A Rare, Informed, Serious Take on Medicaid Expansion

February 25, 2019

A few weeks ago far-left legislators in both the House and Senate filed companion bills to expand government, reduce options, and increase government debt. Tonight Gov. Roy Cooper will deliver his State of the State speech and assuredly much of it will be focused on Medicaid expansion with a lot of the same talking points about how wonderful government expansion is.

Dr. Chris Conover from Duke University highlights some of the problems with Medicaid expansion in this entry in the North Carolina Medical Journal from 2017.

From the relative low quality of care and stress it places on physicians:

Medicaid is among the worst forms of health insurance offered in our state. Despite the comprehensiveness of Medicaid coverage, many Medicaid beneficiaries have great difficulty in locating a provider.

Before the ACA was enacted, 31% of doctors nationally refused to accept new Medicaid patients, compared to only 17% refusing new Medicare patients and 18% refusing new patients with private insurance. There are many reasons for this refusal to accept Medicaid patients, but a principal driver is low reimbursement rates.

To the unaffordability in both the short term and long term:

The most recent annual report on Medicaid’s finances issued by the US Department of Health and Human Services (HHS) showed that the average cost of the ACA’s Medicaid expansion enrollees was nearly 50% higher in FY 2015 than HHS had projected just 1 year previously.

It eliminates jobs:

But the RAND Corporation has shown that every new job added to the health care sector results in 0.85 fewer jobs in the rest of the economy. Even worse is that every $1 raised in taxes shrinks the economy by 44 cents. This implies we would lose 144 jobs for every 100 health sector–related jobs that might be induced by expansion.

So, aside from gutting the economy, making healthcare worse for nearly everyone, and pushing even more debt on to our children, Medicaid expansion sounds great.