He has no insurance nor can he get insurance in a non expanded state.
http://www.healthinsurance.org/texas-medicaid/
He goes to the ER. They bill him. He doesn’t pay.The hospital tries to collect.
They eventually write it off but HE STILL OWES the money. That does not go away. Maybe someday he can declare bankruptcy to eliminate the debt if he ever gets a job and starts making money.
He is not getting free care.
I guess you can’t believe that was really one of the “purposes of Obamacare”…
My brother works in a hospital and says the illegal pregnant Hispanics use their emergency room as a place to find out the sex of their babies. He says they come in complaining of stomach pain and get a free sonogram and can find out the sex of their child. Can’t deny them ER services and can’t give out polygraphs. He says they give fake names to them all the time too. Health care is going to get a lot more expensive with Obamacare, most of my friends are paying $400 more a month in premiums since it was implemented for lesser insurance. Great for the poor and expensive for everyone else.
In many states that didn’t expand Medicaid, nondisabled men are not eligible for Medicaid no matter how low their income.
I’m confused about “free” emergency room care. ERs are required to treat anyone who shows up, but not for free. They treat the person, and then they bill him. Maybe this guy can’t pay his bills, but if so he is being hounded day and night by collection agencies.
Let’s not get political, please.
I disagree with the proposal to increase tax on liquor, cigarettes, gas. Many responsible citizens who have medical coverage buy those items (like me) and there’s no reason they (I) should have to pay an increased tax to take care of the freeloaders.
Semantics. Its “free” (at no cost) to the patient until he/she pays for it. The cost may be paid for by the citizens of that county or increased rates for hospital services charged to all patients to help cover the write-offs.
Medicaid doesn’t pay for “virtually unlimited medical care”–it only pay for medically necessary medical care.
It’ll pay for cancer chemotherapy or an appendectomy or substance abuse rehab, but not dermabrasion for acne scars or a face lift.
Private doctors who treat medicaid patients are those who choose to accept the reimbursement rates offered by the state according to a payment schedule set by the state. Medicaid reimbursement may be the same (or higher or lower) than the rate for the same procedure that is set by various insurance company.
In fact, to get reduced-cost care at the hospital, you have to prove that you applied for Medicaid and were turned down. If not, you are billed at a rate that is often double the rate of the insured. It is possible to get this amount reduced to something closer to what the insurance companies and insured pay, if you know that you can negotiate and have the ability to do so. If you don’t negotiate a payment plan with the hospital and then keep up with it, you are besieged by collection agencies.
Unfortunately, many poor people don’t know this and simply pay the inflated bills over time, impoverishing themselves further.
I guess that the real deadbeats just walk away, but eventually it will catch up to them.
It is always easy to see who has always enjoyed good health insurance in these discussions…
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Medicaid doesn’t pay for “virtually unlimited medical care”–it only pay for medically necessary medical care.
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That’s not unique to Medicaid. I have very good private insurance, and it sure as heck won’t pay for cosmetic treatment. AFAIK no insurance will.
<< Semantics. Its “free” (at no cost) to the patient until he/she pays for it. <<<
Right. And since he doesn’t show any income, to him, it’s free.
I’m not sure that they understand all of this. I don’t think that they think that there is some “forever debt” out there. I think that they think that once they say, "he has no income, " even if a bill is sent or even if a collector called, their line of, “he’s unemployed,” soon stops any more pursuit of payment??? I don’t know. I will ask.
Medicaid doesn't pay for "virtually unlimited medical care"--it only pay for medically necessary medical care.>>>
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I should have been more clear. I didn’t mean cosmetic, etc. What I meant is that the woman that I know doesn’t worry about co-payments, etc, for her pain shots, etc, that “paying” people worry about.
The person who may have a $2000 deductible, and/or a 20% co-payment will weigh everything before deciding to seek treatment. Back pain? Well, can I afford the co-payment? Have I met my deductible? For the medicaid person there is no vacillation in regards to that.
It’s like my upthread mention about having the flu. I’m not going to run up a doctor or ER bill, just to “fill a little better”. The cost just isn’t worth it to me. The discomfort would have to be great (or life at risk) for me to cause a $200+ copayment for the flu (plus any Rx, or whatever).
We got into this discussion because H may need another hip replacement. He’d like to delay as much as he can. The subject of these shots (every 6 weeks??) came up. For this lady, cost is not a consideration at all. For us, shots every 6 weeks, could end up being costly. May as well get the hip replacement which is inevitable anyway.
That’s what I meant by virtually unlimited…
Agree wowm. Medicaid is not gonna pay for elective stuff like cosmetic surgery 
I’m not an expert in this at all, but did a very cursory google perusal of what happens in Alabama, and it looks similar to what I had seen for Texas. Certain hospitals offer “charity care” for the indigent, and the cost is then borne by the county (taxpayers) in which the patient resides. It does not look like these people lack care due to their ineligibility for ACA/Medicaid; rather it is the source of reimbursement that differs (federal taxpayer for ACA/Medicaid vs. the AL county taxpayer for “charity care.”)
<<< Or we could just have universal insurance <<<
I’m not totally against that…as long as everyone pays in. If not directly thru income taxes (which doesn’t capture everyone), at least thru taxes on purchases, particularly ones that aren’t necessary and are more-likely harmful to the body (cigs and booze).
If your friend is over 55 and lives in a Medicaid “clawback” state she may be shocked to realize that the government has a lien against her assets and will recover money spent on her (from age 55 until she qualifies for Medicare) from her estate after she dies.
M2CK, I’m sure it’s possible to fund it somehow. Like I said, everyone else manages to do it, and they spend far far less on health care than we do.
We went through a long period during which we had a $15,000 deductible per person, and still paid about $400 per month. We didn’t get ANY care unless it was a real emergency. Many conditions that most of you would have seen a doctor about went untreated. Eventually, when they raised the premium even higher, we gave it up entirely and were uninsured for a short time. H developed prostate cancer. Luckily for us, the Sisters of Mercy hospital decided to pay for his surgery. We didn’t qualify for Medicaid because we owned a house. Even owning a car worth more than about $2K disqualifies one from Medicaid. (Completely ignoring the fact that without a car of some kind, one simply cannot hold a job in many, many areas of the country, including ours.)
People on Medicaid may in fact experience few concerns about seeking care–I don’t know–but I do know that it is very, very difficult for an adult to GET Medicaid.
Over that period of time we probably paid over $40K in insurance premiums while getting virtually no care. We would have been better off not being insured at all and paying directly when necessary. As it is, we subsidized the health care of all of the genuinely insured people with our premiums.
You’re welcome. B-)
We were in the same boat until 2 years ago, Consolation. Huge deductibles, huge premiums, little usage because in effect we paid everything out of pocket since we never came close to meeting the deductible.
Under the new rules, I don’t know that it’s as difficult to get Medicaid as it was. My experience with the exchanges is I don’t remember being asked about assets, just income.
Now you are getting it. Everyone now has “access” to insurance, by law. This means nothing. It doesn’t mean you can afford to pay for it and still eat next month. It doesn’t mean anything made it more affordable. You will still be charged $10,000 for that test, only now they will take your “insurance” and cover $2000, and you cover the rest with your stratospheric deductible, on top of paying hundreds or thousands a month per person for premiums.
Nothing changed in the crappy economy. We still have college grads with multiple degrees waiting tables because they can’t find anything for which they are more suited. The jobs aren’t there. So much for access without means to pay for it.
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If your friend is over 55 and lives in a Medicaid “clawback” state she may be shocked to realize that the government has a lien against her assets and will recover money spent on her (from age 55 until she qualifies for Medicare) from her estate after she dies.
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she has no assets. Her home is owned by her parents, and her parents’ will is leaving the home and their assets to her brother.
I guess the parents knew that there would be a clawback, so they’re not letting their home get clawed-back. I wondered why they weren’t leaving her anything, but that must be why. Maybe there’s a family understanding that she can live there, but it will never be hers? That somehow seems to be what’s going on.
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but I do know that it is very, very difficult for an adult to GET Medicaid.
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I don’t know anything about this. She’s been labeled “disabled,” and seemed to rather easily qualify …around 1993?? When she was in her 30s. I know she told me her disability more than once, but right now, I can’t remember if she said, “anxiety” or “adhd” or ??? It wasn’t a physical disability like a heart condition or something like that.
I'm sure it's possible to fund it somehow
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as long as it’s not only funded thru income taxes, it will be more fair. Everyone needs to contribute.
It’s like K-12 education, which is typically funded thru property taxes. Even renters indirectly pay property taxes. Everyone pays something.
There are lots of us healthy people who use $0 coverage every year, yet pay more in premiums than we did before the ACA. That is the goal of the ACA: to make the healthy people pay for the sick people. No gratitude demanded.