Medicaid Expansion has been a dismal failure and as we predicted ten years ago the people most adversely impacted have been the people that Medicaid was originally designed to help. These are people living on the margins with chronic diseases who through no fault of their own cannot provide for their own medical care. I cannot think of a group of experts who have been more consistently wrong regarding policies than those “experts” in the medical and public health communities in our state who have designed programs that have failed their constituents and had consistently had a negative impact on the communities they represent.
Think Covid mitigation and treatment strategies. Think about the collusion that occurred during the “Great Covid faux pandemic” between politicians, government bureaucrats, and industry lobbyists and corporations—think large hospital networks, insurance companies, and pharmaceutical monopolies. When trillions of dollars of transfer payments slosh around the health care universe without any accountability or documentation about where that money goes and who it is spent on—is it any wonder that one CEO of a local hospital system made $18.2 million his last two years on the job according to IRS Form 990, in 2018 and 2019—can we all say FUNGIBLE(?)! And our legislators just want to “nibble around the edges regarding Medicaid spending!
My data for this article comes from three sources—An article in the WSJ by Brian Blaseon 2/18/2023, and studies reported from The Paragon Health Institute and Mercatus Center published this year. Remember when the “Experts” mantra was “access—quality—costs”? None of those promises have come true and here are the facts after 10 years and after forty out of fifty States have expanded their Medicaid programs:
- Expansion has led to increased spending and decreased access for those enrolled in traditional Medicaid programs such as low-income children and those with disabilities.
- After the Affordable Care Act spending surge Federal officials found that at least 20% of payments nationwide were improper—in our state it was estimated two years ago to be over 30%. These included fraudulent enrollments, upcoding by providers, and improper payments to health insurers for ineligible recipients
- In the 39 States that have expanded Medicaid—North Carolina is a recent state that joined the ranks, mortality rates were worse in expansion states.
- Medicaid Expansion decreases access to patients on traditional plans. After expansion one third of enrollees were less likely to secure doctor appointments causing more people to use emergency rooms for non-emergent reasons
- In those states like Idaho that have expanded, if the formula for Federal matching (FMAP) reverts back to 90%, the burden on the State budget will go up by 30%. The overall budget for the Idaho Department of Health and Welfare is $4.9billion—55% comes from the Feds. The entire State budget is $12billion.
Our legislative leaders must keep Medicaid a priority for those who truly need it. Today those patients’ futures are more vulnerable than ever before. Instead of cozying up to IACI/IMA/IHA lobbyists this legislative session, instead of “nibling around the edges” of a wedge salad at the Arid Club, please act in the best interest of your constituents (patients), before it is too late—please. The only people who have been helped by Medicaid expansion are large corporations and their executives at the top of the food chain. After 10 years of expansion the promise of “ACCESS—QUALITY—COSTS” truly rings hollow.
Non-profits 501(c)(3)s that don’t pay real estate, corporate, or state sales tax and then pay executives a high seven figure compensation (sometimes eight), need to be held to “account” for the value they create for the pay they receive. The doctors, nurses, and technicians that work at these institutions are in my opinion saints. They are competent, loving, professional and compassionate. They deserve leadership worthy of their work. The administrators and boards of directors at these institutions not so much, but those are the people that pay for fancy lunches, sponsor Governor’s Cup participation, and most of all provide campaign contributions in exchange for access and influence. “Pay to play” is alive and well in Idaho and Washington DC and WE The People ultimately pay the price with increased taxes or increased health care premiums.
We have been lied to for so long by “the experts” in and out of government. Covid, Obama Care, vaccine mandate after vaccine mandate. We need outside independent audits of The Idaho Department of Health and Welfare, and all institutions that receive over $100million of transfer funds using the State of Idaho as the conduit (the word trough would be better) for payment via fungible taxpayer funding.
Is there anybody in our legislature that has the courage to rock the Medicaid boat? Certainly, leadership has not taken a stand—yet. The governor doesn’t want to touch it for obvious reasons.
I hope our Attorney General takes the Bull by the horns and investigates appropriately these payments and transactions.
If we don’t stop “nibbling around the edges” our State will soon financially become less stable and those in need will suffer the most.