Florida legislature rejects ObamaCare Medicaid expansion

From: Conservative News

Reuters reports a hitch in Governor Rick Scott’s plans to expand Medicaid coverage, as directed by the ObamaCare plan he once vowed to oppose:

On the eve of convening of the 2013 session, the House Select Committee on the Patient Protection and Affordable Care Act rejected the expansion. A Senate counterpart committee postponed consideration of the issue, which is sure to be one of the biggest controversies of the session.

Scott, a Republican who bitterly fought President Barack Obama’s national healthcare plan as a candidate and in his first two years as governor, stunned conservative supporters on February 20 when he endorsed a three-year expansion of Medicaid, provided the federal government picks up the full cost for the first three years as promised.

“There’s definitely a fight between the governor and the (state) legislature over this. The Republicans in the legislature are much more fiscally conservative than his actions have shown him to be,” said Susan MacManus, a Tampa-based political scientist at the University of South Florida.

Republican legislative leaders have been openly hostile toward the plan, emphasizing that state lawmakers will make the final decision in drawing up a budget for next fiscal year.

The conservative James Madison institute released a statement partly quoted by Reuters, but reproduced here in full:

The House made the right decision today to not draft a committee bill expanding Medicaid under PPACA provisions. Many Members expressed valid concerns that this could hurt the people that it is aimed at helping. State leaders should focus on providing more access to quality care — expanding a program that is inefficient in this effort is not a way to do that.

Additionally, in our recent poll of 600 registered Florida voters more than 63 percent said they are wary that the federal government would keep the funding level promises made, and clearly many House Members share this worry. If history is any indicator, costs of such programs are often underestimated and there has been examples of the federal government going back on their promise before. These issues cannot be ignored.

Well, those issues shouldn’t be ignored, but a lot of people seem intent on doing so, with eyes firmly fixed on that pot of federal subsidy gold.  In a previous policy brief on Medicaid expansion, the James Madison Institute expressed skepticism that promises of 100 percent federal funding for three years, followed by 90 percent indefinitely, will stand the test of time: “Of course, all of these projections are based on the assumption that the federal government — currently plagued by record deficits and alarm over the growing national debt — will keep its pledges with regard to matching funds.”

Fueling this skepticism is the Institute’s description of Medicaid programs across the nation as “plagued by bureaucracy, ballooning expenditures, poor access, and low quality care.”  And that could lead to a pointedly counter-productive outcome:

As Medicaid costs explode, regulators and legislators at- tempt to restrict costs by reimbursing providers less and less. Low reimbursements severely impede the access of Medicaid beneficiaries to timely and appropriate high quality care. Some studies even suggest that Medicaid patients receive worse care than the uninsured.

A costly expansion of means-tested eligibility for Medicaid will not rectify the deeply-rooted problems with the program. In fact expanding the program will not only expand these problems and impact more people, but it will likely put more strain on the system and could very possibly worsen the already grave access problems and poor quality care that Medicaid patients encounter.

That sounds like a much more likely outcome than the government that can’t stand a 2.3 percent spending cut happily ladling out billions of dollars to cover cost overruns, long into a future where mandatory entitlement spending and debt service will soon consume the entire current budget baseline.

SEIU siphons 'dues' from Mich. Medicaid payments

If you're a parent who accepts Medicaid payments from the State of Michigan to help support your mentally-disabled adult children,  you qualify as a state employee for the purposes of the Service Employees International Union (SEIU). They can now claim and receive a portion of your Medicaid in the form of union dues.

Robert and Patricia Haynes live in Michigan with their two adult children, who have cerebral palsy. The state government provides the family with insurance through Medicaid, but also treats them as caregivers. For the SEIU, this makes them public employees and thus members of the union, which receives $30 out of the family's monthly Medicaid subsidy. The Michigan Quality Community Care Council (MQC3) deducts union dues on behalf of SEIU.

Michigan Department of Community Health Director Olga Dazzo explained the process in to her members of her staff.  "MQC3 basically runs the program for SEIU and passes the union dues from the state to the union," she wrote in an email obtained by the Mackinac Center. Initiated in 2006 under then-Gov. Jennifer Granholm, D-Mich., the plan reportedly provides the SEIU with $6 million annually in union dues deducted from those Medicaid subsidies.

“We're not even home health care workers. We're just parents taking care of our kids,” Robert Haynes, a retired Detroit police officer, told the Mackinac Center for Public Policy. “Our daughter is 34 and our son is 30. They have cerebral palsy. They are basically like 6-month-olds in adult bodies. They need to be fed and they wear diapers. We could sure use that $30 a month that's being sent to the union.”

According to the Mackinac Center, the theoretical public employer for whom the Haynes' work is the Michigan Quality Community Care Council (MQC3), an entity within the DCH that continues to operate, even though the state legislature has defunded it. Even the MQC3 calls the families hiring in-home health care providers "employers of providers," but these health care providers are also treated as employers of MQC3 when it comes time each month to take dues out of their Medicaid payment and send it to the SEIU.

Mr. and Mrs. Haynes, of course, are both the parents (the employer) and the health care providers for their children, but they still lose money to the SEIU every month, despite having no interest in joining the union.

They have been arbitrarily classified as state employees so that the union can take money from them.

Gov. Rick Snyder, R-Mich., already ended a similar scheme to provide unions with new "public employees" in the area of child care. His predecessor, Gov. Jennifer Granholm, D-Mich., had classified in-home daycare providers as public employees -- a designation that forced them to pay union dues but conferred no other benefits upon them. Snyder's director of the Department of Human Services ended that program. "[We] will stop all funding and, because these providers are not state employees, will also cease collecting union dues,” DHS director Maura Corrigan said at the time.

Michigan's state House has already passed a bill to prevent this sort of rent-seeking by public-sector unions, but it has stalled in the state Senate.