Monday, April 6, 2015

Another 5-4 Supreme Court Ruling Hammers Medicaid For 68 Million Americans

Elizabeth G. Taylor and Jane Perkins of the National Health Law Program (NHeLP) (see also Taylor's blog), writing at TPM:
When it comes to health care at the Supreme Court this year, all eyes are focused on the Obamacare tax credits case, King v. Burwell. But a case decided this week, Armstrong v. Exceptional Child Center, Inc., has raised significant concerns for the availability of quality health care for those who need it most.

In a 5-4 ruling, the Supreme Court turned against decades of legal precedent and ruled that Medicaid providers cannot use the Supremacy Clause of the U.S. Constitution to stop state provider payment policies that are inconsistent with the federal Medicaid Act’s requirement for adequate reimbursement rates. That may sound like a bunch of legalese, but the outcome has a real impact on the 68 million-plus people relying on Medicaid. If a state’s Medicaid payment rates are too low (and many providers complain these rates are below their cost of providing services), then provider participation in Medicaid—and the ability of enrollees to obtain care—is at risk.

[/face-palm] Yes, that's our Supreme Court, all right.

Dr. GOPer 'fixes' Medicaid
And unfortunately, that's our Medicaid system. Taylor and Perkins note that "Congress established Medicaid in 1965 as a cooperative program between states and the federal government"; the operative word there is "cooperative" ... in states run mostly by Republicans, the state implementation of Medicaid is as obstructionist as the state's governor and legislature can make it. I know: my late mother finally qualified for Medicaid to help with my late father's payments for her otherwise uninsured institutionalization for Alzheimer's disease... the week my mother died in 1990. Dad ended up nearly broke from paying for her treatment. Texas GOPers can be very proud [/irony] of what they accomplished in that case, goddamn them.

If there is one good reason above all others to hold your nose and vote for a Democratic president in 2016, it is to make sure the effing bastards of the Greedy Oppressive Party lack the power to appoint another Supreme Court Justice for at least another four years. A Democratic president will not assure an optimal replacement for a Justice who retires or dies... the GOPers can continue playing their obstructionist politics as surely as they obstruct Mr. Obama... but if the GOP has the presidency and both houses of Congress, it will be an utter disaster for healthcare in America. Don't let that happen!


  1. Over in Louisiana, we once had a saying, "in Texas they let people die in the streets, but we take care of our sick and elderly here in Louisiana." Louisiana's charity hospital and nursing home system worked on a sliding scale basis for the uninsured/underinsured and used Medicaid funds to make up the remainder under a Medicaid exemption that they got from the Federal government. That was before Governor Mike Foster and his protege Governor Paiush Jindal destroyed the system under the guise of "privatization". Now Louisiana is no different from Texas. SIGH.

    1. BadTux, I'm afraid Jindal (and indeed most Republican gov's of states) have the flavor of the white rice w/o the yellow curry; whatever system Louisiana had apart from the charities attached to one or more churches, they, like Texas, seem determined to use as close to zero gummint money as possible to prevent poverty. And they aren't willing to debate the morality of such a "system," if one can dignify it with that term. My best guess: we can begin to back out the worst our gov't inflicts on the very poorest of its citizens, and we just have to come back later for the rest. That's tough and sometimes outright offensive, but that's how things work now.



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