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The Supreme Court of the United States will begin hearings on the affordable care act, some states adopted the Medicaid expansion, and some did not. MI did.
Craigd asked my thoughts on it, I started an OT thread that might illustrate my experience and understanding of it.

Medicaid expansion Picks up The people that are in the zone That Isn't met well by the lowest wrungs of the ACA.

Working poor, people changing jobs, Covid disrupted businesses, not necessarily only the poorest people. And not just women and children.

The income constraints that represent the Medicaid expansion extend subsidized coverage up AND down to cover the people falling down the income ladder away from employer provided coverage.

So, Medicaid expansion casts a broader net.

My experience is only vicarious, as I have multiple layers of Cadillac level health insurance, and am too young to benefit from Medicare. But I have a huge community network, and I ask questions and listen to people.

What I see in practice is a financial buffering effect on the households that slip from employer provided insurance down to self provided coverage.
Every county in MI has a few providers, all working to meet ACA requirements profitably.
I see the rise of healthcare conglomerates in every urban center, regionally, and nationally.

It seems to provide access, and most importantly, improve the health of the people that fall into the formerly unaddressed income bands.

I have seen 1st hand People Improving their management of chronic illness People that were previously destined to unproductive lives.

My position, is that a person with a chronic illness that needs to be managed, is a wasted asset if the means are unavailable to do so.
I do not want to carry the social cost and financial cost of wasted assets.

I choose to support the ACA because as a nation, I believe we are better off if our general health is not a "How much money is in my pocket today?" concern, but rather just a daily thing that everyone uses and benefits from.

In my view, no kid should have their teeth pulled out, no diabetic have their legs cut off, etc. etc.

On a per capita basis, I'm comfortable with the national cost of shoring up the bottom of the ACA.


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Do you support AOC? I see a trend in your thoughts.

bill

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No
But I don't think being poor is a sin either.

I have traveled a great deal in countries that have a different tax structure than ours, and their citizens are healthier and consistently surprised that we don't make basic healthcare available to everyone.

The Dutch choose from a variety of private plans as example. They just require everyone to be in one.

This thread, other than the SCOTUS element, needn't be political.

Craigd asked how it worked in practice.
I presume he's in a state that didn't broaden the net.


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Originally Posted By: ClapperZapper
No
But I don't think being poor is a sin either.....

....Craigd asked how it worked in practice.
I presume he's in a state that didn't broaden the net.

Actually, thanks for the follow up. I was hoping for input from participants, not the infomercial?

I suspect many of us have our own Chevy plans, a few have those Cadillac plans. I suspect, as in the past, when we discuss the real world implications of aca expansion of Medicaid, few of us realize the benefits. Maybe, biden care will address the shortcomings, would you care to invest in a small wager?

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I don't think learning and relaying what I see everyday is infomercialling.
My view of people as productive vs unproductive assets contributing by paying their income taxes to the national common good, is at odds with many that don't pay any. They don't pay taxes, yet condemn investing in those that want to.
Health is like changing oil, or fitting new shovel handles.

I think how SCOTUS deliberates this case will be quite insightful.

I fully believe there will be tremendous social pressure brought to bear if the decision is to end the ACA.

And I would extend pre-runoff pity to the poor folk of Georgia that have to endure more electioneering after a decision.

I would wager a beer that Georgia would see great senatorial change if the ACA is overturned.


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CZ, Thank you for informed and humane input here. You do your part to end the war on truth.


Bill Ferguson
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You wasting your time. thrifty is not interested in discussing the effects of the ACA, only wants to needle, hence the infomercial remark.


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Bill, it may be because I travel. Or that Catholicism demands social justice.
Bird hunting takes you to many places where people don't have much.
I just think not helping someone when you can is bad.

I want everyone to work.
I want everyone to pay income tax.


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Originally Posted By: ClapperZapper

I don't think learning and relaying what I see everyday is infomercialling.
My view of people as productive vs unproductive assets contributing by paying their income taxes to the national common good, is at odds with many that don't pay any. They don't pay taxes, yet condemn investing in those that want to.
Health is like changing oil, or fitting new shovel handles....

I have discussed this ad nauseam with rm Bill. Are you a physician in public health? I dont think Bill is?

The Medicaid system is broken and biden care is not advocating for solutions. Health is not a discussion among elites, or court cases. My observations have been that without skin in the game, recipient value healthcare in the same way that they value other free things.

How can you measure productivity in terms of income tax contribution when a taxable income is generally a barrier to receiving Medicaid benefits? What does it run in Michigan, across the country, failure to show for a Medicaid health appoint runs around forty percent? Does your same Medicaid system advocate to decriminalize illegal drug use, and then lobby for funding to treat substance abuse and addiction as a medical problem?

Is this your concept of a healthier, more productive US of A? On the average, if a generic person does not follow up with their generic health appointments forty percent of the time, do you want that percentage of commitment from the person that changes the oil for your Cadillac?

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Originally Posted By: ClapperZapper
Bill, it may be because I travel. Or that Catholicism demands social justice.
Bird hunting takes you to many places where people don't have much.
I just think not helping someone when you can is bad.

I want everyone to work.
I want everyone to pay income tax.

As with Bill many times in the past, I hope you can accept my objection to lumping people that fall below some income line on a chart as sinners or some other second class citizens.

I too, and Ive mentioned it before, was raised Catholic, and even attended some parochial schooling. On a personal note, the days of the head down hard working Catholic concerned about their neighbor is fading fast. The pope says Catholicism is now for social justice activism. Not for me, my wife happens to be of a Protestant denomination and thats where our truth lies.

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