Originally published on Tue April 16, 2013 11:58 pm
A crowd estimated at more than 1,000 crammed into the Rotunda of the Missouri Capitol Tuesday to hear Governor Jay Nixon (D) call for expanding Medicaid to an additional 300,000 residents, nearly 260,000 of them by next year.
He told the crowd that the people he wants to add are those with low-paying jobs that don’t include health coverage.
Every Friday, KBIA's Health & Wealth Desk talks about the week's most interesting articles and reports on rural health, wealth and society issues.
'Redneck reality' and rural portrayal in cable television
Entertainment newspaper The A.V. Club muses on A&E's popular reality show Duck Dynasty, saying the show is the 21st century incarnation of old rural-themed sitcoms that once dominated network television. Think Petticoat Junction, The Beverly Hillbillies, and Hee-Haw. It's an interesting read, but we were especially interested with the author's take on ways the television shows have to negotiate the rural-urban political disparities.
While the rural-themed programming of days gone by tended to depict the small Southern town as a bucolic haven for good-hearted folk, redneck reality is more apt to acknowledge the social and economic ills of the subcultures it depicts. These shows are sanitized for the protection of viewers with blue-state sensibilities; when they occur at all, political discussions tend to center on generalized platitudes about freedom and family, rather than specifics that might turn off half the potential audience.
Did headlines about death rates at rural hospitals tell the wrong story? The Daily Yonder is killing it with their opinion pieces this week.
Case in point: A new report made headlines last week, saying death rates are rising at rural, geographically isolated hospitals. But an opinion writer for the Yonder says news reports are not telling the real story of these so-called critical access hospitals:
The patients in the small rural hospital with heart attack, heart failure or pneumonia have become a select population. A large proportion has decided that they are through paying all the human costs of the miracles of modern medicine. They have made the decision to stay in familiar surroundings near home and family.
The researchers found that 13.3% of the patients at critical access hospitals with one of the three conditions died, compared to 11.4 % of the medical center patients. Given all the terrible tools that modern medical centers have to work with, I’m amazed they only manage a small difference in patient survival over the most basic, little country hospitals in America.
In his proposed budget, President Barack Obama wants to delay cuts to federal payments to hospitals, keeping the payments intact for an extra year. That could affect the debate over expanding Medicaid in Missouri.
Through what’s called the disproportionate share hospital payments or DSH payments, the federal government gives money to hospitals that provide a lot of free care to patients who are uninsured and can’t afford services. The Affordable Care Act, though, includes significant cuts to DSH payments.
Governor Jay Nixon says he could support the House Republicans’ alternate Medicaid proposal, but only if some crucial changes are made. He met with the GOP caucus today to discuss his Medicaid expansion proposal and their plans to reform the system. Nixon told reporters that any proposal still needs to expand Medicaid to 138 percent of the federal poverty level.
Rep. Jay Barnes (R-Jefferson City) was in one of the committees that struck down Rep. Hummel's Medicaid expansion proposal. Barnes has since introduced his own version of the expansion -- outlined in House Bill 700.
The Missouri House has rejected another Democratic effort to add a Medicaid expansion to the state budget.
The House opened debate Tuesday on the state's 2014 budget by defeating an effort to send the budget back to a committee in hopes of adding more than $900 million of federal funds to expand Medicaid for low-income adults.
The defeat of Tuesday's motion was almost a foregone conclusion in the Republican-led House, because the House Budget Committee had previously rejected the Medicaid expansion.