Word: nebraska
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...NEBRASKA...
...comes with a high opportunity cost, given the political hot spot of the moment. Say you're sitting in Belmont, Mass., or Needham, and you're watching the unions get their deal and Nebraska get its deal and everybody else get their deals. What would you say to that person, who probably voted for you because you promised change and - I was just reading David Plouffe's book [The Audacity to Win] - the emphasis on going after the special interests? But you've made deals with all the special interests to get this done. Well, I'll tell you what...
...their state's program and even more so by the process they saw going on in Washington. Rather than being drafted with the common good in mind, they said, the health bill was turning into a series of backroom deals - a Medicaid exemption for Senator Ben Nelson's Nebraska, tax breaks for unions, sweeteners for the hospital and drug industries. As a veteran of the Kennedy political operation put it, "They think there's a lot coming out of Washington - and none of it is for them...
...size-fits-all plan where the Federal Government is going to take and potentially hurt jobs, tax medical devices? We're talking about 220,000 jobs potentially being affected, cutting half a trillion from Medicare, affecting Tricare for veterans, having potentially longer lines in competing plans and subsidizing Nebraska and other types of situations. (Read "Does Brown's Senate Win Mean the End of Health Reform...
Aside from the financial feasibility of extending the Nebraska deal to all states, there could be far-reaching policy implications of such a move. In contrast to Medicare, the other massive public insurance program, which is funded and run by the Department of Health and Human Services (HHS), administration of Medicaid has historically fallen to states. This has given governors and legislatures the flexibility to structure their Medicaid programs based on their populations and budgets. States now determine who qualifies for Medicaid, what's covered by the program and how much doctors and hospitals get paid for taking care...