US 2024 Presidential Election

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tstorm823

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If the salaries of the US rise, it becomes more expensive to produce goods and services in the USA. So that has two knock-on effects: firstly, companies are more likely to transfer production overseas (increasing unemployment), and/or goods and services become more expensive, thereby eroding any benefit of increased wages. Whole sectors of industry could even become uncompetitive - think particularly about sectors more dependent on cheap migrant labour like agriculture. Do you let these die (and the communities based around them), or prop them up with subsidies?
Agriculture isn't going to die without migrants, the resource value is too substantial, it would likely become increasingly automated though. Construction, on the other hand, is neither going to be automated nor transferred overseas. That is the industry with the highest percentage of migrant workers in the US, one that frequently has labor unions, enviable wages, and opportunities for career advancement over time, which is deeply impacted by exploiting undocumented migrants as scabs.
Finally, it is bewildering to read a lot of right wingers talk complain about "boosting the US economy to the almost exclusive benefit of the rich and powerful". There are a whole load of tools we could readily employ to do something about that effectively, why don't you ever act on them? There's only one reason the right spurns every single one of them except anti-immigration, and that reason is dishonesty. The right couldn't give a monkey's about inequality, but it does make for a useful way to try to trick people into opposing immigration.
It's not about inequality. I don't care if there's inequality if it comes about in moral ways. But I also don't care about boosting the US economy if it's only benefitting the people who need it least. Economic growth is definitely a good thing in a vacuum, but it is not a pure virtue, an economy can grow in ways that are bad. Draining the livelihoods of millions and destroying foreign nations for the benefit of only the already well-off is not the sort of economic growth worth applauding.
 

tstorm823

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You are still arguing that if someone else fulfils the shortfall, then there wasn't a cut; like if someone steals my phone, and an insurance company is obligated to pay for a replacement, then my phone somehow wasn't taken and the thief doesn't exist.
You're trying to win an argument through pure pedantry. If the people being covered by Medicaid continue to all receive exactly the same coverage, was Medicaid cut? No, absolutely not. If a Democrat did the opposite and increased compensation 10%, well that's 10% less that the state's are paying. Was that a cut to Medicaid because the states are putting less money in? Absolutely not. Shifting the burden of the same legal entitlement to a different part of government is not the same as cutting back the entitlement.
 

Agema

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It's not about inequality. I don't care if there's inequality if it comes about in moral ways. But I also don't care about boosting the US economy if it's only benefitting the people who need it least. Economic growth is definitely a good thing in a vacuum, but it is not a pure virtue, an economy can grow in ways that are bad. Draining the livelihoods of millions and destroying foreign nations for the benefit of only the already well-off is not the sort of economic growth worth applauding.
If "It's not about inequality", why is so much of your reasoning about equality?
 

Silvanus

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You're trying to win an argument through pure pedantry. If the people being covered by Medicaid continue to all receive exactly the same coverage, was Medicaid cut? No, absolutely not.
On the contrary, pedantry is trying to reclassify a reduction of funds as not a "cut", though that's universally how the term is understood in budgetary parlance.

If a Democrat did the opposite and increased compensation 10%, well that's 10% less that the state's are paying. Was that a cut to Medicaid because the states are putting less money in? Absolutely not. Shifting the burden of the same legal entitlement to a different part of government is not the same as cutting back the entitlement.
Oddly enough, increasing funds does not qualify as a cut, no.

You keep shifting to talking about a cut to entitlement rather than a cut to funding. It is the latter. And a funding cut means that even if the provider is obligated to cover all the same functions, they're expected to do so with less external money, they'll be stretched and provision can suffer.

This is how we talk about all public works. This has always been how "cuts" are discussed. Say the government reduces the money it provides to the dept of education, but the dept of education is still expected to fulfil all the same functions-- we would say the dept of education has received a funding cut. Obviously, because that's what words mean.
 

Schadrach

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and/or goods and services become more expensive, thereby eroding any benefit of increased wages.
Isn't this word for word the argument against raising the minimum wage? Why would it not apply to min wage increase but make all the difference in the world if the wage increase was caused by less illegal economic immigration?
 

tstorm823

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If "It's not about inequality", why is so much of your reasoning about equality?
Because it isn't about equality. You don't have to care about equality to want to help the poor. I don't care about the comparison between the average person and Elon Musk, nor do I get upset if Musk gets richer. I do care if people suffer in poverty. If someone gets rich in a way that makes people suffer more poverty, I oppose that. If someone gets twice as rich as that but in a way that helps the poor, I am for that. It's not about comparative wealth.
Oddly enough, increasing funds does not qualify as a cut, no.

And a funding cut means that even if the provider is obligated to cover all the same functions, they're expected to do so with less external money, they'll be stretched and provision can suffer.
It's an increase federally, and a cut from the state, which perfectly offset each other. Overall you would call that not a cut.

The medical providers will receive the same money. That isn't being changed. Just a higher percentage for one specific group will come from the state budget rather than the federal budget.
 

Silvanus

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It's an increase federally, and a cut from the state, which perfectly offset each other. Overall you would call that not a cut.
We're talking about federal funding for a program. So yes, obviously if it goes down its a cut, and if it goes up it's not.

The medical providers will receive the same money. That isn't being changed. Just a higher percentage for one specific group will come from the state budget rather than the federal budget.
And if your stolen phone is replaced, it was never stolen.
 

tstorm823

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We're talking about federal funding for a program. So yes, obviously if it goes down its a cut, and if it goes up it's not.

And if your stolen phone is replaced, it was never stolen.
You really just don't care about effects of politics on real people, do you? It does not matter to you that this change has zero negative impact on Medicaid recipients, you only care that you can weaponize it against your enemies.
 

Trunkage

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Because it isn't about equality. You don't have to care about equality to want to help the poor. I don't care about the comparison between the average person and Elon Musk, nor do I get upset if Musk gets richer. I do care if people suffer in poverty. If someone gets rich in a way that makes people suffer more poverty, I oppose that. If someone gets twice as rich as that but in a way that helps the poor, I am for that. It's not about comparative wealth.
Do you understand that you need money to help poor people? If all the money is being sucked up by a few hundred people, there isn't money for poor people. Or middle class people

Noting how much the rich Hoover up all the available money is noting how little there is for everyone else

This is not rocket science

This is not even taking into account that you strawmanned the position that people hold

It's an increase federally, and a cut from the state, which perfectly offset each other. Overall you would call that not a cut.

The medical providers will receive the same money. That isn't being changed. Just a higher percentage for one specific group will come from the state budget rather than the federal budget.
I'm willing to wait and see. My money is that nothing or very little is going to be offset because that's the plan
 

Trunkage

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Isn't this word for word the argument against raising the minimum wage? Why would it not apply to min wage increase but make all the difference in the world if the wage increase was caused by less illegal economic immigration?
You're applying logic to the situations. This means you automatically lose for vague reasons and are clearly a bully and against Free Speech
 

tstorm823

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Do you understand that you need money to help poor people? If all the money is being sucked up by a few hundred people, there isn't money for poor people. Or middle class people
A) No, you don't specifically need money to help poor people. It certainly helps by buying the things you do need, but everything you do need can be (and often is) acquired without money.

B) The rich people don't have all the money. They own things that are highly valued. People owning Amazon stock does not take food away from the poor or money out of circulation that could buy that food. That's not how wealth works, that's not how money works.
I'm willing to wait and see. My money is that nothing or very little is going to be offset because that's the plan
That's not an option. Any repayment rate over 50% is fulfilling the base federal obligation, the states have to cover the difference, that's the law. They cannot just choose not to pay for Medicaid.
 

Eacaraxe

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...People owning Amazon stock does not take food away from the poor or money out of circulation that could buy that food. That's not how wealth works, that's not how money works...
Please, by all means tell us all how Amazon's share price got that high to begin with (hint: it has everything to do with poverty-level wages and rabidly antisocial business tactics in every possible sense, just like Walmart).

I for one, as someone who actually worked for Amazon and had (still have) friends who worked for Zappos before the acquisition, would love to hear your lukest of lukewarm takes on the subject.
 

Silvanus

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You really just don't care about effects of politics on real people, do you? It does not matter to you that this change has zero negative impact on Medicaid recipients, you only care that you can weaponize it against your enemies.
A stunning thing to say, when the primary purpose of the cut is to pressure states to withdraw healthcare coverage from migrants.

Federal funding cuts stretch services. Even if that shortfall is supposed to be made up elsewhere. States have less means at their disposal; either they will be forced to withdraw coverage from some people, or they will be forced to cut something else/ raise taxes, or the service itself will be stretched and lower in quality. That's the reality. All of which will adversely affect people.
 

tstorm823

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A stunning thing to say, when the primary purpose of the cut is to pressure states to withdraw healthcare coverage from migrants.

Federal funding cuts stretch services. Even if that shortfall is supposed to be made up elsewhere. States have less means at their disposal; either they will be forced to withdraw coverage from some people, or they will be forced to cut something else/ raise taxes, or the service itself will be stretched and lower in quality. That's the reality. All of which will adversely affect people.
Again, the third option isn't an option. They can't try to stretch the lower federal funding further, the states have to cover the difference. They are legally required to.

You are correct, the primary purpose of this is to pressure states to withdraw healthcare coverage for migrants. You may agree or disagree with that as a goal, but you can't call that a cut to Medicaid, healthcare coverage for migrants isn't Medicaid. If this policy passes and reaches the intended conclusion, there is zero change to Medicaid, it is funded in exactly the same amount with exactly the same proportions of federal funding, and those states drop their health programs for undocumented migrants, removing an incentive for people to cross the border illegally, and giving those states back a portion of budget with which they can either do more elsewhere or lower taxes. And then, ideally, most of those people losing healthcare access go back to the nations in which they are entitled to healthcare access.
 

Silvanus

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Again, the third option isn't an option. They can't try to stretch the lower federal funding further, the states have to cover the difference. They are legally required to.
Not quite: they're legally entitled to provide a certain level of coverage. There's a lot of wiggle room to how. The CBO estimates states would respond to a federal shortfall by;

1. Covering shortfall themselves;
2. Reducing payments to healthcare providers (which will result in a lowering of care quality & consistency from them);
3. Reducing provisions;
4. Reducing enrollment.

You are correct, the primary purpose of this is to pressure states to withdraw healthcare coverage for migrants. You may agree or disagree with that as a goal, but you can't call that a cut to Medicaid, healthcare coverage for migrants isn't Medicaid.
You have zero concern for how these things affect actual people, do you?
 

tstorm823

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Not quite: they're legally entitled to provide a certain level of coverage. There's a lot of wiggle room to how. The CBO estimates states would respond to a federal shortfall by;

1. Covering shortfall themselves;
2. Reducing payments to healthcare providers (which will result in a lowering of care quality & consistency from them);
3. Reducing provisions;
4. Reducing enrollment.
The CBO estimates states in aggregate, under more severe changes, and without any other option. If the federal repayment rate were to drop for expansion coverage, some states would drop the entire Medicaid expansion, they have trigger laws in place that would do it automatically. Those are not the same states as those with medical payment programs for undocumented migrants. The only one of those scenarios even slightly comparable is the first one, which is considering a change 2-4 times as severe. The CBO here was not asked to consider the option of dropping care for illegal immigrants.

And on top of the ways their conclusions are not directly applicable to this question, their conclusions aren't based on data in any meaningful way. This is another one of those "rational vs empirical" moments. The rational mind decides within itself that more federal funding would lead to better health programs. The empirical evidence does not actually support that, different states already have their own slight variations in Medicaid plans (within federal guidelines) as well as different federal reimbursement rates, there's not a simple correlation between the two, most of the most lauded plans come from states getting the statutory minimum FMAP.

California is the most obvious example here, they get the minimum 50% federal reimbursement already. This change, if they keep covering migrants, would require them to increase their state budget for Medicaid by ~3%, they already spend enormous parts of their state budget on Medicaid. Do you think that means their plan for enrollments or provisions is worse? Do you think that makes the total spent less? That's obviously not the case.

And also, the CBO is in Washington, DC, where everyone is a Democrat, even the Republicans. They're only going to say whatever Democrats already think, they don't know anyone who thinks differently.
 

Silvanus

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The CBO estimates states in aggregate, under more severe changes, and without any other option. If the federal repayment rate were to drop for expansion coverage, some states would drop the entire Medicaid expansion, they have trigger laws in place that would do it automatically. Those are not the same states as those with medical payment programs for undocumented migrants. The only one of those scenarios even slightly comparable is the first one, which is considering a change 2-4 times as severe. The CBO here was not asked to consider the option of dropping care for illegal immigrants.
Obviously it estimates states in aggregate; that's it's remit. Dropping expansion coverage would be a severe cut in eligibility, so I have no idea why you're putting this scenario forward as if it bolsters your argument rather than mine.

The first scenario is indeed directly comparable. It lays a range of rates from 50 to 77. The actual rate is... 80, down from 90.

The main point, though, is that the CBO envisions states can and would drop provisions and eligibility in the event of federal shortfall. So your confidence this could not happen is not shared by the office.... unless you think the 3pp difference between 80 and 77 completely alters all their available options.

their conclusions aren't based on data in any meaningful way. This is another one of those "rational vs empirical" moments. The rational mind decides within itself that more federal funding would lead to better health programs. The empirical evidence does not actually support that, different states already have their own slight variations in Medicaid plans (within federal guidelines) as well as different federal reimbursement rates, there's not a simple correlation between the two, most of the most lauded plans come from states getting the statutory minimum FMAP.
Why exactly should I trust you over the CBO here?

Besides, initially you were arguing that states literally couldn't drop provisions or eligibility in response to a federal shortfall. This argument-- that "rationally" they could but empirically they haven't so far-- is a substantial departure and hardly inspiring much confidence.

And also, the CBO is in Washington, DC, where everyone is a Democrat, even the Republicans. They're only going to say whatever Democrats already think, they don't know anyone who thinks differently.
:rolleyes:
 

tstorm823

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Why exactly should I trust you over the CBO here?
Because they are dumb and I am not.
Besides, initially you were arguing that states literally couldn't drop provisions or eligibility in response to a federal shortfall. This argument-- that "rationally" they could but empirically they haven't so far-- is a substantial departure and hardly inspiring much confidence.
What they can't do is not cover the difference. Whatever the shortfall between total cost and federal spending, the states have to cover it. If someone on Medicaid is treated for something and Medicaid is billed $100, and the FMAP is 90%, the federal government gives the state $90 for that treatment and the state covers the last $10. If that FMAP drops to 80%, instead DC sends $80 and the state has to cover the last $20. They have to. It has to be 100% funded, the state has to cover whatever the difference is.

If the state imagines "ok, we lost $10 of federal funding, so we'll just drop our payment rate to the doctor by that amount", it doesn't work out, cause if they charge $90, now the federal government covers $72 and the state still pays $18. The percentage is locked, they can't escape it. If they wanted to not increase state spending at all, they'd have to drop the payment to $50, at which point they doctor isn't agreeing to treat it and the state is violating federal Medicaid standards. Even if they could do that, they'd be giving up $4 of federal money into their state for every $1 saved in their coffers, some of which is gained by state taxes downstream of those federal dollars, and the state still ends up in a worse financial situation than if they just funded the extra 10% themselves.

This is a big part of why the costs of medical care in the US are so screwed up: the federal government through medicare and medicaid pays for things almost universally as a percentage of the total. They don't say "we pay X amount to treat a broken arm", rather they say "we pay X% of whatever it costs to treat a broken arm", and that situation creates financial incentives towards inefficiency. In the imaginary scenario where increased economic activity downstream of healthcare resulted in $0.11 of tax revenue for each $1 spent, a state can actually generate funds for itself long term by negotiating worse terms with healthcare providers for expansion recipients because the federal spending is worth more than the additional cost. Similarly, the ACA told healthcare companies they could only profit a certain percent, which gives them a financial incentive to increase the costs they are paying. The whole incentive structure is flipped upside-down. The economic incentive structure built by Medicare and Medicaid makes it economically detrimental to states and providers downstream to be tightly budgeted or cost efficient.
 

Silvanus

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Because they are dumb and I am not.
Perhaps unsurprisingly, I don't find this persuasive.

What they can't do is not cover the difference. Whatever the shortfall between total cost and federal spending, the states have to cover it. If someone on Medicaid is treated for something and Medicaid is billed $100, and the FMAP is 90%, the federal government gives the state $90 for that treatment and the state covers the last $10. If that FMAP drops to 80%, instead DC sends $80 and the state has to cover the last $20. They have to. It has to be 100% funded, the state has to cover whatever the difference is.
They're obligated to cover the cost, but have numerous ways of changing what the cost is. Much like how an insurer may be obligated to fully replace something, but if their budget is shitty they'll opt for a cut-price or shoddier supplier or consider something cheaper to constitute full replacement.