AHARadioShow on rumble (must be a rumble subscriber to see):

America's Healthcare Advocate on YouTube Podcast:

Play full audio podcast (above) or find it by clicking from the list below:

Spotify

iHeart

Spreaker

Soundcloud

TuneIn

Amazon

RSS

Pandora

Google

Overcast

Pocket Casts

Apple

YouTube Podcasts

Or search for "America's Healthcare Advocate" on your favorite podcast platform.

Episode 2119 Transcript:

00;00;01;01 - 00;00;09;21

Announcer

Ladies and gentlemen, this is America's Healthcare Advocate broadcasting coast to coast across the USA.

00;00;09;24 - 00;00;17;29

Caller 1

It's a pleasure to be with you. And I do have to say, you are the most knowledgeable about health policy to the this.

00;00;18;02 - 00;00;22;11

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;22;14 - 00;00;40;23

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate show, broadcasting Coast to coast across the USA here on the HIA Radio Network. You can find out more about us by going to the website, AmericasHealthcareAdvocate.com and all of these shows are posted on our 16 podcast platforms and our YouTube platform.

00;00;40;29 - 00;00;57;24

Cary Hall

You want to tell somebody about it and you don't get to listen on the air to our affiliates all over the country. You can certainly go up on the podcast or YouTube platform. If you like us, like us, and you can also follow us and you can subscribe at no cost to you. If you choose to do that, you can always get our shows.

00;00;57;27 - 00;01;16;06

Cary Hall

You know, America's Healthcare Advocate is the show where we like to say we separate fact from fiction. Well, we're going to do just that today. We're going to talk about this whole issue. The first part of the show on Medicaid, this supposed fact that 7.8 million people are going to lose their Medicaid health insurance.

00;01;16;09 - 00;01;34;26

Cary Hall

We're going to tell you who those people are and why they're going to lose it, and what the impact that that's going to be, and who's not going to lose it, because there's a lot of chatter out there about people losing their Medicaid who have dire circumstances, medical conditions, and they're going to lose their coverage. Well, we're going to separate fact from fiction.

00;01;35;03 - 00;01;52;29

Cary Hall

So this is a Multi-Topic Show today. So the first topic is going to be what's going to happen and what's happening with Medicaid after this bill gets passed and where that's going to land. All these folks that are on Medicaid now. Joining me in studio, John Stockton, a member of the Detego team from the Detego Health. Welcome back John.

00;01;53;00 - 00;01;53;24

John Stockton

Thank you., Cary.

00;01;53;26 - 00;02;00;15

Cary Hall

You’re going to be a pro at this if we keep doing these shows. Maybe I'm thinking maybe at some point he could just kind of take over and I could take more holidays. Do you think?

00;02;00;15 - 00;02;01;09

John Stockton

You're not going anywhere.

00;02;01;10 - 00;02;12;08

Cary Hall

I don't know. We might. You never know. Okay. So that's the first topic we're going to talk about. And then we're going to go into the ACA plans and we're going to talk about what's going to happen there.

00;02;12;13 - 00;02;30;09

Cary Hall

There are huge changes coming in the fourth quarter. I'm sure many you've heard Aetna has pulled completely out of the market. 1 million people are going to lose their health insurance. So we're going to talk about that okay. And how is that going to impact all of you in the marketplace. What are the solutions. We're going to give you some solutions.

00;02;30;09 - 00;02;47;25

Cary Hall

So this should be a pretty interesting show. And we may be fortunate enough, because one of our listeners reached out to me to comment on this topic about Medicaid, and I thought it might be interesting to bring her on. So we're hoping in the third segment, she's going to be available. We're going to bring her on. So let's just start out with this issue.

00;02;48;00 - 00;03;13;21

Cary Hall

7.8 million people are going to lose their coverage in 2034 by 2034. That's what they're saying. This is a scare tactic okay. And so then let's talk about who is really going to lose it and how does this break down. So out of that 7.4 excuse me. Out of that 7.8 million, 4.8 million are uninsured because they don't comply with the bills part time work requirement.

00;03;13;24 - 00;03;32;08

Cary Hall

Okay. So now think about that. All right. You have a group health insurance plan. Or if you have an individual health insurance plan you pay for that. So you have to work to be able to pay for it. Well these people don't. So they either are going to be required to work 20 hours a week, or do volunteer service for 20 hours a week.

00;03;32;15 - 00;03;57;10

Cary Hall

So this is kind of an interesting demographic, right? That that's 4.8 million of the 7.8 million people. So how does that work? Well, here's an interesting article out of the Wall Street Journal. This is a report from the American Enterprise Institute for the Medicaid recipients who did not report working. The most common activity after sleeping is watching television, playing video games.

00;03;57;16 - 00;04;26;14

Cary Hall

They spend 4.2 hours a day watching television and playing video games, or 124 hours during a 30 day period. In a healthier political culture, even Democrats would agree that men who declined to work shouldn't get free health insurance to go check out of life. The real call to duty is taking a job. So so John, I thought that defined it probably better than anything I could possibly come up with on my own.

00;04;26;14 - 00;04;45;00

Cary Hall

Especially when you're talking about the American Enterprise Institute and how this whole thing worked. And here we are, this great wailing and gnashing of teeth that we're hearing out here, unfortunately, and I don't do political on this show, okay, unless it involves health care. But the noise is coming out of the far left. It's coming from the progressive Democrats.

00;04;45;06 - 00;04;57;20

Cary Hall

It's coming from the AOC’s the Hakeem Jeffries’, the you know, Pramila Jayapal out of Washington. These are the people that are screaming and yelling. So again separate fact from fiction.

00;04;57;26 - 00;05;04;17

John Stockton

A little accountability goes a long ways doesn't it, Cary? a little fiscal responsibility perhaps that is long overdue.

00;05;04;18 - 00;05;25;12

Cary Hall

It's remarkable to me. I mean, what I can't understand is how you can stand up there with a straight face and say, 7.8 million people are going to lose their coverage. And how heartless this is. And there are people, by the way, posting on Facebook, there's a woman locally here who's been posting on Facebook. She has a daughter who has a significant illness.

00;05;25;12 - 00;05;45;05

Cary Hall

She's basically an invalid that she's going to lose her coverage. No she's not. No she's not. This does not apply to those people. I just told you who, this is one part of who it applies to. And I'm going to tell you now with the second part of it, is that it applies to. So another 1.4 million of the uninsured.

00;05;45;05 - 00;06;17;23

Cary Hall

The CBO says this is coming from CBO. This is not me or Fox News or the Epic Times or any conservative, origin out here. This is coming from the Congressional Budget Office. Another 1.4 million uninsured, CBO says, would be people who do not meet citizenship and immigration status requirements for medical enrollment. The budget letter also suggests a figure of 1.6 million who have access to other forms of care under the Obama care ACA piece.

00;06;17;23 - 00;06;45;06

Cary Hall

So let's go back to the 1.4 million. So let's just call this what it is. You have 1.4 million illegal aliens on these policies. So how does that work? Well, 60% of the Medicaid budget comes from the federal government, right. So now we'll talk. Let's use California as the example of... if we’re fortunate enough in the third segment to get this young lady on who's going to talk about real life experience, you'll understand why I'm using Cal Med.

00;06;45;08 - 00;07;07;22

Cary Hall

And I recall Lori and I are at LAX. We're getting ready to go to Hawaii, but we stay one night at the Marriott before we make the jump the next day to Hawaii. I'm sitting in the hotel room in a nice hotel looking out over the runways and everything, and I see this television commercial saying, if you're here as an undocumented immigrant, they don't use the word illegal aliens, undocumented immigrant.

00;07;07;29 - 00;07;27;24

Cary Hall

We have health insurance. They're advertising health insurance under (Cal-Med) Medi-Cal. And I call Lori into the room and say, I want you to see this this this is... I'm amazed and never in a million years would I expect that. So if you want to know why we had 20 million people flying across that border. Okay.

00;07;27;26 - 00;07;29;24

John Stockton

Free health care and five star hotels.

00;07;29;25 - 00;07;58;17

Cary Hall

Thank you. Yeah, yeah. I mean, this is like. Yeah, it's I don't care if you're a Democrat or Republican. Independent. It doesn't matter. These are facts, people okay? 1.4 million people on these Medicaid plans. I don't know how many are on Medi-Cal. I haven't looked that number up. Okay. But it's significant. And those people are the are the ones that you and I in Kansas, Missouri, anywhere across Ohio, all you people in Mississippi, Georgia, Alabama listening to this show.

00;07;58;20 - 00;08;06;02

Cary Hall

And of course, all of you in California that are federal and state tax paying federal and state taxes, this is what you're paying for.

00;08;06;05 - 00;08;15;19

John Stockton

And I would throw this under the fiscal responsibility umbrella. We can't spend 2 trillion more than we're taking it. So where do you start to cut in this. This is a no brainer.

00;08;15;21 - 00;08;35;10

Cary Hall

Yeah. And that's interesting because you used the word cuts. Those who wrap up the segment, let me just point something out here okay. Actually what's going to come out of this bill is $200 billion more. It's going to go to the needy in this country who actually have Medicaid. And it was designed to protect and help those people.

00;08;35;17 - 00;08;52;24

Cary Hall

So when you hear cuts, that's what they call cut. In reality it's 200 billion. I didn't say million. I said billion, 200 billion more that's going to flow in to Medicaid to help the people this was really designed for, John.

00;08;52;24 - 00;08;55;23

John Stockton

Yeah. Yeah. Absolutely. It's it's net net more. Yeah.

00;08;55;23 - 00;09;17;09

Cary Hall

It was never meant to be used like this okay. But you know under the Obama and under the Biden administration, that's exactly what happened. And that's why we got where we are. All right. You're listening to America's Healthcare Advocate broadcasting coast to coast across USA here on the HIA Radio Network. We're going to be right back with more on this Multi-Topic Show today.

00;09;17;09 - 00;09;46;13

Cary Hall

We're going to be switching gears here talking about ACA. And hopefully in that third segment we're going to have this young lady call in and talk about her actual experience in California with Medicaid and illegal aliens. We'll be right back. Stay tuned. You're listening to America's Healthcare Advocate coast to coast across USA.

00;09;46;16 - 00;10;14;23

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate Show, broadcasting coast to coast across USA here on the HIA Radio Network. As I always tell you, all of our shows are available on 16 different podcast platforms. You name it, we're probably on it and our own YouTube channel. Also all of our radio stations across the country. I want to give a shout out to KACI 1300 Am and 103.9 FM in Portland and The Dalles, Oregon, I want to shout out to them.

00;10;14;29 - 00;10;32;16

Cary Hall

One of our affiliates been with us for a long time, all the folks up there in Oregon. So as I said, folks, it's a Multi-Topic Show. Now we're going to talk about how Medicaid interacts with hospitals. John's going to take this piece. You know he had 25 years with Aetna in the large group field. And he really understands this piece.

00;10;32;19 - 00;10;39;13

Cary Hall

He's now part of our Detego (Health) team. But I thought it'd be a great way for you to hear the other side of this regarding hospitals, John. Yeah.

00;10;39;13 - 00;10;51;23

John Stockton

So the topic is the provider tax, which has been in the news and in the headline is that wrap your brain around this, Cary, the hospital industry is protesting a tax cut for itself.

00;10;51;26 - 00;10;59;19

Cary Hall

And did you see the other day in the halls of Congress, all the physicians lined up in the lab coats and I'm like, for real?

00;10;59;21 - 00;11;23;06

John Stockton

It so the the process and the Wall Street Journal laid out a great article on this and I'm going to steal from some of that. So think about providers pay the state. The state gets more federal money and then the state pays the provider more. And so it's a net net gain for everybody involved. So it inflates the spending. There's more federal dollars without any real state investment in Medicaid.

00;11;23;08 - 00;11;48;08

John Stockton

So Wall Street uses articles like “gimmickry”, “racket” “scam”, with this provider tax. But that's certainly not how the left is going to characterize this. But the real facts talk about, you know, it for the reference is to 2010 the prices. And in terms of what's happened with inflation. So overall inflation has gone up 48%.

00;11;48;10 - 00;11;51;14

Cary Hall

In medical costs overall okay.

00;11;51;14 - 00;12;09;28

John Stockton

So they're talking about hospitals have gone up 97%. Physicians 31%. RX 42%. So that's why they're using words like scam, gimmickry, and racket is because it's it's it's kind of laundering money.

00;12;10;00 - 00;12;21;14

Cary Hall

So I want to go back to that first part of this and break it down for the audience. So the Medicaid is here, the hospitals participating, they get paid by the state.

00;12;21;16 - 00;12;25;14

John Stockton

The providers are paying the state their provider tax.

00;12;25;18 - 00;12;27;24

Cary Hall

Right. And then that money goes to the state.

00;12;27;24 - 00;12;31;07

John Stockton

And then so the state then is getting more federal money .

00;12;31;09 - 00;12;34;25

Cary Hall

because they're matching the dollars at the 60% level.

00;12;34;25 - 00;12;59;03

John Stockton

And the dollar match is 3 to 1. Or if it's ACA, it's 9 to 1. So they're getting all these significant dollar matches from the government. So this goes back to the George H. W Bush administration crack down on it. And then the Biden administration crack down on it. And and so now it's coming back out.

00;12;59;03 - 00;13;15;09

John Stockton

And this bill is let's, let's crack down on this provider tax. And when I ask ChatGPT, okay, give me the give me the summary narrative of this is it's it's a reduction in Medicaid overspending is is how they characterize it

00;13;15;11 - 00;13;15;25

Cary Hall

ChatGPT said that.

00;13;15;26 - 00;13;43;27

John Stockton

And it encourages state fiscal responsibility. Now there's a novel thought and more transparent budgeting and prioritization. So this this whole and and even going back, Pelosi was voting for this back in the early 90s and it is still going on. So yeah. How the following the trail of money. There was a fascinating podcast from Vin Scully. Nice about how this is working, how the provider tax needs to go away.

00;13;43;27 - 00;13;45;28

John Stockton

But that's not how the left is characterizing this.

00;13;46;05 - 00;13;53;06

Cary Hall

So this whole... when you described this as money laundering. I can't think of a better way to describe it.

00;13;53;06 - 00;13;58;21

John Stockton

Why else would an industry oppose or protest a tax cut for itself?

00;13;58;26 - 00;14;28;06

Cary Hall

Because they're taking that money, inflating it so that, so that then the state gets a larger piece of the pie from the federal government. Remember what I said in the first segment? 60% of the Medicaid contribution and budget is paid by the federal government. So all these states where this is going on. Yeah. Which is across the country, I'm quite sure, okay, that they're getting that's pumping more money out of the federal system into this system that goes back to the hospitals.

00;14;28;08 - 00;14;51;22

John Stockton

Yeah. And the headline from Wall Street is a great Medicaid hospital scam. But what's interesting, a question to ask. This goes back to 1991. Pelosi and Schumer voted bipartisan legislation to crack down on this scheme. And here we are in 2025, still talking 30 some years later, talking about it and why we're spending far more than any other of our peer countries on health care.

00;14;51;24 - 00;14;59;01

Cary Hall

So to that point, okay, we spend, what, 80% more than any other any of the European countries?

00;14;59;03 - 00;15;09;08

John Stockton

Yeah, that might be a little much because we're spending 5 trillion and 25% of that is waste. If we took care of our waste, we could pay off the interest on our national debt.

00;15;09;10 - 00;15;33;07

Cary Hall

You know, you see how this all comes together and you see how it's being distorted. Okay. And and you see, this is why hospitals have these huge lobbying firms to work with them. This is why you see physicians showing up in the halls of Congress when this legislation is being voted on, dressed in their lab coats. Okay. It absolutely makes no sense.

00;15;33;09 - 00;15;47;17

John Stockton

Yeah. And it eliminates all, fiscal responsibility by the states. So they've got no skin in the game because they're just getting this, these dollars back from the government and spending it. And there's no fiscal discipline.

00;15;47;19 - 00;16;10;09

Cary Hall

You know. And the sad part is, and by the way, this was Josh Hawley and a number of other Republicans to their credit, Lisa Murkowski. I'm not a particular fan, but I give her credit forced the action in this bill, this being passed to up the amount of money's going to the rural hospitals, because the real use that the biggest use of Medicaid.

00;16;10;15 - 00;16;30;28

Cary Hall

Yes, it's in the inner cities as well. But in the rural communities where people are below the poverty level, this makes a huge difference. And those hospitals that are trying to treat these people, that's targeting money to them so they can continue to do this and maybe raise that level of treatment. Because here's the dirty little secret about Medicaid.

00;16;31;00 - 00;16;35;22

Cary Hall

You may get a medicaid plan, find a doctor that'll take you. Right. Yeah. Talk about that for.

00;16;35;24 - 00;16;50;06

John Stockton

Yeah. No, it it creates, massive access issues. And there's a lot of cost shifting going on with clinicians. They don't want Medicaid. A lot of times they don't want Medicare. They want a cost shift to the private sector, to the the BUCA members, the Blue Cross United Cigna Aetna members.

00;16;50;07 - 00;17;05;14

Cary Hall

And that's what's happening and say, you know, and it is by the way, just so you know, this also goes on the side for dental. We had a woman who came to us through the radio show who had a horrible situation with cancer. She had gone through, and she had dental treatment paid for by Medcaid, but she couldn't find a dentist.

00;17;05;16 - 00;17;23;02

Cary Hall

Nobody wanted to treat her. We were able to find somebody and able to make it happen. But this is the problem with, you know, when when you talk about government getting into health insurance, all of the people out there, they're crying for, we need Medicare for all. Take a look at what's going on right here. Take a look at this program.

00;17;23;07 - 00;17;40;25

Cary Hall

Take a look at the VA program. I know about the VA program from a personal level. Okay. Take a look at that program. Look at the waste and the fraud and the abuse and, you know, some upcoming shows. We're going to get really into that topic and show you some of the numbers on waste, fraud and abuse in Medicare, Social Security.

00;17;40;29 - 00;18;01;10

Cary Hall

Right to the whole story and explain to you how this all works. I think you're going to find it very interesting. This is what I mean when I say Separating Fact from Fiction. Okay? That's why John's in here today. So we can do some of that Separating Fact from Fiction and actually bring you the truth about what's really going on in the health care markets and the world of government health insurance.

00;18;01;10 - 00;18;24;25

Cary Hall

We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA radio network. Coast to coast across USA. Stay right there. We've got more coming up in the next segment.

00;18;24;27 - 00;18;46;00

Cary Hall

Welcome back to America's Healthcare Advocate Show, broadcasting coast to coast across the USA here on the HIA Radio Network. You can find out more about us by going to the website AmericasHealthcareAdvocate.com. All the shows complements of Mr. Dave Thiessen are put on all of our podcast platforms and our YouTube platform. We had about 497,000 views.

00;18;46;00 - 00;19;03;24

Cary Hall

The last time was about it, right? Yeah, about 497,000 views accumulated on our YouTube. So we've got a lot of people watching what we're doing, which is why we do this in-studio. By the way, I'm wearing a shirt with a bunny on the top up here. Please don't send me emails. Ask me why I'm wearing a shirt with the Playboy bunny.

00;19;04;01 - 00;19;26;01

Cary Hall

That's a psycho bunny. It's a whole different clothes line called Psycho Bunny. So I just want to make sure know I don't get emails. Well, why are you wearing t shirt with the Playboy bunny? It's not a Playboy bunny. It's a psycho bunny. Great clothing line, by the way if you haven’t taken a look at it. I had to get that in, John, because I know somebody is going to see that on camera, not see the, you know, the the logo clothing.

00;19;26;01 - 00;19;53;22

Cary Hall

Go, what, what what is he doing every time in Playboy? Okay. So we're going to talk about ACA. Now we're going to change gears. And the reason why this is important. And I've been seeing this develop over probably the last six months. Would you say that's about right? Yes, yes. There are big changes coming in the marketplace. Well, here's the first big change: Aetna’s gone. 1 million people are without ACA as of January 1st (2026) from Aetna.

00;19;53;28 - 00;20;14;12

Cary Hall

They lost too much money. They couldn't sustain it. And it's gone okay. So that's going to be a huge shift in the marketplace for a million people. Here are the other things that are going to happen. This is what we are seeing as we talk to carriers, as we talk to government officials, various people that we talked to this broadcast to be able to bring you facts and information.

00;20;14;15 - 00;20;40;11

Cary Hall

So the current poverty level to qualify for one of these policies and get a subsidy up to a 100%, okay, is 400% of the poverty level that's going to be rolled back to the original area of between 150 and 200%. That in and of itself, John is going to have an enormous impact. Yeah. So you may remember that when they expanded these subsidies it was Covid.

00;20;40;13 - 00;20;42;16

Cary Hall

Remember that that got a.

00;20;42;16 - 00;20;43;11

John Stockton

Lot of free money then.

00;20;43;11 - 00;21;10;05

Cary Hall

And that's what it was. Yeah. And now it has exploded in terms of cost for the federal government on the subsidy side. This was never what this was intended to do. And I harken back to the days when this bill was passed, and I'm sitting on public television doing a two hour broadcast on Obamacare and explain, I'm the one person on this broadcast on a panel of five people who are saying, this is going to blow up, it's going to become a huge problem.

00;21;10;05 - 00;21;27;19

Cary Hall

And once you put a government subsidy in place, you'll never be able to pull it back to a point where it makes sense. Okay. And I remember Barney Frank saying, we're knocking on the door now to go to Medicare for all, and then we're going to kick the door in. So this is what this is what's always been the design with this plan.

00;21;27;21 - 00;21;50;25

Cary Hall

Do they do a lot of good? Does it help a lot of people? Yes. Is there a need for it? Yes. And, but it's for the people that it was designed for. For people who don't make the kind of income to be able to afford a health insurance policy without a subsidy. The problem is because of the subsidies, this thing has ballooned so that if you don't get a subsidy.

00;21;50;26 - 00;22;19;17

Cary Hall

Now, I'm going to give you two examples. 52 year old realtor with one child costs $3,100 a month. Lives here in Overland Park, $3,100 a month. Enrolled in a Detego plan called Gig Care for 1099 workers. Okay, he cut that cost to $1,400 a month. Auctioneer Western Missouri paying $2,400 a month. 51 years old. Him and his wife for an HSA with the $5,000 deductible.

00;22;19;20 - 00;22;46;23

Cary Hall

He moved out of that plan onto a Gig Care plan. He's paying $1,200 a month. Okay, well, we're not giving out subsidies. Detego, of which I am a partner, and John works for. We don't have subsidies on our policies. You buy policy, you buy a policy like it was in the old days. What's happened is these subsidies, if you're not getting a subsidy, have driven the prices up so the people who aren't get a subsidy, literally cannot afford to do this or it's costing them an arm and a leg.

00;22;46;23 - 00;22;47;29

Cary Hall

And that's the first part of the problem.

00;22;47;29 - 00;23;11;19

John Stockton

Yeah. And I think the point, Cary, when you go from 400% down to 150 to 200%, you're talking about 4.2 million Americans, right. And so then you have to ask yourself, those are the people losing subsidies. So who stays on? And what happens to the risk pool within the ACA. And that's why you're seeing for the people losing subsidies, premium increases projected as high as 75%.

00;23;11;22 - 00;23;21;15

John Stockton

So who's going to continue to pay that 75%? It's the sickest of the sick. And that's what we call a death spiral as it relates to what's going to happen with the ACA.

00;23;21;17 - 00;23;42;24

Cary Hall

So it's not a pretty picture what's coming in the fourth quarter. So premium increases. You know I'm hearing between 25 and 30%. said John said they could go as high as 75%. If you take the healthy people off the plan, obviously you increase the cost of the plan, that's what you're saying. Yeah. And then either the subsidy gets bigger, okay.

00;23;42;24 - 00;24;09;09

Cary Hall

Or like in the case of Aetna who lost billions of dollars on this thing. And they are one of the first people in the market they pull out. Well let's talk about UnitedHealthCare for a minute. They're under investigation by the Department of Justice. Under a federal investigation, they've got significant problems. They they've lost themselves on the on the Medicare Advantage plans, of which they're partnered, you know, with different organizations.

00;24;09;12 - 00;24;38;25

Cary Hall

And so, you know, there's a huge market shift that's coming. So the premium increases 25 to 30%. I'm hearing projections from the carriers that are still in the market of a loss of 25 to 30% of enrollees. Yeah. Okay. And then and and so, you know, here's some other things are going to happen. So under the expanded policy where you were getting 400% of poverty level and these big subsidies, you were allowed to do what was called self-affirmation.

00;24;38;27 - 00;24;59;28

Cary Hall

So you call it or you go on the government website and you get one of the ‘navigators’ or the ‘sisters’, if you're using the government website and you say the, well, what's your income? I make 60,000 a year. You arn’t being asked to show your tax return. You just said, I make 60,000 a year. Well, if you got a subsidy and you're really making 120,000 a year, what happens?

00;25;00;07 - 00;25;13;20

Cary Hall

You're getting a subsidy for something you shouldn't be getting. That's over. You will now be required to present a tax return to show what your actual income is. That's what's going to happen. So there's a whole other group of people. Okay. Yeah.

00;25;13;21 - 00;25;18;22

John Stockton

And those people on subsidies were used to auto re enrollment and that's all going away okay.

00;25;18;22 - 00;25;20;07

Cary Hall

Talk about that a minute.

00;25;20;09 - 00;25;37;04

John Stockton

So the subsidies were automatically renewed. And so the auto enrollment must be fully verified first. So it gets back to the IRS documentation. So it's it's not just going to be because I told you so. You're going to have to document it with your with your tax returns.

00;25;37;06 - 00;25;55;08

Cary Hall

Yeah. So you see what's happening here. There's a huge shift coming in this marketplace. The other part is from the carrier standpoint, let's talk about Narrow Networks. Explain what a narrow network is, and what we're going to see with more narrow networks. And I've already heard this from two carriers.

00;25;55;08 - 00;26;20;12

John Stockton

Yeah. Yeah. Well everybody loves a broad network. Everybody wants everybody in the network. But not all providers are treated equally. And I think the marketplace will evolve to where there's a lot more focus on quality and efficiency. And in doing narrow networks, providers or carriers start to carve their narrow networks to where it might be a third to a half of a very broad network.

00;26;20;14 - 00;26;36;28

John Stockton

So for the for the patient or for the member listening, it translates to less choice. You got to be much more of a consumer when you're choosing your provider and know that the carriers are focusing on the quality and efficient providers who can help drive a lower cost of care.

00;26;37;01 - 00;26;40;16

Cary Hall

And if you control access, you control cost.

00;26;40;17 - 00;26;41;04

John Stockton

That's right.

00;26;41;05 - 00;27;00;10

Cary Hall

And and what we're talking about here is controlling access. Here's the thing to think about what he just said. You're going to narrow the network, which means more people are going to be trying to access those doctors. What do you think that's going to do to weight times? Abilities to get in to see an orthopedic surgeon, to get in, to see a urologist, to get in, to see, yeah.

00;27;00;13 - 00;27;08;27

Cary Hall

You pick a doctor, you know, it doesn't matter how much of a difference and a jam up of the space is this going to do?

00;27;09;00 - 00;27;24;08

John Stockton

There's already a jam up with large, broad networks. The experience with providers in the broad networks is isn't great right now. I keep talking about this provider I've gone to for 30 years, and, and literally I get a seven minute office visit there.

00;27;24;09 - 00;27;30;16

Cary Hall

By the way, that's the average time you get with the primary care physician in the United States of America. Seven minutes.

00;27;30;18 - 00;27;41;19

John Stockton

And so the hope is that we can evolve into more of a direct primary care concept in our country, which is going to enhance the quality of care you're getting with your primary care physician.

00;27;41;22 - 00;27;59;00

Cary Hall

And we're seeing that. And when I come back from the break. We’re giving you a lot of not so great news right now. Okay. Unless you consider getting 1.4 million illegal aliens off of Medicaid, positive news, which I happen to think it is, or people being required to go do a little work if they're going to get a medicaid policy.

00;27;59;06 - 00;28;18;29

Cary Hall

But this is not good news on the ACA side for a lot of people out there, and I have a lot of empathy for that. So when I come back from the break, we're going to talk about some of the things that can be done that will help people in this situation. Where can they go? What can they look for, what other kinds of opportunities are out there, and how is all that going to work in the marketplace?

00;28;18;29 - 00;28;36;25

Cary Hall

So we'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network coast to coast across the USA. We've got more. Don't go anywhere. One more segment.

00;28;36;27 - 00;28;58;20

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate Show broadcasting coast to coast across USA here on the HIA Radio Network. I always say you can listen to all these shows on our podcast and YouTube platform. Our producers in studio today Mister Dave Thiessen behind the cameras and Garner Cowdrey doing all the work here in our Cumulus studio and flagship station in Overland Park, Kansas.

00;28;58;26 - 00;29;23;10

Cary Hall

All right. We got lucky. This young lady, who is an avid listener of this broadcast, was in a casual conversation with me about the show the other day, and I talked about this topic of Medicaid and illegal aliens, and she launched into a whole tirade, basically, of her experience living in Los Angeles, dealing with this issue. She had two children and now she has four, but she had two.

00;29;23;13 - 00;29;46;04

Cary Hall

All right. And, they had to use this woman as a nanny. She was well known in the West Los Angeles area. She's an illegal alien. Okay. And I want her to explain the circumstances. And then. And then why she didn't want to become a legal resident in this country, so. Hello, young lady. Feel free to start the conversation here.

00;29;46;09 - 00;29;51;00

Cary Hall

Tell us about, you know, where you lived and then how this all evolved.

00;29;51;03 - 00;30;18;13

Caller 2

Sure. Thanks for having me today. Big fan of the show. Love everything you guys are doing and so informative. And, I'm really happy to be here and kind of tell this story, I guess. It's a very common story for people living in major metropolitan areas throughout the country, not just Los Angeles, but I think because of the unique nature of LA it’s probably, even more prevalent there than than elsewhere.

00;30;18;13 - 00;30;37;16

Caller 2

But, you know, I think everyone knows there's a shortage of good and reliable and affordable childcare in this country. Right? So a lot of times in big cities, especially parents, new parents are panicked going back to work. My husband, I are both professionals. We rely on both of our incomes, especially living in Los Angeles to afford our cost of living.

00;30;37;19 - 00;31;02;00

Caller 2

And I went back to work right at three months after having my first child, and there was really no option but to hire a full time nanny. And there's really no good way of finding a nanny aside from either paying a firm or a company thousands of dollars to bring you candidates or word of mouth. So we were fortunate to have some other people that we knew who knew of this wonderful woman recommended her to us.

00;31;02;00 - 00;31;39;10

Caller 2

We interviewed her. She instantly connected with my baby, and we hired her. It was great. But we didn't really know what we were getting into at the time. We didn't really know the racket, if that's what you want to call it. But basically, you know, we had our first daughter and then we had our second shortly thereafter, and we found ourselves paying our nanny our after tax dollars cash under the table because she demanded to be paid in cash and demanded that we not, record any of that money on our tax returns or 1099 her or W2, her or anything like that, even though my husband has his own business and we could

00;31;39;10 - 00;32;04;09

Caller 2

have done that. But, you know, that wasn't an option for her because she didn't tell me this. But I know that she wasn't reporting her income because she was taking advantage of the free services in the state of California, like Medi-Cal, Medicaid, probably food stamps, a lot of those other, you know, aid services that are available to people, including undocumented immigrants.

00;32;04;11 - 00;32;16;27

Cary Hall

We use the word here. We use the word here, illegal aliens. Feel free to be a little politically crazy. How much were you paying her by the time you got to two children and she was doing both children, what was she costing you a month?

00;32;17;00 - 00;32;34;16

Caller 2

Well, I'll tell you a funny story about how that happened. So this also also, you have to keep in mind this also went down right during the pandemic. And when LA went on lockdown, I gave birth to my second daughter in May of 2020. So we're talking about, you know, my husband and I, our careers are kind of up in the air. We’re working remotely.

00;32;34;16 - 00;32;49;09

Caller 2

We're not definitely not in a great place financially, and we still need childcare so we can continue to work. And I mean, there were no daycares open. There was nothing. And we were fortunate enough, you know, to have a nanny at that time. And she was still willing to come in and obviously take care of our kids because she needed the money, too.

00;32;49;09 - 00;33;10;15

Caller 2

But we hired her at $18 an hour, which was actually pretty, a pretty good and low rate for our area. We were very lucky. And then we had our second daughter, she demanded, and she said it was common practice for her to then be paid one half of the amount that we were paying her on top of what we were paying her.

00;33;10;15 - 00;33;29;02

Caller 2

So, for instance, we were to pay her $9 more an hour because of our second child. So now our cost would have gone from $18 to what is that, $27 an hour? We would have paid her. And we we told her, look, we simply can't afford that. You know, I was on a maternity leave at the time.

00;33;29;04 - 00;33;45;12

Caller 2

Like I said, it was the it was the pandemic, the middle of pandemic. It was the start of the pandemic. It was a lot was up in the air. So she took 21 an hour cash under the table. But there was a very firm line saying that if we weren't able to come up on that within a certain amount of time, she was going to find another job.

00;33;45;14 - 00;33;51;04

Cary Hall

So. So let me stop you right there. So what did that amount to monthly for you then? A ballpark.

00;33;51;05 - 00;33;55;06

Caller 2

It was about $5000 a month from what I remember. Five.

00;33;55;06 - 00;34;16;27

Cary Hall

Oh, I want to hold on right there. I want the audience here. It was $5,000 a month, so. And we only got about three minutes left. But I'm assuming one of the reasons you left Los Angeles and relocated was given that situation, along with state taxes, the highest taxes in the country outside of New York and the rest of it, you were never going to be able to afford a single family home.

00;34;16;27 - 00;34;20;09

Cary Hall

Have I jumping to a wrong conclusion or is that correct?

00;34;20;12 - 00;34;42;11

Caller 2

Absolutely right. I mean, we ended up moving, as you said, out of state to the small town where my husband's from in Washington. And, you know, we were able to afford a home or able to send now all four of our children to private school. Including private daycare, for less than the cost that it would have cost us for just our two children to have a nanny.

00;34;42;16 - 00;34;55;10

Caller 2

No schooling. It's to have a nanny in Los Angeles, if you were living in a two bedroom apartment in the middle of the city, whereas now we're able to own a home and all of those things. So, yeah, I mean, you're set up for failure. I have to say.

00;34;55;15 - 00;34;57;00

Cary Hall

Really, what.

00;34;57;00 - 00;35;03;06

Caller 2

What all of our friends have left, almost all of our friends who are in similar situations have since left California.

00;35;03;13 - 00;35;13;25

Cary Hall

And this is why. This is why we see a massive outmigration in California. Thank you so much for joining us today. I really, really appreciate this.

00;35;13;25 - 00;35;14;06

Caller 2

I hope its helpful.

00;35;14;06 - 00;35;29;29

Cary Hall

it's going to be very insightful for people. All right folks. So, you know, we'll get to the other news in another broadcast. But I really thought it was important for me to be able to let you hear an actual story of people who have lived through these kinds of situations.

00;35;29;29 - 00;35;53;19

Cary Hall

So back to the 1.4 million illegal aliens receiving Medicare in California. Medi-Cal. They have no incentive, John, to become United States citizens because they're going to pay FICA, FUTA. They're going to pay taxes. They're going to have to buy health insurance. This woman is making 60, $70,000 a year now, obviously not getting rich in Los Angeles.

00;35;53;19 - 00;36;18;18

Cary Hall

Both she and her husband worked. Both of them were illegal aliens. Both of them are on Medi-Cal. Cal med okay, and this is when I talk about these stories. This is what I'm talking about. So this is why I do this. You know and again, Fact Versus Fiction. This is the fact, okay? This is what people in these communities Seattle, Los Angeles, you heard this young lady other major metropolitan areas are faced with.

00;36;18;21 - 00;36;39;04

Cary Hall

And that's why California has had a massive outmigration and will continue to have that go on because the young people can't deal with this anymore and middle class families can't either. I thank you all for listening today, John. Thanks for coming in studio. Thanks to our guest who called in and now, ladies and gentlemen, I leave you with this thought from Albert Einstein, the one who follows the crowd.

00;36;39;04 - 00;36;58;21

Cary Hall

They usually get no further than the crowd. The one who walks alone is likely to find himself in places no one has ever been. Remember, friends, it's a funny thing about life. If you refuse to accept anything but the very best, you most often get it. Thank you for listening to America's Healthcare Advocate Show. Broadcasting coast to coast across the USA.

00;36;58;23 - 00;37;05;06

Cary Hall

Goodbye America.

00;37;05;09 - 00;37;10;02

Cary Hall