Another element of Paul Ryan's budget plan: Persons who are approved for Supplemental Security Income (SSI) would no longer be automatically eligible for Medicaid. That would be at the discretion of the states which would be receiving much less federal funding for Medicaid.
11 comments:
I totally support that plan. WHY should someone in Washington DC decide who gets medicaid when the local entity would be the best to decide that?? They can investigate the fraud that I see every day better....not Washington
No one in Washington DC is involved at all. Local people in community based field offices make the decision on SSI eligibility. Why would a County agency want to spend time verifying income, resources, and other factors already evaluated in making the SSI decision?
This is already the case in what are known as the "opt out" states, as they did not adopt the intertwined model at the inception of the program. I practice in Indiana where Medicaid and SSI are not tied together. The processes are separate. Indiana has a separate application, does all their own qualifications financially and has disability standard for Medicaid, and separate state ALJs to determine disability. Typically the state process moves faster, allowing us to use these decisions and files in an SS proceeding. If a claimant does receive a grant of SSI for disability without already attaining or applying for "disability medicaid," it becomes a rebuttable presumption of medical disability only, but the claimant must still go through the entire application process.
I never understood why people who are already getting disability benefits automatically get Medicaid. I'll tell you what, if you are a poor but not disabled person, you'd better be the primary caregiver for a minor child or you're never getting Medicaid.
SSI makes more sense being a state/local program since the states and counties/townships/cities are already making determinations regarding eligibility for various other types of public assistance, including Medicaid and monetary benefits.
Anonymous at 1:10, how else will they get medical care? It's not like they have employer's policies and no company is going to issue them individual insurance, even if they could afford it. Should they just suffer and die untreated?
4:22 -- they have more money to purchase care than the non-disabled, childless person who can't find work and has any number of pre-existing conditions that will just as completely leave them uninsurable.
Just another hysterical outburst from Mr Hall. Fact is, SSA no longer has any control of the SSI program. It is a massive black hole into which the taxpayers' money is dumped by the billions, and needs to be transferred back to state control. There are over 8 milion SSI recipients, and maybe a few hundreds of SSA employees who have the expertise needed to deal with it.
8 million out of a population of 310 million. Hmm..
It may be only 8 million, but only 2 million are the elderly cohort. Almost 5 million adults are on SSI for "disability", with another 1.3million children.
As for the issue of how will people without Medicaid get medical care -- the same way they do now -- free clinics and emergency rooms
7:45, you're exactly right. Emergency rooms are often used.
Why are Americans so stupid about costs? Unless something is boldly labeled "SPENDING ON UNINSURED" or some such, most of our fellow dolts will never realize that we spend a ton of money--all of us--on the uninsured. It may not show up on your taxes or insurance premiums, etc. as "the money you pay because so many people go to the ER for most of their problems and can't pay," but trust and believe, you pay it.
I'm reminded of a large study on homelessness that was done in Colorado a fews years back. The researchers found that it would have been cheaper for the community to provide housing, food, healthcare, and something to do during the day (work for those who could, work training, or similar stuff) than it was to not provide any of that and keep the people homeless. How, you say? Well, I don't recall the exact numbers, but the average homeless person was being arrested so many times per month, riding in the back of an ambulance and otherwise presenting to the ER for minor things so many times per month, etc. Adding up all these costs, it would have been cheaper for the community to have provided all those things than to not do anything and keep them homeless. That must put those rugged individualists in a strange spot--we want people to be self-reliant, but we also want the government to spend less. How do I deal with the fact that leaving people on the streets on their own is more expensive than giving them all this stuff?? [head explodes]
But, of course, since the PD budget, the courts' budgets, and all the other budgets don't clearly show line items that are readily visible for "money spent on homelessness," a lot of people just don't realize it. The costs of homelessness, uninsured, etc., are talked about, but aren't easily seen in one place on a budget somewhere, whereas the program costs to home, feed, care for them would be obvious (and large).
Homelessness, healthcare, etc., there are a multitude of studies showing that spending a significant chunk of change upfront will lead to a better bottom line for everyone (except maybe private prison corps and health insurance corps) versus what we are (not) doing now. And that's just to appease the pure dollars and cents people. Implementing these programs would also, you know, do the noble and moral deed of actually reducing homelessness and people being sick and dying because of lack of medical care...
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