -- most likely -- higher state deficits instead.
Walker may be clueless, but it's not like no one else saw this coming. The association representing Wisconsin's hospitals heavily lobbied the Walker administration and legislators to accept federal dollars to expand the state's version of Medicaid, known as BadgerCare, knowing in advance that, otherwise, this very thing would happen. The governor's answer to that concern: <cue sound of chirping crickets>
Nevertheless, you can bet that when some if not all of Wisconsin's hospitals are forced to cover their increasing losses, they'll make up part or all of them by raising rates on patients who do have health insurance coverage. And when those hikes in turn lead to rises in private insurance premiums, then watch guys like Walker blame the increases on ... "Obamacare"! Nice little sleight-of-hand magic trick, don't you think? Let's give the gov a mirror for his birthday; might help him acquire a little more self-awareness. He is a governor who wants to start drug-testing any low-income people who get public assistance. Because, so his thinking goes, poor people are often lazy and cannot be trusted whereas rich people -- many of whom get other forms of relatively lavish public assistance, such as tax credits -- well, those wealthy folks simply never, ever use drugs, now, do they?
Thus it isn't only Wisconsin hospitals that have a health-care problem and a revenue problem. Thanks to Walker's intransigience and rather crude notions of the social safety net, the state's own public health-care budget remains under water. Meanwhile Walker's grandiose announcements that he was "expanding" the state's BadgerCare program turned out to be mostly a wash, because the people he added to the program's rolls largely were offset by others he cut off. A good summary of the shambles that is Walker's BadgerCare budget is available from the Wisconsin Budget Project, at the web address in the links below.
According to Reuters wire service, the federal government expects nearly three-quarters of the national Medicaid savings -- $4.2 billion -- will be in the 27 states that chose to expand Medicaid under the Affordable Care Act -- Wisconsin, as we said, is not among those states.
In states that accepted Medicaid expansion, coverage has been extended to most citizens living near the federal poverty line. That's the main way across this country that significant health care reform is reducing uncompensated care for the poor, which in turn benefits all the rest of us who do have health insurance. However, because of a national GOP political hissy fit, millions of Americans have been left without health coverage in the 23 other states. That includes Wisconsin where 53,000 adults just over the official poverty line but still considered poor got the old Walker heave-ho from BadgerCare.
Worse yet, statistically speaking, thousands of those still uncovered Americans in Wisconsin and elsewhere will die unnecessarily for lack of care that the federal government would otherwise cover, if all the states went along with Medicaid expansion. So, arguably, Walker's decision also amounts to creating a virtual, Sarah Palin-type "death panel."
No change of heart on that stance so far in ideologically rigid Walker-land, but in a growing number of Republican-controlled states, governors are beginning to face the spreadsheet and do a 180-degree turn, pushing their legislatures to reconsider and implement Medicaid expansion in favor of more red ink. Indeed, the public increasingly is beginning to demand it. Walker is out of step, but thinks he's leading a march.
But that's not all, folks.
Meanwhile, according to the Associated Press, Wisconsin is one of only four states where cuts in the food stamp program are occurring. That's thanks to provisions in the massive agriculture funding bill that congressional Republicans rammed through. Republicans expected far more sweeping cutbacks in food stamp support, but in a dozen states, Democratic governors have since acted within the law, finding ways to preserve benefits in an era when more people are falling behind economically.
The GOP-led law (the party of Big Bidness threatened to hold up the entire agriculture bill unless Democrats gave them much of their way) says poor people can only get higher food stamp benefits if they also receive more
than $20 a year in home heating assistance. Republicans expected that level of heating aid would be too expensive for states to cover -- because many more people, many of them in working families, are still having trouble paying their heating bills, thanks to the continuing, conservative love affair with upwards wealth redistribution.
To the surprise of the Republicans, however, those dozen Democratic governors and the mayor of the District of Columbia said they would be able to manage the cost using federal heating assistance dollars, while California plans to pay for the assistance with state funds.
In short: too many Americans are still poor, even if they work full time, and they're hungry and cold. That hasn't outraged Republican lawmakers, but they are outraged that Democrats have found ways to work around the GOP's punitive cuts to the nation's social safety net.
Result: In all of the 50 states, food stamp cuts only will occur in Wisconsin, Michigan, New Jersey and (the only state with a Democratic governor) New Hampshire. What's Scott Walker's plan to deal with more Badgerlanders going hungry and cold this winter? Apparently, it's .... zzzzzzzzz.
Scott Walker: He's not going to wear pants until he loses this election.
