Looks like vaccination is going away

[jonatha]

But the vast majority of counted lives that will go away are either dual-enrolled people who will be better off without the tax liability or they're not citizens at all.

Citation please.

(I am wondering if this falls under the heading of not knowing how medians work...)

 

[crazyfingers]

I'm expecting to have to pay for the covid vaccine out of pocket. Me wife 2 boys. My daughter is pregnent again. Possibly her too.

RFKjr is a dickstain

 

[Emily Lake]

Several million more who are going to be disenrolled from Medicaid aren't Americans - they're either undocumented or temporary immigrants who no longer qualify for Medicaid under the new bill.

Those people do not get Medicaid now, except for emergency services. The hospital gets the money. .4 percent of the Medicaid budget from FY 2023.

Well, no, that's not actually true.

Otherwise non-eligible non-citizens currently get coverage through Medicaid for Emergency Services, and for pregnancy and delivery, and frequently CHIP (this varies by state). Many states extend coverage exceptions for a host of people in other situations as well.

 

[Elixir]

Look, be angry about it, be pissed off at it. Just do so for real reasons, not made up ones.

But why? Why be angry? What’s the actual problem? All these “cuts” only affect cheaters, right?
Oh - ‘scuze me again - I forgot they’re not cuts, they’re increases; just, ones that now won’t happen.

 

[Emily Lake]

But the vast majority of counted lives that will go away are either dual-enrolled people who will be better off without the tax liability or they're not citizens at all.

Citation please.

(I am wondering if this falls under the heading of not knowing how medians work...)

This falls under the heading of it's my actual fucking job. My company alone, which isn't exactly big nor is it the dominant insurer in ACA in my state, has around 10,000 current overlaps that we're trying to get cleared up. If you want to know more, go read the fucking regulations instead of just demanding a citation for something that you gleefully accept without any citations if it agrees with your pre-existing bias.

People covered by Medicaid are ineligible for APTC. If they receive APTC through error or incorrect information being provided to CMS via the Exchange, they are responsible for paying that APTC back as a tax liability.

 

[Emily Lake]

Look, be angry about it, be pissed off at it. Just do so for real reasons, not made up ones.

But why? Why be angry? What’s the actual problem? All these “cuts” only affect cheaters, right?
Oh - ‘scuze me again - I forgot they’re not cuts, they’re increases; just, ones that now won’t happen.

Did you even bother to read what I wrote at all? Or are you just inclined to argue with everything I ever say no matter what?

There are many people who will be very much affected by OB3. But the magnitude is overstated, and many of those affected are supposed to be ineligible in the first place. But there are definitely many people who will no longer be able to afford ACA coverage.

Don't put words in my mouth, don't make shit up about me, and just stop being rude and antagonistic without bothering to actually read and understand things.

 

[Elixir]

But the magnitude is overstated

Really?
So you assert; without evidence.
All the available evidence indicates to me that this administration will steal anything that is not bolted down and give it to a Trump donor, and that they’re doing precisely that.
Prove me wrong.

 

[jonatha]

But the vast majority of counted lives that will go away are either dual-enrolled people who will be better off without the tax liability or they're not citizens at all.

Citation please.

(I am wondering if this falls under the heading of not knowing how medians work...)

This falls under the heading of it's my actual fucking job. My company alone, which isn't exactly big nor is it the dominant insurer in ACA in my state, has around 10,000 current overlaps that we're trying to get cleared up. If you want to know more, go read the fucking regulations instead of just demanding a citation for something that you gleefully accept without any citations if it agrees with your pre-existing bias.

People covered by Medicaid are ineligible for APTC. If they receive APTC through error or incorrect information being provided to CMS via the Exchange, they are responsible for paying that APTC back as a tax liability.

I'm not questioning your knowledge of the rules.

I'm wondering where you get the data that backs up your assertion that the majority of people who are going to lose Medicaid coverage fit into the two categories you describe.

Wikipedia says there were 85 million people on Medicaid in 2022. The Pew Research center puts the figure at 71.4 million as of January 2025. If your assertion is true, it looks like about 12%-14% of them were ineligible. That percentage strikes me on its face as unlikely.

Pew also says that in 2023 the Federal government spent $614B on Medicaid. The proposed reduction of about $88B/year is thus a decrease of 14%, which would be in line with the asserted ineligible figure.

I have not found an estimate of the number of Medicaid recipients who are ineligible (most of what Google gives me are what might be called screeds from conservative think tanks on the large percentage of ineligible recipients in Medicaid expansion states, often based on surveys of extremely small populations).

 

[Emily Lake]

Wikipedia says there were 85 million people on Medicaid in 2022. The Pew Research center puts the figure at 71.4 million as of January 2025. If your assertion is true, it looks like about 12%-14% of them were ineligible. That percentage strikes me on its face as unlikely.

You're missing a key piece of this. There were emergency rules put in place during Covid that have had some monumental impacts. The first actions were... late 2020? I don't recall exactly when. There were a lot of bits and pieces, but the biggest impacts came from two items specifically. The first was that Medicaid was told to stop doing income and asset verifications of existing enrollees - thus if someone got a job and would no longer qualify, they weren't dropped from Medicaid coverage but were allowed to continue as a Medicaid enrollee. The second was that if a person became unemployed for at least two weeks (plus or minus, but a very short period of time) they were deemed to be automatically eligible for Medicaid. The result of these two items is that a whole lot of people ended up on Medicaid, and were just left there even though they didn't meet the actual criteria for Medicaid eligibility.

The number of lives on Medicaid at the end of 2022 was massively higher than it ought to have been. Medicaid across the country has spent two years "unwinding" and clearing their logs to disenroll people who shouldn't have Medicaid coverage any more. The Pew number for 2025 is a better indicator of how many people qualify for Medicaid - that's pretty much a count shortly after all of the states are supposed to have finished the clean-up.

Pew also says that in 2023 the Federal government spent $614B on Medicaid. The proposed reduction of about $88B/year is thus a decrease of 14%, which would be in line with the asserted ineligible figure.

That Pew amount is just past the peak of enrollment generated during covid, and is inextricably wrapped up with the high volume of people covered who wouldn't meet actual eligibility requirements.

I have not found an estimate of the number of Medicaid recipients who are ineligible (most of what Google gives me are what might be called screeds from conservative think tanks on the large percentage of ineligible recipients in Medicaid expansion states, often based on surveys of extremely small populations).

I don't have specific numbers. I know it varies considerably by state - some states enforce the rules more than others, some are expansion states where others aren't. I think blatant violations are fairly low in general... but DACA might be material. You're going to get very different results in California than in Minnesota, or Florida versus North Dakota.

 

[laughing dog]

Anyone else see the thread title as "Looks Like Vacation is Going Away"? I do, every single time.

 

[Emily Lake]

Anyone else see the thread title as "Looks Like Vacation is Going Away"? I do, every single time.

I always have to re-read it.

 

[Loren Pechtel]

RFK Jr. Vows Overhaul of Lawsuit-Sparing Vaccine Injury Program

Robert F. Kennedy Jr. said he plans to make substantial changes to a federal program that compensates people who have serious side effects from vaccines

www.claimsjournal.com

What company in their right mind would make vaccines when they'll be held liable for everything that happens whether or not the vaccine caused it.

The lawyers really hate the systems that put such claims before medical panels (that understand the reality) rather than juries (that are prone to responding to the emotions.)

'The government is looking at ways to expand the VICP program “so Covid vaccine-injured people can be compensated,” Kennedy said'​

If they expand the program it would presumably reduce jury-tried lawsuits. Am I missing something?

They want to permit bogus claims.

Incidentally, the success rate for vaccine lawsuits is higher in VICP than in civil courts.

Yeah, that's what tends to happen when you apply proper scrutiny. People don't bring emotional arguments to the VICP.

 

[Loren Pechtel]

I lost you. What insurer or agency who who used to pay for their medical care is being ordered to fold up shop? If people are poor enough for Medicaid the taxpayers are ordered to pay for it. If they have insurance the insurer is ordered to pay. If they don't have insurance but aren't poor enough for Medicaid they're ordered to buy insurance (aka "individual mandate") and an insurer is ordered to sell it (another provisions of Obamacare,) If they're illegal aliens Medicaid won't cover then the emergency room they go to is ordered to pay for it. Who does that leave? Are you talking about foreign aid?

Summer child.

Many states are throwing roadblock after roadblock in the way of Medicaid. And taking a guilty until proven innocent approach--you fail to submit proof of eligibility, you're dropped. Whether you failed because the overloaded system failed to accept your documentation is irrelevant. Whether you failed because nobody had time to look at what you actually got submitted is irrelevant.

In practice the ERs aren't getting paid enough and are closing up shop. Insurance without a doctor doesn't mean much.

 

[Loren Pechtel]

If they expand the program it would presumably reduce jury-tried lawsuits. Am I missing something?

Yes, the obvious unintended consequences of this change in policy. Do you need it to be explained as to what they most likely will be?

What they most likely will be, I presume, is "Looks like vaccination is going away". What I need to be explained is the mechanism by which expanding the program will obviously have that consequence.

Permit bogus claims against the vaccine makers. Who will touch vaccines if they'll have to pay out or all the autism cases they "cause"?

Simple example: DOW Corning. Bankrupt over silicone breast implants. Except in the end they were completely exonerated by the science. Didn't matter.

 

[Elixir]

Simple example: DOW Corning. Bankrupt over silicone breast implants. Except in the end they were completely exonerated by the science. Didn't matter.

Yeah, that was a bad mistake. Ooops. Can't even blame Trump for that one. Litigiousness pre-dates The Felon. But he has raised it to an artform (The only one he knows)
Of course if you donate to his "campaign" fund(s) you can kill people left right an center and walk away unharmed. You can probably even shoot someone on fifth avenue, if it's someone Trump doesn't like.

 

[Loren Pechtel]

​

"• Medicaid and SNAP (food assistance) face steep reductions" -- not a fact. SNAP faces a reduction; how steep remains to be seen since its cost varies with the economy so much. Medicaid is not being reduced. Your "AI" is mindlessly reciting disinformation it was fed.​

I'm not going to address the AI, just the reality.

Medicaid should be expected to scale at least linearly with population and the cost of healthcare. Anything less than that is in the real world a cut.

(And, in practice, the cost should be expected to rise faster because improved medical care means some people that would have been dead end up disabled instead.)

​

"potentially causing millions to lose health insurance." -- not a fact. If millions lose health insurance it will be caused not by nonexistent cuts but by the Medicaid payments being reprioritized to different patients. Total funding increases even as some patients are turned away, because cost per patient is going up, because medical professionals keep raising their prices.​

I believe that 11 million is those that were caught between Medicaid and the ACA. The ACA has a flaw, the highest subsidy band doesn't extend down to $0 as it was expected Medicaid would be covering them. Those caught below the bottom of the band pay full price--which would be a large percentage of their income.

​

", and imposes new restrictions and paperwork requirements on Medicaid recipients, which is expected to further reduce access to these services." -- a fact not in dispute, but that's an element of the Medicaid payments being reprioritized to different patients.​

Except it's not. You're acting as if the changes are sane, but in reality it's just breaking everything they can break.

​

Your … uh … misrepresentation thst “social services have increased funding” remains BS.

I misrepresented nothing. Your hostility to zero-based-budgeting doesn't make it incorrect.

Zero based budgeting is an atrocity. Unpredictability greatly reduces the benefit.

And any service provided to the population should be expected to scale with the population.

And any spending should be expected to scale with inflation.

Hiding behind the fact that dollar numbers go up every year does little to hide the gutting of government services to pay for tax breaks for billionaires and corporations.

What they're paying for is the U.S. medical industry raising its prices faster than inflation for decades on end and gobbling up an ever-increasing fraction of total production. If you have any evidence that the money is actually being given to billionaires or to corporations in general outside the medical industry, I'm all ears.

Because the medical world is accomplishing a lot more than it used to.

Simple illustration: I recently had a kidney stone removed. Completely asymptomatic, in the old days it would not have been caught until it caused kidney damage. (A stone that is not fully occluding creates back pressure on the kidney but it causes no pain.) Modern equipment, I have no incision anywhere, just an annoying stent left behind for a few weeks to ensure no obstruction develops at the spot where it had been. In the old days it would be substantial abdominal surgery to get to it and a lot more risk from the anesthesia. Nor do I even think it would have been discovered as it is not visible on x-ray. (It was caught on a CAT done for totally unrelated reasons.)

Looking elsewhere, an example I've given before. 1925, I would be dead. 1975, I'm not sure but I think I would be dead. 2000, I would be dependent on stuff that was in chronic shortage. Alive but with malnutrition damage. 2025, what I need to stay alive is all OTC, although I need a couple of scripts to remain reasonably functional.

 

[Loren Pechtel]

The problem here is that vaccines don't hurt anyone; at best they cause much more mold versions of what happens during a normal infection.

That's not actually true. Vaccines don't cause mild versions of the actual infection. Vaccines can cause generally "flu like" symptoms, and that's true for almost all vaccines, regardless of what symptoms the actual infection causes. Vaccines prompt the body to produce antibodies for the inactive virus strains included in the vaccine - and the production of antibodies causes inflammation and soreness, and often a slight fever over a short period of time. Tetanus vaccine doesn't cause any of the symptoms of tentanus, not even mild ones - it causes generally "flu like" symptoms. Same for diphtheria, and for rubella, and for shingles. Arguably, one could say that influenza vaccines cause mild flu symptoms, but that's largely because the symptoms from influenza are almost entirely a result of antibody production in the first place .

Most vaccines do not have specific symptoms, just the general flu-like from fighting the "infection".

But we do sometimes see mild myocarditis from the Covid vaccine--which is a Covid symptom.

And dengue fever has the nasty effect of a subsequent infection being worse than the original--and the vaccine has exactly the same effect. Thus the vaccine is only given to those who have already had dengue fever.

It's also not entirely true that vaccines don't hurt anyone. They don't hurt many people, but there are people who have allergic reactions to the vaccines pretty much across the board. Additionally, people with certain types of immune system conditions shouldn't take vaccines because it can cause severe reactions in them that can lead to serious injury or death. Vaccines in general come with warnings for certain types of allergies and immunocompromising conditions. Additionally, although it's rare, there have been some few vaccines in the past that have been associated with unexpected deleterious outcomes.

Which is why the VICP exists.

 

[Emily Lake]

In practice the ERs aren't getting paid enough and are closing up shop.

Baloney.

Key Facts About Hospitals | KFF

This analysis presents key facts about hospitals with more than 40 charts related to national spending on hospital care, characteristics of the hospital industry, rural hospitals, use of hospital care, out-of-pocket spending and medical debt, hospital prices, hospital finances, and charity care.

www.kff.org

Visualizing The Top 50 Health Systems' Operating Margin Performance in 2024 - Hospitalogy

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hospitalogy.com

 

[jonatha]

From the kff page:

Operating margins were lower among hospitals in rural (nonmetropolitan) areas than hospitals in urban (metropolitan) areas (3.1% versus 5.4%, respectively). Operating margins were especially low among the nearly 1,000 hospitals in rural areas that were not micropolitan areas (1.7%) (i.e., that do not include and are not closely connected to any substantial population center).

Hospital closures outpaced openings in rural areas from 2017 to 2023. During that seven-year period, 61 hospitals closed compared to 11 that opened, a net reduction of 50 hospitals. Over the twenty-year longer period from 2005 to 2024, 193 rural hospitals closed.

 

[ZiprHead]

In my twenty plus years working in the finance department of the largest healthcare system in the region I've seen some pretty damned stupid spending. The board and top admin get free memberships and dues to the local private golf country club. Free membership and dues to the snobby private social club. Their personal tax return processing is paid for by the Hospital at over a thousand dollars a pop. Monthly (sometimes more) luncheon meetings with the board and entire management team at the before mentioned social club (meals and drinks not covered by monthly dues) that the hospital pays for even though there are very nice and large conference rooms off of both of the main campuses cafeterias. Probably more.

I was never privy enough to get the full total of all that spending but I could see it reaching probably a half million.