Thursday, March 09, 2017

March 9, 2017--Health Care Lottery

In an attempt to be responsible, I tried to read through the 123-page American Health Care Act, Trump- or Ryan-Care, promulgated by the Republican House leadership on Tuesday. I needed to do so, I thought, to enter the debate credibly with facts at hand.

I failed at that but did stumble on something morbidly fascinating and all too revealing--after ten pages of gobbledegook (see below) there were six pages of reasonably readable text about what to do with people covered by Medicaid who win state lotteries.

When I mentioned this to Rona, she said my new meds were making me hallucinatory. So I showed her the text and now she believes me, but has been walking around the apartment mumbling to herself.

First, a taste of the gobbledegook, taking it from the top of the text--
TITLE I—ENERGY AND COMMERCE Subtitle A—Patient Access to Public Health Programs
(a) IN GENERAL.—Subsection (b) of section 4002 of the Patient Protection and Affordable Care Act (42 U.S.C. 300u–11), as amended by section 5009 of the 21st Century Cures Act, is amended—
(1) in paragraph (2), by adding ‘‘and’’ at the end;
(2) in paragraph (3)— (A) by striking ‘‘each of fiscal years 2018
and 2019’’ and inserting ‘‘fiscal year 2018’’; and
(B) by striking the semicolon at the end and inserting a period; and (3) by striking paragraphs (4) through (8).
Pop quiz to follow. 

Then, after ten pages of this, clearly by placement to highlight its importance, for a full six pages they turn to what to do about state lottery winners who are currently covered by Medicaid.

Here is a bit of the text--
(a) LETTING STATES DISENROLL HIGH DOLLAR LOTTERY WINNERS.—IN GENERAL.—In the case of an individual who is the recipient of qualified lottery winnings (pursuant to lotteries occurring on or after January 1, 2020) or qualified lump sum income (received on or after such date) and whose eligibility for medical assistance is determined based on the application of modified adjusted gross income under subparagraph (A), a State shall, in determining such eligibility, in- clude such winnings or income (as applicable) as income received—
‘‘(I) in the month in which such winnings or income (as applicable) is received if the amount of such winnings or income is less than $80,000;
‘‘(II) over a period of 2 months if the amount of such winnings or in- come (as applicable) is greater than or equal to $80,000 but less than $90,000;
‘‘(III) over a period of 3 months if the amount of such winnings or in- come (as applicable) is greater than or equal to $90,000 but less than $100,000; and‘‘(IV) over a period of 3 months plus1additional month for each increment of $10,000 of such winnings or income (as applicable) received, not to exceed a period of 120 months (for winnings or income of $1,260,000 or more), if the amount of such winnings or income is greater than or equal to $100,000. 
Of course if someone wins more than $80,000 that should be taken into consideration when determining Medicaid eligibility; but to give it this prominence, to devote so much textual energy to this literally one-in-a-million reality is to reveal the mean-spirited nature of conservatives when it comes to compassion for those who struggle. They reveal here how much they resent any poor person allegedly "getting away with" anything these politicians, themselves imbibing at the public trough, feel they do not deserve.

Take congressman Jason Chaffetz (R-UT) as another example when he spoke about health care for those with little or low incomes. There is an easy way to pay for heath care, he said--the poor should give up their smart phones and by doing so would have enough money to pay for health insurance.

To quote his version of the Golden Rule:
Americans have choices, and they've gotta (sic) make a choice. So maybe rather than getting that new iPhone that they just love and they wanna (sic) go spend hundreds of dollars on that, maybe they should invest in their own health care. They gotta (sic) make those decisions themselves.
Maybe if he knew how much he paid for his health insurance (nothing as a senator) or his smartphone (again, nothing as a $174,000-a year member of Congress) he would realize that if they gave up their beloved iPhones they still gotta get a lot more money from other sources to pay for it. 

Maybe they could give up eating. From the looks of Chaffetz his doing so wouldn't be a bad idea. But as everyone can see he doesn't wanna do that.

Senator Jason Chaffetz

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