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house Bill H.R. 4588

Do States Need More Federal Funds to Expand Medicaid?

Argument in favor

States that haven’t expanded Medicaid for people who are newly eligible under the Affordable Care Act should receive extra federal funds if they do so.

Michael777's Opinion
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10/28/2016
To everyone who voted NAY: Just how freaking ignorant are you all? Nearly every other modern nation on Earth has universal healthcare that is affordable and accessible to everyone! For f***'s sake, 45,000 Americans DIE EVERY YEAR because they do not have access to basic healthcare! If we can afford to spend $100 billion of our tax dollars funding +800 military bases EVERY YEAR and spend $2 trillion on the Iraq War that that idiot George W. Bush put us in, then why the f*** can we not spend more money to give Americans better access to Medicaid? It is because many Americans, including those who voted NAY to this, have fallen for idiotic, right-wing propaganda that government healthcare is somehow bad for us, but price-gouging, greedy healthcare companies are good. How freaking sad that there are actually adults who still believe in such silly bull****.
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SouthernGal's Opinion
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10/28/2016
Stop all this tinkering and just give us single payer healthcare like the majority of the world has.
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HonestHorton's Opinion
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10/28/2016
I support the idea of making the Affordable Care Act more efficient and supportive to those who need it most. If this assists Americans in paying less for their life-saving medicine and bills, then I shall support it; after all, the state of one's health should not be determined by the state of one's wealth.
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Argument opposed

The federal government shouldn’t be bribing states with taxpayer dollars to expand Medicaid. If they want to, they will make their own decision to expand it.

Maggie's Opinion
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10/28/2016
Healthcare is not a role of the federal government.
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TuckerWantsLiberty's Opinion
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10/28/2016
This is simply a blatant bribe to try to salvage something from the ACA. The states that didn't take the federal money for Medicaid expansion in the first place declined because they saw that that match was only in place for a short time and then the states would be left to shoulder the hugely more expensive Medicaid on their own. This doesn't fix that. It makes it more appealing in the short term but it was always the long term pain that deterred participation. Because the states realized it's too expensive. Because it IS too expensive. But now it's all couched in helping the poor and the sick. Give me a break. They don't give a flying flip about the poor and the sick. They're trying to buy sentiment. Read up on Thomas Sowell: "The welfare state is the oldest con game in the world. First you take people's money away quietly and then you give some of it back to them flamboyantly." The federal money they're trying to bribe states with? Don't you realize that that was already YOUR money before they stole it from you via taxation? And do you think they're giving it ALL back to you if the state goes along with this? No! Of course not! They take your money, then offer a mere portion of it back to you, but only if you agree to concede some of your autonomy to the federal government. And they will have the nerve to claim the moral high ground in that scenario! All while they've taken YOUR money and are making you BEG and SUBMIT in order to get back mere PENNIES on the dollar! It's DISGUSTING!
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···
10/28/2016
Every liberals response to their failing programs. "Just give more funding and everything will be fine"
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bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
  • The house has not voted
      house Committees
      Committee on Energy and Commerce
      Health
    IntroducedFebruary 23rd, 2016

What is House Bill H.R. 4588?

This bill would amend Medicaid to give states that expand their Medicaid coverage for individuals who are newly eligible under the Affordable Care Act (aka Obamacare) the enhanced Federal Medical Assistance Percentage (FMAP) when the expansion occurs. In essence, it would mean that those states would get more matching funds for their Medicaid program by expanding their coverage.

Currently, the enhanced FMAP equates to 100 percent in 2014-2016, 95 percent in 2017, 94 percent in 2019, and 90 percent thereafter. This bill would retain the enhanced FMAP but base it on a term of years rather than specific dates, so states would get three years of full federal funding when they expand Medicaid.

The bill would also apply retroactively, so states that have already expanded their Medicaid programs would receive the FMAP based on when their expansion occurred.

Impact

States that have already, or are yet to expand their Medicaid program; and the federal government.

Cost of House Bill H.R. 4588

A CBO cost estimate is unavailable.

More Information

In-Depth: Sponsoring Rep. Gene Green (D-TX) introduced this bill to incentivize states that haven’t yet expanded Medicaid to do so:

“Expanding Medicaid is as much of a good deal for states as it is for patients. In our District alone, 55,000 residents would gain coverage if Texas expanded Medicaid, and 1 million people would gain coverage statewide. Under the ACA, this would happen at minimal cost to the state with the federal government financing 100 percent of expansion costs for the first three years and after that, no less than 90 percent on a permanent basis. Rather than letting the 90 percent match rate take effect in 2017 as originally written into the ACA, this bill would allow all states who expand now or in the future to receive 100 percent backing for 3 years from the date of expansion.”

Those who oppose states expanding their Medicaid programs argue that federal assistance will decline over time and that even without the expansion, many states struggle to balance their budget each year. Not only that, but Medicaid is the largest expenditure for most states and its costs increase faster than tax revenue can be brought in to keep pace.

This legislation has the support of 18 cosponsors in the House, all of whom are Democrats.


Of Note: Following a 2012 ruling by the U.S. Supreme Court that states weren’t required to expand their Medicaid programs to accommodate the Affordable Care Act, 19 states opted not to expand their program. 31 states plus the District of Columbia have expanded Medicaid since 2014. Seven of those states are still in the process of implementing the expansion.


Media:

Summary by Eric Revell

(Photo Credit: Ragesoss / Creative Commons)

AKA

Incentivizing Medicaid Expansion Act of 2016

Official Title

To amend title XIX of the Social Security Act to provide the same level of Federal matching assistance for every State that chooses to expand Medicaid coverage to newly eligible individuals, regardless of when such expansion takes place.

    To everyone who voted NAY: Just how freaking ignorant are you all? Nearly every other modern nation on Earth has universal healthcare that is affordable and accessible to everyone! For f***'s sake, 45,000 Americans DIE EVERY YEAR because they do not have access to basic healthcare! If we can afford to spend $100 billion of our tax dollars funding +800 military bases EVERY YEAR and spend $2 trillion on the Iraq War that that idiot George W. Bush put us in, then why the f*** can we not spend more money to give Americans better access to Medicaid? It is because many Americans, including those who voted NAY to this, have fallen for idiotic, right-wing propaganda that government healthcare is somehow bad for us, but price-gouging, greedy healthcare companies are good. How freaking sad that there are actually adults who still believe in such silly bull****.
    Like (33)
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    Healthcare is not a role of the federal government.
    Like (20)
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    Stop all this tinkering and just give us single payer healthcare like the majority of the world has.
    Like (26)
    Follow
    Share
    I support the idea of making the Affordable Care Act more efficient and supportive to those who need it most. If this assists Americans in paying less for their life-saving medicine and bills, then I shall support it; after all, the state of one's health should not be determined by the state of one's wealth.
    Like (20)
    Follow
    Share
    This is simply a blatant bribe to try to salvage something from the ACA. The states that didn't take the federal money for Medicaid expansion in the first place declined because they saw that that match was only in place for a short time and then the states would be left to shoulder the hugely more expensive Medicaid on their own. This doesn't fix that. It makes it more appealing in the short term but it was always the long term pain that deterred participation. Because the states realized it's too expensive. Because it IS too expensive. But now it's all couched in helping the poor and the sick. Give me a break. They don't give a flying flip about the poor and the sick. They're trying to buy sentiment. Read up on Thomas Sowell: "The welfare state is the oldest con game in the world. First you take people's money away quietly and then you give some of it back to them flamboyantly." The federal money they're trying to bribe states with? Don't you realize that that was already YOUR money before they stole it from you via taxation? And do you think they're giving it ALL back to you if the state goes along with this? No! Of course not! They take your money, then offer a mere portion of it back to you, but only if you agree to concede some of your autonomy to the federal government. And they will have the nerve to claim the moral high ground in that scenario! All while they've taken YOUR money and are making you BEG and SUBMIT in order to get back mere PENNIES on the dollar! It's DISGUSTING!
    Like (16)
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    We need a single-payer healthcare system in the United States as soon as possible. Nearly every developed modern nation has it, and it's time we take care of our people. Even conservatives in Europe acknowledge the fact that government should take care of the people and make sure that they are healthy. Millions of people in this country do not have health insurance, and the prices don't seem to be dropping anytime soon, due to the greed of the insurance and pharmaceutical corporations. We need socialized healthcare and socialized medicine, so that we can boost the abilities of Americans by them being the healthiest they can be.
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    I'm disabled and in order for Medicaid to kick in I have to spend over half of my income on medical bills first, and then the next month start all over again. This keeps me from lifesaving treatments. They don't even leave you enough money for rent let alone anything else.
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    Should be eliminated, as should Obamacare
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    Every liberals response to their failing programs. "Just give more funding and everything will be fine"
    Like (9)
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    Healthcare is a state by state issue.
    Like (8)
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    Maybe if the federal government would quit plundering all of the money from the states, the states would have more to spend on the programs that they need. Tax cuts and further decentralization are the solution. These programs are failing, and making them larger will NOT make them solvent. The federal government is not omnipotent.
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    The ACA, while flawed, is our only effective tool to provide universal coverage for healthcare for all our citizens. The ACA was passed through Congress in its current less-than-perfect state because the resistance to it in Congress was almost impossible to overcome without maintaining the system of insurers controlling it in certain specific aspects. Now that it is law, we must keep it law, and modify it effectively to provide coverage for all Americans, preferably, in my opinion, without the involvement of insurance companies. Insurance companies should insure contracts, money, property, cars and any other tangible items a human being might have of which they do not wish to lose the value. Human lives can even be insured against untimely death. Services used by human beings to care for themselves and their families should never provide a profit to insurers. Healthcare is a right for all members of a society, and it's availability should be guaranteed by the country's government. The fact that our government does not provide some form of universal healthcare for all of our citizens is a travesty long overdue for a change. The ACA is the best attempt that could be made under the political circumstances prevailing at the time of its enactment. It must be modified over time, and how it is changed will depend on the political winds prevailing each time an attempt to modify it is made. This bill is such an attempt, and it seems to me to move the ACA in a direction appropriate to the goal of ever-expanding coverage to our citizens. Linking the ACA to our Medicaid and Medicare systems is a move in the right direction. These changes should have evaluative goals and processes included in them so that the effects of these changes can be monitored, evaluated and adjusted as needed to improve efficiency, cost control and effectiveness.
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    Why would add money into an already failing program where the American people are losing money
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    States need to begin making a progression of refusing federal aid, and start exercising their sovereignty. Learn history, the laws of the federal government are only supreme if pursuant to the Constitution. See also, 10th Amendment
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    We need to make Health insurance more affordable for all Americans. Expanding funding for Medicaid would be a great step in the right direction towards insuring more Americans, but ultimately, the healthcare crisis in this country will only be remedied by a Single Payer Public Option.
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    We should try to expand Medicaid as much as we can. Yes, premiums have been going up for many people- however, we need to look at the big picture. Millions of Americans are now covered under the Affordable Care Act- medical care is now more accessible to the American people. More people than ever are receiving medical care. If we offer federal funds to expand it, we can approach the 100% coverage that we need.
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    When people say there isn't enough money, I wonder if they don't understand how much we pay on war... and then I wonder if they think spending that much on war makes sense to them... then I wonder why people like that are aloud to reproduce, lol
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    It's more economical to provide preventive care and to care for minor issues before they become major. Hospitals cannot turn anyone away for being poor, so we can pay some extra tax and people to plan for it, or we can face even more ruinous hospital bills when we need care.
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    This would simply extend the original deal offered to all the states to apply to states that waited to expand medicaid in an equal fashion. This is not a bribe. There is no huge cost awaiting states that expand, as this, from the beginning, covered 90% of the cost in perpetuity.
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    Yep
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