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Regulation and Compliance > Federal Regulation

Is Medicaid expansion PPACA blood money?

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SAN DIEGO — No matter what happens at this point with King vs. Burwell in June — which is when nearly everyone expects the Supreme Court to rule on the subsidy case — PPACA could very well work its way back there sooner rather than later.

Florida Gov. Rick Scott is suing the feds because he’s convinced they’re trying to strong-arm his state into accepting Medicaid expansion by taking away other federal funding for hospitals in lower-income areas. To be fair, I’m oversimplifying a much more complicated issue, but at its heart, Scott is upset because he’s convinced the feds are taking some federal money away because he refused to take some other federal money — because it’s PPACA blood money as far as he is concerned. (Besides, he would love to run for Senate next year.)

Jokes aside, I can see both sides to this argument. On one hand, I kinda respect Scott sticking to his guns. I’m always bagging on politicians of both parties for their chronic hypocrisy, so I have to give him credit here.

On the other hand, let’s keep in mind this is a governor who not only won re-election by less than a point-and-a-half, but whose state remains one of the country’s most dependent on Uncle Sam. If the states are this country’s children, Florida refuses to move out of his parents’ basement.

According to data gathered by WalletHub, Florida residents receive more than $4 in federal tax money for every dollar they send to DC. That’s quite a deal for a state so dead-set against federal spending.

All of which made me think of “Mad Men,” a series I’ve followed since day one, and whose conclusion is mere weeks away.

During its most recent episode, protagonist Donald Draper spent half the hour talking to various coworkers about what they want next. You know, the old five-year question. One of the partners at the ad agency confesses he wants to land a pharmaceutical company — the apparent white whale of accounts in 1970. Another colleague of his in the creative department — after admitting she wants his job — ultimately reveals that she wants to create something lasting, leave some kind legacy. Of course, that also means she wants to be famous, too.

None of these answers, of course, satisfy Draper, who’s clearly facing some existential crisis that will no doubt linger until — if not beyond — the show’s finale.

“And then?” he repeatedly prods. “What’s next?”

It made me think of us, and all of these border skirmishes over PPACA. If we win in June, what next? If we lose, what then?

Have we all become so preoccupied with this summer’s court decision, next fall’s enrollment, next year’s election, that we’ve lost sight of ourselves? Our businesses? Our clients?

Who are we working for, anyway?

And if you’ve made it this far, a couple of housekeeping notes: One, click here to take this year’s Voluntary Survey. We want to hear from all of you.

And, two, the host hotel for this year’s Benefits Selling Expo is sold out, but you can still register for the conference here. Would love to see you there.


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