Health Policy

Commentary & Community

Ohio Governor Pushes to Preserve Medicaid


A major part of the Affordable Care Act, or Obamacare, is expanding the Medicaid program. As Republicans in Congress consider their plans to repeal Obamacare, one Republican governor is asking them to preserve this Medicaid expansion: Governor John Kasich of Ohio.


In mid-January, he urged Congress not to eliminate Medicaid expansion during an Obamacare repeal. Medicaid is the joint state/federal program that provides health care coverage to lower-income individuals. In the traditional Medicaid program, the federal government generally pays 43% of the total cost (rates vary by state). Under Obamacare, states would receive federal funds covering 90% of the cost of expanding coverage to childless, able-bodied adults with incomes up to 133% of the federal poverty level.


According to Gov. Kasich, “Thirty-one states — more than half of them with Republican governors — extended Medicaid coverage. Those that did are experiencing significant positive benefits.”


The majority of people who received coverage under Obamacare have done so through Medicaid. Preserving Medicaid expansion would mean preserving this aspect of Obamacare, which troubles some Republicans in Congress. Senator Rand Paul of Kentucky, who has been pushing Congress to replace Obamacare at the same time it repeals the law, said:


A lot of these people actually qualified for Medicaid already so the interesting thing is they thought they were getting something new and they already qualified. My main point is we have to take care of those who can't take care of themselves. But it should be paid for. If we need to expand Medicaid every state needs to decide how much they're going to raise taxes to pay for Medicaid.


If Congress did not preserve the Medicaid expansion, states would still be free to design their programs to continue covering those eligible under Obamacare. However, states would not receive the 90% federal match, but would instead receive the lower matching rate for the traditional Medicaid program.


Supporters of Medicaid expansion worry about what will happen to enrollees if Congress does not preserve the higher federal matching rate. Those who want to end the expansion point to the long-term budget issues that could result from Medicaid spending.


Do you think that Congress should preserve Medicaid expansion as it debates repealing Obamacare?


Iowa Senate Bill 2: End taxpayer Funding for Planned Parenthood


Check out this key bill recently passed by elected officials in Iowa, and go to to signup and see how your legislators voted.


Senate Bill 2, End taxpayer funding for Planned Parenthood: Passed 30 to 20 in the state Senate on February 2, 2017


To direct the state health department to not spend Medicaid money on organizations that perform abortions, and to set up a new state program to give family planning services. This is known in the press as the "defund Planned Parenthood" bill.


Medicare Heats Up NC Senate Race

 In North Carolina, the Senate race between incumbent Richard Burr and challenger Deborah Ross is increasingly focusing on Medicare. Will Republican control of the Senate hinge on what North Carolinians think about Medicare reform?

At issue is Senator Burr’s 2012 proposal (never actually put in bill for) to restructure Medicare. When he announced it, Burr said, “We made a promise to our seniors that Medicare will be there when they need it most, but the program as it currently stands is broken. We have a moral obligation to our parents, children, and all Americans to take steps now to save Medicare. The Medicare program in its current form is unsustainable, and we have an obligation and opportunity to improve it for our nation's seniors within the next few years.”

Ross is charging that Burr introduced his plan to help insurance companies, not seniors. According to Ross, “some politicians in Washington want to fundamentally change Medicare by privatizing it and putting the insurance companies in charge. For example, Richard Burr has taken more than $1 million from insurance companies. In turn, he wrote a plan that would raise the retirement age, privatize Medicare, and give seniors a voucher that may or may not cover their health care costs. While this may help private insurers' profits, it will force seniors to pay more.”

Senator Burr has said he stands by his proposal. However, he also distances himself from it, saying, “We threw that out as an option as to what could be considered. Until you decide what you’re going to do with the Affordable Care Act, there’s no sense in even having a debate on what Medicare in the future looks like or how you make Social Security sustainable.”

What would Burr’s Medicare plan, dubbed “The Seniors’ Choice Act,” actually do?

  • Limit out-of-pocket expenses for seniors in traditional Medicare Parts A and B
  • Provide targeted care coordination for seniors in traditional Medicare
  • Increase the age of eligibility from 65 to 67 over 12 years
  • Starting in 2016, this proposal would have allowed seniors to receive funds from the government to choose a private Medicare plan

The last part is the most controversial part of the legislation. Senator Burr contends that allowing seniors to have choice for their Medicare plans will give seniors a “choice of a better benefit that meets their individual health care needs.” Ross calls it “privatization.”

Ross has also released a Medicare plan, which includes:

  • Paying doctors based on quality, not quantity, of care
  • Cracking down on inefficiencies, errors, and abuse
  • Giving consumers information and incentives to make better health care decisions
  • Ending the FDA backlog for generic drug approval

When Senator Burr says that Medicare is unsustainable, he is talking about the program’s future unfunded liabilities. The Senate Finance Committee’s Republican staff sum up the issue in a 2015 analysis: “Assuming current law remains unchanged, the Trustees project Medicare’s 75 year total spending in excess of dedicated revenues is $27.9 trillion. Again, using the CMS Actuary’s more realistic alternative scenario, that figure soars to $36.8 trillion.”

What do you think? Should Medicare be reformed along the lines of what Senator Burr has suggested? Or is Ross right to focus on minor fixes to the program?

What’s the Holdup for Zika Funding?


With 42 Floridians catching Zika, there is concern there and in neighboring states that the virus could spread. In Congress, both Democrats and Republicans say they want to provide federal funds to combat the virus. And yet, no funds have been approved.

The culprit, as is so often the case, can be blamed on partisan gridlock.

Funding for combatting Zika is contained in one of the thirteen appropriations, or spending, bills that Congress must pass every year to fund the government. This bill contains funding not only for Zika efforts, but also for other government functions.

The House of Representatives passed this legislation with a vote of 239-17 on June 23. Senate Democrats, however, are refusing to allow the bill come to a vote in that chamber. Although a majority of Senators voted to proceed with a final vote in late June by a vote of 52-48, that vote was not enough to reach the 60-vote threshold to overcome the Democrats’ filibuster.

Why are they blocking the bill?

It’s not because of the Zika funding, but because of the other items in the bill. Among their issues of concern:
• Defunding the Affordable Care Act, or Obamacare – the legislation would remove $500 million in funding for this program
• Defunding Planned Parenthood
• Allowing wider use of pesticides to destroy mosquitoes
• Continuing to allow Confederate flags to fly in military cemeteries

Republicans contend that Democrats are so fixated on these unrelated issues that they will allow Zika to spread in order to protect Obamacare and Planned Parenthood. Democrats, on the other hand, say that Republicans are holding Zika funding hostage to get their way on these contentious social issues.

This situation is why Congress recessed for its summer break without coming to agreement on an issue that both Republicans and Democrats, in essence, agree on.

Should the Senate pass this legislation, even with these controversial provisions? Or should Senate Democrats insist that Republicans remove the contentious sections of the spending bill before Zika funding is approved?


More ways for lawmakers to exhibit warm-and-fuzzy

Last week explored methods lawmakers use to associate their names with certain interests or causes: Granting specialty license plate fundraising privileges toselect nonprofits. This edition expands on that theme, looking at bills in the current legilslature that grant select nonprofits additional privileges including state income tax fundraising privileges and property tax breaks.


House Bill 5225: Authorize income tax checkoff for prostate awareness group

Introduced by Rep. Paul Muxlow (R), to allow an individual to choose to automatically contribute $5 or more from his or her state income tax refund, which the state would give to a particular foundation named in the bill that does various things related to prostate cancer (PCUPS Foundation). Referred to committee, no further action at this time.

House Bill 4817: Authorize income tax checkoff for Junior Achievement organization

Introduced by Rep. Brandt Iden (R), to allow an individual to choose to automatically contribute $5 or more from his or her state income tax refund to provide grants to local Junior Achievement organizations. Signed into law by Gov. Rick Snyder on June 15.

House Bill 4647: Authorize income tax checkoff for Boy Scouts

Introduced by Rep. Phil Potvin (R), to allow an individual to choose to automatically contribute $5 or more from his or her state income tax refund to a state Scouts Fund. House Bill 4648 would convert an existing state Girl Scouts Fund into a Scouts Fund to benefit both organizations. Advanced from committee, pending before the full House.

House Bill 4892: Authorize Lions Club income tax checkoff

Introduced by Rep. Wendell Byrd (D), to allow an individual to choose to automatically contribute $5 or more from his or her state income tax refund to provide grants to the Lions Club organizations. Referred to committee, no further action at this time.

Senate Bill 428: Authorize Red Cross income tax checkoff

Introduced by Sen. Rick Jones (R), to allow an individual to choose to automatically contribute $5 or more from his or her state income tax refund to provide grants to the mid-Michigan Chapter of the American Red Cross. Signed into law by Gov. Rick Snyder on June 15, 2016.

Senate Bill 570 and House Bill 5109: Give tax break to some conservation clubs

Introduced by Sen. Peter MacGregor (R) and Rep. Jim Tedder (R), to exempt from property taxes conservation clubs that allow their facilities to be used for charitable purposes at least 55 days a year. SB 570 has been advanced from committee and is pending before the full Senate.

Senate Bill 732: Exempt Masons lodges from property tax

Introduced by Sen. Rick Jones (R), to allow local governments to exempt property owned by Masons' lodges from most property tax levies if the property is used for charitable purposes. Advanced from committee, pending before the full Senate.

Wisconsin To Drug Test People For Unemployment Benefits

A new Wisconsin law will allow the use of drug testing for unemployment benefits. Drug testing for government programs has been tried in other states with mixed results. Do you think it is a good idea to require drug tests for unemployment insurance or food stamps? Or is this type of program too costly with too few benefits?

Copyright © 2018 Votespotter Inc. All rights reserved.