How Many Americans are Poor?

[Josh]

How do you figure HCAP it isn't government assistance? It is a state program run by Medicaid and funded by Medicaid through the Medicaid Disproportionate Share Hospital (DSH) Payments program.

It is effectively funded by the hospital institutions themselves. Most nonprofits “contribute” as part of the 55% of their care that’s supposed to be provided for free.

[Josh]

Interesting.
So this is something a church could do to help poor people in the US.
Help them move away from a situation that causes financial stress and burdens, and assist them for 6-12 months until they can get on their feet. And show them the love of Jesus all along the way.

Would you be ok assisting with this sort of migration?

No. I don’t think it makes sense to move people around the country for economic reasons and such changes often cause a lot of instability and disruption.

It would be worthwhile to try to plant churches where people already are, though, and see if it is possible to live by kingdom principles there. If I think I need to find some poor people to help. There are already plenty of them in Ohio. It would behoove us to first focus on our neighbour instead of finding ways to shuffle people around the country.

[Ken]

How do you figure HCAP it isn't government assistance? It is a state program run by Medicaid and funded by Medicaid through the Medicaid Disproportionate Share Hospital (DSH) Payments program.

It is effectively funded by the hospital institutions themselves. Most nonprofits “contribute” as part of the 55% of their care that’s supposed to be provided for free.

They might tell you that, but most of the cost is reimbursed by Medicaid through the Medicaid Disproportionate Share (DSH) program: https://www.medicaid.gov/medicaid/finan ... index.html

In Ohio, HCAP is actually just the Ohio version of the Medicaid DSH program. They say so right on their web site: https://ohiohospitals.org/Health-Econom ... nance/HCAP

The Medicaid Disproportionate Share Hospital program, or DSH, is a vital funding stream for hospitals that serve a high percentage of uninsured, low-income and Medicaid patients. Congress implemented this program in 1981, requiring states to take this disproportion into account when designing state payment systems. In Ohio, the DSH program is known as the Hospital Care Assurance Program, or HCAP. Payments under the HCAP program are supplemental to standard Medicaid hospital payments.

I'm not saying its not a good program. I'm just taking issue with the notion that it isn't public assistance. It clearly is.

[Josh]

How do you figure HCAP it isn't government assistance? It is a state program run by Medicaid and funded by Medicaid through the Medicaid Disproportionate Share Hospital (DSH) Payments program.

It is effectively funded by the hospital institutions themselves. Most nonprofits “contribute” as part of the 55% of their care that’s supposed to be provided for free.

They might tell you that, but most of the cost is reimbursed by Medicaid through the Medicaid Disproportionate Share (DHS) program: https://www.medicaid.gov/medicaid/finan ... index.html

I’m speaking of Ohio’s program specifically, which is not paid by Medicaid funds. Most hospital financial aid offices will try to get a patient to apply for Medicaid, but if they aren’t successful, they still have to cough up the money. The state effectively uses this as leverage to make hospitals staff departments with social workers to sign people up for various programs.

At my last hospital stay, there were 3 full time social workers on the wing of the floor I was on. My roommate’s stay was going to be eligible for hcap and they were very busy trying to convince him to cooperate with the social worker and sign up for various aid.

Back on topic. A typical plain person will try to negotiate a hospital bill and offer to pay cash. Due to large family sizes they are usually hcap eligible. Most plain people feel this is acceptable and don’t view it as “welfare” (because it isn’t - Ohio law simply requires hospitals to provide free care to people under a certain percentage of the poverty line which is based on family size).

[Ken]

It is effectively funded by the hospital institutions themselves. Most nonprofits “contribute” as part of the 55% of their care that’s supposed to be provided for free.

They might tell you that, but most of the cost is reimbursed by Medicaid through the Medicaid Disproportionate Share (DHS) program: https://www.medicaid.gov/medicaid/finan ... index.html

I’m speaking of Ohio’s program specifically, which is not paid by Medicaid funds. Most hospital financial aid offices will try to get a patient to apply for Medicaid, but if they aren’t successful, they still have to cough up the money. The state effectively uses this as leverage to make hospitals staff departments with social workers to sign people up for various programs.

At my last hospital stay, there were 3 full time social workers on the wing of the floor I was on. My roommate’s stay was going to be eligible for hcap and they were very busy trying to convince him to cooperate with the social worker and sign up for various aid.

Like I said above. In Ohio, HCAP is actually just the Ohio version of the Medicaid DSH program. They say so right on their web site: https://ohiohospitals.org/Health-Econom ... nance/HCAP

The Medicaid Disproportionate Share Hospital program, or DSH, is a vital funding stream for hospitals that serve a high percentage of uninsured, low-income and Medicaid patients. Congress implemented this program in 1981, requiring states to take this disproportion into account when designing state payment systems. In Ohio, the DSH program is known as the Hospital Care Assurance Program, or HCAP. Payments under the HCAP program are supplemental to standard Medicaid hospital payments.

I expect their propaganda is working well if they have you convinced it isn't a form of government-funded public assistance and just something that hospitals are doing out of the goodness of their hearts.

[Josh]

I expect their propaganda is working well if they have you convinced it isn't a form of government-funded public assistance and just something that hospitals are doing out of the goodness of their hearts.

Ken, with respect, I used to work in this industry, specifically working on care management and payor systems for Ohio Medicaid’s MCO at the time and private insurers in Ohio. I am intimately familiar with how HCAP works and is funded, and your perception based off of reading a few websites is wrong.

I am not interested in arguing with you further about this. If you want to claim to be an expert on Ohio’s public assistance programs, go right ahead.

[Josh]

Relevant to this topic:



In short, housing is unaffordable for half of American renters. This is a serious problem that millions of Americans are facing.

[Ken]

Relevant to this topic:



In short, housing is unaffordable for half of American renters. This is a serious problem that millions of Americans are facing.

The question is why are we not building more apartments?

[Ken]

I expect their propaganda is working well if they have you convinced it isn't a form of government-funded public assistance and just something that hospitals are doing out of the goodness of their hearts.

Ken, with respect, I used to work in this industry, specifically working on care management and payor systems for Ohio Medicaid’s MCO at the time and private insurers in Ohio. I am intimately familiar with how HCAP works and is funded, and your perception based off of reading a few websites is wrong.

I am not interested in arguing with you further about this. If you want to claim to be an expert on Ohio’s public assistance programs, go right ahead.

Fine, you are the expert. Perhaps you can tell us then what percentage of HCAP payments are reimbursed by Medicaid. This is a knowable number that someone in your position has ready access to.

[Josh]

Relevant to this topic:



In short, housing is unaffordable for half of American renters. This is a serious problem that millions of Americans are facing.

The question is why are we not building more apartments?

Lots of apartments are being built. The problem is they aren’t affordable either. As I stated earlier, the median rent is $23k to $33k per year (depending on which source you ask).

Apartment rents (or house rents) used to be modest - prices like $450 or $600. The NPR article referred to how lower cost apartments or house rentals simply are vanishing.