Southwest Virginia Hospitals Face Merger and Possible Closures

As noted in posts on this blog and some of my columns in VEER Magazine, Southwest Virginia is a bastion of far right Republicans.  One of the policies most resisted by these Neanderthals is the expansion of Medicaid to some 400,000 Virginians which would bring much needed financial relief to hospital systems burdened with treating the uninsured in order to keep the non-profit status.  Among the financially stressed hospitals are those in Southwest Virginia, many of which are principal employers in their respective regions.  Closure of such hospitals would deal a double blow to their local economies by job losses and less accessible medical care.   The failed policies of the Virginia GOP is about to bear bitter fruit as the two hospital systems that dominate far Southwest Virginia seek to merge and open the prospect of the closure or downgrade of local hospitals.  The Roanoke Times looks at what could be karma inflicting ironic justice on those who vote Republican due to the party's pandering to religious extremism and racism.  Here are article highlights:

In advance of merger filings, executives at far Southwest Virginia’s dominant hospital systems said they are “absolutely committed” to improving the health of people in the Appalachian communities they serve and to satisfying regulators by holding prices below the national average.
Mountain States Health Alliance and Wellmont Health System are the predominant health care providers for people living in Virginia and Tennessee’s Appalachian communities. They plan later this month to file formal applications with both states to gain consent to merge their systems. While they pledged to keep their three flagship hospitals open, changes could come for 16 community hospitals.

Wellmont and Mountain States said they serve one of the unhealthiest populations in the United States, with a high concentration of Medicare, Medicaid and uninsured patients.

“The two health systems have expensive, unnecessary duplicative health care resources that are allocated inefficiently,” according to the report, which notes that a merger would bring efficiency and lower the cost. Together, they have $1.5 billion in debt they said arose from duplication of services.

While the health systems pledge to keep their three advanced-treatment hospitals open, the report said the community hospitals in operation at the date of the merger “will remain operational as clinical and health care institutions for at least five years. … The new health system may adjust scope of services or repurpose hospital facilities. No such commitment currently exists to keep rural institutions open.”

Any jobs lost through consolidation would be offset by those created through the investments and by developing new services, they said. Both companies are headquartered in Tennessee. The executives said the merger allows them to keep corporate jobs that would be lost if one or the other firm was acquired by an out-of-area health system.

The cynical side of me is laughing at the cretins that vote Republican to their own detriment.  If one votes based on religious and racial based hate, perhaps you should end up getting what you deserve after all.   I feel sorry for the non-extremists who will be harmed if hospital closures result.

 come for 16 community hospitals. hospitals.

Republican Governors Begin to Cave on Obamacare

GOP Governor Mike Pence

While Virginia Republicans continue to drink vast quantities of Kool-Aid and, in some cases (perhaps many cases) allow their racial hatred for Barack Obama to blind them to the concrete benefits of expanding Medicaid under the Affordable Health Care Act, a number of conservative Republican governors are taking the federal funding to expand healh care coverage to their states' uninsured.  Some are trying to have their cake and eat it too by not calling the programs Medicaid expansion, but the end result is the same and as more citizens benefit, it will be increasingly difficult for the GOP as a whole to roll back coverage.  A piece in Salon looks at the phenomenon.  Here are excerpts:

It’s fair to say that Indiana Gov. Mike Pence has thrown Obamacare politics for a considerable loop. Pence, a staunch conservative and opponent of the Affordable Care Act, plans to use money made available by the ACA to expand Indiana’s program for insuring low-income residents. Pence will deny up and down that he’s made himself a party to Obamacare, but federal money flowing into Indiana to provide health coverage for Hoosiers would make those denials fairly hollow.

The governor is already taking heat from conservatives who say he’s betraying conservative principles and not being forthright about it (an on-point critique!), but Pence’s apostasy could have ramifications beyond ticking off a few Heritage Foundation fellows.

Pence is not the first conservative leader to ask for Obamacare funds to expand health coverage in his state. John Kasich, Chris Christie and Jan Brewer all expanded Medicaid in line with the Affordable Care Act’s original intent. Other Republican governors have successfully implemented customized expansion programs, like Terry Brandstad in Iowa and Rick Snyder in Michigan.

Pence is different, though. He’s a conservative darling with well-established ambitions to run for the presidency. And he’s mapping out a strategy to claim the benefits of Obamacare while purporting to keep the law at arm’s length. That strategy requires a fair bit of willful obtuseness and chutzpah – his office’s announcement of the expansion plan claims that it “will alleviate the coverage gap created by the Affordable Care Act,” even though it was Pence himself who created that gap when he chose not to expand Medicaid. But that’s largely beside the point.

When a committed and high-profile Obamacare foe like Pence indicates he’s going to find a way to work within the new reality of the Affordable Care Act, he’s doing two things. First, he’s making the die-hard “repeal Obamacare” crowd look unreasonable. If Mike Pence can learn to live with the ACA, then anyone can. Second, he’s sending a message to Republican leaders in other states that it’s possible to take advantage of the law’s benefits while saving face as a small-government conservative.

[F]or conservatives who resent Pence for giving up the ghost, this is a problem.

Specifically, it’s a problem for Republicans who still hope to make the Affordable Care Act a deathly toxic issue for Democrats in 2014. Yes, the issue has receded lately as a streak of ACA victories sucked the wind out of the anti-Obamacare movement, but it will return in time for Election Day. If the feds give Pence the thumbs-up to go ahead with his expansion plan, Republican candidates fulminating against the law could find themselves asked to explain why they can’t tolerate Obamacare when the ultraconservative governor of Indiana found a way.

There's more to the piece that deserves a full read.  The bottom line, is that what Pence has done is to show the lie of the Virginia GOP's anti-Medicaid expansion obsession.

 

Virginia Republican's Increasingly Isolated Stand on Medicaid

 Outside the knuckle dragging, drooling, spittle flecked circles of the Republican Party of Virginia base, sentient Virginians want Medicaid expansions.  Supporters of expansion range from the state's chambers of commerce, to hospital associations, charities that work with the uninsured, to those who - unlike the Pharisee like Christofascists - believe the Gospel message mandates caring for the sick and less fortunate.  Yet hatred for America's first black president trumps all else with the Virginia GOP.  Even as other GOP controlled states are shifting towards Medicaid expansion.  A column in the Washington Post looks at the Virginia GOP's increasingly lonely position which harms hundreds of thousands of Virginians and puts many hospital systems at financial risk.  Here are excerpts:

REPUBLICANS IN Virginia’s House of Delegates have blocked hundreds of thousands of poor Virginians from getting health insurance under the Obama administration’s Medicaid expansion. At the same time, they’ve refused to suggest any alternative method by which the needy people in the state might arrange health coverage.

Meanwhile, the list of Republican governors around the country who want new federal Medicaid funds — and the huge benefits they bring for their states — continues to grow. Richmond’s just-say-no crowd, led by House Speaker William J. Howell (R-Stafford), looks increasingly isolated and callous.

The latest to opt into the Medicaid expansion, albeit on terms the federal government must first review, is Gov. Mike Pence, the Republican governor of a very Republican state: Indiana. 

Other GOP governors, alert to the acute need to provide coverage for millions of people who need it, have either embraced the expansion outright or pitched creative ideas to the Obama administration in the hope of drawing on the new federal funds. 

Gov. Tom Corbett of Pennsylvania has negotiated with federal officials on allowing his state to use the new Medicaid funds to purchase private health insurance for low-income people. That’s similar to a plan being carried out by Arkansas, where Republicans who control the legislature were divided but ultimately accepted a private option in the belief that the for-profit marketplace would administer the federal benefits more efficiently than Medicaid would.

Lawmakers in Virginia’s Senate adopted a similar approach, passing a bill sponsored by a Republican, Sen. John C. Watkins (Powhatan), that would extend health coverage to several hundred thousand indigent Virginians. Gov. Terry McAuliffe (D) said he was amenable to the plan. But Republicans in the House of Delegates, led by Mr. Howell, said no.

We wish Ms. Brewer, the Arizona governor, would come to Virginia for a little sit-down with Mr. Howell. Ms. Brewer is no one’s idea of a patsy for Mr. Obama: She once delivered a finger-wagging lecture to the president’s face. But even after denouncing Obamacare, she could not defend refusing millions of federal Medicaid dollars — dollars that her constituents have paid in taxes — that would help some of the neediest people in her state.

“[T]here comes a time [when] you have to look at the reality,” she told Politico last year. “You have to do the math. . . . It’s not only a mathematical issue, but it’s a moral issue.”

 As seemingly is more and more the case, the Republicans offer no solutions and simply say "No."  And in the process they show the utter hypocrisy of their claims  that they value "Christian values."  They and their party's base are increasingly foul and make the Pharisees of the Bible appear to be upright, moral individuals.  The sooner conservative Christianity becomes a dead religion, the better off America will be.

Lynchburg News Advance: Virginia Needs to Expand Medicare

At the moment Virginia finds itself in a deadlock over the expansion of Medicaid.  On one side are Gov. McAuliffe, the Virginia Senate and most of the business community not to mention the state's hospital associations.  On the other is the GOP controlled House of Delegates which in its quest to pander to the racists in the party base continues to say "No" to anything tied to America's first black president.  The estimated 400,000 Virginians who would benefit from Medicaid expansion, including many poor children, simply do not matter to these extremists in the Virginia GOP who are so stupid that they refuse to grasp that all of us are already paying for the uninsured but in the least cost effective manner possible.  A main editorial in Lynchburg's News Advance makes the case as to why Medicaid must be expanded.  Here are excerpts:

The Republican House of Delegates and Gov. Terry McAuliffe and the Democratic Virginia Senate continue their standoff over the budget and Medicaid expansion. Stuck in the middle are thousands of state employees, local governments, public school systems, public colleges and universities and 8 million Virginians.

Ladies and gentlemen in Richmond, it’s time to negotiate, craft a compromise and get the commonwealth out of the Medicaid corner it’s been painted into.
 

When President Obama and Congress crafted the Affordable Care Act, a.k.a. Obamacare, in 2009 and 2010, a key element was reform of Medicaid and Medicare reimbursement rates for the nation’s hospitals. Gone was the old system of pay-for-services, replaced with incentives for the system to keep would-be patients healthy and out of the acute care system. As an industry, hospitals signed on to the changes because part of the bargain was that more people would be covered, especially through Medicaid, leaving hospitals harm-free in the final analysis.

Many states have taken advantage of the tax dollars Washington is directing back to them to expand Medicaid, but many others — primarily those controlled by Republicans — have not.

Virginia falls into the latter category, and thus the current stalemate we find ourselves in.

The Democratic Virginia Senate, working with Democratic Gov. McAuliffe, has approved a state budget that expands Medicaid but by working through private insurance providers. The Republican House simply says no to Medicaid expansion, period.

The money for Medicaid expansion is tax money Virginians are already sending to Washington ... if Virginia doesn’t accept it, it simply goes to states that already expanded Medicaid. In Virginia, we’re talking about $2 billion per year.

The federal government would pay 100 percent of the costs of expansion through 2016, slowly dropping over the next decade to no less than 90 percent of the costs.

It’s the hit to hospitals across Virginia that has people worried though. The University of Virginia Medical Center and the Virginia Commonwealth University Medical Center will see roughly $500 million sliced from their budgets. Here in Lynchburg, Centra officials estimate they’ll lose roughly $17.3 million. Smaller hospitals could simply be forced to close their doors.

Caught in the crosshairs in this budget/Medicaid fight are real people who could be harmed by the actions — or inactions — of ideologically driven politicians. They deserve better.

On their behalf, we repeat our original exhortation to our legislators: Negotiate, craft a compromise and get the commonwealth out of the corner you’ve painted it into.

GOP Legislators Ejoy Rolls Royce Healthcare While Blocking Medicaid Expansion

When it comes to hypocrisy, few individuals are bigger hypocrites than Virginia Republicans in the General Assembly who are blocking Medicaid expansion - something that would bring healthcare coverage to 400,000 Virginians and create 30,000 jobs.  Why the hypocrisy?  Because even as GOP legislators seek to deny access to healthcare to 400,000 Virginians they are enjoying a gold-plated, Rolls Royce healthcare plan at taxpayer expense even though they are members of an only part time legislature.  The hypocrisy parallels that Congressional Republican who seek to kill Obamacare even as they enjoy healthcare plans that the rest of us could only wish for.  The Richmond Times Dispatch looks at the hypocrisy in the Virginia Legislature.  Here are highlights:

On Monday mornings, in the ninth-floor conference room of a Main Street tower overlooking the state Capitol, lobbyists for industry, hospitals, insurance companies, physicians and regional trade groups swap intel and plot strategy in the health care fight that is paralyzing a part-time legislature with a little-known secret: full-time, gold-plated health coverage.

Gridlock is the norm in Richmond. It has been for more than a decade. Among those contributing to this almost-continuous standoff are lawmakers who get from the government what they are insisting the government shouldn’t give others: health insurance, which, among other things, paid for the weight-reduction surgery of at least one senator.

That senator, Republican John Cosgrove, makes no a secret of his bariatric surgery. But that didn’t stop Del. Joe Morrissey, D-Henrico, from making a veiled reference to it during the House debate on health care this past Thursday. Told of the comment, Cosgrove alluded to one of Morrissey’s maladies — an incurable appetite for attention: “I never brought an AK-47 on the floor of the House. We all have our weirdnesses.”

For the General Assembly, as a whole, it’s a seeming delight in dysfunction, particularly on issues touching the most lives.

For the dozen or so lobbyists who gather in the offices of the Virginia Chamber of Commerce, this means their push to fully extend Obamacare here is back to the future.

The meetings — led by chamber President Barry DuVal, a former commerce secretary to a Republican governor — are a reminder of the strained relationship between business and the Republican Party. Once natural allies, they have been rent asunder by the GOP’s subservience to anti-taxers, culture warriors and tea partyers, all of whom depict the party as subordinating ordinary people to profit-obsessed oligarchs. This clash plays out in primary contests.

The chamber-led alliance is looking for ways to pry away enough Republican votes in the House of Delegates to three-peat. Having twice loosened the leadership’s grip on the rank and file over taxes, business is going for the hat trick: arguing that a health care fix subsidized with more than $2 billion from Washington can help stabilize the economy as well as the workforce.

For Manoli Loupassi of Richmond, it could be additional restrictions on Medicaid, a health care program for the poor, which has one of the lowest fraud rates in the nation at three-tenths of 1 percent. Another possible inducement for him: How all that federal money could shore up Virginia Commonwealth University’s teaching hospital, where the demands of research and education collide with those of an impoverished urban population.

Another motivation may be humiliation; that legislators will have to publicly explain extending to themselves services they deny others.

According to the state personnel office, 104 of 140 delegates and senators and 202 of their spouses and children are covered by the government’s health plan, which last year legislators closed to part-time civil services workers to save money.

Enrolled in the state program are such Republican anti-Obamacare stalwarts as House Speaker Bill Howell of Stafford County, House Whip Todd Gilbert of Shenandoah County and Appropriations Committee Chairman Chris Jones of Suffolk.

If you want to look a hypocrite in the face, look no farther than your nearest GOP member of the Virginia General Assembly.

The Victims of GOP Obstructionism

The economy continues to struggle to recover even as the Congressional Republicans engage in non-stop obstructionism and gridlock legislation on everything from economic stimulus, infrastructure rebuilding and immigration reform.  While these GOP saboteurs win the praise of delusional Christofascists and their likewise bigotry filled Tea Part first cousins, the obstructionism has very real victims. Millions of Americans have suffered directly and many, many more have suffered indirectly.  It is an ugly legacy and it underscores the hypocrisy of the GOP's feigned reverence for Christian values.  A column in the New York Times looks at these victims.  Here are some column highlights:

In an election year, there are always winners and losers. Rarely, however, are there so many victims.

Legislative gridlock, which was already bad enough, has devolved into a cynical, poisoned status. 

With a few obvious votes, Congress could improve the lives of millions of people — the unemployed, the undocumented, the uninsured. But instead of being helped, those in need are punished for nakedly political reasons.

It says a lot about this shameful state of affairs that Senate Minority Leader Mitch McConnell (R-Ky.), one of the most powerful and savvy officials in Washington, had to put his career on the line to win an increase in the federal debt ceiling. Failure to act would have caused a catastrophic default. No new government spending was involved; rather, the Treasury simply needed to pay for spending that Congress already had authorized. Raising the limit was a no-brainer.

Yet Sen. Ted Cruz (R-Tex.), who continues to redefine the word “shameless,” almost led the nation into calamity by forcing Republican senators to go on record in favor of the increase. Since the GOP base has been told — wrongly — that refusing to hike the ceiling would somehow help get the debt under control, senators who voted to do the right thing risked a tea party challenge.

Congress managed to avoid inflicting grievous harm on the entire nation. A number of subgroups have not been so fortunate.

The Americans most obviously suffering because of Congress’s unwillingness to do the right thing are the 1.7 million jobless workers who have lost their long-term unemployment benefits.

Again, Republicans are wary of angering the party’s conservative base. It’s not so much a matter of increasing the deficit — a three-month extension would cost only $6 billion, and Democrats have proposed offsets — but that far-right dogma considers such payments a moral hazard that encourages idleness. Never mind that recipients of unemployment benefits, by definition, were employed until relatively recently and can demonstrate that they are actively looking for jobs.

The working poor are suffering unnecessarily as well. The federal minimum wage of $7.25 is far too low. In the past, Republicans have joined Democrats in voting for needed increases. In an election year, however, struggling wage-earners are out of luck.

The 11 million men, women and children who are in this country without documents are also victims of the calendar. President Obama and the entire congressional leadership agree that there is an urgent need for immigration reform. 

Also unfairly punished are the millions of uninsured Americans seeking coverage through the Affordable Care Act. Despite the Republican Party’s best efforts, Obamacare is working. But it would work better if Congress would cooperate with Obama in making a host of technical adjustments to the program.

 It’s one thing to seek an advantage at the polls. It’s another thing to make innocent people suffer for your ambition. Guilty members of Congress — and I’m specifically including you, Sen. Cruz — should hang their heads in disgrace.

Will GOP Dominated States Rethink Rejecting Medicaid Expansion?

As Terry McAuliffe is sworn in as Governor of Virginia today the stage is being set for a battle with the GOP controlled House of Delegates to embrace Medicaid Expansion.  As noted before, this would bring health care to 400,000 Virginians, create an estimated 30,000 new jobs, and bring billions of dollars in federal money to Virginia.  Among rational, sentient people (which excludes most Republicans), expansion is a no brainer.  But among the Christofascist/Tea Party crowd, expansion is tantamount to heresy.  Why?  The real reason, in my view boils down to racism: the opponents of expansion think most beneficiaries will be poor minority group members.  You know, the folks these pious folks view as disposable garbage.  But despite this opposition from the GOP base, some states and governors may be reconsidering - perhaps because of the pressure brought by powerful hospital associations that would benefit from expansion.  Politico looks at the possible changing situation:

Republicans counting on a year of nonstop Obamacare-bashing may be in for an unwelcome surprise: more red-state governors ditching the political script to take a second look at the law’s huge expansion of Medicaid.

The party plans to make Obamacare and its early stumbles a central campaign issue in 2014; the House plans two anti-Obamacare votes Friday. But in the states, the Medicaid expansion — a giant, dangling carrot worth billions of federal dollars to states that sign up — has proved attractive to nearly a dozen GOP governors, and a handful more are on the fence.

Governors like Rick Perry of Texas and Bobby Jindal of Louisiana remain firmly in the “no way” camp. But Pennsylvania and Tennessee are actively working with the Obama administration to expand Medicaid, although their efforts to squeeze policy concessions on the GOP wish list — like requiring enrollees to pay more — could be a dead end.

Indiana and Oklahoma are eyeing alternative versions of expansion and were granted a one-year reprieve by the Obama administration to extend existing state health care programs while they think about it.

Governors in small, Republican-dominated states like Wyoming, Kansas and Utah say they’re keeping an open mind in 2014, despite their hatred for the overall health law. And in every undecided state, an unusual alliance of powerful hospital, business and religious interests has been leaning on Republican leaders to reverse course.

In short, the 26 states that have already approved Medicaid expansion are likely to be joined by at least a few more in 2014 — and the “hell no” states could find themselves an increasingly isolated bunch, concentrated in the South.

Already, seven states have approved expansion with the blessing of Republican governors — including Arizona’s Jan Brewer, Ohio’s John Kasich and New Jersey’s Chris Christie. Medicaid is growing quickly under Obamacare, with an estimated 3.9 million people determined eligible for the program in the first three months. Supporters say that if all 50 states expanded Medicaid, another 5 million people would become eligible.

In general, Republican-dominated states outside of the South aren’t taking as hard a line against expansion as conservatives would prefer.

Kansas’s top hospital trade group signaled that it’s readying a new Medicaid offensive in the coming legislative session. Just before the holidays, the Kansas Hospital Association hired former HHS Secretary Mike Leavitt, who’s advising GOP states on Obamacare implementation, to craft a Medicaid expansion plan that its members could pitch to reluctant state lawmakers.

Hopefully, common sense and decency - rare traits in today's GOP - will prevail.

Under Reported GOP Generated Human Disasters

At times I have nothing but disgust for the main stream media which seems like either the lap dog of big business or some larger version of the National Inquirer which focuses on petty and unimportant stories while ignoring real significant problems.   Right now, two huge under reported problems in America - of GOP creation, I might add - are the 1 million plus unemployed workers losing emergency unemployment benefits and the related number of the working poor who remain without health care coverage.  The Gospels stress the need to care for the poor, sick and hungry, yet today's self-congratulatory folks in the Republican Party deem the poor, sick and the hungry only worthy of society's trash heap.  A column in the Washington Post looks at these stories largely ignored by the media.  Here are excerpts:

As The Post’s Brad Plumer expertly outlined on Friday, there are 4 million people who have been out of work for 27 weeks or longer, translating to the highest long-term unemployment rate since World War II. These people — young, old and from all kinds of demographics — have a 12 percent chance of finding a job in any given month, and, contrary to the theories of Rand Paul Republicans, there’s little evidence that they’re more likely to find work after losing benefits. Cutting off their benefits only causes more suffering for them and more damage to the economy. 

Also last weekend, the Obama administration reported that 1.1 million people had signed up online for coverage under the new health-care law. That’s a dramatic acceleration in enrollment, but it also leaves uninsured millions of people who are eligible for coverage. Some of them are working poor in states where Republican governors have refused to implement the law’s Medicaid expansion, and many more are being discouraged from enrolling by Republicans’ incessant opposition. This month’s CBS News-New York Times poll found that a majority of uninsured Americans disapprove of the new law, even though nearly six in 10 of the uninsured think insurance would improve their health. 

These real outrages make the Christmas-week controversies seem like tinsel. 

Bad things happen because good people stand by and do nothing - and because the media fails to report on stories that need to be told while focusing on matters more appropriately the a topic for Entertainment Tonight.  We once had a responsible main stream media, but those days are seemingly over.  It is part and parcel with the dumbing down of America.

Hispanic Evangelicals Support Obamacare

In the category of more bad news for the GOP which already has a horrendous problem with Hispanic voters who rightly see the GOP as their enemy, now Hispanic evangelicals are supporting  the Affordable Health Care Act, a/k/a, Obamacare.  Pastors rightly see that Obamacare can mean health care coverage as opposed to nothing and, unlike the white supremacists in the Tea Party/Christofascist base of the GOP, are not hoping their parishioners will simply vanish or die off. Politico has details:

Under the big evangelical tent where tens of millions of Americans worship, Hispanic churches are embracing Obamacare despite the concerns about religious freedom that have tarnished the law for many of their fellow believers.

Pastors have encouraged support since enrollment for health coverage began in October. Their take is that the law’s positives outweigh its negatives, especially for the one in three Hispanics without insurance, the highest uninsured rate of any racial or ethnic group. Many of the uninsured are eligible for major new health benefits plus subsidies to help them afford coverage.

On the eve of the first sign-up deadline Monday, church leaders are still working hard to get out the word about how much the Hispanic community will gain. Some draw parallels between the suffering the law is intended to ameliorate and the church’s core mission.

Jesus was a healer,” noted Gabriel Salguero, president of the National Latino Evangelical Coalition. “The health care law can be improved, but I think in its present form it does more good than harm to Latinos around the country.”

[The]embrace of the health law puts Hispanic evangelicals at odds with other evangelicals as well as religious conservatives across denominations. They have opposed Obamacare primarily because of its provision requiring businesses to cover contraceptives in employee health plans, including the morning-after pill.

Although the contraceptive requirement may cause many evangelical Hispanics discomfort, they seem to have made their peace. “Our commitment has always been to strike a balance between religious liberty and individual liberty,” Salguero said.  In doing so, they’ve aligned with the mainline congregations that have been at the center of most of the Obama administration’s faith outreach.

The law is “a start,” said Abraham Hernandez, northeast vice president for the National Hispanic Christian Leadership Conference. He believes Obamacare’s expanded benefits will advance a key conference principle. “If Hispanics in the nation can have access to health care, it indeed preserves life. We believe that access to health care is very critical,” he said.

The divergence from other evangelicals is stark.  But then again, it is important to remember that many far right evangelicals are self-centered, seek to inflict their religious beliefs on all Americans and frankly do not give a damn about blacks, Hispanics or other minorities who they see as interlopers who do not belong in America,  

The Healthcare Industry's Vested Interest in Obamacare Succeeding

The Republican Party is so busy prostituting itself to the Christofascist/Tea Party elements of the party base that oppose the Affordable Health Care Act, a/k/a Obamacare - many of whom are frankly motivated primarily by a racist base hatred of Barack Obama - that they seem to be ignoring another powerful interest group that has significant reasons: the healthcare industry.  Many powerful players in the healthcare industry realize that repealing Obamacare and going back to the increasingly broken system that was previously in place is simply not acceptable.  With the ranks of the uninsured soaring but for Obamacare and healthcare costs out of control, at some point the entire structure will collapse without change.  The Los Angeles Times looks at why the healthcare industry will ultimately strive to make Obamacare work.  Here are excerpts:

WASHINGTON — President Obama's healthcare law, struggling to survive its botched rollout, now depends more than ever on insurance companies, doctor groups and hospitals — major forces in the industry that are committed to the law's success despite persistent tensions with the White House.

Many healthcare industry leaders are increasingly frustrated with the Obama administration's clumsy implementation of the Affordable Care Act. Nearly all harbor reservations about parts of the sweeping law.

But since 2010, they have invested billions of dollars to overhaul their businesses, design new insurance plans and physician practices and develop better ways to monitor quality and control costs.

Few industry leaders want to go back to a system that most had concluded was failing, as costs skyrocketed and the ranks of the uninsured swelled.

Nor do they see much that is promising from the law's Republican critics. The GOP has focused on repealing Obamacare, but has devoted less energy to developing a replacement.  Healthcare industry officials generally view several GOP proposals, such as limiting coverage for the poor and scuttling new insurance marketplaces created by the law, as more damaging than helpful to the nation's healthcare system.

"The principle of providing the opportunity for everyone to get health coverage and of joining everybody together in shared responsibility is the right one," said James Roosevelt Jr., president of Tufts Health Plan, one of Massachusetts' largest insurers. "No one has presented a credible alternative."

The value of the alliance between the administration and major insurers, hospitals, clinics and others in the healthcare industry can readily be seen in steps they have taken to help the White House overcome the rocky start of the law's new insurance marketplaces.

Major retail pharmacies, such as CVS Caremark, have agreed to market the law's benefits in their stores. And hospitals and health clinics in many states are helping patients sign up for coverage.

For many of these organizations, the prospect of new customers and a more rational system outweighs their sometimes intense irritation with the Obama administration.

Despite the frustrations, most insurers remain committed to moving to a new market that would achieve the central promise of the Affordable Care Act: that all consumers can buy health plans even if they have preexisting medical conditions.

Even the chief executive of WellPoint, the nation's second-largest health insurer, which spent heavily in 2010 to help defeat Democrats in Congress who had voted for Obamacare, signaled optimism this week about the prospects for people signing up for coverage under the law in coming months.

"The potential is there for a significant uptake," Joseph Swedish said in an interview this week at a conference for corporate executives sponsored by the Wall Street Journal.

Hospitals, which provided crucial backing for the law in hopes it would reduce the number of uninsured patients, have been redesigning the way they deliver care to keep patients out of the hospital, another goal of the law.

We are still not entirely sure where we are going," said Judy Rich, chief executive of Tucson Medical Center in Arizona, which has been partnering with local doctors to help patients stay healthy so they don't need to be hospitalized.  "But every time we reevaluate the options, we come back to one conclusion: This is fundamentally the right thing to do."

"The fact is that doctors and hospitals around the country are committed to achieving the goals of the health law: expanding coverage and, more importantly, raising quality … and making healthcare more cost-effective," he said.  "There is no going back."

Opposition to Medicaid Expansion: The Next GOP Litmus Test?

Here in Virginia the Republican Party of Virginia - the self-avowed party of "family values" and "Christian values" - is dead set against Medicaid expansion even though it would bring billions of federal dollars to Virginia, create tens of thousands of medical field jobs, and bring health coverage to 400,000 Virginians.  Why the opposition?  The truth - something the GOP likes to avoid - is that the Christofascists/Tea Party base believes those gaining coverage are "those people."  Meaning, blacks and minorities.  Adding to the opposition, but not the major cause is contraception and limited abortion coverage that might be included in medical care for the poor.  As for the 400,000 Virginians in need, the GOP answer is please just go somewhere and quietly die.  Yep, truly godly people.  A column in the Washington Post suggests that such opposition is a growing litmus test in the GOP.  Here are excerpts:

The other day, Republican businessman Vance McAllister defeated a fellow GOPer in a Louisiana House special election, even though he supports the Medicaid expansion, which is of course a feature of the hated Obamacare. While there’s some argument as to how much the expansion meant to the outcome, McAllister’s willingness to embrace the idea of accommodating a part of the health law to bring in federal money suggests something of a schism between pragmatic and ideological Republicans over the issue.

Now the Daily Caller’s Matt Lewis reports that opposition to the Medicaid expansion is set to become a major litmus test issue in GOP primaries:

The issue is now making its way into Idaho’s Second Congressional District —  in what is shaping up to be a brutal primary between Rep. Mike Simpson and  a conservative challenger named Bryan Smith.

In a press release earlier today, The Club for Growth, a powerful fiscally  conservative group,  pointed out that a Super Pac backing Simpson has also endorsed expansion. (It’s not clear where  Simpson stands on the issue, and that’s sort of the point.)

If Idaho is a harbinger of things to come, expect Medicaid expansion to be a  huge issue in Republican primaries — a sort of litmus test for true conservatives.

Meanwhile, House conservatives are beginning to hatch a new strategy for the coming budget talks that would involve pushing for a defunding of the law’s Medicaid expansion, and using the money to offset the sequester’s defense cuts. Though this idea seems to have very little support, it’s not impossible it could gain some momentum.

And in Tennessee, the Republican governor is coming under increasing pressure from local business interests who want him to embrace the Medicaid expansion. He is caught between GOP lawmakers who oppose the expansion, and hospital groups and the local chamber of commerce, who want it.

Democrats increasingly believe that, at a time when the law known as “Obamacare” is suffering serious rollout travails and is sinking in polls, the Medicaid expansion is a good issue for them — one that neatly shows that some of the individual provisions of the law remain politically viable, and as an added bonus could even divide Republicans. Obamacare’s expansion of coverage is most pronounced in the Medicaid expansion area, which could make it politically more difficult over time for Republicans to oppose it — even as conservatives appear poised to continue making opposition to it a defining issue. Whether this emerges as a real wedge among Republicans will be something to keep watching.

 Sadly, the image at the top of this post really does accurately describe today's Republican Party.  The metastasizing cancer in the party - the hate-filled Christofascists - is now nearly complete.

The GOP's Mission to Destroy Medicaid Expansion

One of the biggest examples to my mind of Republican and Christofasist/Tea Party hypocrisy revolves around the effort to kill Medicaid expansion and the Affordable Health Care Act.  These people blather incessantly about upholding Christian values and congratulate themselves almost daily about the piety and religiosity even as they seek to deprive the health care access to millions of the poor and unfortunate.    The Gospel directive to tend the sick means nothing to these foul modern day Pharisees.  To them, the poor - especially if they are not white - are trash to be thrown on the garbage heap.  A column in the New York Times looks at the disingenuous excuses being up forward by the  Republicans and Christofasist/Tea Party crowd to kill health care reform.  Here are highlights:

The real threat remains the effort of conservative groups to sabotage reform, especially by blocking the expansion of Medicaid. This effort relies heavily on lobbying, lavishly bankrolled by the usual suspects, including the omnipresent Koch brothers. But it’s not just money: the right has also rolled out some really lousy arguments.

And I don’t just mean lousy as in “bad”; I also mean it in the original sense, “infested with lice.”

Before I get there, a word about something that, as far as we can tell, isn’t happening. Remember “rate shock”? A few months ago it was all the rage in right-wing circles, with supposed experts claiming that Americans were about to face huge premium increases. 

It quickly became clear, however, that what these alleged experts were doing was comparing apples and oranges — and as Ezra Klein of The Washington Post pointed out, oranges that, in many cases, you can’t even buy. Specifically, they were comparing the premiums young, healthy men were paying before reform with the premiums everyone — including those who previously couldn’t get insurance because of pre-existing conditions — will pay under the new system. Oh, and they also weren’t taking into account the subsidies many Americans will receive, reducing their costs. 

Now, about those lousy Medicaid arguments: Last year’s Supreme Court decision upholding the Affordable Care Act did strike down one provision, the one that would have forced all states to accept an expansion of Medicaid, the already-existing program of health insurance for the poor. States are now free to reject that expansion. Yet how can states justify turning down a federal offer to insure thousands of their citizens, one that would cost them nothing in the first year and only trivial amounts later? Sheer spite — the desire to sabotage anything with President Obama’s name on it — is the real reason, but doesn’t sound too good. So they need intellectual cover. 

Enter the same experts, more or less, who warned about rate shock, to declare that Medicaid actually hurts its recipients. Their evidence? Medicaid patients tend to be sicker than the uninsured, and slower to recover from surgery. 

The application to Medicaid should be obvious. Sick people are likely to have low incomes; more generally, low-income Americans who qualify for Medicaid just tend in general to have poor health. So pointing to a correlation between Medicaid and poor health as evidence that Medicaid actually hurts its recipients is as foolish as claiming that lice make you healthy. It is, as I said, a lousy argument. 

And the reliance on such arguments is itself deeply revealing, because it illustrates the right’s intellectual decline. I mean, this is the best argument their so-called experts can come up with for their policy priorities? 

Meanwhile, many states are still planning to reject the Medicaid expansion, denying essential health care to millions of needy Americans. And they have no good excuse for this act of cruelty.

The GOP’s Lose-Lose Proposition

It seems that Kathleen Parker has once again sworn of Christofascists/Tea Party Kool-Aid at least for long enough to once again see reality and slam the House GOP for it hell bent effort to force a government shut down and tank the U.S. economy yet again.  Parker recognizes that if the House GOP saboteurs prevail, it will be the GOP, not Obama and the Democrats who will ultimately lose.  Only time will tell how long Parker will eschew the mind altering Kool-Aid of the increasingly insane party base.  Would that more once rational Republicans - or at least those few who have not fled the GOP - would do likewise (yes Karen, I'm talking about you). Here are highlights from Parker's take down of the GOP extremists in the Washington Post:

Ask most people on Capitol Hill and they’ll say: 50-50. Those are the odds they give for a government shutdown.

An alternative to the shutdown would be a proposed delay of the individual mandate, the most painful part of Obamacare, which may seem like a Republican victory but on closer inspection would be a win for President Obama and Democrats.

Historians — or commentators, in the meantime — might view either of these possible outcomes as yet another “Putinesca” victory for the president: Saved by the enemy.

Just as Russian President Vladimir Putin emerged at the brink of the U.S. bombing of Syria to orchestrate an alternative solution, Republicans may have provided a rip cord for Obama.

Here’s the problem for Republicans, which will not be news to those with a view of the long game. The short game is to stall Obamacare, but to what end ultimately? Until Republicans can seize the Senate in 2014 and the White House in 2016, at which point they can repeal the whole thing?  Skinny chance, that.

More likely, whether the government shuts down or, should Tinker Bell suddenly materialize and persuade Obama to cave and postpone his personal dream act, Republicans will be viewed by a greater majority than previously as having no talent for leadership.

And if the debt ceiling isn’t raised and the United States defaults, threatening our full faith and credit around the world and sending countries looking favorably for other currencies, not to mention the financial fallout here, then blame will fall at the feet of the Republican Party. No surprise there.

Now consider the alternative scenario: Suppose Republicans succeed in getting the individual mandate delayed for a year — right up to the 2014 midterm elections. Bravo, right? Not necessarily. If voters don’t have to experience the uncertainty and discomfort of being forced to buy insurance in an unwieldy, dysfunctional system — all the while noticing that millions are still without coverage — who benefits?

Surely not the Republicans, who, on the one hand, can be blamed for depriving insurance coverage to those poor sick kittens and ducklings. On the other, they accrue no benefit from having prevented the pain of implementing Obamacare.

Alternatives to present circumstances do not abound. Republicans have drawn their line in the sand.   . . . . Republicans, who will have banished themselves to wander a while longer in the desert, may have drawn a line too far.

 Obviously, the reality denying and ignorance embracing GOP base will accuse Parker of being a "sell out."  But, sometimes being responsible is trying to tell the deranged that they need to rethink their demands and actions.  Even if one's efforts fall on deaf ears.

The Victims of Republican Obstruction: the Poor and Less Fortunate

As noted frequently on this blog, the Republican Party constantly wraps itself in feigned religiosity, pretends to honor the principles of the Gospels, and claims to be the party of "family values."  All are lies and ruses to dupe the ignorant.  Especially, the claim of being the family values political party.  In truth, the GOP only supports families that are well to do whites who are also preferably knuckle dragging conservative Christians.  Families who are non-white, down on their luck financially and/or do not fit the image of the mythical family of Beaver Clever simple are not wanted or welcome.  Indeed, the GOP would rather that these families would cease to exist.   And to achieve this goal the GOP opposes so-called Obama care that would benefit millions of Americans and seeks to dismantle the social safety net.  An editorial in the Washington Post looks at GOP obstruction and those it harms.  Here are excerpts:

AFTER PRESSING for months, Michigan Gov. Rick Snyder (R) last week finally convinced his legislature to expand the state’s Medicaid program as part of the national restructuring of the health-care system known as the Affordable Care Act (ACA). According to calculations from the Urban Institute, some 212,000 uninsured Michiganders now stand to obtain health-care coverage.

It’s a sad fact that Mr. Snyder deserves congratulations for this accomplishment. You wouldn’t think state leaders would need convincing to accept mountains of federal cash to help people with meager incomes obtain health insurance. But many Republican leaders and activists have waged a disruptive and harmful campaign to complicate, delay and undermine the ACA, which starts phasing in when state insurance markets begin enrolling customers in a month.

The most prominent efforts have been in Congress, where conservatives’ latest move has been to insist on holding the government budget process hostage to obtain cuts in funds intended for ACA implementation. But the most disruptive activity has been at the state level. Twenty-one states have refused to expand their Medicaid programs, blowing a large hole in the ACA’s coverage strategy. The Urban Institute estimates that 5 million people won’t get coverage as a result.

As The Post’s Sandhya Somashekhar reported last week, Republicans at the state level also have applied a variety of less visible measures to impede the law’s implementation. Some won’t enforce consumer protections, including a ban on insurance companies rejecting patients with pre-existing conditions. The result will be illegal discrimination.
Georgia’s state government is doing “everything in our power to be an obstructionist,” Ralph Hudgens, the state’s insurance commissioner, boasted.

Congress enacted the Affordable Care Act. The Supreme Court found most of its provisions to be constitutional. Republicans, having opposed the bill and supported the legal challenge to it, are entitled to be unhappy about the outcome, though in our view they are wrong on the merits. They are not entitled to obstruct and flout the laws of the United States. On the contrary, they have an obligation to cooperate in good faith with wholly legitimate laws duly passed and reviewed by all three branches of government.

Where did the GOP get this mind set?  From the "godly Christian" folk and their largely conservative Christian Tea Party first cousins who continue to think that they are above the law.  The GOP has been hijacked by those motivated solely by greed and hate.  Whenever they begin to blather about family values they need to be condemned loudly.  They are liars plain and simple.