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Posted on 10/07/2025 9:11:41 AM PDT by Brian Griffin
While the shutdown is needless, the Democrats are rightly concerned about healthcare cost coverage.
MEDICAID EXPANSION FAIRNESS
What I’m thinking of is to slightly and generally increase the state Medicaid expansion share to 5% plus the highest rate of state income tax. Right now, California pays for Medicaid expansion at 10% and rakes in 13% income tax from doctors.
That would make Medicaid expansion cheaper for no income tax red states like Florida and Texas.
To help fund likely Medicaid expansion to states like Texas and Florida, the state Medicaid shares (traditional & expansion) would increase annually starting in 2028 by a percentage equal to the deficit in the fiscal year ending prior to the calendar year divided by $1 trillion. That would be a 1.5% increase on a $1.5 trillion deficit, or a .6% increase on a $600 billion deficit. To soften this increase for the states, I would have the federal government likewise increase its share of Medicaid drug expenditures. This would have states assume more responsibility for medical service costs which they regulate and the federal government assume more responsibility for drug costs which it has the power to regulate.
Be aware that property tax supported public hospitals such as Parkland in Dallas and Jackson Memorial in Miami exist in Texas and Florida and are heavily used by the indigent. George Bush Jr. would have had to pay about $5,000/year in hospital tax after buying his house after his presidency. If an indigent from another Florida county without a public hospital gets care at my county hospital, my county hospital can collect from that county.
FAIR SHARE PPACA PREMIUM MINIMUMS
To also help fund likely Medicaid expansion to red states like Texas and Florida, I would impose these premium minimums, whichever is the higher:
1. 2% of the Medicare premium amount per insured year of age as of the start of coverage
2. a percentage of the premium amount equal to the household income percentage of FPL - 60% divided by 3
For a 5-year-old, 7-year-old, 32-year-old and 34-year-old, the ages would sum to 88 and the monthly absolute minimum premium amount would be a (88/65)*$185 or $250.46.
For a 5-year-old kid and a 27-year-old mom the ages would sum to 32 and the monthly absolute minimum premium amount would be (32/65)*$185 or $91.07.
To make all that palatable to the Democrats, I would lower the original PPACA subsidy threshold from 100% of FPL to 80% of FPL.
PPACA AFFORDABILITY
Silver plans would be limited to a maximum deductible of three times the Medicare Part A amount [2025: $1676].
I would also make bronze plans low cost by having $10,000 50% co-pays with $10,000 paid up front to the insurance company by the insured. Unused amounts of the $10,000s would be refunded after the policy is closed out.
I would also make copper plans low cost by only covering Part A scope items plus what Part B would pay for any general or regional anesthesia surgery.
I would allow Federal PPACA exchanges to offer Interstate Class Drug Plans, exempt from state control that cover under policy year contract at the time of policy issue at least:
1. 80% of all FDA-approved recombinant drugs by key active entity
2. 80% of all key FDA breakthrough chemical active entities under patent as of January 1 of the coverage year used in a drug approved by the FDA by August 1 prior
3. 80% of all key chemical active entities under patent as of January 1 of the coverage year used in a drug approved by the FDA by August 1 prior
4. 90% of all WHO “essential” drugs
This system would allow for genuine negotiation between drug plans and drug companies. Drug plans would have an incentive to try to buy drugs from drug companies and drug companies would have an incentive to make deals to make sales.
Plan drugs would be supplied at on an all-the doctors prescribe basis. The co-pays would be roughly equal to mere manufacturing cost. Out-of-plan drugs need not be covered at all.
HOSPITAL EMTALA COST ASSISTANCE
I would allow hospitals collect up to $1,000 per incident of EMTALA service from employers, with payment not in excess of $50 per week per employee concerned being due to any and all EMTALA providers and not for more than 100 weeks after service. Such payments on behalf of an employee would be considered to be a debt of the employee to the employer. Employers could collect back from employees and ex-employees (and require EMTALA incident employees to participate in an employer plan).
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You don't do that by replacing one pile of bureaucratic crap with another pile of bureaucratic crap. You just further entrench bureaucratic crap.
People like you are merely preventing the reduction of Big Government back to its Constitutional limits.
How about cutting the socialist crap altogether?
I would also make copper plans low cost by only covering Part A scope items plus what Part B would pay for any general or regional anesthesia surgery.
That’s pretty much the same level of coverage I had as under Blue Cross/Blue shield as a kid.
Medicaid expansion is a win for Zerocare.
Scalpels are like swords, just smaller.
Most here seem do seem to prefer to spend $1 trillion to blast three boats to smithereens, even though the scalpels would get used to save the lives of about a third of persons they would get used on and most guns on military bases would remain uselessly locked up.
The Democrats are never “rightly concerned” about anything except their own power.
Why expand Obamacare? Why expand the nanny state?
“Medicaid expansion is a win for Zerocare.”
The Medicaid expansion would be conditional. It would gradually shift paying for Medicaid service providers back to the states, provided the Democrats go along. And if they don’t, Florida and Texas voters can be told Republicans tried to help.
Be aware that it’s far easier to cut the price paid for drugs than to cut the pay of doctors. And my drug plan would start the process rolling.
“Why expand Obamacare?”
My revision is a practical compromise.
Be aware that people that might die if Obamacare isn’t available might use a gun to shoot a Republican Congressman dead. You could ask a former UHC executive about that, but don’t expect an answer while you’re alive.
You see ... if The Right People are in charge, socialism will work this time. Because True Socialism has never been tried. But THIS TIME, we'll get it right. Because we're The Right People.
And who are The Right People? You don't even have to ask; they'll tell you, while touting "Their Proposal" which will solve all the problem the last set of The Right People caused.
My healthcare: If the VA doesn’t cover it (like stem cell therapy):
Passport, round trip airfare and credit card.
Cheaper, faster and more effective than within the US
It would be more in keeping with the Constitutin and its authors and ratifiers to eliminae Meicade and Mediare altogether as well as almost all other goveernment agencies and programs including Social Security. I am not a young guy railing at grandpa getting government money. I have received SS and had Medicare for years. I would support ending the old age welfare program.
https://www.medicaid.gov/medicaid/program-information/downloads/medicaid-expansion-state-map.pdf
Florida, Texas, South Carolina, Georgia, Alabama, Mississippi, Tennessee, Kansas and Wyoming haven’t signed on.
“My healthcare: If the VA doesn’t cover it (like stem cell therapy):
“Passport, round trip airfare and credit card.
“Cheaper, faster and more effective than within the US.”
Except that I only had a debit card and wasn’t in the service, that was my personal plan for three decades.
“The Right People are in charge, socialism will work this time.”
The British NHS has been around for 77 years.
Social Security has been around for 90 years.
Medicare has been around for 60 years.
Spend $25,000/year ($325,000 total) on Leroy’s K-12 New Jersey public school “education”, but don’t spend a cent to save his life.
Missed Wisconsin!
“blah” has been around for “blah” years ...
And they ALL STINK. They need to be abolished.
Oh, yeah ... government education also needs to be abolished.
You sure do love your government programs ... Are you one of The Right People? You sure talk like one ...
I understand many of you object to paying for Medicare and Medicaid.
A possibility is ranked choice tax allocation.
1040 Schedule ?
Please rank how you would like your tax dollars spent after debt service has been funded, with 1 being your priority:
__ Medicare
__ Medicaid
__ DoD (limit $1 trillion)
__ SNAP (limit $40 billion)
__ National Park Service (limit $12 billion)
__ Veterans Administration, including housing benefits
....
Your contribution may be limited to a percentage of total tax necessary to reach the applicable limit.
*******
It is my understanding that leftists now rake in the majority of the income.
Should Be and Will Be won’t be walking down the aisle in 21st Century America.
America is doomed, because even supposed conservatives on a supposedly conservative wwweb forum are just sloppy in love with Big Government Socialism.
You say you want to wean Americans off the government teat.
But you don’t, really.
You just want Americans sucking on a teat that you control.
Back in 1920s and early 1930s Germany, Communists and National Socialists hated each other and fought in the streets. They didn’t disagree much on government policies ... they disagreed over who should be in charge of those policies, and who should be dead.
You don’t disagree with the democRATs on policy, just on who should be in charge.
That’s a great piece of work.
Thanks for doing it.
As the structures we work in crumble, most people here have zero idea about what is happening, or why.
A+
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