So, the Associated Press decided yesterday to write a story about Republicans – more or less – switching their stance on ObamaCare’s mandated Medicaid expansion, which targets America’s working poor, children, and the elderly. However, what the piece omits is the fact that a) it’s the most expensive provision of ObamaCare and b) the 2010 study showing people on Medicaid are more likely to die than those who are uninsured.
David A. Lieb, the author of the column, reported that one in five Americans are already on Medicaid, and that expanding it was the Obama administration’s way of insuring America’s low-income households.
Republican ideas are still more wistful than substantive. It's uncertain whether they will actually pass. And even if they do, there's no guarantee Obama's administration will allow states to deviate too greatly from the parameters of the Affordable Care Act while still reaping its lucrative funding. Yet a recent signal from federal officials that Arkansas might be able to use Medicaid money to buy private insurance policies has encouraged Republicans to try alternatives.
The GOP proposals could lead to another health care showdown between the White House and states, leaving millions of Americans who lack insurance waiting longer for resolution. Officials in about 30 states that are home to more than 25 million uninsured residents remain either defiant or undecided about implementing Obama's Medicaid expansion, according to an Associated Press survey.
Supporters of the Medicaid expansion have built coalitions of hospitals, businesses groups, religious leaders and advocates for the poor to try to persuade reluctant Republicans of the economic and moral merits of Obama's health care plan. But some Republicans believe the pressure ultimately will fall on Obama to accept their alternatives if he wants to avoid a patchwork system for his signature accomplishment.
So, Republicans may be floating the idea of using the Medicaid provision to bring the president to the bargaining table, and for good reason. With the possible reality that immigration reform could pass, eleven million new people could be eligible for health care benefits. That greatly increases the cost of ObamaCare, which is already at around a trillion dollars, and could add hundreds of billions of dollars – on top of what we already owe– over the next decade. Philip Klein at the Washington Examiner wrote last January that:
After the Supreme Court’s Obamacare decision, the CBO estimated that the law would cover an additional 11 million people on Medicaid (at a cost of $643 billion from 2013 through 2022) and 25 million through the exchanges (at a cost of just over $1 trillion over the same period). So, for every additional 1 million people on Medicaid, the federal government will be spending about $58 billion over the next decade and for every 1 million people on the exchange, taxpayers would be spending about $41 billion. Projecting this out for 8 million new beneficiaries would give a range of $328 billion to $464 billion. This would be conservative, however, because the current 10-year CBO estimate includes fiscal year 2013, though the law isn’t going to be implemented until 2014 – thus the actual 10-year cost is understated.
Forbes’ Avik Roy wrote back in March of 2011 that Medicaid is a “humanitarian catastrophe.”
…I wrote about a landmark study conducted at the University of Virginia that found that surgical patients on Medicaid are 13 percent more likely to die than those without insurance of any kind The study evaluated 893,658 major surgical operations from around the country from 2003 to 2007, and normalized the results for age, gender, income, geographic region, operation, and 30 background diseases.
Despite all of these adjustments, surgical patients on Medicaid were nearly twice as likely to die before leaving the hospital than those with private insurance.
Patients on Medicare were 45% more likely to die than those with private insurance; the uninsured were 74% more likely; and Medicaid patients 93% more likely. That is to say, despite the fact that we will soon spend more than $500 billion a year on Medicaid, Medicaid beneficiaries, on average, fared worse than those with no insurance at all.
This is, simply put, the greatest scandal in America. Bigger than Madoff, bigger than the Wall Street bailout, bigger even than the plight of the uninsured.
At the end of the day, it seems the Obama administration is peddling the expansion of a bad health care program that is a mile wide, but an inch deep – which is a common criticism of all our social programs.
Leib concludes his piece with:
LaTonya Jenkins, a 51-year-old laid off teacher's aide who lives in temporary housing for the homeless in Kansas City, recently enrolled in Medicaid but could lose coverage if her part-time job pushes her income over Missouri's strict eligibility limits. She recently traveled to Missouri Capitol to urge lawmakers to expand Medicaid.
"If they don't, and they cut it out, then what are we to do? We'll be lost," said a tearful Jenkins, who has diabetes and cares for her grandson. "I'll be sicker than ever and back in the hospital."
That’s tragic, but so is that fact that people on Medicaid, like LaTonya, are 13 percent more likely to die than those who don’t have health insurance, which is something Leib egregiously omitted.
