On Monday, Montana became 30thvol state to expand Medicaid coverage. Democratic Gov. Steve Bullock said recruitment will begin later this fall, with coverage beginning early next year (via AP):
The governor’s office said at least 70,000 people would be eligible for coverage under the expansion, but legislative fiscal analysts projected that about 45,700 people would actually be covered over the next four years.
Expanding Medicaid was a key part of President Barack Obama’s health care reform bill, but a 2012 U.S. Supreme Court ruling made it optional for states.
To date, 29 other states and the District of Columbia have expanded their programs. Six of these states received federal waivers, allowing them flexibility in program design.
The goal is to expand eligibility to residents with incomes at or below 138 percent of the federal poverty level, or about $16,000 a year for an individual and $33,000 for a family of four.
Bullock’s original expansion plan stalled during this year’s legislative session and was replaced by a compromise bill sponsored by Sen. Ed Buttrey, R-Great Falls.
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The plan also requires patients to make the maximum contributions allowed under federal law, although total co-pays and premiums cannot exceed 5 percent of a family’s household income.
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In May, Obama administration officials expressed doubts about the plan but were willing to work with the state.
First, expanding Medicaid does not assist the working destitute, which is what the program was originally intended to do. Added to this are childless, able-bodied adults, almost half of whom do not work. Additionally, more than a third of fresh recipients have a criminal record.
Secondly, it is a government program with government projections for student numbers and spending, which means there is a 99.9% chance of both failing. Most states that have expanded coverage have far exceeded their original projections. As a result, Medicaid has become a budget buster, sometimes causing states to find two to three dollars in cuts just to save one dollar in Medicaid spending.
Thirdly, the program is not adaptable and access to it is confined. The Foundation for Government Accountability has detailed the effects of Medicaid expansion. In Virginia, nearly a quarter of doctors are not accepting fresh Medicaid patients. The proposed expansion in the elderly Dominion would mean a tax augment of $1.3 billion to cover 400,000 able-bodied adults over the age of 18. Children are already covered by insurance. Fortunately, the proposed expansion appears to be off the table after Republicans retained control of the state legislature in the last election.
Moreover, a 2011 University of Virginia study found that Medicaid patients undergoing surgery were 13 percent more likely to die compared to patients without insurance. Avik Roy wrote Forbes of 893,658 surgical procedures from 2003 to 2007, with results standardized for age, sex, income, geography, surgery, and 30 diseases – Medicaid patients were twice as likely to die before leaving the hospital as Americans with private insurance:
Patients on Medicare were 45% more likely to die than patients with private insurance; uninsured people were 74% more likely to; and Medicaid patients 93% more likely. This means that despite the fact that we will soon be spending over $500 billion a year on Medicaid, Medicaid beneficiaries fared worse on average than those who had no insurance at all.
Avik called the program a “humanitarian disaster,” which is just an integral part of the unpopular health care bill pushed by President Obama and the Democratic Party. Oh, and did we mention that premiums are going up?
If you want to see how Medicaid is destroying the budget, read Jason Hart’s article on how Governor Kasich’s decision to expand the program will torpedo the state’s finances (via Watchdog):
Medicaid expanded rapidly in Ohio as Kasich added working-age adults without children and people with disabilities to the welfare program, bringing billions in Obamacare spending to the state.
Enrollment in Ohio’s Medicaid program skyrocketed from 2.2 million when Kasich took office in 2011 to three million when his first term ended in January, an augment of 800,000 welfare recipients over four years.
As the state slowly recovered from the 2007-2009 recession, in fiscal year 2011 Ohio spent $17.7 billion on the Medicaid program for the elderly, blind, disabled, children, pregnant women and destitute families.
As a result of Kasich’s expansion under Obamacare, Ohio Medicaid spending increased to $23.5 billion in fiscal year 2015, an augment of $5.8 billion from just four years earlier.
Medicaid spending in Ohio is expected to amount to USD 28.2 billion in 2017, an augment of 59% since Kasich took office and an average annual augment of 9.8% during Kasich’s first six years as governor.
Oh, good grief.
