5-22-25 - 8am - Medicaid Provisions

Episode Transcript

Speaker 1 (00:00):
Like, I'm sure you must have heard about the Jewish
couple that got murdered by the Palestinian supporter.

Speaker 2 (00:05):
What is wrong with people?

Speaker 1 (00:07):
I mean, honestly, let's see, I don't like the government
of your ancestors and your people, so therefore.

Speaker 2 (00:15):
I will kill you. It's just evil, That's correct.

Speaker 3 (00:27):
And I think if if we step back from everything,
you know, the minutia, like I want to talk about
the Medicaid provisions, because there's so much hyperbole out there
about the Medicaid provisions in this bill.

Speaker 2 (00:42):
But when you.

Speaker 3 (00:42):
Step away from that and you look at kind of
the big stuff going on in the world, it really
is a battle of good versus evil. And I suppose,
if I wanted to, I could take that come man
about good versus evil and drill it down to almost everything,

(01:06):
including you know, maybe even this Medicaid stuff I'm getting
ready to talk about. To give you an idea of
where I'm going, because today is is it's not what
I expected at all. I'm just walking around with my
laptop trying to figure out everything that's going on in
this legislation.

Speaker 2 (01:29):
The one thing that.

Speaker 3 (01:33):
And I don't think there's anything wrong, because there are
things in this bill that piss me off. And I
know because I'm reading the text line. There are things
in this bill to piss you off. There are also
some things in this bill that I think are good,
and I and I would say, it's about damn time
we've done some of these things. For example, one of

(01:56):
the things that irritates me about the bill is that
it add to the deficit, which so we don't get
an engineering upset, that it adds to the budget deficit annually,
which then means we have to borrow to cover that deficit,
which then that borrowed money gets added to the national debt,

(02:18):
and that drives me crazy. But if if, if Dragon
and I who have And I'm not nearly as good
as what Dragon's done, But I'm as proud of the
weight that I've lost as Dragon is of the weight

(02:38):
that he's lost. But relatively speaking, he has more to
be proud of because he started at a lot worse spot,
relatively speaking than I did.

Speaker 2 (02:49):
Yeah, that's something to be proud of, lightly sarcastic, because yeah,
I shouldn't have been up to over three hundred and
fifty pounds, right, So you you have.

Speaker 3 (02:59):
In terms of more to be proud of you've had.
You've lost more weight proportionally than I have, and so
you should be.

Speaker 2 (03:06):
More proud, could be prouder than I am.

Speaker 3 (03:10):
But we both still lost weight.

Speaker 2 (03:12):
Correct. We both laugh because now I don't do this.

Speaker 3 (03:18):
I don't have a freezer full of frozen crumbled cookie.
I don't have a freezer that has one frozen crumble
cookie in it.

Speaker 2 (03:31):
Yeah, okay, back there, you're.

Speaker 3 (03:34):
Choking on anything but like a frozen crumbled cookie. So
relatively again, relatively speaking, he and I will h You know, well,
I don't Dragon doesn't weigh every day. I tend to
weigh every day because I I'm just I don't know.
It's just a habit now, and so if if I

(03:57):
bump up a couple of pounds, I know exactly what
I've done. But in the grand scheme of things, unless
I just continually gain weight, and so I go from
my current weight and suddenly I'm back to where I
was ten years ago, then I failed.

Speaker 2 (04:17):
Well, I think in many ways.

Speaker 3 (04:20):
Adding a few more billions of dollars or actually now
trillions of dollars to the national of debt in the
grand scheme of things for a country that's already left.
Maybe it's just going to speed up the point where
the cadaver finally just gives up the spirit and we
start all over again. The point being that what I

(04:44):
want to do in the next hour is kind of
put it in a little bit of perspective, because there
are things to be irritated about, and there's some things
that we recognize that are good. So we take the
good with the bad, take the win, and we move
on to try to fix the other stuff. I'm still irritated,

(05:06):
don't get me wrong. I'm still irritated. And some of
the things that irritate me now are the claims like
Clara McCaskill about millions of people are gonna lose Medicaid coverage.
What if I told you that might be true, but
I don't give you any context to it. I just

(05:27):
tell you that, yeah, you know what, there are millions
of people might lose Medicaid coverage. Well, what if I
told you that the bill does indeed introduce significant Medicaid
cuts that could result in millions losing coverage over time.
But that's because the bill also includes Medicaid reforms that

(05:52):
are going to result in stricter eligibility and more accountability
for those who are on Medicaid to make certain that
they continue to meet the requirements to be on Medicaid.
The Congressional Budget Office, in the notes and the bill

(06:13):
estimates that the changes to Medicaid could lead up to
Now that this is the CBO, so take it with
a grain of salt, but they estimate that the changes
can lead up to eight point six million people losing
health coverage over a decade. All right, so eight million

(06:35):
over ten years, and it's primarily for Medicaid. Now, there's
also losses that nobody seems to want to talk about
that come from some of the reforms to the Affordable
Care Act Obamacare. So here are some of the specifics.
What are the Medicaid cuts in the big the one

(06:58):
Big Beautiful Bill and the OBBB. We'll call it the OBBB.
So what are the requirements in the OBB It tries
to save about to save eight hundred and eighty billion
dollars over ten years, primarily through proposals that came out

(07:20):
of the House Energy and Commerce Committee. They are cuts
and reforms. Both these are what I consider to be
what I found so far to be I think the
key components one there's a work requirement. Able body adults
between the ages of nineteen and sixty four who have

(07:44):
no dependence must work, volunteer, or be enrolled in some
accredited institution of education for at least eighty hours per
month twenty hours per week in order to qualify for Medicaid. Now,
that requirement was originally set to begin in twenty twenty nine.

(08:10):
If that were the case, I would be arguing, right now,
that's absurd. Well, they accelerated it to next year, primarily
because of Chip Roy from Texas, who wanted even more cuts.
But he wanted to start right now. The others wanted
to wait till twenty twenty nine. Now, why why do

(08:33):
I have to ask? Do I have to answer the
question for you? Why would they wait until twenty twenty
nine to implement a work requirement for medicaid? What's happening
in twenty twenty eight Dragon.

Speaker 2 (08:47):
The presidential election? Oh yeah, yeah, so we have to
wait ti life for that. So they did, you know?

Speaker 3 (08:53):
So, For as much as I've criticized them, I will
at least give them kudos for accelerating that work requirement
to twenty twenty six. Campaign on it, be proud of it,
say to the millions of people that voted for Donald Trump,
that yes, we decided that if your able body between
the ages of nineteen and sixty four, you got to work,

(09:15):
you got to be actively engaged in volunteer programs, or
you've got to be enrolled in an accredited program of
education for twenty hours a week to qualify for Medicaid. Now,
the CBO estimates that that requirement could exclude one point
five million people from Medicaid. And of the one point

(09:36):
five million, there would be about a little over half
a million, about six hundred thousand that might become actually uninsured. Okay,
that doesn't seem all that bad to me, because why
would you become Why would you get excluded? Well, maybe
you're out of the date range. Maybe there's some reas

(10:00):
and that you don't want to work or volunteer, or
you don't want to go back to school, or you
don't want to stay in school or whatever. Okay, whether
you've made that choice, and if that means you get
kicked off, well then sucks to be you. But that's
those are the choices that you made. That's based on
the CBO estimate. Is I shouldn't say based, but they

(10:21):
cite a study from George's Medicaid work requirement program that
showed that a lot of the eligible individuals failed to
meet those requirements because of the administrative burden, not because
they aren't working, but because it was too much to
try to do all the paperwork. In that study, they

(10:41):
found that ninety two percent of Medicaid recipients were either working,
disabled caregivers, or that they were in school, meaning those
requirements might disproportionately affect those that are already compliant with
a work requirement, but they're just simply unable to navigate
the paperwork. That absolutely believable. Hell's bills, Dragon, going to

(11:04):
tell you, I find the paperwork in this in this
building to be absurd. I'm trying to get the television
fixed in I haven't been down there, Dragon, because I
know you haven't been down there. I've been down So
I finally talked to one of the engineers and they
walked me through the process. And the drop down menus

(11:27):
are absurd. But I finally got a request in. We'll
see what happens. Now. How could it lead to a
coverage loss a work requirement? Well, again, it's the administrative
barriers like proving compliance on a monthly basis, Well, that

(11:49):
could cost someone who's actually eligible to lose their coverage.
And then you have people that live in a rural area.
If you live in Campo, Colorado, Mike Is, there's not
a lot of job opportunities. There's no educational opportunities that
I know. I don't even think there's a public school

(12:09):
in Campo itself. And insofar as a volunteer opportunity, I
don't know, volunteer to watch how many cattle trucks drive
through town? Do it for the county?

Speaker 2 (12:25):
I don't know.

Speaker 3 (12:26):
I'm just saying that there are probably areas where it's
just you know, some people will just be kicked off.
But let's go back to the administrative requirements. That's the bureaucracy,
that's the deep state. Well, why doesn't Congress then step
up and require the deep state, the Medicaid administrators to

(12:50):
streamline the paperwork. Why not do that? There's also a
requirement for scharricter eligibility verification. Kind of gets back to
the administrative problem. Because this resolution, this bill House Resolution

(13:11):
one is what's.

Speaker 2 (13:11):
Called the OBBB.

Speaker 3 (13:15):
It requires Medicaid recipients to verify their eligibility twice a
year instead of once a year. Oh oh, what a burden.
That's awful. Of course, I'm being facetious. If you're taking
opm other people's money, including my great great great grandchildren

(13:36):
who have yet to be born, if I'm going to
have any because we got that much debt piled on,
then the least you can do is twice a year
prove that you're eligible to take other people's money. It
also mandates that there be a home address verification, and
if your home exceeds a value over a million dollars,

(13:58):
then year excluded. Now, considering what's going on in the
real estate market, that might be questionable because there are
probably some seniors or some medicaid recipients that are you know,
of course whom I'd give them advice. But you might
want to call Frank Durant and get that house sold

(14:21):
and get that equity out of there, quit paying those
stupid property taxes and gont go downsize if you could.
But it would exclude an applicant if you have an
asset a home that's valued over a million dollars on
the service. That seems pretty reasonable to me because unless
you've got a million dollar mortgage on that million dollar home.

(14:43):
Then you know, if you got a million dollar mortgage
on the home and you are servicing a million dollar mortgage,
and even if it was in prior rates, that means
you've got some sort of cash flow somewhere, and maybe
you shouldn't be a medicaid. This is the harsh reality
of dealing with entitlements, dealing with when you're using your

(15:06):
tax dollars, my tax dollars. When you're when you're expropriately
expropriating those monies out of my paycheck so that you
can go give it to somebody else, then yeah, I
want to make sure that whoever you're giving I career,
you not to give it to anybody else.

Speaker 2 (15:19):
I'd perfect prefer.

Speaker 3 (15:21):
To keep it myself, selfish mastard that I am. But
if we're going to have a government social safety net
as opposed to a private or volunteer social safety net,
then yeah, I want I want some eligibility requirements to
be met. And you know what's bizarre about me making

(15:41):
that statement. Most volunteer organizations also have eligibility requirements. You
want to go get a uh, you know, help from
some organization. You want to get free therapy, you want
to get free whatever it is. Okay, Well prove to
us that you're you meet our requirements to get it

(16:03):
for free. Well, how could that lead to a coverage loss? Well,
if you happen to be a low, low income individual,
maybe you're a senior citizen, or maybe you're in particularly
might maybe you have disabilities, and so you struggle to
provide documentation that could lead to disenrollment. The home value restriction,
which obviously is trying to target wealthier applicants, may affect

(16:27):
you know, edge cases, you know, cases on the margin
in high cost housing markets. If if you live in
a well, I was gonna say a rent controls apartment,
I'm most sure this would apply to an apartment. But
if you live in a high rent area and you've
just lived there all your life, high value area, and

(16:48):
you bought your home for you know, seventy five thousand
dollars and now it's worth more than a million dollars,
but that you have no other income, and maybe you
can sell right now because there's nothing that you could
I mean, you get your million dollars out of your home. Oh,
they're gonna hit you with capital gains tax on something

(17:10):
over what over half a million or something. Maybe it's
more than that for couples. I don't know, whatever it is.
So you're not going to get a million dollars out
of it, so you could end up being kicked off.

Speaker 2 (17:23):
Then there's another.

Speaker 3 (17:24):
Part, another reason why Democrats are screaming about people being
losing their health fit because there's going to be reduced
federal funding and there's going to be an increase in
cost shore. I'll explain what.

Speaker 2 (17:39):
That means next.

Speaker 1 (17:50):
You usually do very well at thinking outside the box,
but I think you're missing the point here. One of
the big concerns a lot of the Democrats have been
banking that is there is not enough people for the workforce.
Doing this to affect medicaid will get a lot of
people to get off their duff and even volunteer at

(18:11):
like ranches or helping at the produce production places.

Speaker 3 (18:17):
By with all due respect, do you really think someone
who's been milking medicaid medicaid for years is going to
go work in a produce plant or work on a ranch.

(18:38):
You ever worked on a ranch? You ever bailed hay,
you ever drilled the pickup truck? Out of the back
forty dump all the hay out to feed the cattle
and make sure the water tank was full. That's work,
that's real work. I don't think they'll volunteer to do that.

(19:02):
I'm not sure they would work to get paid to
do that either, but maybe they will. Maybe you're right,
maybe they will. I think what will happen is if
if people are let's set of, let's set aside for
a moment, those who are incapable of dealing with the paperwork, elderly,

(19:29):
you know, maybe low IQ, what whatever the situation circumstances
might be. Uh, those people probably should have some sort
of assistance, which I'm sure there'll be volunteer organizations. There
will probably be even divisions. But you know, it'd be

(19:51):
like going to a Social Security office and telling them, hey,
you know, I've reached the age where I need to
apply I'm not sure how to do it or whatever,
and I don't to do it online or I don't
have a computer or whatever it is, and they'll walk
you through and do it for you. But regardless of
any of that, just requiring some sort of work, volunteer

(20:14):
or being getting an education, I think it is a
minimal requirement.

Speaker 2 (20:22):
Excuse me, So what.

Speaker 3 (20:28):
There is reduced federal funding and they have increased the
cost sharing for the states. Now you know that Medicaid
is actually administered by the states, and a lot of states,
excuse me, Colorado, California, I'm looking at you actually allow
illegal aliens on the program. So the OBBB that may

(20:55):
have been too many b's, I don't know. The OBBB
actually reduces what's called the federal medical assistance percentage. For
states that expanded Medicaid using Obamacare, they'll cut the federal
contributions by ten percent if your state covers illegal aliens.

(21:18):
So California, New York, Colorado, all of these blue states
that are doing it, you're going to have to make
up that difference, or you're going to figure out a
way to reverse your dumbass policy of American taxpayers subsidizing
the healthcare of people who are in this country illegally

(21:38):
and who aren't working, or are not getting an education
or what. Well, frankly, just the fact they're here illegally.
In my opinion, they should not be entitled to any
of our benefits other than the protections they're due. That
anybody would do that would be entitled to under our constitution.
Whether you're here as a visitor on a tourist visa,

(22:00):
or you're from a country that doesn't require a truist visa,
you're here on a business trip, or whatever, you're still
subject to the same criminal laws, due process, et cetera.
By got all of that all right, This bill also
introduces copays up to thirty five dollars per visit. It

(22:21):
does exclude emergency, prenatal, pediatric, or primary care for recipients
earning above one hundred percent of the federal poverty level,
which I think is around thirty two thousand dollars for
a family of four. And then it freezes state provided
state provider taxes which fund Medicaid, which will potentially reduce

(22:44):
state budgets. So what's the impact. Go back to the CBO.
They say those funding changes could save could save five
hundred and sixty one billion dollars over the next decade.
Then you have reduced federal support, which will force states

(23:05):
to tighten eligibility. They'll have to probably cut some benefits.
They'll certainly have to stop the stupid Obamacare expansions. And
the only place I can find a citation for the
consequences of that is from the Urban Institute, a very

(23:26):
left leaning organization. Will They project that cutting the federal
medical assistance percentage could lead to about fifteen million losing
coverage if states abandon the expansions.

Speaker 2 (23:44):
States may not.

Speaker 3 (23:46):
So once and if the states don't, and you're like
Colorado and you can't deficit spend, they'll either try to
raid tabor or they'll try to impose a increase on us.
It'll all be done in the name of how can
you be such a cold hearted human being that you

(24:07):
don't want to support someone on medicaid who came to
the country illegally. Well, I'll raise my hand. You can
call me cold hearted, but I think if you came
to the country illegally, you need to go back home.
Or if you're going to stay here until we until
we send you back home, we shouldn't be paying you
to be here. Why why should we pay you when

(24:32):
you broke the law and you came here and now
you want us to take care of you. No, Na,
and it's not going to happen. So how could it
lead to coverage loss? The states that faced the budget
shortfalls would probably try to reduce Medicaid roles or benefits,
particularly in those so called expansion states where they've been

(24:53):
expanding it and providing it to more and more people
all the time, and then the co pays themselves might
lead to some lapse coverage for those who can't afford
the out of pocket expense.

Speaker 2 (25:05):
I would again say, this.

Speaker 3 (25:08):
Is where because we've advocated our compassion to the government
that if if you wanted to start a nonprofit that
would help people navigate, you could probably have a You
could probably make a go of that. Or I would
even say if you wanted to start a nonprofit where

(25:29):
you raise money to help people that can't afford to
pay for the co pays, you could probably do that.
There are enough compassionate people in this country. We're the
most giving country in the world, and people are always
willing to give. I mean, he's bills, look at the
Look at the probably billions of dollars that we give
to save animals in this country. So if you wanted

(25:50):
to save someone who's you know, elderly and can't get
out of their home and doesn't even know what a computer,
they may know what a computer is, but they don't
have one, but know how to operate one they went
to the library. I'm sorry to the library and try
to operate the computer that has had somebody that help
them do it. That that might be a nonprofit that
would work. But then there's there are specific and here's

(26:13):
where you'll probably some people's heads will explode. There are
some restrictions for Medicaid eligibility on specific populations, specific groups
of people. It prohibits Medicaid funds funds from going to
organizations like Planned Parenthood YEP. It also explicitly excludes undocked

(26:44):
illegal aliens from Medicaid, and there are penalties for states
that allow the coverage. So defunding Planned Parenthood could limit
access to non abortion services, which is a very small
port for Medicaid recipients million areas with few alternative providers.
I mean, I'm just trying to be objective here. Excluding

(27:05):
an illegal alien. Well, that absolutely aligns with GOP goals
to limit benefits to citizens. But of course it's going
to affect states that have all those stupid policies that say, hey,
we don't care whether you we don't check, just show
up and we'll just pay for you. And states have
that attitude because it's o PM other people's money. The

(27:29):
CBO's estimate of eight point six million losing coverage is
seven point six to ten point three million from Medicaid specifically,
is driven by all of these provisions that I just
described to you. Now, the Center for American Progress, which
is one of the most progressive organizations in the country,

(27:51):
they're out there citing that thirteen million people are going
to lose coverage by by twenty thirty four, including the
eight point six million, so actually twenty one million. Well,
I don't believe those numbers whatsoever because they have a
vested interest because what does the Center for American Progress want.
They want socialized medicine. They win a single payer as

(28:13):
system in this country. So when you think about from
the Republican perspective, these reforms actually strengthen and sustain medicaid
because it roots out all the ways fraud and abuse.
It actually ensures that the benefits are intended to go

(28:33):
to those that are actually in need, mothers, children that disabled.
The work requirement and the verification targets make certain that
only those who meet the requirements are going to get
oh PM. So why why is it out there in screen? Well,

(28:54):
because you're being gasolined millions. The people are gonna lose
their health care, well not necessarily, so don't believe everything
that you hear.

Speaker 2 (29:03):
Hey, Michael, I kind of got a question. I was
wondering about something.

Speaker 3 (29:08):
Out of everybody that's gotten Medicaid, that are eligible for Medicaid,
how many actually.

Speaker 2 (29:13):
Use Medicaid And is it costing us to have them
on the rolls if they're not using Medicaid. I don't
know just what I was thinking. I never thought about that. Why.

Speaker 3 (29:29):
I suppose you could go and roll in Medicaid because
you've met the qualifications and then you never have an
annual exam or you never get sick, you never need
a surgery, or I suppose that's possible. I don't know
how you find that number out, but that does. Speaking

(29:50):
of numbers, to me, tabs open them number Goober, number
forty three, twenty one. I'm a retired occupational therapist. In
twenty twenty one, when I was still licensed, I received
a letter from Dora. They were looking for Health First Colorado,
that's the Medicaid providers. They were looking for those providers

(30:13):
and what mean to consider becoming one. This statement in
the letter took my breath away. Quote, one in four
Colorados are Health First Colorado members, and more providers are
needed to help treat the influx of new Health First
Colorado members. They write, Now this was during COVID, but

(30:33):
still it is a staggering number. One quarter of the
state population on Medicaid. Well, it wasn't that I didn't
trust you, but I didn't trust you, So I ask,
what's the percentage of the Colorado population is on Medicaid.
What's the raw number as of twenty twenty three, Approximately

(30:58):
thirty percent, So it's way above Now you're twenty five
percent from twenty twenty one. Yeah, we've gone from your
twenty five percent and now thirty percent. Approximately thirty percent
of Colorado's population was enrolled in Medicaid Health First Colorado.
With Colorad's population estimated around five point eight million people,

(31:18):
that translates to roughly one point seven four million people
in this state on Medicaid. Now, those numbers might fluctuate
because we started doing this process back in twenty twenty
three called unwinding, which led to some disenrollments, people dropping

(31:40):
off the Medicaid system. But there's more recent data from
October of last year that indicates we've gone from one
point seven four million down to one point one eighty
five million, one million, eighty five eleven Coloradens currently covered

(32:05):
by Medicaid. But again that is a post unwinding drop
and probably doesn't capture the full population percentage. See this
is the progressives objective. Start pushing people off you know,
private healthcare and get them onto government run healthcare. Now

(32:32):
we know it doesn't work. We we we've got the proof,
We've got the receipts. All you have to do is
look at the national health system, which is literally breaking
the bank in the United Kingdom and leading to really
bad health outcomes. Socialized medicine has never worked, and socialized

(32:53):
medicine is just one of the steps toward Marxism and communism.
You control a person's health, you control everything. And when
the government controls healthcare, I mean to go to make
a giant leap here, but it's not that far of
a leap. You end up with vans like you have
in China that oh guys, we need.

Speaker 2 (33:17):
Can you get us? Yeah, we need a kidney. Can
you find us a kidney? Sure? Does it need to match?

Speaker 3 (33:24):
Who cares? Just go find one? Okay, guys, get in
the van.

Speaker 2 (33:28):
Let's go.

Speaker 3 (33:30):
Throw them in, cut them up, anesthesia. You don't need
no sneak in anesthesia. Just cut him up, cut it out,
throw him out the back door.

Speaker 2 (33:38):
Drive on