No kidding, Sherlock: HHS head: GOP health bill could result in $820M N.H. Medicaid cut

by Skip

“But in the end, Meyers added, the New Hampshire DHHS – like the rest of the country this week – lies at the whim of Congressional forces.”

They never seem to learn the rather straight forward lesson of “with strings attached”, do they?  And the other one is “he who has the gold doesn’t have to hand it out, either”.  This is what happens when politicians, in never learning that it doesn’t matter to taxpayers WHICH level of government is reaching into their pockets, never seem to learn that in creating a local budget (in this case, the State of NH) that highly depends on a higher level of government’s money, you will get screwed in the end.  And politicians, especially the NH Republican ones, have put NH into this position – willingly.  In Pravda on the Merrimack comes this evergreen headline:

HHS head: GOP health bill could result in $820M N.H. Medicaid cut

New Hampshire Department of Health and Human Services Commissioner Jeffrey Meyers predicted a sharp financial toll on the state’s Medicaid program if the federal Graham-Cassidy health care bill passes, and warned of funding shortages that could result from the bill’s block grant system.

Who could have seen this coming, eh?  Oh yeah, ME!  I didn’t have to be a financial genius to see this coming, or a medical policy wonk either.  All I had to see is one number: $20 Trillion for our National Debt.  That just SCREAMS “rationing is coming, one way or another.  But our highly esteemed  (and Republican) jerkfaces decided, like the Venezuelan Socialists (and against the late British PM Margaret Thatcher’s words) that the other guy’s monies would always be flowing – and made a disasterous bet.

Yes, I know that McCain unexpectedly (trademark, Instapundit) decided to side with Obama and the rest of the Democrats once again in letting his bestie, Lindsey Graham, that there’s a knife in his back and that that the latest feeble attempt to fulfill the Republican promise of “Replace and Repeal” is now dead and all the rest of the kvetching is moot for now.

Sidebar: no, Graham / Cassidy was NOT the fulfilment of “R&R” as promised any more than the original one was – neither were the home run we were already supposed to have by now.  So switch in incrementalism – a single instead. At least this half-baked one pushed the implementation away from DC’s Central Planning Kommittees and put it back on the States (where it rightly belonged).  NO, it didn’t get rid of the Medicare taxes.  NO, it didn’t get rid of the almost unfathomable regulations.  And NO, it didn’t allow us to buy the type of insurance we want and from where to buy it.

And because DC is still nominally in control, NO, this is not “Federalism” either.  True Federalism would be that the States would raise their own revenues for their own costs to pay for their own policies – and the Feds would be told to take a flying leap.  But at least it was a step in the right direction and with these bumbling morons with pointy (and pointless) heads, I’m not sure I could expect more from this cowardly bunch.

So, back to the piece (reformatted, emphasis mine):

Speaking at a Monitor editorial board meeting Wednesday, Meyers said that the proposed legislation could cause a loss of about $820 million in Medicaid funding between 2020 and 2026, citing calculations made by his office. And he said other provisions of the bill, such as a mandatory cap on New Hampshire’s Medicaid enhancement tax, could produce deeper revenue cuts.

“We would lose very significantly under the block grant that Graham-Cassidy proposes, as it exists today,” Meyers said. “We would lose significant revenue, which means we’d match less money at the federal level and have less money for care, which would drive up health care costs in New Hampshire.”

Actually, EVERY State that implemented Medicaid Expansion and decided to take more from those that didn’t have any to give are in the same boat.  Deliberately did so and all for the same reason – Greed.  Greed for money that wasn’t theirs.  And lying about it to their constituents by saying, over and over, “Free Money” and it won’t cost NH taxpayers a dime!” thinking that we all didn’t realize that the Feds were taking it and then returning it (with their vigorish cut off the top) back to NH.  All one has to do is DuckDuckGo (my replacement for Google, as it no longer follows it’s own tagline of “Don’t be evil”)

The commissioner’s comments came days after Gov. Chris Sununu disavowed the legislation, and a week into fierce debate over a bill promoted as a last chance to dismantle the Affordable Care

…Supporters have touted the added flexibility given to states, and said the bill, which would benefit states that chose not to accept expanded Medicaid funds over states that did, would redistribute the federal funds more fairly. But Meyers said the block grant system, as designed, would fall short of matching the funding needs of the Granite State for its expanded Medicaid population.  The $820 million loss was calculated by determining the difference between projected funding levels under New Hampshire’s present Medicaid expansion program and an estimate provided by Cassidy’s office of the state’s block grant allotment under the bill, Meyers said.

Again, spending money they THOUGHT would come in – never understanding (or willing to admit) that there was a possibility the rules could be changed.  He and the other pols seemed to think they were ENTITLED to this money forever – you know, like welfare queens?  Or undocumented illegal aliens DEMANDING citizenship for themselves and their relatives?  And you HAVE to love the next two words:

At fault is the bill’s funding structure, he added. Under Graham-Cassidy, New Hampshire’s Medicaid program would change from the present percentage-based model in which the federal government funds between 90 and 100 percent of all eligible recipients in the state, to a capped, per capita model that would kick into place in 2026. The per capita calculations would not take into account seniors, people with disabilities, and families with children.  Meyers said that those provisions would hurt New Hampshire disproportionately, likely necessitating cut-backs to eligibility under the state’s expansion program, which presently serves 50,000 people.

“At fault”?  Hahahahahaha!  He’s pointing the bony finger at the wrong set of people.  NOBODY twisted the NH Republicans to take this money.  NOBODY said that it would last forever.  And NOBODY said that they’d never change the rules.  What were they thinking?  After all, they do the exact same thing to others all the time (just ask Eversource or the local towns and cities).

No, the above is ALL about the magical Kabuki Theater of not mentioning the real thing they are scared of:

“Most of the block grant schemes that I’ve seen reduce funding significantly, and that would be a huge issue in New Hampshire, because then you’d have to either look at reducing services (or) changing the benefit array,” Meyers said.

Nope, those ain’t it either.  No the real thing is That Which Cannot Be Named.  The political garlic is being waved and the signs of the political cross are already being pushed in front of the “DC devil” for changing the rules.

No, the real skeleton in the Republican closet is a broad based tax.  Now, loyal readers of the ‘Grok already know this, but I DARE you in reading the rest of the piece below to find any mention of the OTHER side of this coin.  No, not reducing services (although that’s what SHOULD be done to live within our means) but raising the revenues instead.

To be honest with us, if it Medicaid Expansion was THAT great of a deal, what the Republicans should have done (like the Democrats should have done in passing homosexual marriage here in NH), they should have campaigned on “we’re going to raise your taxes so we can give better healthcare insurance to others than what you can afford” and see what the electorate thought of that idea.

But again, that phrase “political cowards and backstabbers” wafts to my fingertips.

First implemented in 2014, New Hampshire’s Medicaid expansion opened up eligibility for the federal program from the elderly and disabled to low-income adults with children. The program provides participants access to a range of health services including doctor visits and emergency care. But Meyers said that many of the presently provided services are not technically required by law. In the event of increasing cuts to expansion funds imposed by Graham-Cassidy, he argued, the state would have to make tough choices on how to adapt the program. “Pharmaceuticals, as an example, are not a mandated medical service, but I don’t think we want to talk about ending pharmaceutical benefits for people in the state of New Hampshire,” Meyers said. “So you’d have to start looking at cutting eligibility.”

Six of one or half a dozen of the other – this is what happens when Government decides to be Santa Claus with other peoples’ money.  Notice what is NOT said: the impact on the people actually paying the freight – we taxpayers.  Santa’s got to deliver those presents while the rest of us will be made to work in the coal mines (and not with the big machines, either; shovels and pickaxes for the likes of us).  Where’s the sympathy and empathy for us, eh?

No, we’re just the ATM machine for the political machine.

A limit on the state’s Medicaid enhancement tax imposed by the bill would also hamstring the state, according to Meyers. The tax, which since 1991 has been imposed on hospitals to help pay for the Medicaid program, presently stands at 5.4 percent; the new bill would cap that to 4 percent, Meyers said. “That would be a significant loss of revenue,” he said.

Yeah, that’s what happens when you use a ruse to game the system.  Screw you all for using techniques that would send us in the private sector to jail for fraud.  And they still refuse to own up that it’s THEIR FAULT:

In criticizing Graham-Cassidy, Meyers echoes a bipartisan group of state officials. On Monday, Sununu followed New Hampshire’s all-Democratic in decrying the bill’s funding cuts, calling the bill “not practical” for the Granite State. And in an interview with NHPR Wednesday, New Hampshire Senate Majority Leader Jeb Bradley called the funding in the bill inadequate.

Yep, the chief rat comes out of his hole.  It was Bradley, along with NH Senate President Chuck Morse and now GOP Chair Jeanie Forrester, who crafted the bill and decided that grabbing Obama’s cash was a great idea.

THE BLAME LIES DIRECTLY ON THEM.  They are the ones primarily responsible this – and they did it willingly, with gusto, and didn’t care who they lied to in order to get it passed.  They were absolutely giddy that they put NH into thrall to the Feds – and NOW they decided to complain?   Chutzpah doesn’t BEGIN to describe this “turn”.

IF this passes, and there is a chance it might slim though it may be, we ought to figuratively tar and feather them and then bring out the stakes and firewood.

But while Meyers has staked out firm opposition against the funding cuts imposed by the bill, he also stands with the governor in supporting increased financial flexibility to the states. Present Medicaid rules, imposed by the Centers for Medicare and Medicaid Services (CMS), tie New Hampshire’s hands financially, Meyers said. The state must apply to CMS for waivers to use the funds for anything other than direct health insurance, a cumbersome process that doesn’t lend itself well to the creation pilot programs to combat the opioid crisis, he added. “In a perfect world, states would have more flexibility,” he said. “And whether that’s through a block grant program or whether that’s through reforms to the ACA, I think it could be accomplished in many ways.”

The most fundamental “law” is that he who has the gold makes the rules.  And NH proactively asked for the gold.  Sorry dudes (or is that duds?), you accepted that the Feds make the rules. All you could see was that gleaming, glistening gold – and that gold is the Government God.  And you back up the pickup truck to take that load.

Willingly – never really wanting to acknowledge the “Oopsies” of the strings attached.  Surprise – welcome to the reality that you didn’t want to acknowledge

But in the end, Meyers added, the New Hampshire DHHS – like the rest of the country this week – lies at the whim of Congressional forces.

Yep, and that is THE moral of the story – when you sell your political soul and wellbeing to others, you have to dance to their tunes and commands.  Benjamin Franklin was famous for saying “Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety”.

What the NH Republican politicians have done is the financial equivalent of that – trading financial freedom for a bit of medical safety.  In the end, they (and we) shall have neither.

The worst part of it is that they either don’t understand it, or even worse, refuse to admit that they do.

Leave a Comment

Previous post:

Next post: