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Medicaid expansion is the bad idea that just won’t go away

Medicaid expansion is the bad idea that just won’t go away

Wayne Hoffman
November 21, 2014
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November 21, 2014

Imagine an 8-ounce glass of water on a kitchen counter. The glass is almost full. I could, as a matter of public policy, declare that the glass should hold 16 ounces of water. But my declaration won’t make the glass larger. It certainly won’t make the water tastier. And if I do decide to pour more water into the glass, the overage, unsurprisingly, would spill onto the floor.

Similarly, expanding Medicaid won’t mean Idaho will miraculously have more doctors, more nurses, more practitioners of any kind. It won’t cure disease. It won’t even stop your runny nose.

There are three populations that would be most served by Medicaid expansion, and it’s not who you think.

(1) Predominately childless, able-bodied adults. Not the poorest. Not the neediest. Not people who are disabled and unable to work.

(2) The medical providers: Big Medicine and Big Insurance. They’ll rake in the dollars, courtesy of the taxpayers, and they’ll do it at the expense of the future generations of Americans who are stuck paying the bill, as well as older Americans who are seeing cuts in Medicare to pay for it all.

(3) Politicians and bureaucrats. Suddenly, Americans who previously never needed to interact with government will be roped into a system that makes them dependent on decisions made in Washington, D.C., and Boise.

Prior to the November election, we were told that Medicaid expansion is off the table for Idaho lawmakers. But the folks who are pedaling the tired medicine of Medicaid expansion haven’t given up. They’ve created yet another—a third in fact—variation of the same theme. As before, they’re promoting their claim that expansion of Medicaid will save taxpayers tons of money because the federal government will absorb most of the costs associated with the effort.

This time, the proposal is to have newly eligible Medicaid participants earning between 100 and 138 percent of poverty sign up for insurance via the state insurance exchange, using Medicaid expansion dollars. Poorer participants would be enrolled in the regular, though retooled Medicaid program.

It’s a variation of a theme we’ve seen in other states. Pro-expansion forerunner Arkansas produced the notorious “private option” for Medicaid expansion, buying insurance plans for new Medicaid enrollees. Now comes a report that the program will actually cost taxpayers $778 million more than anyone was expecting. It’s no wonder that Arkansas’ new governor and Legislature are itching to ditch the program come 2015.

Gov. Butch Otter’s Medicaid task force is playing up the savings to local and state governments, which would be able to end their participation in Idaho’s unique and horrible single payer health care program that drains taxpayers of about $52 million a year. Lee Heider, a Republican from Twin Falls who chairs the Senate Health and Welfare Committee, voted with his fellow task force members, saying the potential savings “will be the selling point. I think it does have some merit.”

There’s nothing meritorious about a program that puts our country deeper in debt; nothing meritorious about a program that will make able-bodied Americans dependent on government; nothing meritorious about a program that will decrease the quality of health care and access to it.

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