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Expanding Medicaid coverage under the Affordable Care Act violates conservative principles and costs too much

Expanding Medicaid coverage under the Affordable Care Act violates conservative principles and costs too much

Ronald M. Nate, Ph.D.
September 2, 2014

Note: This commentary first appeared in Aug. 29 in the Post-Register in Idaho Falls..

As Idaho contemplates Medicaid expansion (part of Obamacare), please recall Elvis Presley’s great hit “Suspicious minds.” It begins with the line “[w]e’re caught in a trap.”

Medicaid expansion is a trap. Like a drug dealer, the federal government promises “freebies” at first, and then when we’re hooked, they up the price. Medicaid expansion is costly, liberal and it makes Idaho a federal subsidiary, responsible for yet another big chunk of the Obamacare disaster.

Medicaid expansion will extend coverage to an estimated 100,000 Idahoans. This comes by raising the eligibility cutoff from 133 percent of the poverty threshold to 138 percent. These non-poor Idahoans will be dependent on a federal program that punishes them for earning more income.

To make Medicaid expansion palatable for the states, Obamacare promises to pay 100 percent of the costs through 2015, then 90 percent for seven more years, and then all bets are off. But even these promises raise suspicions. The Heritage Foundation’s most conservative estimate is that Medicaid expansion will cost Idaho $61 million these nine years (and add $887 million in federal costs).

And let’s be clear: Idaho taxpayers are also federal taxpayers. For legislators and journalists to say that we should take these federal dollars because they’re free ignores the reality that federal dollars are taxpayer dollars or borrowed dollars. Nothing is free.

Some say that a state legislator’s job is to get as many federal dollars coming to Idaho as possible. I disagree. State legislators should oppose sending Idaho taxpayer dollars to Washington in the first place. Expanding any federal program in Idaho runs against this principle - federal tax burdens will rise.

It’s also been advertised that Medicaid expansion will save perhaps 100 lives annually in Idaho. This claim comes without a counterfactual. It presupposes that a federal program is the only way to save these lives. Imagine the lives saved and helped by private individuals and private charities were they not burdened with the high tax costs of running inefficient and ineffective federal health programs. I’m always suspicious of claims that only government saves lives - especially when you consider our recent defense policies.

Expanding Medicaid is not conservative. Socialized medicine is not conservative. Creating more dependency and disincentives to work is not conservative. Making Idaho an administrative puppet of the federal government is not conservative.

If Idaho conservatives really want to someday repeal Obamacare, then they should resist all attempts to implement it. Regarding Medicaid expansion, perhaps Elvis’ song should finish like this: “We can’t go on together with suspicious minds and we can’t build our dreams …” as we make ourselves and our neighbors more dependent on federal money, raise our tax burdens and submit to the federal control that comes chained to it.

Nate is an economics professor who sits on the board of scholars for the Idaho Freedom Foundation. He is the Republican nominee for House Seat B in Legislative District 34.

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