Tuesday, March 21, 2017

While Nobody’s Watching, Paul Ryan Is Taking A Sledgehammer To Medicaid’s Promise To Seniors

James Comey came to the House yesterday and said that he's investigating the president for potentially coordinating with the Russian government during the election. Just another day in the Trump administration. I broke down the hearing with my new TYT colleague Nomiki Konst here.

The real goal of the Republican repeal of Obamcare is to take down Medicaid, as part of a years-long assault on the New Deal and Great Society. My story on that is here.

We're about 48 hours away from the moment of truth for Obamacare repeal in the House, and the big question is whether Paul Ryan has the votes for it If he doesn't, look for him to pull it off the floor. But the horse-trading has begun in earnest. Last night, Matt Fuller and Jonathan Cohn reported on a sweetheart deal -- the Buffalo Buyout, we're calling it -- that buys the votes of four upstate NY Republicans by forcing the state to pick up the Medicaid tab for rural NY counties. The amendment ONLY targets rural NY counties.

Meanwhile, the Freedom Caucus, a group of far right Republicans who often vote in a bloc, met late last night and are saying they are confident they have the votes to take down repeal, which they think is too liberal. It will be "very difficult, if not impossible" for leaders to find the votes to pass their health care bill, Freedom Caucus head Mark Meadows told Fuller.

Back in 2011, tea party hard liners saved Social Security by refusing to back tax cuts as part of a "grand bargain." They may be doing it again this week on the Affordable Care Act.

While Nobody's Watching, Paul Ryan Is Taking A Sledgehammer To Medicaid's Promise To Seniors

WASHINGTON ― While the debate over Obamacare repeal focuses on insurance subsidies, coverage equity and tax cuts, a far more radical attempt is quietly underway to end the Medicaid program as we know it.

As currently structured, Medicaid guarantees a set of benefits to everybody who qualifies. Most people associate Medicaid with the poor and working class, but historically the program has spent as much or more money on elderly and disabled people who qualify, and use it to pay for things like nursing-home care that Medicare doesn't cover.

The new version of the program would upend this arrangement. It would devolve Medicaid to the states and reimburse them using a predetermined formula that, as the Congressional Budget Office and other experts have concluded, would not actually keep up with the cost of care. As the federal contribution toward Medicaid eroded over time, states could make up the difference on their own or ― more likely ― they could make cuts in who or what the program covers. The federal guarantee would be over, and with it, the Medicaid program as we know it.

FULL STORY HERE



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