Healthcare is a major issue in the mid-term elections. That’s understandable since ObamaCare has been such a disaster. What’s not understandable is Democratic claims that voters should trust them to fix the problem they created in the first place!
In my home state of Florida, Democratic Senator Bill Nelson is running ads where he attacks his Republican opponent, Governor Rick Scott, on his healthcare record. He falsely claims Scott and the Republicans want to do away with pre-existing conditions protections. Then he accuses Scott of blocking Medicaid expansion in Florida – as if expanding Medicaid would be a good thing!
ObamaCare tried to force every state into expanding Medicaid for healthy childless adult males who earn up to 138% of the poverty limit. The Supreme Court struck down this provision, allowing states to make their own determinations.
Blue states jumped on board this government give-away train when ObamaCare promised 100% federal coverage of the cost for three years, tapering off to 90% at present. More than 30 states voted to expand Medicaid under these rules.
How has this worked out for those who expanded Medicaid?
There’s no such thing as a “free lunch.” That’s the first lesson you learn when you become an adult. Those states who expanded their Medicaid are learning this lesson the hard way.
The Wall Street Journal editorial board says, “Every state that has expanded Medicaid has blown the budget by spending more money on more people. The cost overruns are more than double on average.”
On November 6, four states will consider ballot initiatives on expanding Medicaid: Nebraska, Utah, Idaho and Montana, the last of which would extend an expansion that is set to expire. Montana’s expansion has come in 70% over budget, according to the Foundation for Government Accountability. The state is now proposing to fund its expansion with a tobacco tax, which is impressive cynicism even for politicians.
Utah is proposing to raise the sales tax to 4.85% from 4.7% – a regressive tax on the poor to pay for health care for those above the poverty line. Nebraska and Idaho’s ballot measures leave the funding details for another day, ostensibly because voters might figure out that expansion is more expensive than it appears.
Oregon proposed new taxes this year to fund the cost of Medicaid expansion and Medicaid is already the fastest growing line item in nearly every state in the country. The incentive in all of these states will be to cut services from the needy, who receive traditional Medicaid, because it saves states more money.
Unlike the federal government, states must balance their budgets. That means spending more money to pay for Medicaid means less to pay for other important budget items like education, law enforcement and roads. In Idaho the compound annual growth rate for Medicaid spending over the past decade or so triples that of schools and roads, as the Idaho Freedom Foundation points out. And that’s before expansion. So, that “free money” wasn’t so free!
What about accepting the expense “for compassion’s sake?”
First, these newly enrolled patients are not pregnant women, children or the disabled, who are covered by other government healthcare programs. These are able-bodied adult males – many who refuse to work even though jobs are now plentiful. Medicaid was never intended for this demographic profile from its inception.
Second, Medicaid is the worst form of healthcare insurance – arguably worse than having no insurance at all. The Oregon Healthcare Experiment, begun in 2007, has shown those patients on Medicaid are no better off than those patients with no insurance at all when measuring common healthcare data such as blood sugar and blood pressure control.
These Medicaid patients also use emergency rooms for primary care 40% more than the uninsured. Patients without insurance actually have greater access to healthcare since they can negotiate cash payments to doctors, which is illegal for Medicaid patients. Studies on Medicaid patients repeatedly show poorer healthcare outcomes than any other form of healthcare insurance.
Here’s how the WSJ summarizes Medicaid expansion: “Medicaid expansion is a bad fiscal and healthcare bargain that looks worse as time passes. States like Kentucky are already looking for reforms like work requirements before the “free” money drowns their state fisc. Voters would be wise to reject the phony compassion and focus scarce resources on the poor and disabled.”
I’m thankful that Governor Scott resisted the pressure to expand Medicaid in the State of Florida – and all Floridians should be thankful, too. Senator Nelson was a part of the problem that created our healthcare mess and he won’t be part of the solution to fix it.