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None dare call it Obamacare

You’ve probably seen the Politico story by now.

It's constitutional - deal with it

It’s constitutional – deal with it

Gov. Rick Perry wants to kill Obamacare dead, but Texas health officials are in talks with the Obama administration about accepting an estimated $100 million available through the health law to care for the elderly and disabled, POLITICO has learned.

Perry health aides are negotiating with the Obama administration on the terms of an optional Obamacare program that would allow Texas to claim stepped-up Medicaid funding for the care of people with disabilities.

The so-called Community First Choice program aims to enhance the quality of services available to the disabled and elderly in their homes or communities. Similar approaches have had bipartisan support around the country. About 12,000 Texans are expected to benefit in the first year of the program.

One line of thinking as to why the Texas governor, who has honed his national image in no small measure by denouncing Obamacare, would make such a seemingly inconsistent move goes like this: Treating disabled and elderly people is less politically charged than a sweeping national law forcing people to buy health insurance. Perry recently decided against seeking reelection next year but is mulling a second presidential bid in 2016.

[...]

The Texas Legislature approved the program earlier this year, and Perry signed it into law as part of a larger package of health reforms, as well as in the state budget. Now, his administration is working win approval from the Obama administration to fit the program into the state’s existing Medicaid framework.

“Efforts are under way to develop and submit an application to the Centers for Medicare and Medicaid Services for participation,” said a spokeswoman for the Texas Department of Aging and Disability Services. The goal is to implement the initiative by Sept. 1, 2014.

Supporters of home care contacted by POLITICO worried that even a news story about the connection between the Community First Choice program and Obamacare would spook the Perry administration from participating.

“[I]t would be worse than a shame if Texas’s moving ahead with CFC or BIP policies — both are from the ACA — was hurt as the result of scrutiny from a press inquiry,” said one Texas-based advocate.

Added another local advocate, “I would hate for the CFC to become a political football.”

An official with a prominent national advocacy group noted that Texas isn’t the only resistant state to quietly accept some lower-profile components of the health law. Louisiana, Mississippi, Georgia, Maine and others have already been approved for 2 percentage point increases in their Medicaid fund through a little-known provisions of the health law, the advocate said.

“I think some of those [provisions] are easier because they’re not as high profile and people don’t connect home and community services with Medicaid,” according to the advocate.

There’s been a lot of other reporting on this, plus some snarky commentary. However, I don’t think anyone put it better than Ezra Klein.

Remember Peggy Noonan’s “This is the reason many people don’t like ObamaCare”? The “this” in question was the Community First Choice program, which helps Medicaid cover at-home care for the disabled rather than shunting them into institutions.

The program is so irresistible that even Texas Gov. Rick Perry is asking if his state can be part of it. And you don’t get Obamacare haters more diehard than Perry. But for that exact reason, his office is saying the program, which is literally part of the Affordable Care Act’s statute and which would cease to exist if the entire law was repealed, “has nothing to do with Obamacare.”

To be generous to both sides, Noonan didn’t seem to understand the program she was criticizing, and she relied on other people’s reporting that turned out to be wrong, or at least confused. As for Perry, he can argue that Community First Choice program isn’t related to Obamacare’s core coverage expansion, which is really what people think of when they hear the word “Obamacare”.

But the result is the same: you’ve got Noonan saying that the Community First Choice program is the reason people hate Obamacare even though she seems to want something exactly like the CFC program to exist. You’ve got Perry asking the Obama administration for $100 million from a program created as part of Obamacare even as he swears the program isn’t Obamacare.

It’s almost as if there’s much in the law that Republicans would like if only they felt able to give the legislation a chance.

Yes, well, funny how these things work. As Paul Burka likes to say, we don’t have policy in this state, we have ideology. Rick Perry has to BS about this, he has no choice. It’s hilarious hearing him brag about how he’s been making Medicaid better and didn’t need any stinking Obamacare to do it. Given his pathetic record on health care in Texas, it’s a little like the Astros bragging about having quality middle relief pitching. Honestly, I don’t know why anyone would ever believe a word Rick Perry says. But given the state of things in our great state, what’s a few more lies and denials of reality by Rick Perry if that’s what it takes to make things a little better?

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