Comments about ‘My view: Utah needs to expand Medicaid’

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Published: Sunday, Dec. 8 2013 12:00 a.m. MST

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The Hammer
lehi, utah

What happens when the interest payments on our debt balloon to 36% of the budget, Medicare costs sky rocket to 33% of the budget and social security medicaid defense and other programs have to share the rest of the cost?

What happens as we have seen in the sequester, payments to the state get cut. Now they first start with items like school funds, defense contracts and base cut backs and then flow into projects that get cut like transit and other infrastructure items the next thing on the list is conflict with medicaid and unemployment benefits as the state/federal partnership breaks down and it is no longer cost effective for the state to run those programs.

Medicaid expansion is unaffordable and it increases the risk that we will face as a state if we don't find an alternative to the current mess. Tort reform is needed to reduce the size of multi-million dollar lawsuits and a reverting to the true insurance model of HDHPs/HSAs. Otherwise medicare/medicaid and cadillac plans will squeeze these groups that this article is about.

Kent C. DeForrest
Provo, UT

Even though this example makes it perfectly clear how unjust Utah's stance is on health care, we are a Republican state and therefore must oppose Obamacare, even if our policies harm many of our citizens and benefit none. Ideology is all that matters in Utah.

Clarissa
Layton, UT

I'm confused. How can the family who only makes $23,000 not qualify when the family who makes $35,000 can. Doesn't make sense.

jean22
Bountiful, UT

@The Hammer:
The Medicaid Expansion is not unaffordable! The financial reports that have been performed by unaffiliated groups show that Utah will actually come out ahead. Governor Herbert has come as far as to at least say that it would be a wash to the state budget. Right now the costs of uncompensated care are being paid for from other areas, and medical issues are being allowed to be put off until they are large and expensive, rather than catching them and treating them when they are still small and less expensive.

jean22
Bountiful, UT

@Clarissa:
That is due to how the Supreme Court ruled on the Affordable Care Act. The original plan was that people above a certain percent of the poverty level would qualify for vouchers to help them pay for their healthcare premiums, while those below that level would qualify for expanded Medicaid, which would cover their healthcare costs. However, the Supreme Court ruled that states could choose whether or not to expand Medicaid, which now leaves some of the poorest people without coverage in states that decide not to expand Medicaid. This is why it is so important that Utah expands Medicaid. We are already paying taxes to the federal government to help pay for the expansion and we now need to approve the Medicaid Expansion in Utah in order to allow those funds to come back to our state rather than going to other states who are expanding Medicaid. As it stands right now, a large, vulnerable population is left without affordable healthcare options.

outlowd
Salt Lake City, UT

What this situation underscores is not that Medicaid needs to be expanded, rather it highlights the flaws in a drastically flawed ACA.
We simply must fight the ACA at very turn.
Why do we even entertain the thought that Washington DC should control health care in utah? They are beyond bankrupt and will leave us holding the bag.

The Hammer
lehi, utah

@Jean22

Utah will come out ahead if all things remain as payments have always been. Where Utah actually gets back more in tax dollars than it gives to Washington. And our budget will consist of more than 50% of our states income from the federal government. This would be a trap for us going forward financially.

The problem is our federal deficits will continue to cause interest payments on our debt to go up every year. And the federal government continues to not include the dangerous effects of baby boomers draining medicare funds when they get older and the cost model flips and the cost to insure them will balloon to 1/3 of the entire budget maybe even more. This would leave less money for all other programs and as the sequester has shown the first budget items that get cut are money that is returned to the states and Utah would be very vulnerable.

The Utah CPA association has been talking about these realities and making it very clear that if we become reliant on more federal monies to take care of our problems we will be the ones to suffer under unsustainable federal debt.

10CC
Bountiful, UT

It seems like the opponents of accepting expanded Medicaid essentially conclude that we shouldn't accept the additional funds because eventually the citizens of Utah might have to pony up more money to fund Medicaid, if the federal government is unable to.

I think the tax payers from the rest of the states would cheer on this shortsighted approach, because Utah already gets more in federal funding than they provide in tax revenues. We're already a burden on the other states, particularly blue states that pay more in taxes than they get back in the way of federal spending.

The only people who get a raw deal here are the Utah families who need the help... and other healthcare consumers in Utah who have to pay for the uninsured when they eventually go to the Emergency Room, and can't pay.

I've never really thought of Utah conservatives as being concerned about the burden Utah places on Blue states, but I guess I have to admire their owning up to Utah not pulling our weight, nationally.

"Bravo", I guess.

The Hammer
lehi, utah

If you claim to care about the poor than you should be concerned about what excessive federal debt can do to a nation (check France before, during and after the french revolution). The only reason we get to live so extravagantly as a nation with our entitlements (ie. MEDICAID EXPANSION) and defense spending is because we inflate the value of our dollar and other countries are willing to buy our currency. But they also look at us for stability and the one thing we are not proving to be is stable in our debt and deficits.

You cannot out run the laws of finance forever and eventually creditors come calling. Will we have the revenue and GDP as a nation to pay for that debt? Medicaid expansion will prove to be another credit card item as congress and the President punts on the doc fix, the medical device tax, and all other cuts to any program in the budget. Then the true cost of the ACA will show up and it won't be sustainable!

Tulip
West Jordan, UT

You're example is evidence of the non sensical way government processes formulas. Utah isn't and shouldn't be liable for coverage that will likely bankrupt the state and burden it's citizens even more. The federal government is broke. Our governor is trying to prevent that from becoming our future and lucky for us, the Supreme Court has backed him up. We as a society have an obligation to help the poor but how we do it can determine our solvency as a nation and the present course ain't it. Please go back to the drawing board.

Sal
Provo, UT

It's so naive to believe the promises of the federal government. Where is there any proof that it operates within the budgets it sets? It never happens. Not only will taxes sky-rocket for Utahans if we expand Medicaid, but the poor will not receive the medical care they need. Doctors already refuse to accept Medicaid patients; and, there are not enough doctors to handle the influx. Medical care for everyone will diminish.

Sal
Provo, UT

I've lived in several countries with socialized medical care. The lines are long; the taxes are very high; many procedures are denied; and, you wait months for many other medical procedures. I by-passed it all because I was a North American with dollars and I had private insurance. That is what will happen here with the ACA. People with money, members of Congress, and people who can afford private insurance will get the best care. The poor will continue to suffer.

Mike Richards
South Jordan, Utah

When did it become proper and correct for anyone in America to feed from the public trough? When did it become proper and correct for anyone in America to think that his neighbors should pay his medical bills? The government pays nothing. It never has. All payments made by the government come for those of us who work in the private sector. Governments do not pay taxes, they collect taxes. Government businesses do not pay taxes. Private sector businesses pay taxes; however, the taxes paid by private sector companies are really paid by you and me. Those taxes are part of every purchase that we make.

When we finally realize that government is the problem, not the solution, then we might find a real solution.

If each of us had to pay for our own medical costs, we would be very selective about going to the doctor. Doctors would have to adjust their costs. Last week I received a bill for $215 for a blood test. My insurance information had not been sent to the lab. My insurance company allowed $15 for that test. The true value was $15, not $215.

RedShirtMIT
Cambridge, MA

Ok Dr. Tom, tell us, where do we get the money to expand Medicaid? Are you willing to take 2% more out of the paychecks of the poor (Medicaid is a payroll tax so you can't escape it) just to expand an entitlement program?

If you want to help the poor get medical help, why not open a free clinic and take care of those people yourself. You have the skills, and hopefully have the financial means. There are many of us that don't have the means, and each tax hike only erodes what little money we have at the end of the month.

RBB
Sandy, UT

Over the past 40 years we have spent trillions of dollars on anti-poverty programs. All of them cost far more than they were predicted to cost. Yet 40 years later we have more poor people than when the programs started. The great thing about being a Democrat is that your programs create new problems which you can then advocate for more government funding to solve, creating yet more problems, which leads to more government funding.

Just wait until many more people lose their health insurance next year. I know many small business owners who are struggling just to make it. Many are approaching the point where they either have to cut health coverage or go under. What will happen when they shift their employees to 29 hour work weeks with no benefits? The Federal government will be there to hand our food stamps and subsidized health insurance. Who will pay for it - our children and grandchildren of course.

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