Medicaid: Compliance with Eligibility Requirements
Finance, Subcommittee on Health Care, Medicaid: Compliance with Eligibility Requirements, October 30, 2019
An adequate income removes the incentive to cheat. We suggest a $20 per hour minimum wage for workers and stipends for students. No worker is ever kept on shift absent workload, regardless of wage. No high wage worker is allowed to go home when customers are waiting. It is why overtime pay exists. No one should have to work for nothing, to be paid with only an expanded refundable child tax credit. This will end the need for the term “working poor.”
Students from ESL to Ph.D. (regardless of migration status) who are employed will be covered by the plan that the employer participates in, or through a public option, a single-payer plan or under a subsidy to training providers under the plan that covers their workers. Medicaid or a public option will be available to anyone who falls through the cracks, even without pre-registration. The latter will be federally funded but managed by state and local case workers in governmental or charitable settings.
Medicaid compliance should not be an issue. In our proposal, Medicaid will be for those individuals who have nowhere else to go. Medicaid spending for Seniors and the disabled will be shifted to the federal government into a new Medicare Part E. This will save state budgets in the out-years (as would including base funding of pensions to Social Security, with appropriate asset transfers).
Adopting a single-payer option, particularly Medicare for All, removes the need for any compliance as to eligibility. Please see Attachment One for our previous comments on these options.
There has been discussion of a wealth tax to pay for any such plan. We believe that any such tax should be reserved for paying down the debt. Please see Attachment Two for our prior comments on why this is essential for high income taxpayers. The usual ratio of income taxes to gross debt is $6 to $9 of debt liability for every dollar if tax paid. The current ratio is $13.
Rather than a wealth tax, which is both complicated and inappropriate for funding current operations, the creation of tax prepayment bonds will quickly pay down the debt and avoid future interest costs. Adopting this solution requires achieving a balanced budget for all other expenditures.
Paying for any health insurance subsidy should be accomplished by a long-term funding stream; preferably one collected from employers. Payroll taxes for this purpose are regressive. A better tool is the subtraction value added tax laid out as part of our standard tax plan. The Subtraction Value-Added Tax (S-VAT) is an employer paid Net Business Receipts Tax. It will be used as a vehicle for tax expenditures including health care (if a private coverage option is maintained), veterans' health care for non-battlefield injuries, educational costs borne by employers in lieu of taxes as either contributors, for employee children or for workers (including ESL and remedial skills) and an expanded child tax credit.
An adequate CTC discourages abortion, and as such enactment must be scored as a must pass in voting rankings by pro-life organizations (and feminist organizations as well). An inflation adjustable credit should reflect the cost of raising a child through the completion of junior college or technical training. To assure child subsidies are distributed, S-VAT will not be border adjustable.
Employer-based taxes, such as a subtraction VAT or payroll tax, will provide an incentive to avoid health care taxation by providing such care. Employers who fund catastrophic care or operate nursing care facilities would get an even higher benefit, with the proviso that any care so provided be superior to the care available through Medicaid or Medicare for All. Making employers responsible for most costs and for all cost savings allows them to use some market power to get lower rates.
This proposal is probably the most promising way to arrest health care costs from their current upward spiral – as employers who would be financially responsible for this care through taxes would have a real incentive to limit spending in a way that individual taxpayers simply do not have the means or incentive to exercise.
Ultimately, employer taxation should be replaced with employer provided care as part of a cooperative system which has members control production, distribution finance, consumption and retirement savings. There should be many such cooperatives. A state-run entity would produce corruption.
The S-VAT can be used for personal accounts in Social Security, provided that these accounts are insured through an insurance fund for all such accounts, that accounts go toward employee-ownership rather than for a subsidy for the investment industry. Both employers and employees must consent to a shift to these accounts, which will occur if corporate democracy in existing ESOPs is given a thorough test. So far it has not.
S-VAT funded retirement accounts will be equal dollar credited for every worker. They also have the advantage of drawing on both payroll and profit, making it less regressive.
Our previous comments on how employee ownership would work is found in Attachment Three.
Cooperatives and other companies who hire their own doctors and pharmacists, whether as part of a cooperative purchase program or as an offset to a single-payer program (whether it is Single Payer Catastrophic or Medicare for All) will need no eligibility compliance function. All members will be This modality, as well as use of a subtraction VAT generally, ends the need for 1099 employment.
Attachment One - Hearing on Pathways to Universal Health Coverage, June 12, 2019
Attachment Two – The Debt, The Future is Calling: It Wants a Refund, 2019
An adequate income removes the incentive to cheat. We suggest a $20 per hour minimum wage for workers and stipends for students. No worker is ever kept on shift absent workload, regardless of wage. No high wage worker is allowed to go home when customers are waiting. It is why overtime pay exists. No one should have to work for nothing, to be paid with only an expanded refundable child tax credit. This will end the need for the term “working poor.”
Students from ESL to Ph.D. (regardless of migration status) who are employed will be covered by the plan that the employer participates in, or through a public option, a single-payer plan or under a subsidy to training providers under the plan that covers their workers. Medicaid or a public option will be available to anyone who falls through the cracks, even without pre-registration. The latter will be federally funded but managed by state and local case workers in governmental or charitable settings.
Medicaid compliance should not be an issue. In our proposal, Medicaid will be for those individuals who have nowhere else to go. Medicaid spending for Seniors and the disabled will be shifted to the federal government into a new Medicare Part E. This will save state budgets in the out-years (as would including base funding of pensions to Social Security, with appropriate asset transfers).
Adopting a single-payer option, particularly Medicare for All, removes the need for any compliance as to eligibility. Please see Attachment One for our previous comments on these options.
There has been discussion of a wealth tax to pay for any such plan. We believe that any such tax should be reserved for paying down the debt. Please see Attachment Two for our prior comments on why this is essential for high income taxpayers. The usual ratio of income taxes to gross debt is $6 to $9 of debt liability for every dollar if tax paid. The current ratio is $13.
Rather than a wealth tax, which is both complicated and inappropriate for funding current operations, the creation of tax prepayment bonds will quickly pay down the debt and avoid future interest costs. Adopting this solution requires achieving a balanced budget for all other expenditures.
Paying for any health insurance subsidy should be accomplished by a long-term funding stream; preferably one collected from employers. Payroll taxes for this purpose are regressive. A better tool is the subtraction value added tax laid out as part of our standard tax plan. The Subtraction Value-Added Tax (S-VAT) is an employer paid Net Business Receipts Tax. It will be used as a vehicle for tax expenditures including health care (if a private coverage option is maintained), veterans' health care for non-battlefield injuries, educational costs borne by employers in lieu of taxes as either contributors, for employee children or for workers (including ESL and remedial skills) and an expanded child tax credit.
An adequate CTC discourages abortion, and as such enactment must be scored as a must pass in voting rankings by pro-life organizations (and feminist organizations as well). An inflation adjustable credit should reflect the cost of raising a child through the completion of junior college or technical training. To assure child subsidies are distributed, S-VAT will not be border adjustable.
Employer-based taxes, such as a subtraction VAT or payroll tax, will provide an incentive to avoid health care taxation by providing such care. Employers who fund catastrophic care or operate nursing care facilities would get an even higher benefit, with the proviso that any care so provided be superior to the care available through Medicaid or Medicare for All. Making employers responsible for most costs and for all cost savings allows them to use some market power to get lower rates.
This proposal is probably the most promising way to arrest health care costs from their current upward spiral – as employers who would be financially responsible for this care through taxes would have a real incentive to limit spending in a way that individual taxpayers simply do not have the means or incentive to exercise.
Ultimately, employer taxation should be replaced with employer provided care as part of a cooperative system which has members control production, distribution finance, consumption and retirement savings. There should be many such cooperatives. A state-run entity would produce corruption.
The S-VAT can be used for personal accounts in Social Security, provided that these accounts are insured through an insurance fund for all such accounts, that accounts go toward employee-ownership rather than for a subsidy for the investment industry. Both employers and employees must consent to a shift to these accounts, which will occur if corporate democracy in existing ESOPs is given a thorough test. So far it has not.
S-VAT funded retirement accounts will be equal dollar credited for every worker. They also have the advantage of drawing on both payroll and profit, making it less regressive.
Our previous comments on how employee ownership would work is found in Attachment Three.
Cooperatives and other companies who hire their own doctors and pharmacists, whether as part of a cooperative purchase program or as an offset to a single-payer program (whether it is Single Payer Catastrophic or Medicare for All) will need no eligibility compliance function. All members will be This modality, as well as use of a subtraction VAT generally, ends the need for 1099 employment.
Attachment One - Hearing on Pathways to Universal Health Coverage, June 12, 2019
Attachment Two – The Debt, The Future is Calling: It Wants a Refund, 2019
Attachment Three
A. Employee-Ownership, March 7, 2019
B. Hearing on the 2016 Social Security Trustees Report
posted by Michael Bindner at 2:00 PM
0 Comments:
Post a Comment
<< Home