Surprise! HHS pilot program to send 2 million poor seniors from Medicare into … “voucher” programs

posted at 11:01 am on September 8, 2012 by Ed Morrissey

I know that every campaign promise Barack Obama makes has an expiration date … but this is ridiculous.  The confetti is barely off the floor at the Time Warner Cable Arena in Charlotte, North Carolina after Obama’s acceptance speech, and already we find out that he’s flip-flopped.  Remember this part of the speech, in which he attacks the Paul Ryan plan to apply free-market reform and cost controls to Medicare?

And I will — I will never turn Medicare into a voucher.

No American should ever have to spend their golden years at the mercy of insurance companies. They should retire with the care and the dignity they have earned. Yes, we will reform and strengthen Medicare for the long haul, but we’ll do it by reducing the cost of health care, not by asking seniors to pay thousands of dollars more. And we will keep the promise of Social Security by taking the responsible steps to strengthen it, not by turning it over to Wall Street.

Expiration date — the very next day, courtesy of some fine reporting by National Journal’s Margot-Sanger-Katz [see update]:

In his convention speech in Charlotte, President Obama vowed to block the Republican Medicare reform plan because “no American should ever have to spend their golden years at the mercy of insurance companies.”

But back in Washington, his Health and Human Services Department is launching a pilot program that would shift up to 2 million of the poorest and most-vulnerable seniors out of the federal Medicare program and into private health insurance plans overseen by the states.

The administration has accepted applications from 18 states to participate in the program, which would give states money to purchase managed-care plans for people who are either disabled or poor enough to qualify for both Medicare and Medicaid. HHS approved the first state plan, one for Massachusetts, last month.

Bear in mind that Ryan’s plan made the vouchers optional; seniors could choose the traditional government-run Medicare plan or opt for a private insurance plan from a federal exchange of approved insurers.  Ryan also allows all seniors to choose, and didn’t force the poorest seniors to take the voucher option.  Not only will Obama push just the poorest seniors into this plan, in some states they’d have to know to opt back in to traditional Medicare:

California is already counting on more than $500 million in budget savings from its own program this year. Most states are proposing to automatically enroll people. Those who don’t want to participate would need to opt out. The Massachusetts plan includes that feature.

Talk about leaving seniors — the poorest seniors! — “at the mercy of insurance companies.”   And why has HHS decided to roll out this pilot program?  As Paul Ryan has argued all along, the competition will drive down costs, especially given the headaches associated with government bureaucracy for dual-qualified seniors:

Potential cost savings are a big incentive for states. Patients who qualify for both federal health programs are a costly population and include many who need nursing-home care or other expensive services. About 40 percent of Medicaid’s costs go toward patients who are also eligible for Medicare. Advocates of the pilot program also say it could lead to better coordination of care for patients who often struggle to navigate the two different programs.

Don’t get me wrong — this sounds like a good program to test.  In fact, it sounds a lot like the Medicare Advantage program that Obama gutted to pay for his Medicaid expansion in ObamaCare.  It’s similar to the approach Ryan wants to use to drive down costs, except that Ryan didn’t propose to use the poor as guinea pigs to test it out.  And he certainly didn’t propose his plan quietly while hypocritically railing against private insurance and Wall Street just as the program got ready to start.

Update: A couple of commenters object to my description of this as a “voucher” program — but that’s how Democrats describe Ryan’s plan, and that doesn’t have “vouchers,” either.  It’s a premium-support plan in a federal exchange of insurance plans approved by Medicare for coverage.  That’s what Medicare Advantage did too, and Obama raided it to pay for the Medicaid expansion in ObamaCare.  This plan doesn’t even have the federal exchange that Ryan envisioned, but fifty different exchanges doling out federal dollars.  Like I wrote, the plan and the experiment is worth trying, but it’s precisely the kind of push into private insurance that Obama swore the day earlier he’d never do … and he’s doing it with the poorest seniors with only an opt-out in some states rather than the opt-in that Ryan’s plan provided.  I’ll put quote marks on “voucher” in the headline, but this mechanism only differs from Ryan’s in that the exchanges get managed by the states rather than Medicare.

If Obama supporters don’t like the term “vouchers” or want to gripe about its accuracy, look first to the beam in thine own eye.

Update II, 9/10/12: Usually, I try to mention the name of the publication when I link, and especially when the reporter does really good work.  Margot Sanger-Katz did a great job in catching this, and I completely forgot to mention her name and National Journal’s.  I’ve fixed it, albeit a couple of days late.


Related Posts:

Breaking on Hot Air

Blowback

Note from Hot Air management: This section is for comments from Hot Air's community of registered readers. Please don't assume that Hot Air management agrees with or otherwise endorses any particular comment just because we let it stand. A reminder: Anyone who fails to comply with our terms of use may lose their posting privilege.

Trackbacks/Pings

Trackback URL

Comments

Comment pages: 1 2 3

No mas pantalones.

Philly on September 8, 2012 at 1:16 PM

And, yes, I believe they are indeed part of the Liberal power structure.

Dr. ZhivBlago on September 8, 2012 at 1:15 PM

I no longer trust FNC, either.

Liam on September 8, 2012 at 1:17 PM

Empty chair. Empty suit. Empty promises. Vacant.

Philly on September 8, 2012 at 1:17 PM

Key West Reader on September 8, 2012 at 12:01 PM

nice to see you back in the swing of things:)

renalin on September 8, 2012 at 1:27 PM

We have to pay for a private insurance supplement in order not to be at the mercy of MC. I think it’s the only way we get to keep our doc.

Kissmygrits on September 8, 2012 at 1:29 PM

I no longer trust FNC, either.

Liam on September 8, 2012 at 1:17 PM

Glen Beck at least went after the Marxists early on, but all of what’s happening is often confusing and happening relatively slowly. It also doesn’t help that some of the things we right wingers believe in such as free enterprise are actually being used against us…but, that’s how the other side works. They’ll even co-opt religion and family as an effort to destroy them both. But if you’re getting paid big bucks to read teleprompters, yuck it up and look pretty, you’re not going to ruin it by going to far.

Dr. ZhivBlago on September 8, 2012 at 1:37 PM

So I take it this information is all over Fox News correct? Or are they part of the liberal media?

HotAirLib on September 8, 2012 at 12:27 PM

Ummmm…actually the info is from cms.gov:

These two models include:

……

http://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/FinancialModelstoSupportStatesEffortsinCareCoordination.html

……
Dr. ZhivBlago on September 8, 2012 at 1:15 PM

That’ll leave a mark.

CW on September 8, 2012 at 1:38 PM

Hearing this immediately makes me wonder one thing: Just how long has this voucher program been in the works by HHS? If it was before we the public started hearing about the Ryan Medicare Voucher system (which, as Romney/Ryan say began as an idea under CLINTON and is in many ways similar to the very popular Medicare Advantage program which Obama is defunding with Obamacare)…then either Obama is a complete idiot and doesn’t know what his own administration is doing OR he’s a total and complete hypocrite if he DID know about it. This is something the Romney team needs to get onto post haste! Get the details about it, and begin hammering it on the campaign trail and bring it HARD in the debates….but only AFTER Obama begins a demonizing road over Romney’s Medicare plan. And still bring it up if Obama tries to stay away from it, to show his utter hypocrisy. If this program started AFTER Romney/Ryan began talking about THEIR Medicare revision plans…then Obama is a thief and a hypocrite for demonizing the SAME kind of program his own administration is beginning (or…again…the idiot) and stealing his opponents ideas which he decries out of one side of his mouth and approves of to his HHS out of the other side.

Highlar on September 8, 2012 at 1:40 PM

The hypocrisy is astounding. We need Debbie Downer to spin this!

John the Libertarian on September 8, 2012 at 1:45 PM

Dr. ZhivBlago on September 8, 2012 at 1:37 PM

Th problem I find is that once liberals are allowed entry into a system, they corrupt it. Especially when money and a job are at stake.

FNC could have remained ‘fair and balanced’ just by having liberals as guests in panel discussions, with hardball questions directed at them so they can explain themselves. But with liberal hosts like Shemp, FNC is bound to ever-increasingly lean left. Can’t ‘offend’ a colleague, can they?

FNC lost me a long time ago. Not to say that they might be part of the liberal plantation mind you. It’s just I believe that when liberals are allowed room they should not have, the place inevitably goes down the tubes.

Liam on September 8, 2012 at 1:45 PM

And I will — I will never turn Medicare into a voucher.

What promise? He just meant one or the other.

Kenosha Kid on September 8, 2012 at 1:50 PM

This isn’t a voucher program in any shape or form. I’m wondering if Ed understands even the basics of the health care debate.

redfate on September 8, 2012 at 2:04 PM

This isn’t a voucher program in any shape or form. I’m wondering if Ed understands even the basics of the health care debate.

redfate on September 8, 2012 at 2:04 PM

Medicare is a voucher program to begin with. If someone promises you a set amount of money, either in actual dollars or a percentage of your expenses, or a line of credit against any future expenditures, it’s a promissory note. In other words, a voucher!

You can look it up here:

http://dictionary.reference.com/browse/voucher?s=t

Definition 3: a form authorizing a disbursement of cash or a credit against a purchase or expense to be made in the future.

I don’t think Ed is the one who needs to re-check himself.

Liam on September 8, 2012 at 2:32 PM

If they are using this program for the poor and disabled, this must be for those seniors so poor, they get SSI, which probably enables them to qualify for medicaid in addition to medicare and the disabled who get SSDI or SSI (if they never payed into the system). So Obama is creating a two tiered system, one for the poor and disabled and one for the middle class and wealthy. Interesting.

I have often wondered why people qualified for medicare and medicaid. A lot of states of moving their medicaid populations into for-profit HMOs. It looks like they are trying to end the practice of allowing people to be in both programs. It makes sense, but these medicaid HMOs have not proven yet, to be cost savers or very good at managing long term care needs, or for that matter, paying for services!

What a hypocrit! I can’t wait to forward this to my left leaning friends who are afraid republicans will upset medicare!

bopbottle on September 8, 2012 at 2:36 PM

Medicare is a voucher program to begin with.

If that’s the case, go ask Ed how it’s possible to move people off a voucher program into a voucher program.

But it’s not the case. Medicare isn’t a promise of a set amount of money; it’s a promise that you’ll have your health expenses paid for in your old age, regardless of their cost.

Ryan proposes to give you a set amount of money that may or may not cover your health expenses. A voucher, in other words.

That’s what the rest of the planet means when they talk about a voucher program, and the program Ed describes above doesn’t do anything like it.

redfate on September 8, 2012 at 2:39 PM

it’s a promise that you’ll have your health expenses paid for in your old age, regardless of their cost.

redfate on September 8, 2012 at 2:39 PM

So naive.

http://www.usatoday.com/news/health/2001-02-19-medicare.htm

http://www.todaysseniors.com/wp/medicare/can-my-doctor-refuse-to-accept-medicare-coverage/

CW on September 8, 2012 at 2:46 PM

redfate on September 8, 2012 at 2:39 PM

It’s all the same, if you think about it. If you want to quibble about the word ‘set’, then you go for it. I’m not going to play that, while instead running with the dictionary definition.

The point of Ed’s article is simple: Obama and the other Dems are saying they oppose a voucher system like R&R put forth, yet they are doing basically the same thing in a pilot program. And Medicare, like any other government giveaway is, by definition, a voucher system even if unlimited.

I would rather we do away with all government handouts. But reality is a often a royal pain.

Liam on September 8, 2012 at 2:50 PM

Sounds a lot like the New Mexico CoLTS (Coordination of Long Term Services) Program, fully phased in “by April 1, 2009”!
“CoLTS covers primary, acute, and long-term services in one coordinated and integrated program, incorporating Medicaid and Medicare services and funding.” source – http://www.hsd.state.nm.us/pdf/LegislativeSession/2012/CoLTS%20Managed%20Care%20Overview_Jan_2012.pdf

Please note: most Medicaid coverage in New Mexico has been under HMOs for several years already, known as Salud! programs under State-approved insurance carriers. There are many things that Salud! refuses to cover. But if you become dual-eligible (eligible for Medicaid and Medicare coverage at the same time), you are moved into CoLTS, for “coordination of benefits”, under only two MCOs approved by the State.

Sue Anne on September 8, 2012 at 2:59 PM

bopbottle on September 8, 2012 at 2:36 PM

Medicaid that is administered by the States also covers those on Social Security. A Senior that has Medicare is also eligible for Medicaid based on income. This pays what Medicare does not in many cases, co-pays/deductibles etc. A major factor of Medicaid is the coverge for Nursing Homes. Medicare does not provide that coverage.

So Medicaid covers more than just those on SSI, etc.

I’m not clear on whether this “test” program applies to those on the Medicare Advantage Plan or not. The article Ed put up didn’t specify that.

Until we have more info on what this actually entails, there are more questions than answers. When the Government is involved, that is always the case:-)

I’m trying to find out which 18 States have already applied. They would certainly have some details.

bluefox on September 8, 2012 at 3:11 PM

One note: “voucher” implies that the client has control of their care choices, and that they can decide what plan or coverage best suits their needs, and then go to that company and use their “voucher” to obtain such coverage.

These programs, like the CoLTS program in New Mexico, involve government bureaucrats deciding what will limit the government’s costs while appearing to provide “coverage” for the “client”. The government decides for the “client” where their “voucher”, or perhaps “designated allotment” is more precise, may be placed. The MCOs compete for the bureaucrats’ blessings in order to get the contract, then the “client” is told these are your only “choices”.

Generally, there seems to be little difference in the actual “plan” available. But getting the MCO to part with “their” cash in order to actually get services can often be a daunting task. Some providers struggle for months to get payment for services. Sometimes a client will struggle for years to get a service approved and provided.

Sue Anne on September 8, 2012 at 3:13 PM

Has anybody already mentioned the similarity between Obama’s promises and the Pirate Code, which is really only a guideline?

Drained Brain on September 8, 2012 at 3:15 PM

Hearing this immediately makes me wonder one thing: Just how long has this voucher program been in the works by HHS?

The AFA calls for the government to enact a number of pilot programs that have the potential to lower the cost of US healthcare. It doesn’t mean that the Ryan plan has been endorsed, where vouchers fail to keep up with the healthcare inflation. It’s a pilot program- not a policy change.

In a free market system, pilot programs are a good thing.

bayam on September 8, 2012 at 3:16 PM

bluefox on September 8, 2012 at 3:11 PM

There are more states that have applied, list is here: cms.gov Scroll down a bit to see it. The proposals have links there.

Sue Anne on September 8, 2012 at 3:27 PM

Anecdotal info: regarding “medically necessary treatment”, a lawyer in New Mexico said: “Medicaid in New Mexico has given itself the right to deny even life-saving treatment as a matter of ‘cost containment’.” He was referring to a patient in the CoLTS program, who was asking for “medically necessary” services requested by two doctors familiar with the patient’s case and needs. The MCO denied services and the State backed the MCO’s denial. They said, “It’s just not covered.” The lawyer refused to take the case.

Sue Anne on September 8, 2012 at 3:32 PM

In a free market system, pilot programs are a good thing.

bayam on September 8, 2012 at 3:16 PM

I totally agree. My stink, which I think is the whole point of the article that set up this thread, is that one party (usually the Dems) will condemn something while either doing the same, or worse, themselves.

I have long been in favor in privatizing the main programs for care of seniors, in a long and well-planned phase out of what is currently run by the government. I believe it all could work, if Washington will let it happen with a long-term well-thought plan to get it done.

Liam on September 8, 2012 at 3:37 PM

Sue Anne on September 8, 2012 at 3:32 PM

Ever notice that those who think medical care is a ‘right’ are the first ones to deny services to ‘cut costs’?

Maybe I’m missing something along the way…

Liam on September 8, 2012 at 3:39 PM

I’m supposing the term “Health and Human Services Department” is actually some kind of racial coding. I’ll be sure to ask Toure for clarification.

ButterflyDragon on September 8, 2012 at 3:46 PM

“Can we PLEASE get back to the IMPORTANT ISSUE in this election instead of these ridiculous distractions? WHERE ARE YOUR TAX RETURNS MR. ROMNEY????? WHAT ARE YOU HIDING?????”
~DWS/Dingy Reid

Strike Hornet on September 8, 2012 at 4:07 PM

Hey bayam. We missed you on that thread you abandoned.

rogerb on September 8, 2012 at 4:31 PM

He can do anything he wants, the main MSM will never report it.

Wade on September 8, 2012 at 4:35 PM

The AFA calls for the government to enact a number of pilot programs that have the potential to lower the cost of US healthcare. It doesn’t mean that the Ryan plan has been endorsed, where vouchers fail to keep up with the healthcare inflation. It’s a pilot program- not a policy change.

In a free market system, pilot programs are a good thing.

bayam on September 8, 2012 at 3:16 PM

So in other words vouchers program are not the scourge that Obama pretends and now that IS THE POINT rignt?

Oh and do all voucher systems not keep up with inflation? You say that as if it is and absolute or that it has to be an absolute.

You’re such a useful idiot.

CW on September 8, 2012 at 4:37 PM

In a free market system, pilot programs are a good thing.

bayam on September 8, 2012 at 3:16 PM

Not when we seniors have paid all these years. Not when the government has a hand in it. I want a refund.

Wade on September 8, 2012 at 4:41 PM

So, now we are attacking the president for acting too conservative. Good lord, when will the stupid party go back to being the Democrats!?!

astonerii on September 8, 2012 at 4:47 PM

Ryan plan has been endorsed, where vouchers fail to keep up with the healthcare inflation. It’s a pilot program- not a policy change.

In a free market system, pilot programs are a good thing.

bayam on September 8, 2012 at 3:16 PM

And who controls the inflation numbers? The 2 prior years under Obama no SSI raises, because the Obama administration says no COL? I know my COL increased significantly during those years, where did the figures come from, the illegal aliens, abortion or birth controls?

Wade on September 8, 2012 at 4:48 PM

When the opposition party is giving you a gift horse, after making sure it is not a trojan, be freaking HAPPY about it and use it to your advantage. Do not work to make them stop.

astonerii on September 8, 2012 at 4:49 PM

So, now we are attacking the president for acting too conservative breaking promises. Good lord, when will the stupid party go back to being the Democrats!?!

astonerii on September 8, 2012 at 4:47 PM

Wade on September 8, 2012 at 4:50 PM

And who controls the inflation numbers? The 2 prior years under Obama no SSI raises, because the Obama administration says no COL? I know my COL increased significantly during those years, where did the figures come from, the illegal aliens, abortion or birth controls?

Wade on September 8, 2012 at 4:48 PM

MOOCH MOOCH MOOCH. Must get more, always more. SS, my precious, we musn’t let them take you froms me my precious.

astonerii on September 8, 2012 at 4:50 PM

Wade on September 8, 2012 at 4:50 PM

When his promises are wrong and he changes his direction to more right, your going to goad him into sticking with the wrong path? STOOOOPID.

astonerii on September 8, 2012 at 4:51 PM

Hilarious. Some of the lefties have taken to calling our ticket the Vulture/Voucher ticket. Oops.

juliesa on September 8, 2012 at 4:52 PM

This isn’t a flip flop, it’s a flat out lie. The media went ape sh*t over Ryan getting the time wrong on a two decade’s old race, but this? Crickets.

kit9 on September 8, 2012 at 4:58 PM

So, now we are attacking the president for acting too conservative. Good lord, when will the stupid party go back to being the Democrats!?!

astonerii on September 8, 2012 at 4:47 PM

Of course that is not why we are attacking him but you know that. If you don’t you’re not even close to being as smart as you think you are.

Get a friggin life. You and our boy gibbs should have a child and leave this strange obsessive behavior behind.

CW on September 8, 2012 at 5:00 PM

astonerii on September 8, 2012 at 4:47 PM

Remember this part of the speech, in which he attacks the Paul Ryan plan to apply free-market reform and cost controls to Medicare?

Making it easy for you. Did you gradiate high screwel?

CW on September 8, 2012 at 5:02 PM

When his promises are wrong and he changes his direction to more right, your going to goad him into sticking with the wrong path? STOOOOPID.

astonerii on September 8, 2012 at 4:51 PM

Damned right I am, are you on SSI? Do you know the loops we who had to go through just to get the medicare setup for our needs? Have you had $900 a week taken out of you pay for government programs only to have this fool play around with the coverage I paid for? STOOOPID, I think not. At least Paul Ryan does not want to fool with what the current seniors have now and were promised. The retirement of auto union workers are being honored, but non-union workers lost theirs. That is why in the Declaration of Independence is says We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights because what God gives only God can take away. What the government gives the government can take away.

Wade on September 8, 2012 at 5:04 PM

Of course that is not why we are attacking him but you know that. If you don’t you’re not even close to being as smart as you think you are.

Get a friggin life. You and our boy gibbs should have a child and leave this strange obsessive behavior behind.

CW on September 8, 2012 at 5:00 PM

I dunno, when ever someone changes from doing something I do not like, to something I do like, I do not go around attacking them. Even if it makes me feel better inside that I was right and they finally came around to my way of thinking. Talk about obsessive behavior, you cannot even stop attacking when he does something you would approve of.

astonerii on September 8, 2012 at 5:05 PM

Making it easy for you. Did you gradiate high screwel?

CW on September 8, 2012 at 5:02 PM

No, he went to school STOOOPID and came out the same way.

Wade on September 8, 2012 at 5:06 PM

So, now we are attacking the president for acting too conservative.

astonerii on September 8, 2012 at 4:47 PM

No, I’m attacking him for being a demagoguing hypocrite. Try to read all the way through and keep up.

Ed Morrissey on September 8, 2012 at 5:12 PM

I dunno, when ever someone changes from doing something I do not like, to something I do like, I do not go around attacking them. Even if it makes me feel better inside that I was right and they finally came around to my way of thinking. Talk about obsessive behavior, you cannot even stop attacking when he does something you would approve of.

astonerii on September 8, 2012 at 5:05 PM

I do know, you are entitled to you opinion but why do you feel necessary to object to others opinions with comments like STOOOPID? After all we are not a smart and wise as you.

Wade on September 8, 2012 at 5:12 PM

Damned right I am, are you on SSI? Do you know the loops we who had to go through just to get the medicare setup for our needs? Have you had $900 a week taken out of you pay for government programs only to have this fool play around with the coverage I paid for? STOOOPID, I think not. At least Paul Ryan does not want to fool with what the current seniors have now and were promised. The retirement of auto union workers are being honored, but non-union workers lost theirs. That is why in the Declaration of Independence is says We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights because what God gives only God can take away. What the government gives the government can take away.

Wade on September 8, 2012 at 5:04 PM

Well, you had a whole life to change things. Yet you believed the government promises which if you read the fine print, the actual laws that is, that you were not paying for YOUR OWN BENEFITS, but those of others who were currently consuming your money for their wants. Notice that they are taking these people from the poorest, so your you should f^cking be happy. It leaves more of other people’s money for you rich people who paid 900 a week in TAXES not premiums.

Of course, a SMART person would have known all these things well in advance. So, STOOOOPID party with STOOOOPID people imagine they are OWED something that the law and the supreme court have both said the government does not owe you. Can selfish greedy evil people in majority mob rule and keep the government paying them? Sure can, we used to call those people DEMOCRATS, now we can just say pretty much everyone has been reeled in hook, line and sinker by the progressive socializing of the nation. You particularly so. You were an easy sellout. Screw everyone else, you want yours and to hell with the consequences your greed lays on other people’s shoulders.

astonerii on September 8, 2012 at 5:19 PM

No, I’m attacking him for being a demagoguing hypocrite. Try to read all the way through and keep up.

Ed Morrissey on September 8, 2012 at 5:12 PM

Sorry Ed, imma bit bitter about the loss of there being an opposition party to the democrats. Its hard to wake up one day and find out that the conservative party is now essentially as progressive liberal as the Democrat party was in 2000.

astonerii on September 8, 2012 at 5:23 PM

These programs are easily confused.

SSI is supplemental security insurance and is paid for out of the general fund and is managed by the SSA. It typically goes to people who were disabled at a young age and become eligible for it when they turn 18, or for the poor elderly. SSDI is disability insurance for people who have paid into the social security system and aer now disabled.

The problem with the administration pushing these people out of typical medicare, is they are going to end up with the HMOs run by medicaid and it will become very difficult for them to find physicians willing to see them as the medicaid reimbursement if less than medicare.

bopbottle on September 8, 2012 at 5:45 PM


Obama campaign claims that Romney/Ryan are copying President Downgrade in 5…4…3..2…

cntrlfrk on September 8, 2012 at 5:47 PM

bluefox on September 8, 2012 at 3:11 PM

There are more states that have applied, list is here: cms.gov Scroll down a bit to see it. The proposals have links there.

Sue Anne on September 8, 2012 at 3:27 PM

Just getting back online. Thank you very much for the info. I’ve read your other comments. Trying to think of one word that describes this administration and all I can come up with is a four letter word….evil.

bluefox on September 8, 2012 at 5:56 PM

Liam on September 8, 2012 at 3:39 PM

Everyone has a “right” to medical care, but some people have “more rights” than others, yes? (/sarc)
I missed the memo, too, I think…

Sue Anne on September 8, 2012 at 6:01 PM

I no longer trust FNC, either.

Liam on September 8, 2012 at 1:17 PM

I have not trusted FNC for at least two years. I stopped watching about 15 months ago and am much less frustrated.

Ailes and Murdoch are positioning FNC just to the right of CNN.

bw222 on September 8, 2012 at 6:03 PM

Sorry Ed, imma bit bitter about the loss of there being an opposition party to the democrats. Its hard to wake up one day and find out that the conservative party is now essentially as progressive liberal as the Democrat party was in 2000.

astonerii on September 8, 2012 at 5:23 PM

…or… someone is an emotional eunuch who goes off when he interprets only what he wants to read

KOOLAID2 on September 8, 2012 at 6:03 PM

bluefox on September 8, 2012 at 3:11 PM

Fifteen state chosen to participate are: California, Colorado, Connecticut, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oklahoma, Oregon, South Carolina, Tennessee, Vermont, Washington, and Wisconsin

bopbottle on September 8, 2012 at 6:04 PM

You belong to the government.

The real problem with the Ryan Medicare proposal is it gives seniors a choice. Any good liberal knows the masses don’t need no stink’n choices, they will to be told what’s good for them.

WestTexasBirdDog on September 8, 2012 at 6:09 PM

In a free market system, pilot programs are a good thing.

bayam on September 8, 2012 at 3:16 PM

So you think Obamacare is a good thing?

Have you bothered to read the Obamacare Law? Just finished watching Hang em High with Eastwood.

bluefox on September 8, 2012 at 6:09 PM

bluefox on September 8, 2012 at 5:56 PM

It looks to me what they are trying to do is move all these dual eligibles into medicaid. The reimbursement will be much less and state medicaid programs have been turning their programs over to HMOs or what the state like to call Managed Care Organizations. Kansas is in the process of doing that now, and as the parent of a 27 year old who is total care, it scares the socks off of me.

Evil is probably the appropriate word to turn all these people over to medicaid making it tough to find a doctor that will see them.

bopbottle on September 8, 2012 at 6:16 PM

So, now we are attacking the president for acting too conservative. Good lord, when will the stupid party go back to being the Democrats!?!

astonerii on September 8, 2012 at 4:47 PM

What a dumba$$. If you’re not going read Ed’s post why do you waste our time by commenting.

Vince on September 8, 2012 at 6:23 PM

bopbottle on September 8, 2012 at 6:04 PM

Thanks for the list.

bluefox on September 8, 2012 at 6:25 PM

you cannot even stop attacking when he does something you would approve of.

astonerii on September 8, 2012 at 5:05 PM

Making it easy for you. Did you gradiate high screwel?

CW on September 8, 2012 at 5:02 PM

Please. Count how many times I have attacked you. Quit dreaming up your bs. The reality is you come here almost every day with the say tired screed. We heard you dimwit. I normally say nothing but you have gotten to the point of insanity. You’re a nut.

So, now we are attacking the president for acting too conservative.

astonerii on September 8, 2012 at 4:47 PM

No, I’m attacking him for being a demagoguing hypocrite. Try to read all the way through and keep up.

Ed Morrissey on September 8, 2012 at 5:12 PM

OUCH.

CW on September 8, 2012 at 6:32 PM

Sorry Ed, …
astonerii on September 8, 2012 at 5:23 PM

Funny I already told you what was meant. Instead of admitting it when I told you …you wait until you have to kiss Ed’s arse. Funny AND nuts.

CW on September 8, 2012 at 6:33 PM

you cannot even stop attacking when he does something you would approve of.

astonerii on September 8, 2012 at 5:05 PM

Sorry Ed, …
astonerii on September 8, 2012 at 5:23 PM

Nutter.

CW on September 8, 2012 at 6:34 PM

bluefox on September 8, 2012 at 5:56 PM

It looks to me what they are trying to do is move all these dual eligibles into medicaid. The reimbursement will be much less and state medicaid programs have been turning their programs over to HMOs or what the state like to call Managed Care Organizations. Kansas is in the process of doing that now, and as the parent of a 27 year old who is total care, it scares the socks off of me.

Evil is probably the appropriate word to turn all these people over to medicaid making it tough to find a doctor that will see them.

bopbottle on September 8, 2012 at 6:16 PM

Your situation with your 27 year old makes it worse. I really don’t know how the States will set this up. Evidently it’s been a plan by HHS for some time, in order for those States already to have made application. This didn’t occur just today.

Many Doctors don’t accept Medicaid now, so most likely another HHS mandate is included. Many Doctors have also stopped accepting Medicare.

This is why Obamacare was such an evil as it gives total control over Healthcare.

I haven’t read the Obamacare law, but worked for months against it in 2009. Many of the bills were out there showing what the law would contain. They were a disaster. I probably still have files on them. No privacy at all.

What Ed posted today, just seems to be a transfer of those under Medicare/Medicaid to the States with no choices at all. It’s worse than what we have now.

bluefox on September 8, 2012 at 6:39 PM

I have long been in favor in privatizing the main programs for care of seniors, in a long and well-planned phase out of what is currently run by the government. I believe it all could work, if Washington will let it happen with a long-term well-thought plan to get it done.

Liam on September 8, 2012 at 3:37 PM

I’m not so much in favor of privatizing certain things. In this instance, we have a situation where people have paid into what was originally a government-run program and now may be told that it’s going to be administered by insurance companies. Sure, that may indeed work, but the point is that they’re using government to send business the way of private corporations.

Now, if I believed this was an attempt to wean folks off of government programs then I’d be all for it. However, we have to consider the mess that has been created financially with the full compliance of both government and (it seems) the top tiers of the banking industry.

If things were allowed to work as they should, that is, true free enterprise, this would be a non-issue and the vast majority of Americans would do better to see to their retirement/medical needs via a plan they themselves bought from a private entity…assuming that this industry was based upon competitive business practices and competitive rates!

…Not to say that they might be part of the liberal plantation mind you.

Liam on September 8, 2012 at 1:45 PM

Yeah, I see your point, and I still watch FNC because I just can’t take watching the Libtards on MSNBC, etc., and and at least FNC does take some conservative positions. But they seem to refrain from some pretty obvious attacks that many on the ‘net are not afraid to carry out. Kinda reminds me of McCain and Romney come to think of it! LOL

Dr. ZhivBlago on September 8, 2012 at 6:41 PM

And Medicare, like any other government giveaway is, by definition, a voucher system even if unlimited.

Uh, sure. If you define voucher as literally any government program, then your argument makes perfect sense and there’s no difference between a program that guarantees you have medical insurance regardless your preexisting conditions, and a program that hands you a coupon and says good luck buying insurance with that!

But no one defines voucher like that — including Ed.

redfate on September 8, 2012 at 6:57 PM

bluefox on September 8, 2012 at 5:56 PM

You’re welcome.
Evil, and/or perhaps the logical extension of deciding that “people belong to the government”? In that world view, people are disposable, and the only issue for the administration appears to be how to make it look politically correct. There aren’t enough doctors to handle current medical needs generally, fewer doctors who accept Medicare, and even less who are willing to lose money in order to treat the current Medicaid case load; and so, people die.

Sue Anne on September 8, 2012 at 6:58 PM

Animal Crackers.

Limerick on September 8, 2012 at 11:24 AM

Mutts for Mitt all agree …
Better in the crate than on the plate.

timberline on September 8, 2012 at 7:10 PM

I can’t decide if you’re merely ignorant.. or just a walking pile of bitter rage that someone somewhere might actually need help from the society they live in..

Look..

Can selfish greedy evil people in majority mob rule and keep the government paying them? Sure can, we used to call those people DEMOCRATS, now we can just say pretty much everyone has been reeled in hook, line and sinker by the progressive socializing of the nation. You particularly so. You were an easy sellout. Screw everyone else, you want yours and to hell with the consequences your greed lays on other people’s shoulders.

astonerii on September 8, 2012 at 5:19 PM

So now people who have worked their entire lives, and have suffered a catastrophic event,.. are evil greedy thieves who be cat burglin yer personal stash… that about right?

are you THAT out of touch with reality?

I never made over 25,000 a year in my life.. even married our joint income never topped 32,000.. with two children the oldest now 13. There was no extra money to invest.. NONE.. but saps like you sit back and whine like babies.. because the entire country minus a few libertarian hecklers.. who want to end social security entirely.. all federal retirement and disability aid.. the rest of us, BOTH parties have agreed for over 70 years that they are a necessary part of modern life.. we merely differ on how to pay for them, and how to manage them, to allow for the greatest savings and most efficient means of delivering help to those who CAN’T HELP THEMSELVES…

are you that inhuman, so bitter at your personal tax burden.. you stand there, hands on hips.. and bellow out..“WELL, if your MOM and DAD weren’t so STOOPID, and set aside everything they made to buy private insurance for you.. well little Mr…….. You’ll just have to die from that congenital heart defect.. or just live in the streets because your parents died unexpectedly.. or maybe I’ll just drown you myself.. since you are OBVIOUSLY too STOOPID to have provided for yourself!”

That you is it?

This whole country has decided it WILL accept the minimum necessary safety net, and you can’t stop that no matter how much you whine and b*tch about it..

all you can do is prove to the public that those radical leftists were right about us being subhuman haters…..

conservatives under our current status.. ACCEPT THE NEED… only libertarians still hold out.. and you couldn’t eve win a single primary for that clown Paul.. so get that.. and lay off Wade.. SSI is not for the casual drifter, it’s to help those on a disability or a child with a debilitating condition..

My prayers to you and your family Wade..

I do not collect Social Security retirement or SSI.. I’m on SSD.. Social Security Disability.. the in effect catastrophic injury insurance for working people. Strictly speaking, a government run insurance program.. and YES, it’s needed, for lower middle class, the working poor who don’t have the means to buy private insurance, which with every other kind you have to buy, too pricey for the working poor..

But you the perfect human being have decided… “screw the disabled”..

You’d change that tune in a hurry if reality pimp slapped you with a shovel… and it might… Karma is a judgmental wench who doesn’t like absolutists much….

I’m on SSD, because I had my back broken in two places on the job, when I had a disagreement over right of way with an SUV while foot chasing a shoplifter… 8 vertebrae crushed.. 6 discs bulging.. two herniated badly.. I already had advanced osteoarthritis of the spine from a previous injury which had crushed 4 vertebrae in my back in 91.. I’ve had my back technically broken twice.. had spinal reconstruction, six inches of my cervical spine are not my parts.. Titanium which hurts like a b*tch when the weather changes.. no mobility of the neck, can’t even look over my shoulder, I walk with a cane, and any amount of time on my feet is excruciating,.. I still have another surgery coming, probably near Christmas to fuse my lumbar.. I never sleep,.. live on methadone for the pain 2400mg’s of gabupentin a day.. and I have to fight like it was D Day just to even attempt to hold on to enough mobility to keep even a touch of self respect… You CANNOT imagine what 24hrs inside my skin is like.. not a clue…and even with all that..

Do I believe I’m “entitled” to the SSI?

no.. I am humbly, terribly grateful to my countrymen and women for helping out my family.. because I was STOOPID enough to put doing a good job ahead of my own safety.. I was afraid, (he was a BIG shoplifter.. 6’6″ and the security woman ahead pf me was 5’3″).. I was afraid for her.. she came out OK.. and for that, I’m glad.. I am humbled by the family.. the friends who have stood by us, helped us through this.. and to the taxpayers into FICA.. Like I was for 31 years.. I thank you all.. truly,.. I am thankful..

but to a stone cold cave dweller like you astonerii….

I could care less that you’d gladly.. happily dump women and children into the icy river, just so you can pay less taxes.. Americans have never complained about FICA that I’ve ever heard at work.. the income taxes.. sure.. but NOBODY complains about paying for health insurance, or FICA.. because we all know or knew somebody who had the bad luck to be struck down and made unemployable..

not you though.. you have to be as bad a narsissist as Obama to hate the disabled .. the children with conditions to whine this much..

So YES.. we have accepted that a baseline minimum level of socialism we can live with.. even Reagan conservatives.. and if you’d bother to check.. Ron had no problem with SS other than he wanted it switched to a more market oriented system.. as well nearly ALL do in the GOP..

If that lack of purity damns us inn your eyes…

call a whaaaaamulance..

we settled that debate in the 30′s.. we all accept it’s need.. we just argue over how it’s structured and funded.. and if Ryan succeeds.. we’ll move to a better more free market source of funding..but to die hard mine mine mine purists like you.. 75% success is still a failure..

I wish my problems on no one.. except you.. for about an hour.. just one hour.. I figure any longer, you’d reach for a gun.. just to make it stop.. but in that hour.. you’d find what’s so long eluded you.. empathy, compassion, basic human decency to the fact, some people need help..

You had better pray that when your moment comes.. when you can’t snarl and complain about stoopid freeloaders.. and they have to carry you to the hospital.. that our view prevails rather than yours..

They could always just do the Indian style healthcare.. and leave you in the woods to die.. or the Viking method.. and simply put a knife in you and take your stuff… the Soviet method.. a nightmare hospital.. and outdated meds to numb the pain while rats chew on you..

You’d be better off thanking everyone for paying for your coverage too..

because God always sees.. and he hates hubris.. and false pride.

mark81150 on September 8, 2012 at 7:12 PM

bopbottle on September 8, 2012 at 6:16 PM

I’ll pray for you and your 27 year old. A suggestion: find out what the grievance and/or appeal system is and get ready to use it. Keep demanding proper care. It’s apparently the only thing that can be done, until the system is actually fixed by someone that understands how important all people really are.

It does seem like the plan is to take Medicare money and mix it with Medicaid money and then to dilute it across the program somehow. Providers get less money, patients receive fewer services, and the MCOs get more money.

Sue Anne on September 8, 2012 at 7:24 PM

If Obama supporters don’t like the term “vouchers” or want to gripe about its accuracy, look first to the beam in thine own eye.

Obama supporters are too damned stupid for critical analysis. If they had any such ability they wouldn’t be Obama supporters. They will simply wait until tomorrow’s WaPo “fact checkers” for their position.

And if it sounds as if I don’t have a whole lot of respect for Obama supporters, you’d be right.

Happy Nomad on September 8, 2012 at 7:40 PM

So are Sebelius and Obama pushing granny off a high steep cliff or just shoving her off a third story balcony?

farsighted on September 8, 2012 at 7:52 PM

So are Sebelius and Obama pushing granny off a high steep cliff or just shoving her off a third story balcony?

farsighted on September 8, 2012 at 7:52 PM

More akin to the Dem position on botched abortions. Wheel the human being to the nearest janitor’s closet, provide no assistance, and let them die.

Happy Nomad on September 8, 2012 at 7:55 PM

mark81150 on September 8, 2012 at 7:12 PM

I’m very sorry for your physical injuries and what you are suffering because of them. I can just imagine the red tape and hoops you had to endure to get the help you have. It’s never enough, so am glad your friends and family and others are able to help. Will be adding you and your family to my ever growing prayer list.

You are correct in what you say about the Medicare and other taxes via payroll deduction. There are no choices in the withholding. We’ve all had to pay them.

My suggestion regarding astonerii would be to ignore him/her. That is best since when one encounters anyone not making sense of something and being rude and hateful on top of that, no point to discuss anything with them.

I hope you will be doing better and some healing will be taking place soon. Also that your next surgery goes well and also brings the intended relief.

Keep the faith above all:-)

bluefox on September 8, 2012 at 8:48 PM

@astonerii Shame on you for your rude remarks. It is one thing to disagree on a political issue, but to make personal insults is not right. You have no idea about the person or circumstances. That causes hurt feelings and there is no need.

I think you should apologize for that and hope that you will.

bluefox on September 8, 2012 at 9:00 PM

Politifact still rated Obama’s claim “more true than truth itself” and this post got 7,000 pinnochios.

joewm315 on September 8, 2012 at 9:23 PM

Politifact still rated Obama’s claim “more true than truth itself” and this post got 7,000 pinnochios.

joewm315 on September 8, 2012 at 9:23 PM

What claim are they talking about? He’s only made hundreds, LOL

bluefox on September 8, 2012 at 9:25 PM

This feels an awful lot like Michelle’s patient dumping in Chicago. Only this time, it’s the feds who are dumping the poorest and sickest seniors on the state. Seniors dumping.

sydneyjane on September 8, 2012 at 10:27 PM

mark81150 on September 8, 2012 at 7:12 PM

Family, Friends, Immediate Community, Local Community, County, State, Federal. Each one adds more distance between receiver and payer, and thus each level removes accountability on each side of the equation.

I am not at all saying that people should not get help. Then again, from the federal government? Families help each other out. I send money to my wife’s grandparents every month. If they need something special, I send more. Friends, when my friends hit hard times, I help them out. If they got an idea they want to pursue for making money, I help finance it. Community, there are plenty of churches and other places where charity can be found, including local non profit run hospitals, there would be many more if the government was not taking so much in taxes to force people to pay for these things. State, taking money from the citizens of the state and handing it to the federal government moves the power to decide how best that money could be used, if it was going to be taken from people at all. It would also give citizens a better place to submit their grievances, a place their voices would actually be heard. Federal government, so far removed from the people that almost all the real decisions are made by unaccountable unelected officials who refuse to use the same system of benefits they foist on the rest of the people after having taken their money.

As for your moaning about paying into the government… As has been said, taken to court, is written into the actual factual laws. You do not pay INTO the system, you pay for other people who are already in the system. You are OWED nothing.

astonerii on September 8, 2012 at 10:50 PM

@astonerii Shame on you for your rude remarks. It is one thing to disagree on a political issue, but to make personal insults is not right. You have no idea about the person or circumstances. That causes hurt feelings and there is no need.

I think you should apologize for that and hope that you will.

bluefox on September 8, 2012 at 9:00 PM

I have not been treated POLITELY in these forums since Newt won a primary. I have no obligation at all to be nice to these people, particularly after THEY attack me personally first, in order to prevent their feelings being hurt. Are we Democrats? Oops, I forgot, we actually are. The obamification of the Republican party is almost complete.

Do not debate on facts, feelings are more important. If you cannot win, do not debate, shut it down completely.

I could care less if they are giving vouchers or are just simply paying for the bills. In the end if there is a program out there giving away other people’s money, it will be abused, it will be inefficient, and it will not remain within budget. It will be an incentive for people to make bad choices.

When someone is being a hypocrite in my favor, I just simply tend to not stand in their way. Particularly when they have no loyalty to me nor I them to being with.

astonerii on September 8, 2012 at 10:58 PM

The family is stuck. It is a sad situation.

Voter from WA State on September 8, 2012 at 10:55 PM

I am sure they would have more wealth available to bring to bear if they were not forced to pay 14% at an absolute minimum of all their earnings to pay for other people’s welfare. Then there is the friends of the family, or a church that could help. A local donation drive. It helps to be a beloved citizen of a local community. Well, it used to when the government was taking less and not handing it out to people who did not need it. She seems to need it, it would have been great if it remained closer home so her loved ones and community had it available to help.
I hope she finds some kind of help from one of those local places.

astonerii on September 8, 2012 at 11:03 PM

This would even make john kerry’s botox inflated head spin….he broke the promise before he made the promise

wildweasel on September 8, 2012 at 11:45 PM

MY vision is blurring so I can’t put much time in this.. but just for a start… work on your reading skills..

As for your moaning about paying into the government… As has been said, taken to court, is written into the actual factual laws. You do not pay INTO the system, you pay for other people who are already in the system. You are OWED nothing.

astonerii on September 8, 2012 at 10:50 PM

Look chumley.. I said I paid in for 21 years.. that is correct.. at no point did I say that money didn’t do right back out.. or that I was supposed to get ANY back..

what I said.. and you ignored..

and even with all that..

Do I believe I’m “entitled” to the SSI?

no.. I am humbly, terribly grateful to my countrymen and women for helping out my family..

mark81150 on September 8, 2012 at 7:12 PM

do read more carefully..

mark81150 on September 9, 2012 at 12:06 AM

damned blurred vision.. 32 years in.. there.. spellcheck helps, but it’s fuzzy and hard to type right now.

mark81150 on September 9, 2012 at 12:08 AM

try again.. 31 years.. had my wife check that time.. I broke my glasses this morning, and have to use a back up set of reading glasses.. which aren’t strong enough.

mark81150 on September 9, 2012 at 12:10 AM

redfate on September 8, 2012 at 2:39 PM

Douche bag.

DevilsPrinciple on September 9, 2012 at 12:52 AM

and even with all that..

Do I believe I’m “entitled” to the SSI?

no.. I am humbly, terribly grateful to my countrymen and women for helping out my family..

mark81150 on September 8, 2012 at 7:12 PM

do read more carefully..

mark81150 on September 9, 2012 at 12:06 AM

Your countrymen did so at the point of a gun.

astonerii on September 9, 2012 at 1:27 AM

Will Romney kill off 0bamacare, or fix it?

Heck, as he is running like McLame did in 2008 I doubt he’ll get the chance to do a damnthing.

DannoJyd on September 9, 2012 at 3:24 AM

The Vouchers come with an instruction booklet…and a tear off contribution form for the Obama Campaign. You have to furnish your own postage. Each entry also qualifies you for the “mystery voter registration”. Besides your own “legal” voter registration (wink, wink), you also get to register under a name we will pick for you, just our way of saying “Thanks” for playing.

The vouchers will be good for one daily portion of Soylent Green. They will also automatically enter you into a drawing for 20% off of your first Hospice Care bill. For an additional $5,000 contribution to the Obama Campaign, you will received an autographed (auto-pen signed) “Thank You” from Barack himself. Use Coupon Code “Phydeaux”. You’ll need that along with three labels off your current daily servings of Dog Food (can’t use the one for Sunday’s meal, separation of church and state you know), which of course we all know, is all that the Republicans would have you eat.

opaobie on September 9, 2012 at 3:32 AM

…….America’s Affirmative Action President.

If you vote for him all your past racial sins are atoned for. Forget the Death Panels for your Granny (and YOU when you need treatment). Forget doubling gas prices being the norm, threats by punk countries like Iran to have warships off our coast in a 2nd term,

http://www.politico.com/news/stories/0912/80635.html

just vote race..

..and all will be forgiven (for now).

PappyD61 on September 9, 2012 at 9:13 AM

Comment pages: 1 2 3