UPDATED: If #ALpolitics Would #ExpandMedicaidNow, They Could CUT Medicaid Co$t$ More Than 50%

UPDATE: Tuesday, 11 August 2015
CORRECTION ADDENDUM

In my first & earlier calculations, I inadvertently overlooked multiplying the Annual Medicaid Spending in Alabama figure (which is a TOTAL of $5,241,269,869) by 70%, which would represent the portion paid for by the Federal government. Alabama’s 30% share of that figure (the share paid for by the state) would be $1,572,380,960.70. It would also be reasonable to expect that Expanding Medicaid in Alabama to 138% of the Federal Poverty Level would increase total economic activity (through Medicaid spending) in the state at least 38%. So to Expand Medicaid, the baseline figure for TOTAL Medicaid spending (combined Federal and State funds) would approximate $7,232,952,419. According to the provisions of the law, Alabama’s sharing portion (if Governor Bentley chose to Expand Medicaid) would still be 2016-100%; 2017-5%; 2018-6%; 2019-7%; 2020 and beyond-10%. The corrections to the figures herein are dollar amounts only (based on the $7,232,952,419 total expanded figure), not the %ages. Data & figures are now also shown in table format.

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Folks, it may (or may not) surprise you to know a sampling of the collective thoughts of our wrong-wing friends, and relatives on matters political in Alabama, especially as they pertain to Medicaid.

Here’s a verbatim excerpted sampling of what I came across today.

• No one want increased entitlements. Too much waste and abuse. get a job folks. no to medicaid
• Medicaid is a lifestyle
• scare tactic. nursing homes overcharge. working people of Alabama are tired of taking care of lazy people
• ask any hospital administrator or physician in private practice. Medicaid devalues services. Reject medicaid

I dare say, MOST are clueless about the genuinely tangible economic and public health benefits Medicaid provides to this state, and the revenue and jobs it creates. All they hear are the wails and moans of representatives and/or senators – mostly of whom, if not exclusively, are Republican.

Where does Alabama’s Medicaid money come from?
Where does it go?
Source: Alabama Medicaid Agency Annual Report – FY 2012

Medicaid is a Federal/State matching/sharing program which provides (pays for) healthcare services for the impoverished wherein states pay a minority matching portion, while the Federal Government through CMS (Centers for Medicare and Medicaid Services) pays the majority portion. Within reasonable guidelines, the states have broad discretion and liberty to operate Medicaid according to the way they see fit, and the needs of the residents they serve. There are, however, certain minimums standards to which every state must adhere.

Under the provisions of the OLD law, the states that do NOT Expand Medicaid pay a higher %age rate for their services than they would if they were to Expand Medicaid to provide services to those whom are at 138% of the Federal Poverty guidelines – which is what the PPACA provides. The PPACA is the Patient Protection and Affordable Care Act- though it’s more often called the ACA “Affordable Care Act,” and colloquially referred to as “ObamaCare.”

Under the provisions of the PPACA, states that choose to Expand Medicaid will have 100% of those costs paid-for by the CMS beginning 2014, until 2016. The incentive for expansion is based upon

The Power of One Small Idea: How Alabama could hit a home run WITHOUT raising taxes in the budget crisis.

Creativity is in short supply in Monkeytown, Alabama.

I refer, of course, to Montgomery.

And to be certain, there is a backstory on the nickname.

Seems the Montgomery Zoo was originally located in Oak Park, and then named Oak Park Zoo. The zoo also had an island of monkeys, which once escaped. Hence, the nick name.

For what it’s worth, the Montgomery City Planetarium, formerly known as Gayle Planetarium, is also located in Oak Park. I encourage you to go there, sometime! I have.

But back to the creativity thing.

Alabama is in dire straits fiscally. But, then again, that’s nothing new. Governor Bentley has promised (and broken) numerous pledges in his first & second campaigns. The one bothering most folks is the “read my lips… no new taxes” promise he unwisely made while campaigning for a second term.

It may not be the lie the second time around, as much as it is the entire deception thing from the get-go. Because he, the AL GOP, and the entire Legislature knew all about this well in advance. They knew there would come a day when the monies they “borrowed” from the Alabama Trust Fund must be repaid. That day has come… and is now gone. They’re essentially reneging on their promise, which not only makes them liars, but thieves as well, since money is involved.

So, you’re damn skippy the people are hopping mad!

Again, to be certain, Alabama is in a

Alabama Governor Bentley signs Executive Order No.4 Creating Alabama Health Care Improvement Task Force

Yesterday, Monday, April 6, 2015, Alabama Governor Robert J. Bentley, MD signed Executive Order No.4 creating a 38-member “Alabama Health Care Improvement Task Force.”

Though the unspoken ostensible purpose of the task force is to likely make recommendations to the Governor for the expansion of Medicaid in Alabama, it’s being couched to the less-than-observant (or less-than-smart, take your pick), as a home-grown alternative to the big bad wolf of D.C. known as “ObamaCare.”

Again, for the benefit of the uneducated, in addition to decreasing fraud, waste and abuse, increasing efficiency, eliminating discrimination against women, children & people with “pre-existing” conditions, mandating numerous improvements to the quality of the delivery of healthcare from all states in order to receive payment (performance-based payment), the Patient Protection and Affordable Care Act (sometimes abbreviated as ACA, though popularly known as “ObamaCare”), contains a provision encouraging (but not requiring – that decision was made the U.S. Supreme Court) the state’s governors to expand Medicaid for their impoverished residents. The law provides for 100% payment for so doing, then gradually declines to 90%.

Governors in Kentucky and Arkansas have decided to Expand Medicaid in their states, and are already enjoying savings.

Currently, Alabama’s matching portion (the %age it pays to purchase Medicaid) is 32.4%; so to expand Medicaid, and have it ALL paid for, and then to pay a LOWER rate than is presently being paid is one of the smartest fiscal decisions the state could make.

Already, the Governors of Kentucky and Arkansas – both well-known Republican strongholds, with opposition to the ACA – have expanded Medicaid in their states, and are already reaping the rewards.

Here’s a chart showing the compensation plan to the states:

Like Jesus, I wept.

It was one of the few times I have wept over others’ misfortunes – especially my patients.

I went into a closet to weep very bitter tears.

The thought of others seeing me so heartbroken was unconscionable, one which I simply could not bear.

Why?

Open Letter to Alabama Governor Robert Bentley, MD

Open Letter to Governor Bentley
October 10, 2014 at 12:45pm

Governor Bentley,

I need to go to the doctor. But I can’t. For some reason I still can’t understand you turned down Federal money set aside for people like me.

On June 24, 2014, on my way to see a doctor to determine disability benefits, I had a car accident. My car was totaled and my lip busted. I had hit the steering wheel with my face.

I still almost refused the ambulance ride because I was afraid of the bill. It took a street full of people to convince me to go. I had my lip sewn up, some scans done. I was sent home with a neck brace.

I have $12,000 in bills now, and my disability was denied. I am more disabled now than before the accident. I am waiting on an appeal with no medical care and no income. That hospital bill will never get paid. I wonder how many other people in this state are in the same situation. Sometimes I think