What A Day - News Kids On The Medicaid Block Grant

Episode Date: January 31, 2020

The Trump administration unveiled a new Medicaid plan, which gives states the opportunity to convert part of the public insurance system into block grants. This so called “Healthy Adult Opportunity��� could end up reducing health care benefits.Unless the 51 GOP senators get swapped for other, better senators, today is the day that the impeachment will either draw to a close, or get pretty close to it. It was kinda fun while it lasted. We discuss some of the lowlights from the past few days of the trial. And in headlines: life expectancy goes up, Virginia gun laws, Trump’s dead bird and explosion legacy. Plus, Hysteria’s Erin Ryan fills in for Akilah!

It's Friday, January 31st. I'm Gideon Resnick. And I'm Erin Ryan, filling in for Akilah Hughes. And this is What A Day, your first and second choice in any daily news podcast caucus. And unlike the Iowa caucuses, the rules for listening to us are very simple. You just have to turn it on and listen. Sit back, relax, and pump those news tunes. On today's show, Trump rolls out a plan to cut back on Medicaid. We talk to Crooked's political director about voting, then some headlines.

But first, impeachment. Unless the 51 Republican senators get swapped out for other better senators, today is the day that the impeachment will either draw to a close or get pretty darn close to it. Senate Majority Leader Mitch McConnell believes that he has enough votes to block witnesses and documents. Senator Susan Collins says that she will vote for witnesses, but she's lonely. No other Republicans have said they will join her so far. And the other Democrats in that vote, well, at least she tried. Oh, yeah. Susan Collins is trying to get reelected. She's kind of underwater popularity wise in Maine.

And you can always count on her to do something meaningless that will benefit her. So, you know, this tracks. Yeah, it definitely seems like McConnell was like, save yourself. And, you know, this tracks. Yeah, it definitely seems like McConnell was like, save yourself and, you know, otherwise let's wrap this show up. So this likely means that the Senate will probably vote against witnesses and then vote to acquit the president

as early as today or tomorrow if it's in the wee hours of the morning, which means this is finally over, right? We can just forget about it and move on, do other stuff, go outside. Oh, Gideon, you sweet, simple rutabaga of a man. That's what I'm called. You're right that we've moved past the phase where every time we turn on NPR, we hear Alan Dershowitz just kind of doddering about. But the stench of what happened during impeachment will hover over America for quite a while, like a fart in an elevator. We learned today that unless we flip the Senate in 2020, we are ducked. Ducked?

Yeah, no, autocorrect keeps changing it in my phone when I try to text it, the real F word, and I've just decided to go with it, you know, Hakuna Matata. What were some of the more egregious things that we learned from the president's defenders throughout all this? Well, the last couple of days gave senators a chance to pass notes to Chief Justice John Roberts, who read the questions aloud like they were greeting cards and he was the guest of honor at a going away party for America. And a lot of senators showed their whole asps. Is that another autocorrect?

No, actually, that's in honor of How Much I'm Going to Miss the Good Place, which aired its last episode last night. Oh, okay. It's a really good show. Rand Paul donned the trusty old Paul family tinfoil hat and wrote down the name of the alleged whistleblower in his question. Yikes. And Justice Roberts refused to read it. Oh, moderately okay.

After that, Paul marched outside and gave a press conference where he said the whistleblower's name twice more. Yikes. Yeah, I mean, this is a thing a lot of them are doing. It's unethical, obviously, and endangers people who try to hold the government accountable as best as they can in these sorts of circumstances. And different than the way that Paul has historically behaved when there was a Democrat in the White House. I think my favorite moment from the last hours of the impeachment trial was when self-professed moderate Democrats Kyrsten Sinema and Joe Manchin joined forces

with Republicans Lisa Murkowski and Susan Collins to ask the president to nicely stop doing crimes. Will the president assure the American public that private citizens will not be directed to conduct American foreign policy or national security policy unless they have been specifically and formally designated by the president and the State Department to do so. Essentially, this question means, I mean, elephant in the room, can you just assure us that Trump won't dispatch Rudy to do foreign policy anymore? Yeah. Do you pinky promise? Do you cross your heart and hope to die, swear on the Bible, or maybe something you actually value, like this fake Time magazine with you on the cover? Looking uncomfortable, the president's lawyer gave a pretty unsatisfactory

answer. Basically that Rudy Giuliani wasn't doing foreign policy. He was getting helpful information for Trump just as his personal friend and lawyer. That's not policy, not as a policy advisor, which undermines their whole defense that Trump was doing normal president stuff for his job. Okay, boom. It's over, right? We're out of here. That's got to matter.

That's got to be the thing that changes people's minds. Nope, absolutely not. None of them give a flying duck. In fact, there was a head-exploding moment from the president's lawyer, Patrick Philbin, who explained that if Joe Biden were to be elected president, he could be impeached over Burisma. Okay. Just on and on and on. Yeah. None of the Republicans care how idiotic this all is. They don't care if it doesn't make sense. Their leader, quivering mound of wet biscuit dough, Mitch McConnell, doesn't care. But there's one group it should matter to,

and those are people with brains that they're going to use to think about who they're going to vote for in November. As President Trump's lawyer, Pat Cipollone, said, You're agreeing with Patty C? Let me finish, please. He said that because this is an election year, senators should leave the decision to remove the president to the people. Let's take him up on that. Nobody who takes their job as unseriously as President Trump or the Republicans in the Senate should be allowed to keep their jobs. Yeah, they are full of ship. Exactly. And if you're like me and you're pretty past at these ASP holds, stick around. Later in the show, we've got info on how to channel your frustration into voting all these mother duckers out. The Trump administration is proposing something called a healthy adult opportunity. We're going to get into what that is.

But first, can we reflect on the name for a second? I feel like the more positive adverbs or adjectives are in a name, the more you need to be worried that if you were to actually click on a link that had that name, you would wind up in a bathtub full of ice with no kidneys a few days later. Oh, definitely. This was one of the phrases that was sent in that MBS Jeff Bezos group chat before he got hacked. You will get hacked either literally or figuratively. Yeah. But in all seriousness, this is a new Medicaid plan unveiled by the Trump administration yesterday.

Gideon, can you tell us more about it? Yeah, so the new plan, it doesn't mention hacking, but it is effectively another effort from the administration to roll back Medicaid benefits. That's the top line on it. security. But President Trump promised not to do any of this as he campaigned for the presidency, that he was, you know, an unorthodox Republican candidate wasn't going to touch any of these benefits that people like. Here's an example of that in 2015. Save Medicare, Medicaid and Social Security without cuts. Have to do it. Get rid of the fraud, get rid of the waste and abuse, but save it. People have been paying in for years, and now many of these candidates want to cut it. Wow, a man who has

cheated on three wives and broken every promise he's ever made is breaking a promise? I mean, color me shocked. But yeah, besides the hypocrisy angle, I mean, the broader thing is what this plan is actually allowing to happen. And it involves accepting applications from states that want to set up a Medicaid block grant. Now, that has been a long-held conservative goal. In theory, it was applied for welfare benefits in the 1990s. And the result could be giving states the option of reducing health care benefits for people who gained their coverage from the Affordable Care Act. Now, once this, you know, the first state actually takes the plunge on this, it's probably going to prompt

legal challenges. So this is basically the Republican MO at this point, they're going to keep trying to give people something they don't want over and over and over again until they get it. Can you explain how this particular bad idea works? Yeah, I can. But first, I want to explain how Medicaid currently works or is funded. Historically, Medicaid has provided unlimited matching payments from the federal government to states based on what they spend providing for the poor. So states receive as much federal funding as it takes to cover 50 to 77% of the cost of the Medicaid population. That includes pregnant women, kids, the elderly, disabled.

And then for those that are covered under expansion, which is through the ACA, the federal government contributes about 90%. So under that framework, states can also choose to add additional benefits. And as enrollment rises or spending rises, naturally things that would change under these circumstances, the federal government can match the money that they are giving as those things occur. Okay, so matching. Like for every good tweet I get from a nice, hysteria listener, I get another tweet from a man who's displeased with me and by extension all women? Yeah, the duality of humanity right there in a very insular reference, but I think it works. Under this new plan, though, according to the New York Times, a state would use a formula to figure out in advance how much it plans to spend on its adult or expansion Medicaid population in a year. Then they would get a fixed federal share that is based on said formula.

Now, the problem becomes, what if more people become eligible for Medicaid because of an economic downturn or recession or something else of that sort? What happens if costs go up because some people in the state have more expensive medicine and so on and so forth? But Seema Verma, the head of Medicaid and Medicare, said that the program would, quote, allow adjustments if this is the case. But on its face, advocates think that the plan has serious issues. So they're giving states an option to participate in a program

that might result in people getting less health care. Yeah. Who's the craven puppy kicker that's going to take them up on that? The winner of that puppy kicking prize is Governor Kevin Stitt, a Republican of Oklahoma. He said that he wanted to do it and he was there for the announcement of this plan. And the interesting thing that has happened with Medicaid and typically red states recently, Oklahoma is an example, Maine, Idaho, Utah and Nebraska or others, is that ballot measures have passed with voters saying they want to expand Medicaid. Like this is a popular thing. And they see other states doing it.

And they're like, why are our leaders in the state not taking them up on it? So this new program could be a way out of that scenario for people like Stitt who don't want to follow the measure. And a block grant basically is allowing these states much more leeway on how they want to use federal dollars and who they want to give them to. So the Republican argument on all of this is, well, it'll get rid of wasteful spending. Do not worry. We're going to cut down on all of this. But what ends up happening when you create these sort of conditions for things like Medicaid is you impose burdensome requirements that could end up kicking people off. And examples of that are like the work

requirement that was in Arkansas. In places like Oklahoma, where they didn't expand Medicaid, if they take this block grant option, they actually could inevitably end up with more people covered under Medicaid, ironically, because they were starting at such a low point. And then they're going to turn around people like Stitt and say, this is a huge win for us. Look like all the people that didn't have health care are now insured. But at the end of the day, it is still less than what they would have gotten under Medicaid expansion. And the big question in all of that is how the states are actually going to end up spending these Medicaid dollars when they get them. You know, I may be a town simpleton, a feckless farmhand, a cheese-eating country mouse.

You're so negative. I've got a bad brain. But even I understand the messaging differences that could result here in an election year. Democrats like health care and want to give more of it to more people. And Republicans are saying, if you're poor, prove to me why you deserve that insulin. Yeah, that's basically it. I mean, that's in a nutshell, when you take what people have said and stack it against each other, those are the two sides of this conversation. And the block grant plan specifically was a feature of those ACA repeal efforts that failed in Congress in the beginning of the Trump

administration. So after that happens, now the administration is trying to make this happen in an executive format. And it's already getting pushback, of course, from members of Congress, like House Speaker Nancy Pelosi, for one. So yeah, in essence, what else are we supposed to surmise from these continued efforts other than that is what Republicans are trying to do? So this effort will likely face legal challenges. And we'll keep you updated on those as well as anything else the administration is doing to try and sabotage health care. It's 2020 and there are 276 days until the election on November 3rd. Not that I'm counting with a big calendar on my wall with every day X'd out in red lipstick.

Yeah, in blood. In blood, in my own blood. Mark your calendar. This election is going to be very close, much like Brad Pitt's hand and Jennifer Aniston's wrist at the SAG Awards. That's a reference you know, Gideon. That is one. I saw the pic. Everybody liked the pic. It's going to come down to each American voter, what they believe matters and what they want to do about it from now until Election Day. That's why Crooked Media is relaunching VoteSaveAmerica.com as a place for you to get information and get involved. And we've got Shaniqua McClendon, Crooked's political director here to tell us more. Hey, Shaniqua. Hey, thank you for having me. Yeah, of course. So for those

of us who don't know a ton about it, our audience might be, you know, getting keyed into this, perhaps this year. Can you give us a little bit more background on Vote Save America and what it does? Yeah, yeah. So we we relaunched Vote Save America this week. And the way we like to refer to it is just kind of it's a one-stop shop where you can get everything you need to get informed, get involved, and get out to vote. And it's a tool for anyone who cares about voting or getting involved in the upcoming election. You can literally do anything on the site. You can register to vote and even check your registration because sometimes people think they're registered and they're either registered at the wrong address

or they may have been purged from the roll. So it's good to do that. You can find out where you can volunteer with local races in the area. You can also check your ballot as we get closer to the election to see who's on your ballot and what state ballot initiatives. And you can also donate to candidates and the different causes that we'll be advocating for throughout the year. And it's not a static campaign.

It's not a website you just come to once. We'll continue to update it. And so it'll be evolving around the strategy that we've put together to elect a progressive majority up and down the ballot. The website looks great. I'm looking at it right now. It's super easy to use.

I'm on it. What do I do next? So the very first thing we want you to do is register to vote. It's on the homepage. You can check your registration again to make sure that you haven't been purged and everything is accurate. And if you're not registered to vote, you can register on the site. After that, we want your email, not to spam you. But throughout the course of the campaign, we're going to send out the most important information through the election. So registration deadlines, you know, information about election results. We have Iowa coming up on Monday. So just keeping you up to date on everything that's going on.

But we are really sensitive about this email list and we will not spam you. So that is a very good disclaimer. Yeah, because I think a lot of people's inboxes in 2020 are not at zero despite their resolution. A personal request from me from, you know, a candidate's name. Right, yes. I signed up for VSA emails last cycle and they're really selective with what they send. I've always appreciated it. It's

always informative and it's never spammy. So that's a really nice thing about it. Personal testament. Right, exactly. And so like we're talking about a lot of different races that are happening, a lot of information that people are going to want to know besides the presidential election. What races are you focusing on this year? Are you particularly interested in? I am from North Carolina. So any and everything in North Carolina, there's a governor's race.

And Governor Cooper actually won with Trump in 2016. So it was kind of a unique instance in 2016. But we also have the opportunity to flip one of the chambers in North Carolina's legislature to get rid of the crazy gerrymandering that Republicans have done. And what is very important to me, most important, not based on anything, but working for Kay Hagan, Tom Tillis is up for reelection. Nice. That is who beat Kay Hagan when I was working for her and put me out of a job. So I am looking to return the favor. But in other places, you know, Texas has the opportunity to flip their state house.

And we have races in Maine and Colorado to get rid of Susan Collins and Cory Gardner. So I'm really, I mean, obviously we want to flip the White House, but I am really interested in making sure we flip the Senate and state legislatures around the country. That's awesome. Thank you so much for being with us today. Thank you for having me. Thank you. Right. Okay.

So the website is votesaveamerica.com. Go there. Buy some stuff. Sign up. Be a voter. Save America. Wear a cool sweatshirt. Feel good about yourself.

Let's wrap up with some headlines. Virginia is taking some serious steps towards gun control. Yesterday, the state's House passed several gun control bills, including ones calling for universal background checks and red flag laws, which would temporarily take firearms away from people deemed dangerous. After a tragic mass shooting last May in Virginia Beach, Governor Ralph Northam has been pushing for stronger gun laws. Now, the new bills in the House represent some big first steps for a notoriously gun-friendly state. Even just last week, over 20,000 armed pro-gun protesters rallied

outside the Capitol. If passed by the Senate and signed by Governor Northam, this would be a huge victory for Democrats in the state, who recently took hold of both chambers earlier this month. Okay, problem. What are Virginians supposed to shoot in the air to celebrate this? Solution. Smiles? Nerf guns. Okay, problem. What are Virginians supposed to shoot in the air to celebrate this? Solutions. Smiles? Nerf guns. Ugh, that's not as fun. Good news. Life expectancy in the United States went up last year.

That's according to a new report from the Centers for Disease Control and Prevention. They point to factors including a decline in deaths from cancer and heart disease. There's also a big drop in fatal drug overdoses, which signals the potential slowdown of deaths from the opioid epidemic. Unfortunately, like most good news, there's a catch. The U.S. still has a lower life expectancy compared to many other similarly wealthy countries, despite Americans, wait for it, spending way more on health care. Oh, a headline related to a segment? Wow, who could you believe it? Health experts say our current very suboptimal primary health care system is the one to blame.

Luckily, there's a presidential election just around the corner with candidates who want to give us something better than a standard healthy adult opportunity. Don't click the link, Gideon. You will get hacked. I moved my mouse to it. You caught me. I'm not going to do it again. I promise. In their never ending pursuit of what's fair and just, the Trump administration proposed a regulation on Thursday that would make it way easier for corporations to kill birds.

Under the new law from the United States Fish and Wildlife Service, accidental bird deaths would no longer carry a legal consequence for companies. The only way they'd face a penalty is if they demonstrably went out of their way to slay fowl. That's a very medieval phrase to use for killing birds. To give you a sense of the law's real world impact, in 2010 BP faced a $100 million fine when the Deepwater Horizon spill killed hundreds of thousands of birds in the Gulf of Mexico. Under the new law, they would have gotten off scot-free unless someone could find a notebook inside the boat labeled, quote, my bird death manifesto. You will never find mine as long as you search. But that wasn't the only very sensible regulation that took a hit on Thursday. Trump's Pentagon also confirmed plans to allow use of landmines, effectively canceling a 2014 Obama policy that limited their use to the border

along North and South Korea. Huge legacy building week for Mr. Trump, whose legacy will be bird bones and random explosions. I don't like this at all. These are bad things. These are two bad things. Okay. More Trump news, sorry. The Guardian released a huge investigation of 218,100 Trump ads on Facebook on Wednesday, and the results might not surprise you. Many of Trump's ads were attacks, and when you look at the political enemies he had in his crosshairs, you really can't help but notice all the women and Jewish people. Nancy Pelosi was Trump's number one target by a long shot, followed by Chuck Schumer,

Adam Schiff, AOC, and Ilhan Omar. Almost as if Trump can rely on his supporters to react negatively to women and Jews. My brows are furrowed. Among Trump's potential election opponents, public enemy number one was Elizabeth Warren, then Biden, then Sanders. Trump spent almost $20 million on Facebook ads in 2019, which could buy Mark Zuckerberg a lot of smoked meats and might encourage you to avoid his graveyard of a social network in 2020.

Yeah, you know, as one of the shows that's hosted by a Jew and a woman, we might end up in an ad. Meme me, you cowards. And those are the headlines. That's all for today. If you like the show, make sure you subscribe, leave a review, pick us up from the Des Moines International Airport and tell your friends to listen. By the way, if you're into reading and not just the updates to any terms of service and privacy policy like me, What A Day is also a nightly newsletter. Check it out and subscribe at crooked.com slash subscribe. I'm Erin Ryan.

I'm Gideon Resnick. And thanks for giving me the healthy adult opportunity. Clicking the link, watching the fires go. What A Day is a product of Crooked Media. It's recorded and mixed by Charlotte Landis. Sonia Tun is our assistant producer. Our head writer is John Milstein, and our senior producer is Katie Long. Our theme music is by Colin Gilliard and Kshaka.