The Affordable Care Act, better known as ObamaCare, was passed in 2010 without a single Republican vote. One of the provisions of this disastrous healthcare legislation was the federal enticement to expand Medicaid in every state.
In the original form of the bill, every state would have been forced to accept changes in Medicaid. But the Supreme Court ruled that the federal government could not coerce the states into conformity. Therefore, each state has to decide on their own if they want to accept the Medicaid changes under ObamaCare.
The ObamaCare “hook” promised “free” Medicaid expansion for the first three years with declining support thereafter. Initially, 27 states accepted this offer – mostly blue states with Democratic governance. But shortly thereafter they began having “buyer’s remorse.” The Associated Press reported in July, 2015, “At least 14 states have seen new enrollments exceed their original projections, causing at least seven to increase their cost estimates for 2017.”
In a 11/10/15 post I wrote, “The AP says that California expected 800,000 new enrollees after the state’s 2013 Medicaid expansion. The real number was 2.3 million. In New Mexico, new enrollment exceeded estimates by 44%. In Oregon actual enrollment exceeded expectations by 73% and in the state of Washington by more than 100%.”
In my home state of Florida, there was a vicious battle over this issue. I wrote then, “The battle in the state of Florida was even more heated. The Florida Senate tried to fold Medicaid expansion into the state’s annual budget. According to the Florida Senate Committee on Appropriations, the cost to the state taxpayers would be $96.6 million in the first two years, and a yet-to-be-determined amount when the state assumed its full 10% share in 2020.”
Fast forward to today and the issue is still being debated. But now we have ten years of experience to analyze. Brian Blasé, writing in The Wall Street Journal, says, “North Carolina has become the 40th state to succumb to federal cash and adopt ObamaCare’s Medicaid expansion for able-bodied working-age adults. A new study from the Paragon Health Institute shows there is little to celebrate. Overall health is unlikely to improve despite this massive increase in public welfare. . . .The evidence against the policy is overwhelming: Expansion leads to a surge in spending but reduces healthcare access for traditional Medicaid enrollees such as low-income children and people with disabilities. And it doesn’t improve health.”
Florida has maintained its resistance to expanding Medicaid and now we who live in Florida can thank Governor Ron DeSantis. Here’s how Blasé describes it: “The Paragon study contains specific estimates for Florida, one of the most populous states that have resisted the policy. If Florida expands Medicaid, some 2.5 million people would newly enroll in the program. Three in 10 Floridians would be on Medicaid, and there would be only 1.5 workers for every Medicaid enrollee. Among people who join Medicaid, 65% would replace private coverage. The cost of expansion to Florida’s state taxpayers would reach $2 billion by the end of the decade. To pay for that, the state would need to raise its sales tax from 6% to 6.4% or significantly cut other public priorities such as education.”
Some might argue that the cost is justified to improve healthcare for low-income residents. I would counter that Medicaid is the worst form of healthcare insurance – and there is evidence that having no insurance at all is better!
Avik Roy, health care blogger for Forbes magazine, has reported the following studies:
- A University of Virginia study found that individuals enrolled in Medicaid are almost twice as likely to die after surgery as privately insured patients, and about one-eighth more likely to die than the uninsured!
- A study published in the Journal of the National Cancer Institute found that Florida Medicaid patients were 6 percent more likely to be diagnosed with prostate cancer at less treatable, later stages than the uninsured. Medicaid enrollees were nearly one-third more likely to be diagnosed with late-stage breast cancer and 81 percent more likely to be diagnosed with melanoma at a late stage than the uninsured.
- A study in the journal Cancer found that the mortality rate for Medicaid patients undergoing surgery for colon cancer was more than three times as high as for the privately insured and more than one-fourth higher than for the uninsured
- A study in the Journal of Vascular Surgery found that Medicaid patients treated for vascular problems, including plaque in their carotid arteries and femoral arteries, fared worse than did the uninsured.
The undeniable fact is that being enrolled in Medicaid is worse than having no insurance at all!
Blasé concludes that those 10 states who have avoided the Medicaid expansion have saved their residents from higher taxes that don’t improve healthcare. But it takes courageous state leadership to stand up to the false narrative promoted by our federal government.
