Medicaid Expansion? Bad Medicine for Idaho


In a recent article posted Idaho Politics Weekly otherwise known as the “Zions Bank Weekly,” Mr. Jim Jones took on the task of justifying Medicaid expansion. You can read it here. He tried his best to tell his readership how it is unfair that everyone else’s insurance is paid for by the government, so why shouldn’t we pay for the 62,000 that are not covered via Medicaid Expansion. So let’s get down to the nitty gritty of why we shouldn’t pay for them.

Mr. Jones says we currently have 240,000 on Medicaid and almost 300,000 are on Medicaid including the CHIP program. Well Mr. Jones, don’t you think that having almost 18% of Idaho’s population on government-sponsored insurance is enough or just how much is enough for you. First of all when you say we should add 62,000 more to the rolls we all know it will not be just 62,000 and in fact, the estimates are that more than 100,000 will sign up for the benefits. We currently spend around $500 million of our state (taxpayer money) budget or over 2 billion when federal funds are included for Medicaid.

Why is it that the people receiving the benefits don’t seem to get any better year after year as we still have the about the same number on the rolls as we did in 2015? If someone gives you free medical care, what is the incentive to ever get off of the freebie system? We would say looking at those numbers Medicaid expansion would cause more harm than good. Medicaid expansion is costly and does not provide better access to healthcare for low-income individuals.

We are sorry Mr. Jones, but your arguments just don’t hold any water. You say that about 125,000 are getting insurance through government jobs well it just so happens that those people work for that coverage as a benefit and the taxpayers also happen to pay for those benefits. The fact that employers can deduct the cost of insurance from their taxes is a benefit for the employees as an enticement for them to work for those companies and considered part of their compensation not a freebie as you suggest. How about we tax the employers who don’t cover their employees for the state’s cost of giving them Medicaid? You say it would never pass the legislature, well of course not. It is no different for our veterans who served their country and were injured while doing so. They paid a stiff price for their government healthcare unlike the Medicaid recipients. As far as the subsidized insurance through the ACA goes we have learned that this is one of the fastest ways for insurance companies to go broke and raise premiums and deductibles to such high levels it inhibits the insured from ever using it.

Your reference to the Milliman report suggesting that the state would save $15 million per. year by eliminating the need for the States Catastrophic Health Care Fund is a lot of pie in the sky. Do you really think that this program would benefit the state that dramatically by dropping the number of patients from making routine medical visits for care at emergency room rates? This so-called improvement has not proved itself in many of the states that have already implemented Medicaid expansion. Where is your proof?

When we talk about health access let’s consider the experience from the Oregon Health Insurance Exchange, which “concluded that ‘Medicaid coverage generated no significant improvements in measured physical-health outcomes.'” Not only that but other studies show that, in some cases, Medicaid patients actually wait longer and receive worse care than the uninsured which is due to Medicaid’s level of reimbursement to doctors:

While Medicaid costs taxpayers a lot of money, it pays doctors little. On average, Medicaid reimburses doctors only 72 cents out of each dollar of costs. As a result, many doctors limit the number of Medicaid patients they serve or refuse to take them at all. In 2014 54% of doctors refused to take Medicaid and the percentage is worse now. We currently have over 400 doctors in our state who have retired when they could still be working because of these low reimbursements and the high cost of malpractice insurance. We must also look at the fact that the U.S. government is $21 trillion in debt this year, do you really think they can continue to reimburse 90% of the Medicaid Expansion cost beyond 2020? The answer is no they will have to cut the amount to a much lower level and the taxpayers of Idaho will get stuck with higher taxes to foot this welfare bill or take it from someplace else in the budget. Did I hear anyone say the education budget?

You talk about how this expansion will bring an infusion of federal money and create many additional health care jobs for Idaho. We say that this is not the way to expand employment in Idaho with borrowed federal money. We are not sure who taught you accounting but in our book, you have to eventually pay the piper and pay back what you have borrowed or go bankrupt which is what Medicaid expansion will do to Idaho. Before Idahoans cast their ballots in November they should consider whether Medicaid actually improves the health of its beneficiaries. Unfortunately, research says that it does not.

In 2008 Oregon extended Medicaid to 6,300 uninsured randomly and researchers from Harvard, Columbia, and MIT after comparing health outcomes found that whether insured by Medicaid or uninsured, enrollees did not display significant improvements in measured physical health outcomes for the first two years. In fact, other research shows that Medicaid patients fare worse than those who have no insurance coverage. The U of V used data from 900,000 operations from 2003 to 07 and found that Medicaid patients were 13% more likely to die after surgery than uninsured patients.

From another prospective Medicaid may have actually helped fuel the Opioid epidemic by making it easier for recipients to obtain these powerful painkillers. Also keep in mind that in 2000 states spent 19% of their budgets on Medicaid and in 2014 the number was 26% on average while the spending on K-12 education, universities and public transportation fell in proportion. In 2016 Medicaid spending totaled $576 billion and is estimated to be almost 1 Trillion by 2025. This is totally unstainable.

Are you willing to jeopardize Idaho’s education system for a program that has proved to be ineffective and explosively costly with little or no beneficial results? Our medical system is broken and needs to be revamped from scratch. What we need to do is to eliminate the middle man in the medical equation like insurance companies and the government as therein lies the ever-increasing costs. Currently, more than 42 cents out of every dollar can be assigned to the middlemen and that cost goes up every year along with the inflated cost of hospital care. How about we take our non-profit hospitals and ask them to do a real accounting of the 15 to 20% profits they take in every year. Don’t worry it won’t happen because they pay for political campaigns.

We say NO to Medicaid Expansion, and you should too in November at the polls.

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