Gov. Perry refuses to set up health exchanges

[Michelle]

My brain is too tired to share a thought-out opinion on this yet, but I thought you all would have fun with it.

abclocal.go.com/ktrk/story?section=news/state&id=8729292

AUSTIN -- Gov. Rick Perry said Monday that Texas won't establish an online marketplace for patients to shop for insurance or expand Medicaid, two key elements of the federal health care overhaul.
In a letter sent Monday to U.S. Health and Human Services Secretary Kathleen Sebelius, Perry said both elements "represent brazen intrusions into the sovereignty of our state."
"I will not be party to socializing health care and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government," Perry said in a statement released Monday.
The Supreme Court upheld most of the federal health care law last month, although it said the federal government can't withhold states' entire Medicaid allotment if they don't expand Medicaid, the health insurance program for the poor and disabled. If states choose not to set up a health care exchange, the term used for an online service for people to comparison shop for insurance, the federal government will establish one for them.
About 6.2 million Texans -- a quarter of the state's population -- are uninsured.
"From our perspective the more people get covered that is great but then again I understand some of the politics related to that -- so we will do whatever we have to deal with and make the most of it. But the more people that get covered we wouldl certainly encourage that," said David Lopez, CEO of the Harris County Hospital District.
Expanding Medicaid would add millions of people "into the already unsustainable Medicaid program, at a potential cost of billions to Texas taxpayers," said Perry, a Republican. The Texas Health and Human Services Commission has estimated the Medicaid expansion would cost the state $27 billion in the first 10 years, a number that many Democrats dispute.
The state has estimated about 2 million people would be added to the Texas Medicaid rolls in the first two years if it went ahead with the expansion.
Texas House Speaker Joe Straus, another Republican, said he hoped voters would address the issue by electing Republican presidential candidate Mitt Romney, who has promised to repeal the health care law. He would not say what he thought the state would do if President Barack Obama is re-elected.
"There are a lot of stakeholders we'd need to hear from before we could make a decision on that," Straus said.
Texas Medical Association survey given to The Associated Press over the weekend found that the number of Texas doctors willing to accept government-funded health insurance plans for the poor and the elderly has dropped dramatically amid complaints about low pay and red tape.
Only 31 percent of Texas doctors said they were accepting new patients who rely on Medicaid. In 2010, the last time the survey was done, 42 percent of doctors were accepting new Medicaid patients. In 2000, that number was 67 percent.
Texas Democratic Party spokeswoman Rebecca Acuna called Perry's announcement "both cruel and negligent."
"Rick Perry's Texas solution is to let Texans stay ill and uninsured," Acuna said. "That is not a health care plan. Once again Perry is putting partisan political pandering in front of the interests of Texas."
A message left seeking comment from Sebelius' office was not immediately returned Monday.

[jaylea]

Acting like a petulant 4 year old is so professional. I bet our governor (f*cking idiot in chief LePage) will be right on his coattails on this one.

[ttt]

And in not-at-all-related news...

[mrsjuleshs]

I really hate Perry. Refuse to expand medicaid but give TxDOT execs a 42% raise. Makes total sense. Not surprised, seeing as how he handled the whole federal money for education issue.

[heightsyankee]

For those of you who don't want to click the link, ttt's post leads to an article which explains how Texas is worst in the nation for insuring it's citizens...

[ttt]

Jul 9, 2012 12:20:32 GMT -5 heightsyankee said:

For those of you who don't want to click the link, ttt's post leads to an article which explains how Texas is worst in the nation for insuring it's citizens...

Actually it's about how the quality of Texas's healthcare system is the worst in the nation too:
Texas’ health care quality was rated the worst in the nation in the federal government’s annual nationwide health-care report card based on data collected by the federal Agency for Healthcare Research and Quality.

The recently released study is based on 155 quality measures, including success of preventative care measures, disparities in treatment among different ethnic groups and the effectiveness and cost of care for patients with chronic or terminal conditions such as diabetes and cancer.

Texas received its highest scores — none of which were better than average — in the categories of nursing home care, maternal and child health care, and cancer measures, which measure the number of preventative procedures performed, cancer diagnoses made and deaths due to cancer in the state.

For all other categories, Texas was rated “weak” or “very weak.”

The state received its lowest score when it came to home health care and hospital care measures.

Texas proved to be the worst of all the states at caring for breast cancer patients under the age of 70 and home health-care for patients with respiratory problems, urinary incontinence and chronic pain.

According to the study, the goal of the research is to help state officials and their public- and private-sector partners understand health care quality and disparities in their states. Texas’ rating, which was influenced in part by the fact that the state has the highest rate of uninsured people in the country, should be a call for improvement.

“This report includes services far beyond our state Medicaid program, but it does reinforce the need for improving access to preventive services,” said Stephanie Goodman, communication director for the Texas Health and Human Services Commission. “The Medicaid improvements we’re making will help do that.”

Goodman said the state has taken actions that are improving health-care performance.

“Late last year Texas received approval for a new effort that will help fund innovative local projects,” she said. “Hospitals and other health care providers have come together to form regional partnerships, and they’ll soon be sending the state their plans for making better use of Medicaid funds to expand access to preventive services and reduce the need for expensive emergency room care. The regional plans are due September first.”

Minnesota and Wisconsin received the highest scores for overall health-care quality, with scores of 67.31 and 67.20 on a scale of zero to 100. Texas received a score of 31.61, just behind West Virginia’s score of 31.96 and Arkansas’ 32.41.

[MrsAxilla]

"I will not be party to socializing health care and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government."

Someone needs to buy him a newspaper and a copy of the Constitution. Did he miss the SCOTUS ruling, or did he just not understand it?

[ttt]

Jul 9, 2012 12:25:13 GMT -5 MrsAxilla said:

"I will not be party to socializing health care and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government."

Someone needs to buy him a newspaper and a copy of the Constitution. Did he miss the SCOTUS ruling, or did he just not understand it?

Perry KNOWS what's Constitutional and what's not. It's in his heart. He doesn't need some piddly little Supreme Court to tell him.

[heightsyankee]

The belief in Texas is that the SCOTUS was wrong so what they decided doesn't matter. Honestly. People think this.

[MrsAxilla]

Jul 9, 2012 12:28:55 GMT -5 heightsyankee said:

The belief in Texas is that the SCOTUS was wrong so what they decided doesn't matter. Honestly. People think this.

Idiots think this. Seriously, it says RIGHT THERE in the Constitution that, "The judicial Power of the United States, shall be vested in one supreme Court...The judicial Power shall extend to all Cases, in Law and Equity, arising under this Constitution..."

[ttt]

Jul 9, 2012 12:36:40 GMT -5 MrsAxilla said:

Jul 9, 2012 12:28:55 GMT -5 heightsyankee said:

The belief in Texas is that the SCOTUS was wrong so what they decided doesn't matter. Honestly. People think this.

Idiots think this. Seriously, it says RIGHT THERE in the Constitution that, "The judicial Power of the United States, shall be vested in one supreme Court...The judicial Power shall extend to all Cases, in Law and Equity, arising under this Constitution..."

You left off the rest:
The judicial Power of the United States, shall be vested in one supreme Court...The judicial Power shall extend to all Cases, in Law and Equity, arising under this Constitution except in such Cases in which they are obviously biased by the liberal media and are acting against the True Constitution, which all Real Americans have in their Hearts.

[Michelle]

Touche TTT - it is really sad at the disparity in quality of care in Texas across organizations too.

I am really proud to work for one of the highest performing hospitals in the nation on quality measures and number of specialties. Right here in the heart of the Texas Medical Center. You have leading hospital systems like UT MD Anderson, Memorial Hermann, The Methodist Hospital System, St. Luke's Episcopal Hospitals and others who are non-profits who are kicking butt in quality measures as compared to the national average. There are for-profits who struggle to fare so well but HCA has a few hospitals in Texas doing very well on quality measures as well - mostly here in Houston. Then you look outside Houston and then you have those big systems who shall not be named (some of whom are doing well and some of whom are embarrassingly horrible) and a bunch of poor quality small systems. It's very sad.

My company is very successful financially with a very strong physician presence and even so, the leaders of my organization have been shaping the mentality of our workers that something HAS to change (as opposed to jumping on traditional Republican anti-healthcare reform rhetoric). We are focused on how *care* needs to change more than the insurance system, but the fact remains that our nation throws a ton of money at healthcare in our country and our quality-per-dollar has flat lined well below that of other developed nations. Our system IS broken.

Expanding medicare and how it works - I'm not sure that is the answer and it will make being financially successful extremely difficult for organizations who invest in innovations for cures, research, low RN-to-patient ratios, competitive salaries, quality benefits packages for employees, etc. all while providing cost-effective care for patients.

But flat-out refusing to try to be part of *any* solution (Perry's M.O.) is the worst option for Texans.

[heightsyankee]

Jul 9, 2012 13:00:24 GMT -5 @mrdobalina said:

under a white christian male god. amen.

made it better for you.

[MrsAxilla]

Jul 9, 2012 12:58:54 GMT -5 ttt said:

Jul 9, 2012 12:36:40 GMT -5 MrsAxilla said:

Idiots think this. Seriously, it says RIGHT THERE in the Constitution that, "The judicial Power of the United States, shall be vested in one supreme Court...The judicial Power shall extend to all Cases, in Law and Equity, arising under this Constitution..."

You left off the rest:
The judicial Power of the United States, shall be vested in one supreme Court...The judicial Power shall extend to all Cases, in Law and Equity, arising under this Constitution except in such Cases in which they are obviously biased by the liberal media and are acting against the True Constitution, which all Real Americans have in their Hearts.

Damn! I must have the abridged, liberal version.

[Chirp]

Jul 9, 2012 12:25:13 GMT -5 MrsAxilla said:

"I will not be party to socializing health care and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government."

Someone needs to buy him a newspaper and a copy of the Constitution. Did he miss the SCOTUS ruling, or did he just not understand it?

Too many big words. You might want to add a dictionary and a thesaurus to that list.

[MrsAxilla]

Jul 9, 2012 13:11:04 GMT -5 Chirp said:

Jul 9, 2012 12:25:13 GMT -5 MrsAxilla said:

"I will not be party to socializing health care and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government."

Someone needs to buy him a newspaper and a copy of the Constitution. Did he miss the SCOTUS ruling, or did he just not understand it?

Too many big words. You might want to add a dictionary and a thesaurus to that list.

I know. I think it must be "vested" that's tripping him up.

[AJL]

This man is such a fucking joke.

[y4m]

This thread reads like a significant portion of our board is only familiar with half the SCOTUS decision.

[dev22]

Jul 9, 2012 13:20:28 GMT -5 y4m said:

This thread reads like a significant portion of our board is only familiar with half the SCOTUS decision.

Um, I am familiar with the majority decision. Which is what determines constitutionality last time I checked. Unless we are now following the minority decisions instead? Cause if so, shit.

[msmerymac]

So, his opinion that this is going to cost a LOT and that Texans shouldn't pay for it... does he think the federal government will stop taxing Texans for their share of federal health care costs if they just don't participate? I think not. Yo, Rick Perry, your citizens will still be paying for the medicaid expansion - they just won't be able to benefit.

[y4m]

The second half of SCOTUS's decision codify's Perry's right not to do the Medicaid expansion. The ACA itself says he doesn't have to set up an exchange.

[MrsAxilla]

Jul 9, 2012 13:20:28 GMT -5 y4m said:

This thread reads like a significant portion of our board is only familiar with half the SCOTUS decision.

Enlighten us, then

[dev22]

Jul 9, 2012 14:04:39 GMT -5 y4m said:

The second half of SCOTUS's decision codify's Perry's right not to do the Medicaid expansion. The ACA itself says he doesn't have to set up an exchange.

Sorry, interpreted your comment wrong.

I know he has the right to do this. I just still think it is incredibly stupid and shortsighted for him to do. Just because you can doesn't mean you should.

[MrsAxilla]

Jul 9, 2012 14:04:39 GMT -5 y4m said:

The second half of SCOTUS's decision codify's Perry's right not to do the Medicaid expansion. The ACA itself says he doesn't have to set up an exchange.

Cross post.

It may be his choice, but it's Constitutional either way.

[ttt]

"I will not be party to socializing health care and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government," Perry said in a statement released Monday.


I fail to see how expanding Medicaid or setting up a health insurance exchange is in direct contradiction to the Constitution.

[cookiemdough]

Jul 9, 2012 14:04:39 GMT -5 y4m said:

The second half of SCOTUS's decision codify's Perry's right not to do the Medicaid expansion. The ACA itself says he doesn't have to set up an exchange.

I was wondering about this. Doesn't it allow if there is not a state exchange for the uninsured to participate in a federal one? So does that mean that the federal program essentially subsidizes states that choose not to participate?

ETA: I haven't read the decision, I am just going by what I have heard in snippets in the morning talk shows...

[AJL]

Jul 9, 2012 14:04:39 GMT -5 y4m said:

The second half of SCOTUS's decision codify's Perry's right not to do the Medicaid expansion. The ACA itself says he doesn't have to set up an exchange.

This is true and if he chooses not to set up the exchange, the federal government will set it up for Texas.

Doesn't change anything about him being a major fuckwit but that's just a personal opinion.

[KateAggie]

I can't stand Rick Perry (and yes, it kills me to say that as both a Texan and an Aggie), but he'd have to be flat out stupid to set this up when a)he doesn't have to and b)the majority of his constituents oppose it. Talk about political suicide.

[Deleted]

Jul 9, 2012 14:56:22 GMT -5 KateAggie said:

I can't stand Rick Perry (and yes, it kills me to say that as both a Texan and an Aggie), but he'd have to be flat out stupid to set this up when a)he doesn't have to and b)the majority of his constituents oppose it. Talk about political suicide.

but i wonder how many will be pissed as hell when they have to start paying the tax penalty

[KateAggie]

Jul 9, 2012 14:57:37 GMT -5 @septimus said:

Jul 9, 2012 14:56:22 GMT -5 KateAggie said:

I can't stand Rick Perry (and yes, it kills me to say that as both a Texan and an Aggie), but he'd have to be flat out stupid to set this up when a)he doesn't have to and b)the majority of his constituents oppose it. Talk about political suicide.

but i wonder how many will be pissed as hell when they have to start paying the tax penalty

You think they're going to be pissed at him when they pay a federal tax penalty? Really?