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  • How The Baucus Bill Harms State Budgets

    Just hours after the Senate Finance Committee completed its mark-up of its version of health care reform, Committee staff released a statement that announced, “[i]n a letter sent to Congressional leaders yesterday, Democratic governors affirmed their shared commitment to expanding health care coverage to millions of low-income Americans through the Medicaid program.”

    Worried Governors
    The press release, however, overstates the case. The governors’ letter does not even mention Medicaid. The very general sentiments expressed in the governors letter such as “… the status quo is no longer an option …” and “[s]kyrocketing health care costs hurt families …” are broadly if not universally shared. Democratic governors from 21 states signed the letter, of which 8 will be out of office before the Medicaid expansion even begins. One Democratic governor who did not sign the letter, Tennessee Gov. Phil Bredesen warns, “I can’t think of a worse time for this bill to be coming. I’d love to see it happen. But nobody’s going to put their state into bankruptcy or their education system in the tank for it.”

    Tying State Hands
    The letter was also produced before the Committee completed its amendment process and before a final score by the Congressional Budget Office (CBO). A number of amendments will reduce state flexibility in the management of Medicaid. States lost flexibility in designing their benchmark plans. States will be required to extend “spousal impoverishment” rules which apply when one spouse is in a nursing home to community settings as well which will substantially shift costs from private pay to Medicaid. States will be faced with a new, broader definition of medical assistance, the implications of which will be determined through regulation and litigation. Finance is turning SCHIP into Medicaid. CBO has not yet calculated how much it will cost the states in administrative changes that will be required to comply with the new federal mandates.

    Higher State Costs
    Medicaid programs will be forced to absorb open-ended costs in the foster care system. In adopting the Stabenow Amendment on therapeutic foster care, the Committee is now on record to overturn litigation won by the state of California to limit Medicaid’s role in funding the child welfare system. California prevailed in part because there is no agreed upon definition of therapeutic foster care and that while it is required to provide services, it is not required to “bundle” those services as a package. The Federal Court of Appeals for the 9th Circuit determined that states still have administrative discretion in how to run their Medicaid programs. The Stabenow Amendment takes one more step towards taking that authority away.

    The wide-open language of the Stabenow will likely cost states billions as providers will seek to tap into the Medicaid entitlement to fund the child welfare system, which is really what the California litigation was about. Of course the child welfare system must be adequately funded, just as education, child care programs, and the criminal justice system to name a few other government programs that are also trying to tap into Medicaid must be. But should these responsibilities fall to Medicaid? Finance has jurisdiction over the foster care system. But instead of facing its responsibilities in the program, it was apparently easier for Senators to push the issue back onto the states’ Medicaid program. Why have schools turned to Medicaid for funding for special needs children? Because Congress has never fulfilled the promises made under the Individuals with Disabilities Education Act (IDEA). Medicaid has become an enabler. Washington promises more then passes the bill to the states.

    Medicaid Expansion
    States cannot afford a Medicaid expansion and neither can the federal government. The Finance Committee plan includes extra federal funds to pay for most of the new costs and when the bill gets to the Senate floor, Senators will try to get 100 percent federal funding just as Majority Leader Reid has done for Nevada. But simply adding more federal funds into an unreformed Medicaid program is not the answer either.

    One day perhaps, Congress will realize that expanding Medicaid comes at the expense of other state and federal priorities including education and the child welfare system. As Medicaid grows, funding for other programs shrink, which in turn, increases demand for Medicaid to become the source of funding for those other programs. Only the governors have the clout to push back and break the vicious cycle that, as Gov. Bredesen warns, threatens to bankrupt the states.

    Posted in Obamacare [slideshow_deploy]

    15 Responses to How The Baucus Bill Harms State Budgets

    1. Bobbie Jay says:

      That's all folks…

      Threats is all Obama and his folks are clear on. Threats to destroy.

      As a parent, I'd like to know why many parents aren't the providers of their own children? Why parents in this state DEMAND healthier breakfasts and lunches from the government? What happened to the responsibilities of parenthood? Feed your kids breakfast with your government food subsidies and pack their lunch with the same. There's a federal food program being advertised (tax payer paid) as "snap." Little qualifications necessary, I don't even think you have to have kids! So those that can do for themselves are collecting fed and state food and probably frequent the food shelves which is less the government application. It WAS there for desperate situations not as a fill-in. free health care, free housing, free food, free school supplies, free dental, free cosmetic surgeries, by golly, people are living high off the hog even if they are paid minimum wage. No responsibilities no accountabilities. No incentive to live INDEPENDENTLY. The examples of Obama way, has rubbed off on many.

    2. RG St Simons Is says:

      If the 17th ammendment were not in effect, this would not even be being considered. Prior to the 17th, senators represented the states interests in DC.and not their constituents.

      State govenors can say anything they please, but they can't do a thing to stop this. They have no voice or representation.

      Repeal the 17th ammendment.

    3. Rayford Davenport says:

      Oregon recently taxed Hospitals.A Federal plan will do the same.It's not the States that will be bankrupted. It's the people.

    4. Jerry from Chicago says:

      Rayford Davenport — I couldn't agree more. Any impositions, requirements or taxes put on the states by the federal government will come out of the pockets of the state taxpayers. I live in Illinois; I know.

      As usual, the Democrats want to build a constituency of dependency. Open the borders, grant blanket amnesty to all illegal aliens, now everybody here is legal and there's no more problem about covering illegal aliens, because there won't be such a thing. Opening the borders may not be enough. We will need to send all commercial airline flights and ocean going ships to all countries in the world, load them up, and keep bringing them here until we have them all.

      We will then need to process them all through ACORN so they can get government subsidized housing, food, clothing, education, and of course medical care. From the offices of ACORN they can be bussed to the nearest voting registration place so they all be registered as Democrats, or perhaps ACORN can just take care of that for them.

      I'm sure Senators Boxer, Finestein, Dodd, Kerry, Schumer, Durbin and Burris will think this is a great idea. I know Mr. Obama will.

      After this is done, we can all sit around a make believe campfire (no carbon footprint here) and Bono can lead us in singing "kumbaya" and "We are the World".

    5. Bill, Malta, Ohio says:

      Baucus will faucus!

    6. Bill, Malta, Ohio says:

      The Faucus proposal will do exactly what its title says!

    7. Bill, Malta, Ohio says:

      The Baucus health care proposal will (fill in the blank)us – rhymes with Baucus, but it means "sock it to us" (in the vernacular). Think about it!

    8. Lynn B. DeSpain says:

      Name one thing that Baucus doesn't harm, aside from the ACLU and ACORN and his idol, Obama?

    9. Linda Carlsbad, CA says:

      California already has a big problem with our budget, because of illegals. They come here and have babies. We in California support the babies, all the way through college. This is insane. The hard working citizens in California are taxed to death because of this! We make to much money to receive college money for our kids. But we are paying for all the illegals, health care, welfare, college. I love California, but I may have to more out of this liberal state!

    10. Carrie, KS says:


      Wednesday, October 07, 2009

      By Nicholas Ballasy, Video Reporter

      Reid ‘Likely’ to Make Entire Health Bill an Amendment to Unrelated Tax Bill That House Passed in March …


    11. Pingback: Does Obamacare Turn Your State into a Medicaid Monster? | Conservative Principles Now

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    13. Pingback: Obamacare Health Care Reform Will Greatly Expand Medicaid | Fix Health Care Policy

    14. Pingback: Contact our Democratic Senators about the Baucus Bill and the Damage to Minnesota « MN Prager Discussion Group

    15. Pingback: Morning Bell: Speaker Pelosi’s Job-Killing Agenda | The Foundry: Conservative Policy News.

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