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ElwoodBlues · M

@Reason10 says

No you can't. I've already posted the BIG BEAUTIFUL BILL several times and you haven't read it.

Yes, it's long. It requires an educated eye to read it.

You DON'T understand the bill. The the non-partisan Congressional Budget Office DOES understand the bill. And here's what they say.

⚠ The Senate Republican reconciliation bill would cut gross federal Medicaid and Children’s Health Insurance Program (CHIP) spending by $1.02 trillion over the next ten years. That means the Senate bill’s Medicaid and CHIP cuts are $156.1 billion or 18 percent larger than even the House-passed bill’s draconian cuts of $863.4 billion over ten years.

⚠ These larger gross Medicaid and CHIP cuts are driven by changes to the House-passed bill that would further restrict state use of provider taxes to finance Medicaid, eliminate eligibility for many lawfully present immigrants, cut federal funding for payments to hospitals furnishing emergency Medicaid services, and further reduce certain supplemental payments to hospitals and other providers (known as state-directed payments). The spending effect of these additional cuts is modestly offset by increased Medicaid and CHIP spending from provisions not in the House-passed bill including a rural health transformation program, increased federal Medicaid funding for Alaska and Hawaii, and expanded waiver authority for home- and community-based services.

⚠ Overall, the Senate Republican reconciliation bill’s Medicaid, CHIP, Affordable Care Act marketplace, and Medicare provisions would increase the number of uninsured by 11.8 million in 2034, relative to current law. In comparison, the House-passed bill would increase the number of uninsured by 10.9 million in 2034. (More detailed CBO estimates of the specific Medicaid health coverage effects under the Senate Republican reconciliation bill are not yet available. For example, CBO estimates the House-passed bill’s Medicaid and CHIP provisions would cut Medicaid enrollment by 10.5 million by 2034 and by themselves, increase the number of uninsured by 7.8 million by 2034.)

Source: https://ccf.georgetown.edu/2025/06/29/congressional-budget-office-confirms-senate-republican-reconciliation-bills-medicaid-cuts-are-more-draconian-than-the-house-passed-bill/

CedricH · 22-25, M

@ElwoodBlues Point 1 & 2 are accurate descriptions point 3, however, is an estimate and CBO‘s track record of cost or coverage projections is mixed at best. For instance, CBO misjudged the costs and effects of PPACA (Obamacare).

I‘m not even suggesting, as many Republicans do, that CBO is biased in any partisan or ideological way. But these types of highly contingent prognostications are notoriously tricky.

How many people will actually lose health care coverage depends on variables that CBO cannot determine with any degree of certainty. How will the states respond to the reform? How will individuals respond? Will they switch to private health insurance? How will the work requirements increase labor participation and thus secure Medicaid coverage for those enrollees.

It’s also essential to contextualize the 12 million number. After all, the 12 million would include those who‘ll lose their Medicaid coverage because of a more stringent enforcement of existing eligibility criteria, meaning individuals who aren’t technically eligible now but still receive Medicaid coverage due to to a lax federal and state verification process.

SomeMichGuy · M

@CedricH

but still receive Medicaid coverage due to to a lax federal and state verification process.

And there it is...

Kill a bunch? Who cares? Some probably shouldn't be there!

CedricH · 22-25, M

@SomeMichGuy There are a great many people who shouldn’t be eligible for Medicaid who technically are (especially Obamacare expansion enrollees with an income between 100%-133% of the federal poverty line). But there are also those who are technically ineligible and still mistakenly enrollled.

SomeMichGuy · M

@CedricH

but still receive Medicaid coverage due to to a lax federal and state verification process.

And there it is...

Kill a bunch? Who cares? Some probably shouldn't be there!

SomeMichGuy · M

@CedricH
1) What level of problem do you think this is, and why do you think that number?

2) The budget deficit is being increased to keep the rich from paying a fair share.

Do you think that's right?

3) Do you consider yourself to be Christian?

CedricH · 22-25, M

@SomeMichGuy

1) The Centers for Medicare and Medicaid Services (CMS) just produced an analysis showing 4 to 5 million people improperly enrolled in the Obamacare premium subsidy exchanges in 2024—specifically enrollees who claimed an income that was not accurate to qualify for a fully subsidized plan.
In addition, there are at least 5 million more people enrolled in Obamacare’s Medicaid expansion who are also not eligible for the program.

https://www.federalregister.gov/documents/2025/03/19/2025-04083/patient-protection-and-affordable-care-act-marketplace-integrity-and-affordability

https://paragoninstitute.org/medicaid/ineligible-enrollment-in-the-acas-medicaid-expansion-evidence-costs-and-remedies/

Meanwhile, the improper payment rate in Medicaid exceeded 25% in years when CMS conducted full-eligibility reviews.

https://paragoninstitute.org/medicaid/medicaids-true-improper-payments-likely-double-those-reported-by-cms/

2) The budget deficit is being increased because taxes on everyone i.e lower income, middle income and high income groups are lowered across the board. And I‘m not comfortable with deficit financed tax cuts, no.

3) Well I was baptized as a kid, I‘m nominally a member of a Church but I‘m not a practicing Christian, closer to an atheist.

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CedricH · 22-25, M

@Reason10 Have you read all 900 pages?

SomeMichGuy · M

@CedricH

1) Are those new DJT lackeys saying that after people with experience were fired?

The Paragon Institute! lmao

They are there bc they are vultures trying to make $ ofc of disease, pain, sickness.

Our experience since the law changes which allowed "managed" healthcare show that "market-based 'solutions' " ONLY make money for the businesses.

2) More taxes are being lowered for the rich and work requirements for the aged / poor... smh

If you believe in the latter, surely you support higher min wages and proportional benefits for any level of employment (to dry up employers trying to game the system)...?

3) Well, then, at least I can't call you out on your beliefs.

Are you a lawyer?

ElwoodBlues · M

@CedricH Are you familiar with Reagan's 1986 Emergency Medical Treatment and Active Labor Act (EMTALA)?

It basically says that by law anyone who shows up at an ER gets treatment. Regardless of insurance, etc, they get treatment. Even before Reagan signed it into law, it was de facto because that's what the Hippocratic Oath says.

Anyway, fast forward a few years and you find a significant population of Americans using ERs as their primary doctor. Only problem is, emergency care is the most expensive to deliver, while preventative care is the least expensive.

Who pays when people who can't afford it use the ER? It adds to hospital overhead, and they charge insurers. We all pay.

So you object to Obamacare enrolling more people and trying to deliver more preventative care. Rs want to toss people off medicare and medicaid. What will sick & injured people do? They will fall back on Reagan's 1986 EMTALA. We will be paying for them regardless; it's just a question of how much of the care we pay for will be preventative and how much will be in the expensive ER. That's the reality.

CedricH · 22-25, M

@ElwoodBlues I‘m perfectly aware of EMTALA and the savings will, nevertheless, outweigh the increased costs on hospitals.
As for your rhetorical question. Some might fall back on it and I think it’s both humane and proper to keep this ultimate medical safety net but others will switch to a private insurance plan. Overall, I (and others) estimate much greater cost savings than increased overall health care costs because of a growing demand for emergency care.

PS: this bill won’t alter Medicare.

ElwoodBlues · M

@CedricH says

he savings will, nevertheless, outweigh the increased costs on hospitals.

On what do you base this claim?

but others will switch to a private insurance plan.

Really? When the ER is effectively free??

The BBB hopes to legislate away health care costs. It can't legislate away health problems. And people in pain are highly motivated to get rid of their pain. They will flock to the ER in greater numbers as the BBB removes preventative care.

CedricH · 22-25, M

@ElwoodBlues This study attempts to assesss the costs that would accrue to hospitals if 16 million individuals lost Medicaid. The estimated cost savings from this bill far exceed the increased pressure on hospitals/emergency care units and their profit margins.

https://www.commonwealthfund.org/publications/issue-briefs/2025/may/federal-cuts-medicaid-could-end-medicaid-expansion-affect-hospitals?utm_source=chatgpt.com

ElwoodBlues · M

@CedricH Among the 'Key Findings'

Safety-net hospitals could be disproportionately impacted, as they treat a higher share of Medicaid and low-income patients. These facilities could see operating margins reduced by an average of 56 percent — and even more in certain states and rural areas. These adverse outcomes will affect not only Medicaid patients but also the entire community served by these hospitals, as lower revenues and increased uncompensated care could force hospitals to reduce staff or eliminate services.

In other words, safety-net hospitals lose vast amounts of revenue. In turn the hospitals will have to cut staff & services. Or even shut down entirely.

So you're suggesting we'll save money by leaving our sick & injured untreated? And you don't think there will be any costs associated with leaving them untreated? Lost work days, lower productivity, greater spread of communicable diseases, etc? No knock-on costs whatsoever??

And remember, as safety-net hospitals shrink or close, that reduces care and increases costs even for those who can afford to pay.

P.S. What I didn't see in the study is any estimate of net savings to taxpayers.

CedricH · 22-25, M

@ElwoodBlues They will be treated. In any case, not being covered by Medicaid is not a death sentence. The mortality rates among Medicaid recipients are not significantly lower than those among the uninsured.

You seem to assume that the people who‘ll lose Medicaid won’t be able to pay for their emergency treatment or general treatment by themselves. That’s false. The income poor Medicaid enrolles will continue to be eligible. It’s low-middle class individuals who‘ll be primarily affected by this reform. And while these individuals aren’t rich, they usually can pay for their own ER stays. It is possible, however, that they‘ll not be able to afford a vacation if something unfortunate were to happen to them and if they don’t opt for a private insurance to mitigate the financial risk. So they would take a financial hit. Not the taxpayer.

SomeMichGuy · M

@CedricH Sorry, but you're incredibly misinformed if you think that income bracket can afford ER visits.

The trade-off isn't "ER visit v. vacation"--it's more like "ER visit v. car", etc.

Do you realize that medical bills are a big part of bankruptcy? This isn't going to make that better.

CedricH · 22-25, M

@SomeMichGuy Well that would depend on the car or the vacation, wouldn’t it? 🙄

ElwoodBlues · M

@CedricH Remember when you said

How many people will actually lose health care coverage depends on variables that CBO cannot determine with any degree of certainty. How will the states respond to the reform? How will individuals respond?

The same doubts apply to your prognostications. Therefore I reject them on the same grounds that you rejected the CBO's.

Remember what your source says

You seem to assume costs will remain fixed when revenues drop 56%. You seem to assume effects on the paying patients will be nil when revenues drop 56%. Those sound like the rosiest of scenarios.

The father of modern conservatism is Edmund Burke. He says, in effect, that we don't really know what we're doing, so take small steps, make small changes. The vast changes tRump is about to sign into law are the opposite of conservatism.

CedricH · 22-25, M

@ElwoodBlues

The father of modern conservatism is Edmund Burke. He says we don't really know what we're doing, so take small steps, make small changes. The vast changes tRump is about to sign into law are the opposite of conservatism.

I‘m not a conservative and neither is Trump, he’s a nationalist populist demagogue. I‘m a neoliberal, influenced by classical liberal philosophers like John Locke, David Ricardo, Jeremy Bentham, Adam Smith or economists like Milton Friedman, Friedrich von Hayek, or Joseph Schumpeter. So I‘m definitely not Burkean. I do believe in the power of drastic and rapid changes and disruptions to further progress, prosperity and freedom.

Anyways, I do acknowledge your reservations about my predictions. I‘m not a health care expert myself, mind you, I merely consume analyses and commentary produced by experts and institutions who specialize on these issues. But they‘re also human and they can be wrong. At an impasse like this one, Henry Kissinger would usually suggest to let history adjudicate the issue before him and his counterpart.

PicturesOfABetterTomorrow · 41-45, M

@CedricH It is interesting that CBO is viewed as iron clad when it does estimates on Democratic Party bills but as soon as it is the GOP the exact same people claim it is guess work.

There are a great many people who shouldn’t be eligible for Medicaid who technically are (especially Obamacare expansion enrollees with an income between 100%-133% of the federal poverty line). But there are also those who are technically ineligible and still mistakenly enrollled.

Citation needed. The so called welfare queen has been a right wing urban legend since Reagan and nobody has ever found anything to substantiate that.

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