The majority of people covered by Medicaid in the US are covered under "Medicaid Managed Care" (MMO), which is neither 'substandard' nor 'government-run'.

Outcome studies have consistently found that MMO outcomes are equal to (or in some cases better) than HMO outcomes for similar patients. Typically, MMOs have lower administrative overhead (since most are non-profit, altho that is not a requirement), and often provide long-term services that serve to decrease the cost of care over time, by increasing the general level of health among members.

These entities are also stand-alone entities, run either as non-profits, cooperatives, or for-profit organizations…the states do not 'run' them (as the article erroneuously suggests). The majority are operated on a 'capitated' basis where the state pays the provider a set amount per member per month to provide contracted services. The negotation of provider networks, payment, and management is entirely independent of the 'government'.

I agree there are many flaws with the 'reform' plan, but raising the Medicaid-qualification ceiling to 150% of the FPL is a relatively inexpensive way to offer healthcare services to an underserved group, in a proven and efficient manner.

I disagree. If there are to be subsidies it seems fairest to base it strictly on income.

Consider my case as an example. I am an early retiree and I have insurance with my former employer, although I pay the lion's share of the premium, unlike when I was working and the employer paid most of the premium.

I own some real estate and stocks. Those are my retirement assets that should allow me to be financially secure through old age, but will not allow me a life of luxury. As an example, I no longer own a car, I use transit.

Those assets serve exactly the same role for me as a pension plan does for those who have one.

They constitute "wealth", but I am not rich, that "wealth" simply provides me with the means to pay for food and rent, etc. as a retiree.

Now suppose those assets appreciate greatly in value. If they grew to millions of dollars then I would certainly not be deserving of a government subsidy on health care based on need.

But the point is, those assets are for the purpose of income. If they grew large, then my income from those assets would become large also, and a health care subsidy strictly based on income would do exactly what it was supposed to do, screen out people like me under that scenario, that shouldn't get a subsidy.

So my argument is that income is, in fact, the proper criterion to determine who gets a subsidy and how much they get.

A lot of people who shouldn't qualify for subsidies, e.g., graduate students, property rich/income poor, could qualify for subsidies under this definition. Normally the poverty line figures are intended to include all types of income including gifts and nontaxable income.

I am not sure how this has been dealt with in the latest version of the bill.