Photograph by Amanda McCoy/Biloxi Sun Herald/MCT via Getty Images

Residents seeking medical care wait in line outside of Bethel Free Health Clinic in Biloxi, Mississippi, on March 19, 2013, in order to be one of the dozen or so that will be seen by the volunteer staff. The clinic opened following Hurricane Katrina and continues to provide services for those that are uninsured or underinsured.

Poor and elderly Mississippians on Medicaid could lose it by July, as Democrats and Republicans there play a game of chicken over expanding the insurance program under the federal health care law.

The legislature recessed in April without reauthorizing or funding the state’s Medicaid program.  The current authorization ends June 30. More than 600,000 Mississippians — one in four — is on Medicaid now. If the situation isn’t fixed, Mississippi could become the first state in more than 40 years to have no Medicaid program.

Democrats were responsible for killing the reauthorization and funding. They did it because the legislature’s Republican leadership wouldn’t allow a vote on expanding the program to more people, as allowed under the 2010 Affordable Care Act that President Barack Obama promoted, said Democratic House Leader Bobby Moak.

The authorization required a three-fifths vote, and the funding, which required a simple majority in the House, had a few Republicans who wouldn’t consider it and abstained.

Republican House Speaker Philip Gunn accused Democrats of holding the poor hostage in a battle for Medicaid expansion that Democrats can’t win: “They are playing with the lives of 600,000 Mississippians in order to put on a political show.”

“Go ahead and whip us,” said Moak. “Just give us a vote.”

No one knows what happens next.

Republican Gov. Phil Bryant has said he’ll keep the program going out of his own office, an option Democratic Attorney General Jim Hood says isn’t legal, according to Hood spokeswoman Jan Schaefer.  It would also require funding that the legislature didn’t approve.

Bryant spokesman Mick Bullock said the governor “regrets the situation Democrats have created by voting several times to withdraw funding and authorization for Mississippi’s nursing homes, hospitals and other facilities.”

He said the governor would hold a special session to resolve the matter — so that “Mississippi can continue providing services to children, pregnant women and aged, blind and disabled adults” — as soon as Democrats say they’ll vote to do that.

Moak said Republicans are as much or more to blame as Democrats, and that they voted against dozens of Democratic measures that would have continued the Medicaid program and also allowed an expansion vote.

He said Democrats will back down when they get to vote on the wider insurance program, too.

He predicted the standoff will end and no Medicaid beneficiaries will suffer. He said he’s seen similar impasses over the program before. “I’ve seen it happen several times and I haven’t seen granny kicked out of the nursing home yet.”

Original post is Mississippi’s Medicaid in Doubt by Political Capital.

Photograph by Tom Williams/CQ Roll Call/Getty Images

Rep. Michele Bachmann, R-Minn., and Sen. Amy Klobuchar, D-Minn., right, check on judges former Rep. Vin Weber, R-Minn., left, and House Chaplain Patrick Conroy during the second annual ‘hotdish’ competition in the Capitol Visitor Center, featuring casserole-like dishes from members of the Minnesota Congressional Delegation, on March 7, 2012. The dishes of Sen. Al Franken, D-Minn., and Rep. Chip Cravaack, R-Minn., tied for first place in the competition.

Can you smell what Congress is cooking?

Tater-tots and more, washed down with Jell-O.

Not to mention Rep. Michele Bachmann’s volcanic “Metro” dish with a whole can of sweet corn, or Sen. Amy Klobuchar’s hold-the-SPAM (not to be confused with e-mail) pepperoni special.

Al Franken, the Democratic senator from Minnesota, has a well-known sense of humor harking to his SNL days. (And who can forget his 2006 pre-Senate remarks about Dick Cheney shooting a hunting partner in the face?)

But who knew he also had a chef’s eye bigger than the average person’s stomach?

The Minnesota delegation’s bipartisan “Hotdish-Off” plays on a fine Minnesota tradition — the “hotdish,” usually, as it’s explained at Franken’s official Senate Web-site, a casserole that “goes real good” with Jell-O or a salad.

In the annual contest initiated by Franken two years ago, his own “Mom’s Mahnomin Madness Hotdish” tied for first place with a former congressman’s “Minnesota Wild Strata Hotdish” last year.

Klobuchar took top honors in 2011 with a “Taconite Tater-Tot Hotdish.”

In the latest dish-off, served up on April 10, Rep. Tim Walsh’s “Hermann the German Hotdish” (brats and a bottle of Schell’s beer are the keys) captured first-place, competing with Rep. Rick Nolan’s “Real Deal Danger Ranger Hotdish” (venison, presumably not roadk kill, and wild rice) and Bachmann’s “Southwest Metro Hotdish” (something to do with a can of Green Giant sweet corn and taco seasoning — not to mention two pounds of the ever-popular tater tots).

Rep. Keith Ellison weighed in with a “Juicy Lucy Hotdish” (crumbled hamburger buns, ground beef, mushrooms  and cheese),” and Rep. Betty McCollum cooked “Beef, Beer and Biscuits” in her hotdish.

And Klobuchar was back this year with her “Hormel `I Can’t Believe it’s not SPAM’ Pepperoni Pizza Hotdish”), a mix of donkey meat, hamburger and Ronzoni rotini.

As for Franken, he stuck with Willmar Stew, which he assures us goes well with a Vikings game and, as everyone should know, requires a dutch oven and two pounds of Cannelini beans soaked overnight, turkey thighs — duck or pheasant will do — pork roast plus sausage, bacon and butter and a medley of vegetables (for health) salted to taste.

All the hotdish recipes are here.

And that Cheney talk is here.

Original post is Tater Tots and Pepperoni (Hold the SPAM) — What Congress is Cooking by Political Capital.

Photograph by Brendan Hoffman/Getty Images

Stickers in English and Spanish are available for voters at the Martin Luther King, Jr. Memorial Library on November 6, 2012 in Washington, DC.

President Barack Obama has taken at least one good page from George W. Bush’s book.

He knows how to go around the Washington media.

Obama, however, has taken it a step further.

He knows how to go around the English-speaking media.

At 2:25 and 2:40 pm EDT today, the president will sit for back-to-back interviews in the Blue Room of the White House first with Univision and then with Telemundo — the leading Spanish-language television networks.

This is the president who won 71 percent of the Hispanic vote in November, and who is pressing for a comprehensive overhaul of the nation’s immigration laws.

It isn’t only immigration, however, that appeals to the Spanish-speaking electorate. It’s also health care — as Jim Messina, Obama’s 2012 campaign manager and now chairman of the Organizing for Action not-for-profit that is carrying on the work of advancing the president’s agenda in his second term, noted in a lunch with reporters and editors at Bloomberg’s Washington bureau yesterday. The campaign’s Spanish-language ads played heavily on the president’s health care reforms, Messina noted.

Yes, Obama’s agenda centers for the moment on immigration reform, but it also centered, in term one, on health care — offering coverage for tens of millions of uninsured Americans.

As Congress prepares to debate immigration, once again, the White House is taking the issues that play well in the Hispanic community directly to the community, around the filter of the national media, or, in this case, the English-speakng media.

His predecessor often called on the regional or local press to press his case.

And it’s not as if these are rare sessions, these presentations of Obama en espanol:

Pres Obama last gave interviews to Univision and Telemundo at the start of his 2nd Term on Jan 30th.

— Mark Knoller (@markknoller) March 26, 2013

Original post is Obama: ‘Sí, se Puede’ Communicate by Political Capital.

Photograph by David McNew/Getty Images

The industry today is holding the first-ever conference on covering so-called “dual eligibles”, people who are both old enough to qualify for Medicare,
and poor enough to be put on Medicaid. Photograph by David McNew / Getty Images

As at least 24 U.S. states prepare to move their oldest and sickest citizens from the government’s Medicare and Medicaid health programs into managed-care plans, insurers are figuring out the best way to profit.

The industry today is holding the first-ever conference on covering so-called dual eligibles, people who are both old enough to qualify for Medicare, and poor enough to be put on Medicaid. Such residents tend to cost states more money because the combination of their ages and economic statuses often translates into more complicated and expensive health ailments.

More than 9 million people are in that category, according to the nonprofit Kaiser Family Foundation, based in Menlo Park, California. While states had been hesitant to put poor elderly residents into managed-care plans out of concern for the quality of their care, recent budget constraints and rising health costs have left them searching for a better solution.

While dual-eligibles comprise about 15 percent of the Medicaid population, they account for about 40 percent of the program’s spending because of complicated health problems, such as dementia, according to Kaiser.

“The innovative programs and services health plans have pioneered can help improve care for beneficiaries dually eligible for Medicare and Medicaid and help put these programs on sustainable and fiscally-responsible paths,” Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, the industry’s Washington-based lobby group, said in an e-mail.

He said the summit, which his group organized, “is an opportunity to showcase these initiatives.”

Twenty-four states plus Washington, D.C., enrolled at least some of their dual-eligibles in managed care as of 2010 according to data from Kaiser.

Florida was awarded a waiver last month from the U.S. Health and Human Services Department to put almost all of its Medicaid beneficiaries into managed-care plans, including people dually eligible for Medicare. California is testing the idea of managed care for dual-eligibles this year, according to Bloomberg Industries.

Original post is Insurers Set Eyes on States’ Oldest, Sickest by Political Capital.

Photograph by Chip Somodevilla/Getty Images

Texas Governor Rick Perry says his first priority as president would be to do away with the new health care law while being interviewed by Google Soapbox at the Iowa State Fair pin this August 15, 2011 file photo in Iowa.

Updated at 3:30 pm EDT

What don’t Rick Perry and Mitt Romney have in common?

Health insurance for their fellow home states’ residents.

It was Perry, the Texas governor who also sought the Republican Party’s presidential nomination last year, who announced last summer that he would reject the health-care exchanges and Medicaid expansion included in President Barack Obama’s Affordable Care Act.

“The bottom line here is that Medicaid is a failed program,” Perry said in an appearance on Fox News. “To expand this program is not unlike adding a thousand people to the Titanic.”

Yet look what else is sinking:

For the fifth year in a row, Texas ranks No. 1 in Americans lacking health insurance, according to a Gallup-Healthways survey.

More than a quarter of adult Texans — 28.8 percent — lacked coverage in 2012, the highest rate for any state since the survey started in January 2008.

Massachusetts, it goes to figure, has the lowest rate, at 4.5 percent — thanks to another former governor, Romney, who once advocated a mandate there that became less appealing to him in the 2012 presidential election contest.

Nationwide, an average of 16.9 percent of all adults lacked coverage.

While Perry holds out against the Medicaid expansion, other Republican governors — including Florida’s Rick Scott — have started reassessing their opposition to the provision of “Obama-care” that offers states expanded funding and coverage for more people. The Florida Legislature, however, appears to want none of it today.

In Florida, 22.8 percent of all adults were uninsured for health care.

Gallup’s Elizabeth Mendes reports: “Uninsured rates in about half the U.S. remained higher in 2012 than in 2008. Just four states, though, show year-over-year increases every year since 2008 — Rhode Island, New Jersey, California, and New York. And Texas — the state with the highest adult uninsured rate in the country for five years in a row — continues to widen the gap between it and the state with the second-highest uninsured rate in the U.S.”

Results are based on telephone interviews conducted as part of the Gallup-Healthways Well-Being Index survey throughout 2012, with a random sample of 353,564 adults and a possible margin of error of 1 percentage point.

Original post is Perry’s Titanic Texas: Health Insurance by Political Capital.

Photograph by Andrew Harrer/Bloomberg

Representative Paul Ryan, a Republican from Wisconsin, speaks during a news conference following a vote at the U.S. Capitol on Jan. 23, 2013.

Paul Ryan is getting ready to release another budget.

Like the first one the House Budget chairman introduced two years ago, it will contain a provision to move people from Medicare to a voucher for private health care, starting with those who are younger than 55 today.

Bloomberg’s Brian Faler reports today that Ryan’s plan “will reach the politically important milestone of erasing the government’s deficit.”

“The plan, which aides say will be unveiled March 12, will show how Republicans would eliminate the budget shortfall by 2023, when it is projected to total $978 billion. That’s far more ambitious than previous iterations of Ryan’s tax-and-spending plans, the last of which wouldn’t have balanced the government’s books until 2040.”

The additional cuts that would be needed are “modest,” he said today in a meeting with reporters.

“You won’t see big surprises in our budget,” said Ryan, a Wisconsin Republican who served as Mitt Romney’s running mate in the 2012 presidential election. “We can show the country that this is an achievable goal, a goal that we all ought to share, a goal that helps us prevent a debt crisis, a goal that helps our economy.”

The Pew Research Center reminds us of something else today:

Ryan’s Medicare plan, surveyed during the midst of that 2012 campaign, had an approval rating of 34 percent.

Paul Ryan saying new budget plan will have only ‘modest’ changes. Last year, just 34% favored his Medicare proposal.pewrsr.ch/Nezm3z

— Carroll Doherty (@CarrollDoherty) March 6, 2013

Original post is Paul Ryan’s 34% Medicare Plan by Political Capital.

Photograph by Timothy A. Clary/AFP via Getty Images

Women in New York City.

One third of the people in West Virginia are fat.

It’s the most obese state of all, by the measure of the Gallup organization and Healthways.

Coloradans are the least likely in the nation to be obese — theirs is the only state where fewer than 20 percent of adults are obese.

West Virginia, ranked for the third year running with the highest obesity rate,  33.5 percent, has slimmed down somewhat — down from 35.3 percent obese in 2012.

Seven of the top-10 states are Southern. Eight are politically “red.”

All of the 10 leanest states are Northern or Western. Seven are politically “blue.”

New Jersey is among the 10 least obese states — just noting this, in light of former Florida Gov. Jeb Bush’s remark on MSNBC’s “Morning Joe” this week that he feels “svelte” in comparison with New Jersey Gov. Chris Christie. Florida ranks somewhere in the middle.

The national obesity rate remained steady at 26.2 percent in 2012, compared with 26.1 percent in 2011, but is still higher than the 2008 average of 25.5 percent, according to data collected by the Gallup-Healthways Well-Being Index, with respondents self-reporting their  height and weight, in turn used to calculate Body Mass Index (BMI) scores. Americans with a BMI of 30 or higher are classified as obese. Gallup and Healthways have been tracking Americans’ weight situation daily since January 2008.

Before one wonders if the possible margin of error is a few pizzas, it turns out that this is a pretty big survey: The results come from a random sample of 353,564 adults conducted throughout 2012. The possible margin of error is plus or minus 1 percent.

Original post is National Obesity Index: 26.2% by Political Capital.

Jeb Bush, former Florida governor. Photography by William Thomas Cain / Getty Images

Former Florida Gov. Jeb Bush, visiting the Texas legislature, said that sharing his thoughts on Medicaid expansion might raise some hackles back home.

It also might cause him trouble at Tenet Healthcare Corp., whose Chief Executive Officer Trevor Fetter told Bloomberg News yesterday that all Republican governors would eventually expand their programs under President Barack Obama’s 2010 Affordable Care Act.

Bush is a director at Tenet, which is based in Dallas.

Asked to discuss his opposition to expanding Medicaid at a press conference in Austin, Bush said: “No. I just don’t want to get in trouble back home.” Earlier he testified on education reform at a Texas Senate committee hearing.

Florida Gov. Rick Scott, a Republican, last week said he would approve the Medicaid expansion, joining 24 other states participating in the health program for the poor. Fourteen other Republican governors remain opposed, including Rick Perry of Texas, according to a tally by Advisory Board Co., a technology consulting company based in Washington.

Asked about his interest in running for president in 2016, Bush said it’s too early for him to consider the matter.

Original post is Jeb Bush on Medicaid: ‘Trouble Back Home’ by Political Capital.

Photograph by Manuel Balce Ceneta/AP Photo

Chris Christie, Oz, Utah Gov. Gary Herbert, and Maryland Gov. Martin O’Malley, at the conclusion of the closing session of the National Governors Association 2013 Winter Meeting in Washington, on Feb. 25, 2013.

As the star of “The Dr. Oz Show” delivered a half-hour speech today to a majority of the nation’s governors, seated a few feet to his left was his No. 1 pupil: New Jersey Gov. Chris Christie.

Well, the potential 2016 presidential candidate was either taking copious notes on Dr. Mehmet Oz’s tips for a healthly heart or not paying attention at all. He looked up only occasionally from his pen and paper as Oz urged governors to carry nuts in their pocket (to avoid hunger pains that lead to gorging) and have more sex (presumably with their spouses).

Christie, 50, ignored a reporter’s questions after Oz’s speech, delivered to the National Governors Association winter meeting in Washington D.C.

Christie’s health made headlines this month when he called a former White House physician who said he was dangerously overweight a “hack” and said she should “shut up” unless she examines him. The doctor, Connie Mariano, said Christie phoned her to yell at her after she said on CNN that Christie “may have a heart attack.”

Original post is Dr. Oz’s Pocket Nuts: Christie Noting? by Political Capital.

Photograph by Bill Clark/CQ Roll Call/Getty Images

Del. Eleanor Holmes Norton during the news conference in this file photo.

A family that wants to leave the tony Washington, D.C., neighborhood of Spring Valley because of concerns over the area being a former dumping ground for military munitions is getting some help from Delegate Eleanor Holmes Norton.

The District of Columbia’s non-voting representative in the House wrote a letter today to the Army Corps of Engineers, urging it to temporarily relocate Rogerio Zandamela and his family, including two children ages 1 and 5.

They live across the street from a property on Glenbrook Road, where the Army has already demolished a home and removed some of the 500 munitions, 400 pounds of laboratory glassware and 100 tons of contaminated soil found in the area, according to Norton.

During World War I, the northwest neighborhood was part of a site used by the Army to develop and test chemical weapons such as mustard gas. Now, it’s home to multimillion-dollar residential properties and American University.

“The cost of relocating this family is small compared to the overall cost of this years-long project,” Norton, a Democrat, wrote.

The price tag for the entire remediation project, now two decades old, is about $240 million, according to Andrea Takash, a spokeswoman for the Army Corps.

It’s unclear how much it would cost to move the Zandamelas.

Original post is Norton to Army: Move Family From Dump by Political Capital.