Last week the Medicaid expansion bill, SB200, cleared its first hurdle. That was to be expected, with Democrats in charge of everything at the Capitol. The disquieting part was that a new Republican member of the Legislature, Senator Larry Crowder, voted for it.
Reports the Denver Business Journal‘s Ed Sealover:
The Colorado Legislature took its first step toward expanding Medicaid eligibility Thursday, with Republican state Sen. Larry Crowder joining with Democrats on the Senate Health and Human Services Committee to give a 5-2 approval to the idea.
Senate Bill 200, sponsored by Sen. Irene Aguilar, D-Denver, would grow Medicaid eligibility to all adults earning 133 percent or less of the federal poverty level — $15,282 for an individual or $31,322 for a family of four.
…The federal government has agreed to pay 100 percent of the costs of the expansion from 2014 to 2016, then reduce its contribution gradually until it reaches a low point of 90 percent from 2020 forward.
Sure, there are reasonable Republicans whom we respect that disagree, but this one is a no brainer — expanding Medicaid in the way that Obamacare invites will hasten a state budget shortfall and is tantamount to state-level complicity in the debt crisis. That 90% federal match doesn’t come from nowhere. It comes from us.
It’s not a moderate approach either, but rather a step towards a truly socialist system of medicine, as legislative Democrats readily admit themselves:
“I think is one step toward many steps that could lead us to universal health care and the advantages to that not only in providing better outcomes but making health care more affordable for us,” said Sen. Jeanne Nicholson, D-Black Hawk, before voting for the bill.
Even moderate Republicans, like former Florida Governor Jeb Bush, say the Medicaid expansion is a bait and switch.
We don’t have to look to the Sunshine State to know that’s true. Look what happened last time we expanded Medicaid in Colorado, per Tim Hoover in 2011:
Two years after lawmakers expanded Medicaid to cover poor adults without children, the state is vastly scaling back the program because the number of people eligible for coverage is nearly three times as high as first projected and the cost of insuring them is almost nine times original estimates.
The new coverage followed the 2009 passage of major health care legislation that allowed the state to impose a fee on hospitals while drawing down matching federal money to expand Medicaid coverage.
The point is we should be having a discussion about how to improve Medicaid, not expand a broken system, as Louisiana Governor Bobby Jindal recently wrote in a Washington Post Op-Ed:
As the implementation of Obamacare unfortunately nears, every governor must decide whether to expand Medicaid. This is not a simple question. Expanding Medicaid will significantly burden state budgets across the country.
Our state’s analyses, and reports by organizations that have supported Obamacare, such as the Kaiser Family Foundation and the Urban Institute, estimate that such an expansion would cost Louisiana more than a billion dollars over the first 10 years.
The Obama administration heralds this as a tremendous bargain for states. That’s simply not the case. The administration overlooks that Medicaid is largely failing current enrollees with its outdated model that costs billions of taxpayer dollars and produces poor outcomes.
Medicaid operates under a 1960s model of medicine, with inflexible, one-size-fits-all benefits and little consumer engagement and responsibility. Expanding the entitlement program as it stands would further cement a separate and unequal tier of health coverage. Without fundamental reform, Medicaid will continue to deliver what it has for decades: limited access, poor quality and budget deficits.
…Our ideas to fix Medicaid target several areas for reform: eligibility, benefit design, cost-sharing, use of the private insurance market, financing and accountability.
…President Obama said in 2009 that “we can’t simply put more people into a broken system that doesn’t work.” He was right, and today’s Medicaid model doesn’t give states adequate flexibility to improve health outcomes or lower overall costs.
Guess Hickenlooper’s claim to have found $280 million in Medicaid cuts was all a ruse after all. With Medicaid expansion potentially costing billions to implement, we believe the appropriate phrase is penny-wise and pound-foolish.