January 10, 2015

ObamaCare’s Medicaid expansion is supposed to be about getting free money from Washington according to the press around here.

But the Daily Oklahoman reports Washington is already shifting Medicaid costs to the states. “When Obamacare passed, it included a provision increasing Medicaid payments to primary care doctors for two years. The increase ended Dec. 31. Nationally, a study by the Urban Institute estimates affected doctors will see fees cut by 43 percent on average. In Oklahoma, the impact will be less severe, although the Urban Institute still estimates a fee decrease of 10.7 percent.

The fee increase was designed to encourage more doctors to treat Medicaid patients as the program expanded under Obamacare. Its expiration was designed to tacitly shift the additional expense back to the states; federal officials presumed states would maintain higher rates through state appropriations. But many states aren’t doing so.

The reluctance to maintain those higher fees is understandable. Oklahoma already struggles to fund Medicaid as it’s currently constituted without adding thousands more to the program. Due to budget challenges, officials voted to reduce provider payments by $159 million in July. And officials say Oklahoma’s Medicaid program will require at least $164 million more in state funding next year to offset federal cuts. That money will come on top of nearly $1 billion in state appropriations this year.

The above-noted developments provide little reason to think Medicaid expansion will eradicate extant challenges the hospitals face, or that federal officials will hesitate to shift additional costs to states after expansion is completed.

We know ObamaCare’s Medicaid expansion is going to cost North Carolina taxpayers $3 billion if we take the bait. And that’s only the beginning. Teacher raises or more benefits for able bodied adults who don’t work. That’s the choice. Because free benefits aren’t free.